© 2008 delmar cengage learning. chapter 16 aids trish siplon
TRANSCRIPT
© 2008 Delmar Cengage Learning.
Chapter 16
AIDS
Trish Siplon
© 2008 Delmar Cengage Learning.
2
AIDS and Early At-Risk Groups
• Four populations initially targeted by CDC as at-risk groups when AIDS first emerged around 1981– Haitians, hemophiliacs, drug users, and gay
men with multiple sexual partners
• These four groups responded to targeting in divergent ways
© 2008 Delmar Cengage Learning.
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AIDS and Early At-Risk Groups: The Haitian Community
• Haitians launched early struggle to dissociate their community from the disease
• Eventually scored successes during the course of the 1980s– With the CDC lifting ban on Haitian blood
products by 1990
© 2008 Delmar Cengage Learning.
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AIDS and Early At-Risk Groups:Hemophiliacs
• Hemophiliacs divided over their response to AIDS
• Some, along the lines of Ryan White, became AIDS activists– Others were interested in protecting their
confidentiality, remaining on the political sidelines
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AIDS and Early At-Risk Groups:Drug Users
• Drug (particularly heroin) users had no organized advocacy group, and none formed– Remained largely silent on the issue
• Though controversial prevention efforts were launched in certain cities on their behalf
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AIDS and Early At-Risk Groups:Gay Men with Multiple Partners
• Gay community came to “own” the issue of AIDS awareness
• Closely identified the issue of AIDS with the broader struggle for rights– Latter lent particular urgency under the
conservative Reagan administration
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AIDS Activists Take on the Health Care Power Structure
• Early struggles on the part of would-be AIDS activists– Focused around the pricing and availability of
drugs treating specific ailments caused by autoimmune deficiency
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AIDS Activists Take on the Health Care Power Structure
• ACT UP– Early activist group– Led spirited demonstrations in New York that
drew attention to inequality of access to AIDS treatment(s)
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AIDS Activists Take on the Health Care Power Structure
• Activists also challenged:– Drug companies on account of seemingly-
exorbitant pricing– Insurance companies for failing to cover those
with AIDS
© 2008 Delmar Cengage Learning.
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AIDS Activists Take on the Health Care Power Structure
• Activists also challenged:– Federal government over its mixed response to
the epidemic • Some even conducting their own drug trials when
the FDA dragged its feet in approving new courses of treatment
© 2008 Delmar Cengage Learning.
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Self-Empowerment Among PWAs
• AIDS activists stressed empowerment among People with AIDS (PWAs)– Drawing inspiration from those who stressed
female medical empowerment– Such advocates encouraged PWAs to take
control of their own treatment• Carefully defining their position vis a vis medical
providers
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Congress CARES
• Ryan White Comprehensive AIDS Resource Emergency Act (CARE) – Originally passed by Congress in 1990
• Only piece of major social spending legislation aimed at a specific disease
© 2008 Delmar Cengage Learning.
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Congress CARES
• Passage ensured through its appeal to four different constituency groups:– Cities and metropolitan areas– States– Local health centers– Women and children with AIDS
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Conflicts Over CARE
• As AIDS began affecting different communities– Spending continued to be focused on the same
groups– White, gay men controlled many city HIV
health service organizations• Spending thus reflected their perspective
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Conflicts Over CARE
• Competition broke out between cities– Some claiming that they were underfunded
relative to others• Due partly to the way AIDS “caseloads” were
calculated• Double-counting of AIDS patients in more urban
states
© 2008 Delmar Cengage Learning.
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Recent Regression in the AIDS Response
• Erosion of federal AIDS budget relative to new cases– Particularly in the field of prevention
• Prevention efforts today focused largely on abstinence– As opposed to (often more effective) harm
reduction strategies
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Recent Regression in the AIDS Response
• This priority carries over to the way the U.S. funds international assistance to combat AIDS
© 2008 Delmar Cengage Learning.
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Chapter 16 Summary
• AIDS arose in America during early 1980s– Initial “at-risk” groups responding to epidemic
very differently
• Early battles between AIDS activists and broader sociopolitical power structure
© 2008 Delmar Cengage Learning.
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Chapter 16 Summary
• Self-empowerment movement– People with AIDS (PWAs)
• Legislative success and CARE
• Recently “lost ground”