Cities dirty needles, unsafe blood transfusions more sexual partners greater mobility How Did HIV Spread?

Jet travel

How Did HIV Spread?

HIV spread silently around the world for fifty years 1930s 1981 How was the Epidemic Discovered?

June 5, 1981 Five cases Los Angeles pneumocystis pneumonia 30 Morbidity and Mortality Weekly Report How was the Epidemic Discovered?

=APB all points bulletin

November 5, 1982 Just 17 months after the first LA cases Similar pattern: hepatitis B Possible cause: unidentified bloodborne agent 31 Morbidity and Mortality Weekly Report at How was the Epidemic Discovered?

December 10, month later Infant: multiple blood transfusions developed AIDS Donor had developed AIDS 31 Morbidity and Mortality Weekly Report at How was the Epidemic Discovered?

And six months later? How was the Epidemic Discovered?

June 1983 French announce: New bloodborne pathogen How was the Epidemic Discovered?

2008 The Nobel Prize in Physiology or Medicine Françoise Barré-SinoussiLuc Montagnier How was the Epidemic Discovered?

ARV HTLV-III LAV How was the Epidemic Discovered?

HIV Human Immunodeficiency Virus How was the Epidemic Discovered?

June 1981 June months How was the Epidemic Discovered?

HIVisbloodborne

People living with HIV & AIDS The Law Discrimination: same civil rights have the as all persons living with serious illness. Mainstreaming Principle

Universal precautions: How We Protect Others The Law Workplace Safety: Treat all blood, at all times, from all sources, as if it is infectious.

Heightened privacy protections How -- and Why -- We Specially Protect People with HIV The Law Privacy and Confidentiality: from other people’s fear and stigma. people living with HIV & AIDS to protect

HIV is Bloodborne DiscriminationPrivacy and Confidentiality Workplace Safety The Law

AIDS/HIV contagious new stigma sexuality race death Epidemics Brief Golden Age of Infectious Disease Control

Paramedics Should HIV information be broadcast? Case Study #1:

Discrimination Workplace Safety Case Study #1:Paramedics

Privacy and Confidentiality Workplace Safety Case Study #1:Paramedics

Privacy and Confidentiality Discrimination Case Study #1:Paramedics

Can dentists refuse to treat persons with HIV because of the risk to others? Dentist Staff Other patients DentistsCase Study #2:

Workplace Safety: Case Study #2:Dentists Universal precautions: Treat all blood, at all times, from all sources, as if it is infectious.

But... What if there’s an accident??? Cut off your hand? Jump out the window? Case Study #2:Dentists

Early 1980s:200 HCWs died each year HBV Late 1980s: HIV seroconversion rate 1: 2.5 seroconversion rate 1: post-exposure prophylaxis (PEP) “remote risk” Case Study #2:Dentists 250 lowered further by

US Supreme Court: School Board of Nassau County v. Arline “significant risk” “remote risk” 480 U.S. 273 (1987) Case Study #2:Dentists

524 U.S. 624 (1998) Bragdon v. Abbott Courts should defer to the reasoned judgement of public health officials, Case Study #2:Dentists US Supreme Court: not the unsupported judgment of a single dentist.

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