AIDS - Acquired Immune Deficiency Syndrome


Timur Eren Spring 96 HPE12

BACKGROUND

Since the first AIDS cases were reported in 1981, through mid-1994 more than
402,000 AIDS cases and more than 241,000 deaths have been reported in the United
States alone. This is only the tip of the iceberg of HIV infection, however. It
is estimated that nearly 1 million Americans had been infected with the virus
through the mid-1990s but had not yet developed clinical symptoms. In addition,
although the vast majority of documented cases have occurred in the United
States, AIDS cases have also been reported in almost every country in the world.
Sub-Saharan Africa in particular appears to suffer a heavy burden of this
illness. No cure or vaccine now exists for AIDS. Many of those infected with HIV
may not even be aware that they carry and can spread the virus. Combating it is
a major challenge to biomedical scientists and health-care providers. HIV
infection and AIDS represent among the most pressing public-policy and public-
health problems worldwide. COSTS

I think that the AIDS epidemic is having a profound impact on many aspects of
medicine and health care. The U.S. Public Health Service estimates that in 1993,
the lifetime cost of treating a person with AIDS from infection to death is
approximately $119,000. Outpatient care, including medication, visits to doctors,
home health aids, and long-term care, accounted for approximately 32 percent of
the total cost. Persons exposed to HIV may have difficulty in obtaining adequate
health-insurance coverage. Yearly AZT expenses can average approximately $6,000,
although in 1989 the drug\'s maker did offer to distribute AZT freely to HIV-
infected children. The yearly expense for DDI is somewhat less at $2,000.
Therefore, if the AIDS epidemic is not controlled, its cost to American
taxpayers will become overwhelming. I feel that the effects of the epidemic on
society at large are increasingly evident. AIDS tests are now required in the
military services. Various proposals have been made for mandatory screening of
other groups such as health-care workers. A number of nations, including the
United States, have instituted stringent rules for testing long-term foreign
visitors or potential immigrants for AIDS, as well as testing returning foreign
nationals. In the United States one frequent phenomenon is the effort to keep
school-age children with AIDS isolated from their classmates, if not out of
school altogether. Governmental and civil rights organizations have countered
restrictive moves with a great deal of success. There is little doubt in my mind
that the ultimate physical toll of the AIDS epidemic will be high, as will be
its economic costs, however the social issues are resolved. Concerted efforts
are under way to address the problem at many levels, and they offer hope for
successful strategies to combat HIV-induced disease.

Politics and AIDS

In the United States, I feel that AIDS provoked a grass-roots political response,
as well as government action. First evident in urban gay men, AIDS moved an
already politically organized gay community to create service, information, and
political organizations, such as Gay Men\'s Health Crisis (GMHC) and AIDS
Coalition to Unleash Power (ACT UP). Those groups have lobbied the federal
government for funding and favorable policies. ACT UP was formed in 1987 to urge
speed in drug approval and to protest high prices for AIDS drugs. By
successfully promoting reforms, ACT UP and other advocates have provided a model
for other disease groups, particularly breast cancer advocates. During the 1980s,
AIDS groups accused the government of neglecting its duty in responding to AIDS.
Critics cite government reluctance to promote condom use as a prevention method,
and the fact that President Ronald Reagan did not mention AIDS publicly until
April 1987, six years after the epidemic began. The epidemic\'s spread to people
of color, often drug users and their intimates, introduced race into the
politics of AIDS. Competition for funding and influence arose between gay and
minority groups. Disagreements emerged about prevention methods, in particular
needle exchange programs. Many African Americans and Hispanics viewed needle
exchange as promoting drug use in their communities, while others cited its role
in curbing HIV transmission. The AIDS activists have helped increase federal
funding for AIDS from an initial $5.6 million in 1982, to over $2 billion in
1992. The 1990 Americans with Disabilities Act included protection from
discrimination for people with HIV; the Ryan White Comprehensive AIDS Resources
Emergency Act was passed to provide funds to cities hard hit by AIDS.

CONCLUSION

As you can see, AIDS does not discriminate by color nor socio-economic
status as was once believed. It has become an epidemic for the entire nation
and will need