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Chapter 16

Chapter 16. AIDS Trish Siplon. 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

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Chapter 16

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  1. Chapter 16 AIDS Trish Siplon

  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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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)

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Recent Regression in the AIDS Response • This priority carries over to the way the U.S. funds international assistance to combat AIDS

  18. 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

  19. Chapter 16 Summary • Self-empowerment movement • People with AIDS (PWAs) • Legislative success and CARE • Recently “lost ground”

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