Global HIV/AIDS Prevention and Treatment: Public Health Ethics Considerations

2019 ◽  
pp. 471-485
Author(s):  
Mark Barnes ◽  
Devin Alexander Cohen
Keyword(s):  
Public Health ◽  
Personal Autonomy ◽  
Civil Liberties ◽  
The United States ◽  
Contact Tracing ◽  
Ethical Challenges ◽  
Antibody Testing ◽  
Aids Epidemic ◽  
Prevention And Treatment ◽  
Hiv Aids

The global response to HIV/AIDS has struggled with balancing personal autonomy with public health needs over the past four decades. This article discusses the chronology of ethical developments in prevention and treatment methods, both within the United States and abroad. It tracks the globalization of the HIV/AIDS epidemic alongside the rise of the international response, particularly following the development of safe and effective HIV treatments. The ethical challenges posed by effective public health responses to the HIV/AIDS epidemic, including voluntary and mandatory antibody testing, contact tracing, partner notification, and even quarantine, are highlighted by social and political responses to restrictions on civil liberties worldwide.

President's Emergency Plan for AIDS Relief (PEPFAR) Policy Process and the Conversation around HIV/AIDS in the United States

2020 ◽  
Vol 5 (2) ◽  
pp. 149-166
Author(s):  
Laura E. Jacobson
Keyword(s):  
Public Health ◽  
Policy Process ◽  
Immune Deficiency Syndrome ◽  
The United States ◽  
Deficiency Syndrome ◽  
Policy Framework ◽  
Emergency Plan ◽  
Aids Epidemic ◽  
Process Factors ◽  
Hiv Aids

In 2003, the George W. Bush administration passed the President’s Emergency Plan for AIDS Relief (PEPFAR), a US government initiative to address the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic primarily in Africa. PEPFAR’s US$18 billion budget remains the largest commitment from any nation towards a single disease and has saved countless lives. Given the historical and current political resistance to foreign aid, PEPFAR’s drastic spike in spending on HIV/AIDS raises questions over how the policy process resulted in bipartisan support. Using two policy process theories, punctuated equilibrium theory (PET) and the Narrative Policy Framework (NPF), this analysis helps explain the framing of the global HIV/AIDS epidemic and the factors that resulted in the creation of PEPFAR. The analysis of the PEPFAR policy process reveals a ‘tipping point’ in the early 2000s, when political actors, the media and advocacy coalitions benefitted from issue framing, narrative change and measures of political attention to elevate the global HIV/AIDS crisis to the public agenda. The findings highlight an increase in presidential attention, the evolution of the HIV/AIDS narrative away from stigma and the formation of powerful coalitions. Looking back on the combination of policy process factors that led to PEPFAR’s bipartisan success might lead to insights for dismantling the grand public health challenges of the present and future. This study’s findings have implications for currently stigmatised public health crises, such as the opioid epidemic.

scholarly journals Contact Tracing for COVID-19: An Opportunity to Reduce Health Disparities and End the Human Immunodeficiency Virus/AIDS Epidemic in the United States

2020 ◽  
Vol 71 (16) ◽  
pp. 2259-2261 ◽  
Author(s):  
Bohdan Nosyk ◽  
Wendy S Armstrong ◽  
Carlos del Rio
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Human Immunodeficiency Virus ◽  
The United States ◽  
Contact Tracing ◽  
Public Health Strategy ◽  
Aids Epidemic ◽  
Health Strategy ◽  
Immunodeficiency Virus ◽  
Critical Components

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing and contact tracing have been proposed as critical components of a safe and effective coronavirus disease 2019 (COVID-19) public health strategy. We argue that COVID-19 contact tracing may provide a unique opportunity to also conduct widespread HIV testing, among other health-promotion activities.

Recent measles outbreaks in the United States: A look at the causes and responses

2019 ◽  
Vol 14 (10) ◽  
pp. 491-496
Author(s):  
Tracy Perron ◽  
Heather Larovere ◽  
Victoria Guerra ◽  
Kathleen Kilfeather ◽  
Nicole Pare ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care Providers ◽  
Personal Autonomy ◽  
Disease Outbreaks ◽  
The United States ◽  
Care Providers ◽  
Course Of Action ◽  
Public Health Officials ◽  
Measles Outbreaks

As measles cases continue to rise in the United States and elsewhere, public health officials, health care providers and elected officials alike are facing critical questions of how to protect the health of the public from current and future vaccine preventable disease outbreaks while still preserving the religious and personal autonomy of the populations they serve. As measles cases are being examined and carefully managed, public health officials are also tasked with revisiting vaccination policies and agendas to determine the best evidence-based interventions to control this epidemic. To determine the best course of action for the public's interest, research and current literature must be examined to protect and promote the health and wellbeing of those currently affected by the measles outbreak and those yet to be exposed.

Public Bioethics

2020 ◽  
Author(s):  
James F. Childress
Keyword(s):  
Public Health ◽  
Public Policies ◽  
Civil Liberties ◽  
National Level ◽  
The United States ◽  
Public Health Ethics ◽  
Task Forces ◽  
Health Ethics ◽  
Bioethical Issues ◽  
Policies And Practices

Doing public bioethics involves analyzing and assessing actual and proposed public policies regarding biomedicine, healthcare, and public health. “Public bioethics” also refers to commissions, councils, task forces, and the like, that are governmentally established, sponsored, or funded for the purpose of deliberating collectively about bioethical issues, again with a primary goal of recommending public policies. Most chapters in this book grow out of, some reflect on, and all are profoundly shaped by the author’s experiences as a participant in several public bioethics bodies, especially at the national level in the United States. The processes of publicly deliberating in such bodies about bioethical issues and appropriate policies and of publicly justifying collective recommendations have profoundly shaped this book. After examining respect for autonomy—both thin and thick conceptions—and paternalistic policies and practices, as well as the tensions between particular case judgments and general principles and rules, this book next examines the appropriate role of religious convictions in public bioethics and in public policy and in conscientious claims to exemptions from expectations to provide certain health-related services. The third section of the book focuses on public policies and practices in organ transplantation, particularly difficulties in determining death, in obtaining first-person consent for deceased organ donation, and in fairly allocating donated organs. The final section maps the terrain of public health ethics, argues for a presumptivist approach to justifying public health interventions that infringe civil liberties, proposes a framework of triage for public health crises, and recasts John Stuart Mill’s misunderstood legacy for public health ethics.

Making Race and Gender Visible in Brazil’s HIV/AIDS Epidemic

2018 ◽  
Author(s):  
Kia Lilly Caldwell
Keyword(s):  
Hiv Prevention ◽  
Black Population ◽  
Race And Gender ◽  
Race And Class ◽  
Aids Epidemic ◽  
Prevention And Treatment ◽  
And Gender ◽  
Hiv Vulnerability ◽  
Hiv Aids ◽  
Afro Brazilian

Brazil has been long considered a global leader in HIV/AIDS prevention and treatment; however, little is known about the effectiveness of these prevention and treatment efforts for the Afro-Brazilian population. This chapter examines the shift toward greater government action focused on HIV prevention for Afro-Brazilians. The chapter also explores HIV prevention initiatives developed by black women’s organizations and how the dynamics of gender, race, and class shape HIV vulnerability for Afro-Brazilian women. Finally, this chapter examines critiques of racially specific HIV prevention initiatives and the tensions between universalism and race consciousness that have characterized the shift toward focusing on the black population in HIV prevention efforts.

The Right to Know, The Right to be Counted, The Right to Resist: Cancer, AIDS, and the Politics of Privacy and Surveillance in Post-War America

2015 ◽  
Vol 3 (1) ◽  
pp. 45-64
Author(s):  
Amy L. Fairchild
Keyword(s):  
Public Health ◽  
United States ◽  
National Security ◽  
The United States ◽  
Right To Know ◽  
Aids Epidemic ◽  
The Right To Know ◽  
The Face ◽  
Post War ◽  
The Right

The practice of public health begins with surveillance, the identification of individuals with disease. But while not all efforts to monitor morbidity and mortality entail formal notification of individual cases, the name-based reporting of individuals always involves a breach of privacy. The pitched battles over surveillance that marked the first two decades of the AIDS epidemic and, indeed, more recent global debates over the reach of the surveillance state in the name of national security might suggest a kind of timeless, furious battle on the part of those who would be subject to surveillance to defend a 'right to be left alone.' But just as often, indeed, perhaps more often, citizens have claimed a right to be counted, demanding surveillance in the face of unknown health threats. In either case, however, in the United States, regardless of whether communities pushed for or against disease reporting, marked citizen engagement has shaped the politics of surveillance since the 1970s. To be sure, privacy was always at stake. But so, too, were what activists conceived of as the right to be counted and the right to know.

scholarly journals Mental health in 2020 for men who have sex with men in the United States

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 59 ◽  
Author(s):  
Abigail W. Batchelder ◽  
Steven Safren ◽  
Avery D. Mitchell ◽  
Ivan Ivardic ◽  
Conall O'Cleirigh
Keyword(s):  
Mental Health ◽  
Hiv Prevention ◽  
The United States ◽  
Hiv Care ◽  
Hiv Care Cascade ◽  
Age Related ◽  
The Us ◽  
Prevention And Treatment ◽  
Sex With Men ◽  
Hiv Aids

Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.

The legacy of the global HIV/AIDS epidemic for public health

The Lancet ◽  
2003 ◽  
Vol 362 (9392) ◽  
pp. 1339
Author(s):  
J Michael Kilby
Keyword(s):  
Public Health ◽  
Aids Epidemic ◽  
Hiv Aids
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