Transcript Chapter 16 - Delmar

Chapter 16
AIDS
Trish Siplon
© 2008 Delmar Cengage Learning.
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
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© 2008 Delmar Cengage Learning.
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
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© 2008 Delmar Cengage Learning.
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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© 2008 Delmar Cengage Learning.
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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© 2008 Delmar Cengage Learning.
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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© 2008 Delmar Cengage Learning.
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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© 2008 Delmar Cengage Learning.
AIDS Activists Take on the
Health Care Power Structure
• Activists also challenged:
– Drug companies on account of seeminglyexorbitant pricing
– Insurance companies for failing to cover those
with AIDS
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© 2008 Delmar Cengage Learning.
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
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© 2008 Delmar Cengage Learning.
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
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© 2008 Delmar Cengage Learning.
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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© 2008 Delmar Cengage Learning.
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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© 2008 Delmar Cengage Learning.
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
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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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© 2008 Delmar Cengage Learning.
Recent Regression
in the AIDS Response
• This priority carries over to the way the
U.S. funds international assistance to
combat AIDS
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© 2008 Delmar Cengage Learning.
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
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Chapter 16 Summary
• Self-empowerment movement
– People with AIDS (PWAs)
• Legislative success and CARE
• Recently “lost ground”
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© 2008 Delmar Cengage Learning.