© 2008 Delmar Cengage Learning. Chapter 16 AIDS Trish Siplon

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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)

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 17 Recent Regression in the AIDS Response This priority carries over to the way the U.S. funds international assistance to combat AIDS

© 2008 Delmar Cengage Learning. 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

© 2008 Delmar Cengage Learning. 19 Chapter 16 Summary Self-empowerment movement –People with AIDS (PWAs) Legislative success and CARE Recently “lost ground”