Outbreak Of AIDS Research Articles

Public Policy and Aids

In summary of some of the major issues raised by AIDS (Table 1), social, political, and economic forces all impact on the global outbreak of AIDS. Conversely the epidemiologic and medical realities of this disease have forced a reconsideration of moral and ethical values, prioritization of resource allocation, and pervasion of virtually every aspect of the health care delivery system. Advocates for AIDS funding have set a model for other espousing the significance of diseases ranging from rare disorders to breast cancer. As this issue was written (summer 1993), it was apparent that attention of the media had shifted to numerous other domestic and foreign concerns. Hopefully, when the Clinics next present perinatal AIDS, the pendulum will have swung back and there will be a wider variety of effective therapeutic agents available permitting longer survival of greater quality.

China Report: AIDS, Law, and Social Control

China has a growing number of HIV-infected individuals. The vast majority are intravenous drug users from Yunnan Province near the Golden Triangle region, though the infection has been found among prostitutes and in the homosexual community. The Chinese government is approaching the outbreak of AIDS from a public health and a public security perspective. The public security portion of the response employs a philosophy of treatment and resocialization that should facilitate efforts by the Chinese to manage the spread of the AIDS virus.

Linkage and independence of AIDS and kaposi disease: The interaction of human immunodeficiency virus and some coagents

SummaryThrough epidemiological considerations we conclude that full-blown AIDS may occur only if the index patient is infected by the human immunodeficiency virus (HIV) and, in addition, by some other infectious coagent. Since the dynamical behaviour of the spread of AIDS cases with manifestation of Kaposi's sarcoma differs fundamentally from that of the non-Kaposi cases, we conjecture that two independent coagents (together with HIV) are responsible for the outbreak of full-blown AIDS with or without manifestation of Kaposi's sarcoma, respectively. Our formal epidemiological considerations appear to be supported by recent microbiological findings.

Risk taking, frame of reference, and characterization of victim groups in AIDS treatment decisions

Subjects' frame of reference was manipulated in a hypothetical medical decision-making task patterned after Tversky and Kahneman's (1981) “Asian disease task”. Subjects in the positive framing condition received an option of definitely saving one-third of the lives of potential victims of a new outbreak of AIDS and an option with a one-third probability of saving all lives and a two-thirds probability of saving no lives. Equivalent options in the negative framing condition were one where two-thirds would die and one where there is one-third probability no one would die and two-thirds probability that all would die. Characteristics of the potential groups of victims were also manipulated. Results for the more desirable victim group, hemophiliacs, displayed the usual preference reversal with changing frame of reference: risk-averse choices when considering “lives saved” and risk-seeking choices when considering “lives lost”. This was not the case for the less desirable groups, e.g., intravenous drug users. These results were replicated in a forced-choice variant of the task. Analogous results were obtained when comparing risk-taking for “ingroup” and “outgroup” members. Results were discussed in terms of differences in the subjective value functions for “lives saved” and “lives lost” for the different groups. An independent scaling procedure supported the hypothesized differences in value functions.

On the Structure of the Epidemic Spread of AIDS: The Influence of an Infectious Coagent

The reported AIDS cases in the USA and the Federal Republic of Germany are growing almost exponentially. Considering the epidemiological curves for different risk groups (homosexual men, i.v. drug abusers, heterosexual partners etc.) it is extremely surprising, that nearly exactly the same development occurs in all risk groups. One only has to consider a certain time shift for each group. The conformity of the development for all groups is evident by the fact, that the curves representing the reported AIDS cases for different risk groups are straight lines (in a logarithmic scale) running nearly exactly in parallel. This remarkable parallelism can be understood only if the spread of AIDS is independent of the sexual or drug risk in a certain sense. On the other hand, the drastic overrepresentation of the sexually highly active groups and drug abusers in the number of AIDS cases obviously requires that the transmission of AIDS unequivocally depends on the sexual and drug risk. We present a mathematical model that is suitable to reconcile this apparent contradiction in the interpretation of the epidemiological data: the observed parallel time series for the spread of AIDS in groups with different risk of infection can be realized by computer simulation, if one assumes that the outbreak of full-blown AIDS only occurs if HIV and a certain infectious coagent (cofactor) CO are present. Such a situation is not uncommon, see, e.g. the influenza virus--Staphylococcus aureus system. According to the mathematical model this cofactor would spread independently of the sexual and drug risk--in contrast to HIV. However, due to its analytical properties the simulated cofactor cannot be identified so far with any known infectious agent.

Urban desertification, public health and public order: ‘Planned shrinkage’, violent death, substance abuse and AIDS in the Bronx

Techniques and approaches from population and community ecology, along with theoretical viewpoints from criminology and the ‘social support hypothesis’ of health maintenance, are used to examine recent patterns of rising homicide and suicide, intensified substance abuse, low birth weight and AIDS deaths in the Bronx section of New York City. Empirical and theoretical analyses strongly imply present sharply rising levels of violent death, intensification of deviant behaviors implicated in the spread of AIDS, and the pattern of the AIDS outbreak itself, have been gravely affected, and even strongly determined, by the outcomes of a program of ‘planned shrinkage’ directed against African-American and Hispanic communities, and implemented through systematic and continuing denial of municipal services—particularly fire extinguishment resources—essential for maintaining urban levels of population density and ensuring community stability. This work complements a recent study by McCord and Freeman [1. New Engl. J. Med. 332, 173, 1990] on Harlem, and suggests the present overburdening of New York's criminal justice system arises from almost exactly the same causes as its accelerating inability to meet demands for acute medical service, so-called ‘medical gridlock’, in that both are expressions of the increasing social disorganization of poor communities initiated and continued in considerable part by government policy. The critical role played by improper policy in triggering the syndrome suggests ecologically informed interventions, particularly essential service restoration, may hold the potential for great positive impact.

Response of parents to learning that their child is homosexual and concern over AIDS: a national study.

This study was a survey of 402 parents of gay and lesbian children from the northeastern, southern, midwestern, and western regions of the United States. Of particular interest was parental response to the knowledge of their child's homosexuality and the AIDS outbreak. Although parents suffered emotional upset upon learning of their children's homosexuality, many progressed through a five-stage grief process that ended with acceptance. Fear of the spread of AIDS, that their offspring might contract AIDS, or that their child might suffer from the backlash related to AIDS were concerns for most parents. Attitudes toward AIDS were not very different between mothers and fathers. However, older parents were more likely to have more positive attitudes toward AIDS than younger parents, and liberal parents were more likely to have a more positive outlook than their conservative counterparts.

Children infect mothers in AIDS outbreak at a Soviet hospital

Children infect mothers in AIDS outbreak at a Soviet hospital

AIDS legislation--turning up the heat?

This paper is not about the medical condition of AIDS. Nor is it about the history of the condition since it was first reported in Atlanta, Georgia in 1981. It looks rather, at the catalogue of legislative and other legal responses to the spread of AIDS. The paper analyses the AIDS condition in its historical context. The hysteria accompanying the outbreak of AIDS is contrasted with the similar hysteria associated with other previous epidemics experienced in Australia over the past two centuries. The paper categorises the responses of lawmakers to the condition, according to the approach taken; from 'full blast', through 'moderate heat' to 'low key' or an attempt to avoid or minimise legal intervention. It is suggested that the appropriate response should depend upon such factors as the present magnitude of the condition, its likely future course, the availability of cures and protections against its spread and objectives being sought by intervention. Unless these factors are taken into account gross over-reaction can occur, causing social disruption and much personal injustice.