"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
|
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.
|
|
|
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 |
|
|
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
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. |
|
** In order to view PDF files, you must have Adobe Acrobat Reader installed on
your computer. Many computers already have this software; however, if you need
it, a free copy is available for download at this site: Click
here to get Adobe Acrobat Reader.
