While the public health approach to AIDS has certainly been well nigh insane for the last 25 years, there are indications that that might be
All adolescents and adults should routinely be tested for HIV infection in hospitals, clinics and doctors' offices, the federal government said
yesterday, signaling a radical shift in the public health approach to the 25-year-old epidemic.
Under the new recommendations from the Centers for Disease Control and Prevention, patients would no longer have to sign a consent form and get
extensive pre-test counseling. But they would have to be told they were being tested for the AIDS virus, asked if they have any questions and given
the opportunity to "opt out."
Twenty-five years after the first diagnosis of the first case of AIDS, the world is finally waking up to the epidemic.
The policy is a huge change from an era when stigma and fatalism led to a unique and -- in the opinion of some practitioners, onerous -- set of
procedures for HIV testing.
"This represents a milestone for CDC and for our national health protection," Julie L. Gerberding, the CDC's director, said in a telephone news
When AIDS first surfaced , there was virtually nothing known about the disease, except the obvious clues that gay, promiscuous men were the primary
victims. Sexually transmitted diseases have never been high on the social sensitivity list, but somehow all that changed with AIDS.
Public health officials became hypersensitive about AIDS testing and identification of the victims. One can only guess how many people were infected
by sexual partners who unknowingly carried the disease because there was no protocol in place for early detection of the disease.
So, now that AIDS has gone from being the "gay plague" to being the
victimizer of minority women
, officials and common folk are beginning to
get a grip on the reality of the disease.
It's been one whole generation since the disease was first discovered and only now are the CDC recommending routine screening.
AIDS has the power to change the global gene pool completely. Entire continents are being ravaged by the disease and a generation of children are
growing up without parents in some parts of the world because of the disease.
Some might argue that the effect of AIDS on the species might not be all that bad, but clearly the scale of human suffering has the potential to be
greater than any epidemic in human history, even if the impact is more protracted than in previous epidemics.
The 20th century saw more technological advances than in any century in history. Medical advances have eradicated many common killer diseases and
very much credit for these advances goes to John Snow
the father of epidemiology,
whose studies of cholera during the early 19th century paved the way for the medical treatments we take for granted in the 21st.
However, it would seem that the initial touchiness about HIV infection and our having forgotten the lessons learned in 19th and early 20th centuries
have lead to the resurgence of a disease once thought conquered.
Due to the elimination of public health facilities in New York and the emergence of HIV, there was a resurgence in the late 1980s. The number
of those failing to complete their course of drugs is high. NY had to cope with more than 20,000 "unnecessary" TB-patients with multidrug-resistant
strains (resistant to, at least, both Rifampin and Isoniazid). The resurgence of tuberculosis resulted in the declaration of a global health emergency
by the World Health Organization in 1993.
HIV is the "craftiest pathogen"
that I personally have any knowledge of and its ability to
may just be enough to stay just a
step ahead of our collective learning curve.
Whatever the case may be, a generation of ostrich-like public health policy can not have helped.
Epidemic to Endemic:
The Impact of HIV on Health Care Policy and Nursing Practice
[edit on 2006/10/25 by GradyPhilpott]