Legal control measures for AIDS: reporting requirements, surveillance, quarantine, and regulation of public meeting places

How will the second wave of the dreadful COVID-19 be with the increasing number of the infected cases and mortality in Iraq?

Since the first period of the virus's emergence in Iraq, the government and health-related authorities have rushed to impose home quarantine and suspend work in all facilities of the country besides prescribed the sear measures for doubtful cases. From that time, the detected cases elevated with the number of mortality. Our study aims to take an overview of the disease during the past seven months, and a general review of the effects of quarantine measures that have resulted in an altitude graphic curve for both injuries and deaths. Data were analyzed using statistical software with significant values. The number of cases and mortality was elevated in a linear curve. The quarantine has been a factor for containing the virus in the early stages, but on the contrary, no impact was observed recently. The World Health Organization has warned that Iraq will face a second wave of coronavirus next fall, due to the lack of commitment of citizens to the comprehensive implementation of the ban and shortcomings rules of social spacing, proceed to hold special events, and increased activity in the markets. To see the country free from COVID-19, the responsible necessity to focus on the indigence to meet the public health requirements at a proper time.

How will the second wave of the dreadful COVID-19 be with the increasing number of the infected cases and mortality in Iraq?

Since the first period of the virus's emergence in Iraq, the government and health-related authorities have rushed to impose home quarantine and suspend work in all facilities of the country besides prescribed the sear measures for doubtful cases. From that time, the detected cases elevated with the number of mortality. Our study aims to take an overview of the disease during the past seven months, and a general review of the effects of quarantine measures that have resulted in an altitude graphic curve for both injuries and deaths. Data were analyzed using statistical software with significant values. The number of cases and mortality was elevated in a linear curve. The quarantine has been a factor for containing the virus in the early stages, but on the contrary, no impact was observed recently. The World Health Organization has warned that Iraq will face a second wave of coronavirus next fall, due to the lack of commitment of citizens to the comprehensive implementation of the ban and shortcomings rules of social spacing, proceed to hold special events, and increased activity in the markets. To see the country free from COVID-19, the responsible necessity to focus on the indigence to meet the public health requirements at a proper time.

Ethical issues in early detection of HIV infection to reduce vertical transmission

Proposals to make prenatal HIV testing routine and universal dramatize ethical issues regarding early detection of HIV. These proposals would abolish pretest counseling and written informed consent for prenatal HIV testing. Ethical concerns include whether pregnant women are adequately informed that they may refuse such testing and whether patients have an opportunity to obtain more detailed information about the benefits and risks of HIV testing in this context. Several pertinent research questions need to be studied, including whether pregnant women find routine universal HIV testing acceptable and whether safeguards adequately protect women who receive testing. If analogous policies to enhance early detection of HIV are considered in other clinical contexts, the important clinical and ethical differences between vertical transmission and other situations of HIV transmission must be kept clearly in mind.

Tuberculosis in patients with HIV infection

Tuberculosis is the most common opportunistic infection in patients with HIV infection worldwide and is the only one that is transmissible to others by the respiratory route. Tuberculosis is curable and preventable. Early detection of tuberculosis disease and infection in individuals with or at risk for HIV infection is paramount. This approach can minimize the devastating interaction between these two diseases.

Thinking and rethinking AIDS: implications for health policy

In the United States, we see three main phases in the construction of the history of AIDS, with each having very different implications for health and social policy. In the first, AIDS was conceived of as an epidemic disease, a "gay plague," by analogy to the sudden, devastating epidemics of the past. In the second, it was normalized as a chronic disease, similar in many ways to diseases such as cancer. In the third, the authors propose a new historical model of a slow-moving, long-lasting pandemic, a chronic infectious ailment manifested through myriad specific HIV-related diseases. The new paradigm of AIDS incorporates the positive aspects of both earlier conceptions. It emphasizes, like the plague model, the etiology, transmission, and prevention of disease but rejects its assumption of a time-limited crisis. It takes from the chronic disease model an appropriate time frame and concern with the clinical management of protracted illness but insists on the primacy of prevention. The authors criticize both infectious and chronic disease models for their individualistic conceptions of disease and their narrow strategies for disease prevention. They further argue that the traditional distinction between, and approaches to, infectious and chronic diseases need to be rethought for other diseases as well as for AIDS.

Ethical dilemmas in HIV infection: what have we learned?

The acquired immunodeficiency syndrome (AIDS) has raised perplexing ethical and public policy dilemmas. Early in the epidemic, closing of bathhouses, testing blood donors for human immunodeficiency virus (HIV) infection, and notifying seropositive blood donors evoked passionate controversies. Current dilemmas include testing and using promising new treatments, notifying partners of seropositive persons, and, most recently, restricting the clinical activities of seropositive health,care workers who perform invasive procedures.

These dilemmas about HIV infection involve scientific judgments, cultural norms, and social values. In the HIV epidemic, public rhetoric and political pressure have been prominent. On the one hand, some persons have launched moralistic crusades against homosexuals and injection drug users. For these persons, AIDS symbolizes the breakdown of traditional family values and the social order. On the other hand, some advocates for persons with HIV infection have used confrontational tactics such as sit-ins and disruptive demonstrations.

Self-disclosure of HIV infection to sexual partners

Self-disclosure of HIV infection to current sexual partners was examined in 138 seropositive men, mostly lower income Hispanics, from Los Angeles. Forty-five percent had been sexually active since learning their serostatus. Of these, 52% had kept their infection secret from one or more partners. The likelihood of disclosure decreased in direct proportion to the number of partners. Nondisclosure occurred in conjunction with unprotected receptive and insertive anal intercourse. Potential factors promoting nondisclosure are discussed.

The ethical approach to AIDS: a bibliographical review

This bibliographical study involved first the exploitation of four data-banks: Medline, CNRS, Bioethics and AIDS, with the following key words (in conjunction with AIDS): ethics, human rights, confidentiality, legislation, jurisprudence. A total of 412 references were listed between 1983 and the end of 1987. Examination of the quantitative increase of articles over these years shows that, while references to AIDS and/or HIV infection--referred to as 'AIDS' for brevity--increased by about one third per year, the number of papers treating ethical problems linked to AIDS doubled each year. This increase makes it clear that these problems are important and pressing, that they are evolving rapidly and can be given no easy solution. After reading and analysis of accessible articles in readily comprehensible languages, the different themes can be classified in two categories: 1: Measures intended to protect society (starting with the most coercive); quarantine and isolation; discriminatory measures concerning specific groups; non-respect of the confidential nature of medical information; application of the penal code; screening; obligatory declaration and registration; testing of blood given by donors; vaccination and medical innovations, therapeutic assays; information, education. 2. Measures intended to protect the individual: fundamental rights of the patient: his/her right to confidentiality, to information and to treatment; civil rights: civil liberty, right to education, right to work, etc...; rights of the healthy individual: right of those in contact with the patients, safety of hospital staff, of those receiving blood-transfusions, etc... The legislation adopted in the various countries and the main opinions to be found in these articles are listed and analysed, and for each particular theme it is possible to refer to a list of the 232 most important articles. While the debate seems to concentrate on the conflict between the right of society to protect itself against the spread of infection and the 'civil' rights of the infected minorities, our conclusion tends to reduce this antagonism, showing that, particularly as far as the confidential nature of medical information is concerned, measures intended to protect the individual also protect society.

The AIDS pandemic: a nursing model

The pandemic of acquired immunodeficiency syndrome (AIDS) calls for global cooperation to develop strategies for interventions both to prevent the disease and to care for persons with it. The conceptual framework "Health for all: A model for nursing's contributions" provides guidance for the processes of assessment, diagnosis, planning, implementation of care, and evaluation of mortality and morbidity related to AIDS. The disease challenges the biologic, sociologic, medical-technical, and environmental determinants as they affect health. Specific recommendations for health care interventions are relevant to each determinate, with community health status as the focus.

Notifying contacts of HIV-infected patients. Strategies to use until health agencies assume responsibility

Although physicians have a moral and professional duty to prevent the spread of human immunodeficiency virus (HIV) by seeing that the infected patient's contacts are informed of the risks, they have no legal guidelines on how to approach the problem. Medical organizations recommend that physicians notify an endangered third party if the infected patient refuses to cease high-risk activity and the authorities do not take action. However, many questions remain about practical application of these recommendations. Some federal recommendations place the burden of notifying the third party on the infected patient, then on the public health authority, and finally on the physician. However, these suggestions are not law. Legal precedent has placed responsibility on the physician for warning persons exposed to an infected patient that a risk exists. However, warning someone who is not clearly at risk can also invite a lawsuit. At present, there is no clear public policy to give guidance either. By considering the infectivity of the virus, injury potential of the infection, and the exposed person's relationship with the patient, the physician can better weigh the risk of breaching patient confidentiality versus ignoring the health dangers to the third party. Thorough counseling of the patient about infectivity, careful documentation of all conversations and efforts, and use of good judgment are the best tools that physicians have at present for handling this legal void.

Issues of definitions and their implications: AIDS and leprosy

It is demonstrated how definitions can determine social consequences of impairment and disability. A comparison between leprosy and AIDS provides the basis for the discussion. The United States is the geographic and political arena under consideration. Issues of classification as STD (sexually transmitted disease) or as contagious, communicable disease are relevant. An important factor to predict the social impact is the nomenclature utilized by CDC (Center for Disease Control). CDC represents the government as the official agency to gather and report morbidity and mortality information. Hypotheses to explain stigma on the basis of epidemiological bases are added to the usual sociological concepts or historical considerations. Potential application of the findings are discussed.

Legal rights and duties in the AIDS epidemic

This article provides an overview of some major areas of legal concern in which the AIDS epidemic is having an impact. The rights of infected individuals to testing, treatment, and confidentiality are reviewed, and emphasis is given to their claims to nondiscrimination regarding access to health care, employment, housing, education, insurance, and related interests. Infected persons' duties to contain transmission of AIDS are outlined under principles of criminal and civil law, including liability for provision of contaminated blood products. Uninfected people's general rights to protection are considered, and health professionals' and authorities' rights and duties are given more detailed attention. In conclusion, some legal developments outside the United States are reviewed.

The HIV antibody test: why gay and bisexual men want or do not want to know their results

Beginning in the latter part of 1985, 2,047 gay and bisexual men who were enrolled in the Pitt Men's Study, the Pittsburgh cohort of the Multicenter AIDS Cohort Study (MACS), were invited by mail to learn the results of their antibody test for HIV infection--human immunodeficiency virus infection. Participants were asked to complete and return a questionnaire designed to assess the factors influencing their (a) decision about learning the results, (b) recent sexual behavior, (c) knowledge about acquired immunodeficiency syndrome (AIDS), and (d) attitudes toward AIDS risk reduction. Of those men, 1,251 (61 percent) accepted the invitation, 188 (9 percent) declined, and 608 (30 percent) failed to respond. Fifty-four percent of the cohort subsequently learned their results. There were no significant differences in demographic, behavioral, and attitudinal characteristics or HIV seroprevalence between the men who accepted and those who declined. However, significant demographic differences were noted between the men who responded to the invitation versus those who did not; the latter group was composed of a greater proportion of men who were younger, nonwhite, and less educated. The most frequently cited reason (90 percent) why men wanted their test results was to determine if they had been infected with HIV. Of those who declined, 30 percent cited concerns about the psychological impact of learning about a positive result as being the most important factor for their decision. The two most frequently selected reasons for declining were the belief that the test is not predictive of the development of AIDS (48 percent) and concern about the worry that a positive result would produce (48 percent). These findings are discussed in the context of a nationwide, voluntary HIV screening program for gay and bisexual men.