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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

 


AIDS/HIV & Hepatitis:
Miscellaneous Articles

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"Our nation has been in the fight against HIV/AIDS for over 20 years now. The government pours millions of dollars into care, treatment and prevention. Why are there still so many Black people becoming infected and dying from this virus? We know from reports that there are health disparities between communities of color and the white population. We also know that in communities of color there is an inherited mistrust of the system. Do these reasons equate to the disproportionate amount of black people infected by this disease? Yes, they do play a part, but only a part. African Americans have other obstacles, which put them on the frontline of this virus.

Many people in Black communities are under the misguided perception that AIDS is a disease that only affects the gay population and those people who misuse drugs. In the 1980s, the gay and lesbian community did a great job of putting a face on this horrific virus, and should be commended. They refused to let their brothers die in silence. Now the time has long passed for the other faces of AIDS to be brought to the forefront. Black communities around the country need to rise up and refuse to perish without a fight. We should not pass silently into the night.

Many of those who lose the battle to AIDS in the Black community are not counted as those who have fallen to this virus. Cancer, pneumonia, or heart attacks are causes of death that we tell our family and friends. Those who are infected still fear letting others know on the chance they may be ostracized from family, friends, and the community at large. Many continue to die alone with no one to hold their hands or wipe their brows. Far too many do not seek care fearing that family and neighbors will discover the secret. Still others do not test, wrongly believing that ignorance is bliss. Shame is robbing our community of its lifeline and its future.

Even our churches, which have been a bastion of support in the Black community for many worthy causes, have not risen to this fight in appropriate numbers. Ministers continue to blame those who are infected for being immoral and sinners. How sad it is that some of our churches take this view. Some of our politicians are saying teach abstinence-only in our schools. Abstinence-only has been taught for many years and we still have a problem in this country with teen pregnancy. We cannot allow our children to die using antiquated solutions, which have never proven effective. If we do not become educated about this disease, if we do not drag AIDS out of the shadows where it has been able to fester and grow in our communities, then we will perish. The shame and ignorance surrounding AIDS in Black America could lead to the demise of us all.

We are in a burning building and only a few are shouting for all of us to get out." Dying in Silence-African Americans

ADDITIONAL ARTICLES:

Document Name & Link to Document

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Sacrificing Science and Sensibility : How Squeamishness over Syringes is Stalling Public Health Efforts on Long Island

Over the course of the last decade, a growing number of Long Islanders have fallen prey to the rapidly expanding and converging epidemics of substance abuse and AIDS.  Though both problems have prompted unparalleled suffering in our community, strained health care delivery and adversely impacted our local economy, neither has been dealt with as a public health emergency. Instead, our deeply ingrained social notions of morality, sin and fear have fostered public policies that have only entangled and exacerbated both epidemics. The results -- nationwide, statewide and here on Long Island -- are both startling and distressing.

Without access to sterile injection equipment, thousands of drug-addicted men and women have shared contaminated needles and become infected with HIV. In turn, they've passed the virus on to their sexual and drug-sharing partners, fueling a fatal epidemic that under most circumstances, is completely preventable.
 
Safe Sex and the Facts While a few STDs can be transmitted apart from sex acts, all are transmissible by the exchange of bodily fluids during intimate sexual contact. I want to discuss the severity of the problem as well as what must be done if we are to save a majority of the next generation from the shame, infertility, and sometimes death, that may result from STDs.  

Self-help Acupressure for Hepatitis C

These Acupressure points help with fatigue, rebuild the immune system, support the liver, relieve water retention, nausea, indigestion, headaches, confusion, depression, and pain, and will increase your energy

50 kb pdf

Seniors and Hepatitis C

Hepatitis C is not just a disease of young people.  Seniors (people over 60 years old) who are infected with Hepatitis C Virus face particular challenges, both in the progression of the disease and their options for treatment.

 

Sex and Hepatitis C Transmission While there is sufficient evidence to support the conclusion that sexual transmission of hepatitis C virus (HCV) occurs, quantifying the magnitude of an individual's risk of HCV acquisition by sexual contact has been more challenging. The available data suggest the efficiency of transmission by the sexual route is low. Nonetheless, since sex is a common behavior and the reservoir of HCV-infected individuals is substantial, sexual contact likely contributes to the total burden of HCV infection in the United States  
Sexual Activity Literature review concerning sexual activity and our youth  

Sexual Activity Among Women With HIV

Previous studies have shown that women with HIV infection continue to be sexually active, and advances in medical treatment have helped to transform HIV infection into more of a chronic condition than an immediately debilitating and life-threatening disease. The continued sexual behavior of women with HIV raises concerns about maintaining sexuality, safe sex practices, disclosure of the disease, and possible transmission to sexual partners and offspring.

 

Sexual Activity as a Risk Factor for Hepatitis C Infection Sexual Activity as a Risk Factor

Percutaneous exposures are well-recognized risk factors for Hepatitis C Virus, hepatitis B virus (HBV), and HIV. However, there are clear differences between these viruses with respect to their frequency of transmission through sexual contact.

 

Sexual decision-making and negotiation in the midst of AIDS This report explores choices made by young men and women regarding sexual activity and the extent to which it is influenced by HIV/AIDS.  Communication between partners was poor, and young women appeared powerless to enforce their preferences in sexual situation.  AIDS was not a significant factor in any aspect of sexual decision-making. 80 kb pdff
Sexual relations among young people in developing countries: evidence from WHO case studies In every setting, sexual activity begins during adolescence among many young people.  Much of this activity is risky—contraceptive use is often erratic, and unwanted pregnancy and unsafe abortions are observed in many settings.  Sexual relations may be forced.  There are wide gender-based differences in sexual conduct, and in the ability to negotiate sexual activity and contraceptive use.  Despite this, relatively few young people think they are at risk of disease or unwanted pregnancy.  Awareness of safe sex practices seems to be superficial, and misinformation regarding the risks and consequences of unsafe sex is wide-spread 356 kb pdf

Sexual transmission of hepatitis C virus infection

Although most infections become chronic, and it may lead to chronic liver disease, most patients with Hepatitis C Virus infection are asymptomatic. The predominant modes of transmission are by blood, blood products, or other parenteral exposure, particularly injecting drug use.

 

Sexually Transmitted Diseases Field medical officers are likely to encounter sexually transmitted diseases—a diverse group of infections caused by bacterial, chlamydial, and viral pathogens—in an active—duty population of men and women.  Worldwide, STDs account for millions of patient visits to health clinics and serious perinatal complications, and expose sexual partners to the risk of infection with the human immunodeficiency virus. 264 kb pdf

Sexually Transmitted Diseases Treatment Guidelines --- 2002

Physicians and other health-care providers play a critical role in preventing and treating sexually transmitted diseases (STDs). These recommendations for the treatment of STDs are intended to assist with that effort. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed.

 

Special Treatment Populations Adobe PowerPoint presentation 51 kb

STDs: A Comprehensive New Guideline

Knowledge about sexually transmitted diseases (STDs) is increasingly important in the care of adolescents. In the recently released STD treatment guidelines from the CDC, therapy is the main focus, but diagnosis is also discussed. Therapeutic highlights include:

 

Strategies to Improve Access to Sterile Syringes for Injection Drug Users

The high prevalence of infection with HIV and other blood-borne pathogens in injection drug users (IDUs) is directly related to the lack of syringe access.

 

Struggles for National Health Reform in the United States

Highlights in a century of popular efforts to achieve a national system of health care in the United States.

 

Summary of HIV prevalence and Sexual Behavior Findings

This study compares levels and trends of behavioral indicators such as abstinence and age of sexual debut among youth, faithfulness in sexual relationships, multiple sexual partners, and condom use.

288 kb pdf

Surveillance is The First Step to Solving the Problem-EPINet Power Point Presentation explaining a computer program that can be used as a management tool to identify key areas where needlesticks occur frequently, thus targeting areas for reduction of risk 331 kb
SV-40 SV-40 infection is now widespread within the human population almost certainly as a result of poliovaccine produced in rhesus monkey kidney cells during the 1950s. A recent study showed infection in 23% of blood samples from normal individuals. The virus can also be detected in sperm fluid and is likely to be passed congenitally to future generations (Martini et al. SV40 Early Region and Large T Antigen in Human Brain Tumors, Peripheral Blood Cells, and Sperm Fluids from Healthy Individuals. Cancer Research 56: 4820-4825, 1996). As the title indicates this paper also confirms previous reports that SV-40 is present in a significant proportion of human brain tumors. Other reports have shown SV-40 in human brain tumors, e.g. Bergsagel et al. New England Journal of Medicine 326: 988-993, 1992. SV-40 has also been detected in a high proportion of human mesotheliomas (Carbone et al. Oncogene 9: 1781-1790, 1994); and in bone tumors called osteogenic sarcomas  
SV40 stands for Simian Virus 40 Upon the discovery that SV40 was an animal carcinogen that had found its way into the polio vaccines, a new federal law was passed in 1961 that required that no vaccines contain this virus. However, this law did not require that SV40 contaminated vaccines be thrown away or that the contaminated seed material (used to make all polio vaccines for the next four decades) be discarded. As a result, known SV40 contaminated vaccines were injected into children up until 1963. In addition, it has been alleged that there have been SV40-contaminated batches of oral polio vaccine administered to some children until the end of the 1990's  

Sweden and the drug problem-seen through Dutch eyes

The central question was: what is the nature and extent of the drugs problem in Sweden, what policy is being followed and to what effect.

 

The Art of Getting Hepatitis C

Getting a tattoo can lead to liver disease

 

The attitude of nurses to HIV/AIDS patients in a Nigerian University Teaching Hospital “The revelation that perhaps up to four million Nigerians might have contracted (the) AIDS virus should spur the country into some form of coordinated action. Despite the havoc which HIV/AIDS has caused throughout the world, particularly Africa, Nigerians have, regrettably, continued to carry on as if nothing is happening. Many people still maintain multiple sex partners and engage in casual and unprotected sex. Our AIDS control strategy remains, at best, unstructured, without direction. If the report that some people have received blood infected with the virus is true, then there is danger on the horizon. It only goes to show that AIDS screening is not properly carried out in the country. Sadly, the problem has been compounded by the fact that the disease is still being treated with a less than honest approach by many Nigerians” (Daily Times 1997) Pdf 152 kb

The Battle to Make Health Care Work

Will a system set up to maximize profit ever truly care for patients? One indication comes from looking at how HMOs organize their lists of approved drugs, or formularies, for their doctors to use. As one might expect, the drugs are often the cheapest and typically not the best. For instance, PacifiCare, now the nation's largest HMO for Medicare recipients, replaced an effective, high-cost schizophrenia drug called Risperdal with the low-cost, 36 year-old drug, Haldol. A thirty-day supply of Risperdal costs $240 compared to $2.50 for a similar supply of Haldol — nearly a 1,000% savings for PacifiCare. But the side effects of the inferior Haldol include severe, uncontrollable shaking  

The Discriminatory Attitudes of Health Workers against People Living with HIV

 

The results suggest that some health-care professionals discriminate against and stigmatise PLWA. For instance, 9% of professionals reported refusing to care for a patient with HIV/AIDS, and 9% reported that they refused a patient with HIV/AIDS admission to hospital. Two-thirds reported observing other health professionals refusing to care for a patient with HIV/AIDS, and 43% observed others refusing a patient with HIV/AIDS admission to hospital.  
The Duty to Warn and Protect - Impact on Practice The authors discuss the concepts of the duty to protect and the associated threat to confidentiality and their impact on practice for Canadian psychiatrists. They review these concepts and provide a synthesis of legal cases impacting psychiatric practice. and conclude that the onus is on the psychiatrist to make him or herself aware of the current state of the legal obligation with respect to duty to protect. The evolving concept of duty to protect has and will continue to have significant impact on the practice of psychiatry.The practice of medicine is increasingly subject to external review and legislation. Both have a significant impact on psychiatry in terms of risk assessment and the duty to warn or protect third parties  

The Ethics of AIDS Care

The readers of this journal are acutely aware of the expanding research data on the most effective treatment regimens for HIV/AIDS, as well as the medical and socioeconomic dimensions of the formularies that often govern access to these regimens, their costs, and the characteristics of the population affected. This article will, therefore, focus on the question of what is appropriate medical care for people with HIV disease and the ethical principles involved in providing drugs to the medically indigent for such appropriate medical care. An opinion concerning the ethical issues that the problem raises is given. Then suggestions are made to solve the problem in an ethically acceptable way.  

The Hepatitis C Threat

Health experts say ignorance can kill

 

The High Cost of Health Goes Higher

The price of health insurance is soaring, says new study

 

THE KNOWLEDGE AND ATTITUDES OF PHYSIOTHERAPISTS TOWARDS PATIENTS WITH HIV/AIDS IN THE LUSAKA PROVINCE, ZAMBIA With the increase in the number of persons suffering from HIV/AIDS, physiotherapists are often required to treat these patients who present with respiratory and neurological complications. Although physiotherapists are at a lower risk of HIV infection in the workplace than nurses and doctors, it is necessary to determine their knowledge and perceptions of the risks, fears of HIV transmission and their attitudes towards patients with the disease. The aim of the study was to determine the physiotherapists’ knowledge of, and their attitudes towards patients with HIV/AIDS. Pdf 925 kb

The Myth of Confidentiality

 

The concepts of privacy, confidentiality and privilege are related, but it may be helpful to clarify: The right to privacy is a Western philosophical concept.   Privacy is considered essential to maintain human dignity and freedom of self-determination.  It is the right of an individual to keep his or her thoughts, feelings, or personal data from being shared with others.  Privacy is not simply the absence of information about us in the minds of others; it is the control we have over information about ourselves.  Confidentiality, or the obligation to maintain confidentiality, refers to the general standard of professional conduct that requires a professional to not discuss information about a client with anyone.  Privilege is a legal term rather than an ethical concept.  The legal system has always had the inherent power to require witnesses to testify in court so that the judicial system will have access to all relevant information associated with a case.  However, the law recognizes that there are certain special relationships that are viewed by our society as being so important that they deserve protection from such intrusion.  Those special relationships are granted "privileged communication" status and are exempt from compulsory disclosure, with limited exceptions.  "Special" relationships granted privileged status in most states are husband and wife, attorney and client, clergy and confessor, physician and patient, and therapist and client.  Privilege is a right that must be granted by law and belongs to the client in a professional relationship  

The needle-stick epidemic

The International Health Care Worker Safety Center (University of Virginia) estimates more than 1 million accidental needle sticks occur per year. Higher rates have been reported by the Centers for Disease Control and medical journals. Although nearly invisible to the public, this epidemic of accidental needle sticks is infecting thousands of American medical workers with potentially lethal diseases. It has reached a crisis stage, as each day medical workers suffer some 2,400 accidental sticks.

 

The Scope of Injuries as Public Health and Research Problems It is interesting that notions of fault and negligence of individuals immediately involved in damaging transfers of mechanical, thermal, chemical, and radiation energy have seldom been applied to interpersonal transfers of harmful biologic organisms. In medieval times, persons thought to be carriers of the plague, but who actually were not, were persecuted and in some instances murdered.(2) But in modern times people seldom if ever think of suing someone who conveys bacteria or viruses that result in disease. Surely the person who knowingly has a disease that is transmitted by sneezing in crowds, kissing, sexual intercourse, or whatever and who then infects others by engaging in those activities is no less negligent than the alcoholic who drives while intoxicated and injures someone. Why do we believe that the latter is somehow more subject to control by legalistic fault finding and punishment than the former? Infectious-disease epidemiologists seldom if ever concern themselves with blame assignment, although carriers of the more serious diseases may be pursued by public-health physicians for the purpose of treating the disease and stopping the chain of transmission. Yet the primary purpose of police and often of expert investigation of car crashes is to assign fault in reports or to testify in lawsuits for damages.  
Therapist’s Duty to Protect Third Parties-Balancing Public Safety and Patient Confidentiality When a therapist determines, or pursuant to the standards of the profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger.  The discharge of this duty many require the therapist to take one or more of various steps, depending upon the nature of the case.  Thus it may call for him to warn the intended victim or others likely to apprise the victim of the danger, to notify the police, or to take whatever other steps are reasonably necessary under the circumstances. Pdf 26 kb

To protect your health, dentists use "universal precautions."

Listing of precautions

 

Transfusion Related Acute Lung Injury

This is to alert you to the possibility that patients who receive blood products, particularly plasma-containing products, may be at risk for Transfusion Related Acute Lung Injury (TRALI), a serious pulmonary syndrome that can lead to death if not recognized and treated appropriately. Even small amounts of plasma in packed red blood cells may induce TRALI.

 

Understanding Cirrhosis

A patient's history and symptoms, along with the results of a physical examination, are usually enough to determine a case of cirrhosis. Once the diagnosis has been made, the physician may order one or more liver function tests, which use blood samples to identify specific liver diseases and assess the organ's overall health.

 

'UNLESS THERE IS A FUNDAMENTAL CHANGE IN BEHAVIOR, THERE WILL BE NO DRASTIC CHANGE IN THE EVOLUTION OF THE EPIDEMIC' The statistics indicate what few officials are willing to admit: that this region faces a crisis of shattered mores, where sexuality is no longer guided by traditional norms. In an environment where old rules have clashed with, or been eclipsed by, rapid social change, African men are killing themselves - and their women and children - with sex.  Hiding behind a historical reluctance to speak openly about sex, African political and religious leaders have failed to acknowledge this deeper cultural crisis at the root of the AIDS epidemic. And international experts, averse to sounding judgmental or racist, tread lightly on the epidemic's behavioral undercurrents. Behavior, consequently, has been narrowly defined as simply having safe sex. But as effective as condoms are in stopping the transmission of HIV, they do not stop epidemics.  
Use of Lemon/Lime Juice Douching by Women To Prevent Infections and Pregnancy in Jos, Nigeria Power Point Presentation concerning the use of Lemon/Lime Juice Douching 1708 kb pdf

Vaccine for Hepatitis Badly Needed

Hepatitis C Virus positive individuals should not donate blood or semen. They should practice safe sex although transmission by this route is very low, and should not share razors or toothbrushes. IV drug users should use needle exchange programs or quit.

 

Wake Up to the Healing Properties of Sleep

Sleep is essential to our physical and mental health.

 

Waiting for a liver - Hidden costs of the organ shortage

Discussion about the economics of end-stage liver disease has typically focused on the high cost of liver transplantation, but the management of complications in patients waiting for an organ can also be very expensive.

 

Washington Governor's Advisory Council on AIDS Asks Locke To Reject Abstinence-Only Federal Education Funds

The Washington Governor's Advisory Council on HIV/AIDS last month sent a letter to Gov. Gary Locke (D) asking him to reject federal funding for "Teen Aware," an educational program that teaches abstinence as the only prevention method for pregnancy and sexually transmitted diseases,

 

Withholding and Withdrawing Life-prolonging Treatments: Good Practice in Decision-making This guidance develops the advice in Good Medical Practice and Seeking Patients' Consent: The Ethical Considerations It sets out the standards of practice expected of doctors when they consider whether to withhold or withdraw life-prolonging treatments.  

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