Healthcare And Research Issues

The early ethical debates regarding the AIDS epidemic were largely driven by the concerns of the politically active, primarily white, homosexual or bisexual men in the United States in whom the disease was first identified. Because of severe discrimination against HIV/AIDS patients, early activists argued for special confidentiality protections for HIV information. Because infection at that time was almost always fatal, patients also demanded access to experimental treatments, which offered the only chance of survival. Over the 1980s and 1990s, however, the epidemic changed, as did many of the ethical issues.

The global impact of HIV/AIDS in the twenty-first century dominates ethical and policy debates. In late 2001 an estimated 40 million people worldwide were HIV infected, with approximately 5 million new infections and 3 million deaths that year. More than 95 percent of new infections are in developing countries. AIDS is the leading cause of death in sub-Saharan Africa and the fourth leading cause of death worldwide. Although Africa has been particularly hard hit by the AIDS epidemic, with about 70 percent of HIV-infected persons and new infections, the looming epidemic in other developing areas, particularly China and India, may surpass it. Failure of governments to acknowledge the threat of HIV may be exacerbating the epidemic.

In the United States, HIV/AIDS remains a serious public health problem. Spread primarily through sexual transmission and injection drug use, the epidemic in the United States increasingly affects poor people of color. In 2001 an estimated 800,000 to 900,000 people in the United States were HIV-infected, with over 300,000 diagnosed with AIDS. But as a result of the introduction of highly active antiretroviral therapy, as well as prevention and education efforts, the number of AIDS deaths in the United States has fallen dramatically.

This entry discusses ethical issues regarding HIV testing, confidentiality of HIV information, HIV infection in women and children, end-of-life issues for HIV-infected patients, and access to healthcare for HIV disease. This entry also discusses clinical research issues, with particular attention to international HIV research and HIV vaccine research.

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A time for giving and receiving, getting closer with the ones we love and marking the end of another year and all the eating also. We eat because the food is yummy and plentiful but we don't usually count calories at this time of year. This book will help you do just this.

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