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During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease. During this period of great uncertainty, decision-making regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system. The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was doneâ€"and recommends what should be done to produce better outcomes in the face of future threats to blood safety. The committee frames its analysis around four critical area: Product treatmentâ€"Could effective methods for inactivating HIV in blood have been introduced sooner? Donor screening and referralâ€"including a review of screening to exlude high-risk individuals. Regulations and recall of contaminated bloodâ€"analyzing decisions by federal agencies and the private sector. Risk communicationâ€"examining whether infections could have been averted by better communication of the risks.
Increased HIV screening may help identify more people with the disease, but there may not be enough resources to provide them with the care they need. The Institute of Medicine's Committee on HIV Screening and Access to Care concludes that more practitioners must be trained in HIV/AIDS care and treatment and their hospitals, clinics, and health departments must receive sufficient funding to meet a growing demand for care.
HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The Institute of Medicine recommends that the United States and African nations move toward a strategy of shared responsibility such that these nations are empowered to take ownership of their HIV/AIDS problem and work to solve it.
he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.
With insightful discussion of program evaluation and the efforts of the Centers for Disease Control, this book presents a set of clear-cut recommendations to help ensure that the substantial resources devoted to the fight against AIDS will be used most effectively. This expanded edition of Evaluating AIDS Prevention Programs covers evaluation strategies and outcome measurements, including a realistic review of the factors that make evaluation of AIDS programs particularly difficult. Randomized field experiments are examined, focusing on the use of alternative treatments rather than placebo controls. The book also reviews nonexperimental techniques, including a critical examination of evaluation methods that are observational rather than experimentalâ€"a necessity when randomized experiments are infeasible.
Confronting the toughest issues surrounding AIDS in America, Gostin, an internationally recognized scholar of AIDS law and policy, confronts the most pressing and controversial issues surrounding AIDS in America and around the world.
This is an invaluable resource for lawyers, policy makers, and other practitioners with an interest in countries' responses to HIV/AIDS. Legal Aspects of HIV/AIDS: A Guide for Policy and Law Reform covers 65 wide-ranging topics in a concise, accessible format, explaining how laws and regulations can either underpin or undermine public health programs and responsible personal behavior. For each topic, the Guide summarizes the key legal or policy issues, provides relevant "practice examples" (citing actual laws and regulations), and offers a selective list of references that may be consulted for more information. Laws relating to many areas of our lives - from intimate physical conduct to international travel - can contribute to stigma, discrimination, and exclusion or, contrariwise, can help remedy these inequities. In order to create a supportive legal framework for responding to HIV/AIDS, it is important that governments effectively address gaps and other problematic aspects in their legislation and regulatory systems. This book, written by a team of leading legal experts, helps them do so.
Up until now, many articles have been written to portray stigma and discrimination which occur with people living with HIV/AIDS (PLWHA) in many parts of the world. But this is the first book which attempts to put together results from empirical research relating to stigma, discrimination and living with HIV/AIDS. The focus of this book is on issues relevant to stigma and discrimination which have occurred to individuals and groups in different parts of the globe, as well as how these individuals and groups attempt to deal with HIV/AIDS. The book comprises chapters written by researchers who carry out their projects in different parts of the world and each chapter contains empirical information based on real life situations. This can be used as an evidence for health care providers to implement socially and culturally appropriate services to assist individuals and groups who are living with HIV/AIDS in many societies. The book is of interest to health care providers who have their interests in working with individuals and groups who are living with HIV/AIDS from a cross-cultural perspective. It will be useful for students and lecturers in courses such as anthropology, sociology, social work, nursing, public health and medicine. In particular, it will assist health workers in community health centres and hospitals in understanding issues related to HIV/AIDS and hence provide culturally sensitive health care to people living with HIV/AIDS from different social and cultural backgrounds. The book is useful for anyone who is interested in HIV/AIDS-related stigma and discrimination in diverse social and cultural settings.
"The book is a balanced and comprehensive treatment of an important social issue. It is accessible to the general reader and belongs in public as well as academic libraries." -- Religious Studies Review "Painstaking analysis of the knotty ethical problems involved in human-subjects research, and a well-thought-out proposal for a community approach to conducting field trials for an HIV vaccine.... Highly recommended for medical ethicists and anyone concerned about the AIDS epidemic and how HIV research is conducted."Â -- Kirkus Reviews "... a carefully reasoned account of how research for and trial of a preventive vaccine differ from the methods used to discover a therapy."Â -- Booklist "I highly recommend reading this book which I would attest to be a thrilling, ethically challenging, and informative descent into the allopathic solution." -- Ryan Hosken, Bastyr University Library Newsletter "As the scientific effort to produce an efficacious vaccine continues, [Grady's] work provides an ethical compass that will guide us well, regardless of where phase III HIV vaccine trials ultimately occur." -- Journal of the American Medical Association "Highly recommended... " -- AIDS Book Review Journal "A remarkable treatment of a most difficult and complex subject... Grady's book is of special merit because it is simple, readable, and understandable, while conveying in-depth perceptions that are critical to the reader. A useful and essential reference work for those who would engage in the initiative to bring about a resolution of a mighty human health problem." -- Maurice R. Hilleman, Ph.D., D.Sc., Director, Merck Institute for Therapeutic Research "Dr. Grady's important study captures the complexity of the search for an AIDS vaccine with startling clarity. Her insights into the full range of forces that shape our national response to AIDS vaccine development should read like signposts to vaccinologists, AIDS community activists, and most importantly, the Public Health Service. An impressive contribution." -- Derek Hodel, Gay Men's Health Crisis "This book is recommended to medical ethicists, those involved in non-HIV vaccine trials, and all persons involved in HIV vaccine trials, including investigators, sponsors, study subjects and communities at risk." -- Journal of Health Politics, Policy and Law The creation of a vaccine now seems the best hope for controlling AIDS. Yet developing and testing an HIV vaccine raises a host of difficult ethical issues. These concerns are the focus of this timely and important book. Essential reading for everyone interested in ethics and the conduct of HIV vaccine research.