Treatment As Prevention Tasp And Governing Human Immunodeficiency Virus Hiv In British Columbia

In 2010, the government of British Columbia (B.C.) dedicated $48 million to stop the spread of HIV. The STOP HIV/AIDS pilot project promotes the uptake of HIV testing in the general population, and the use of antiretroviral therapy amongst those living with HIV/AIDS. This project operates with the rationale of 'treatment as prevention' (TasP), meaning that antiretroviral therapy is beneficial for the person living with HIV/AIDS, and has the secondary benefit of reducing the spread of HIV in the general population. Public health discourses are constructed via particular worldviews and involve the creation and delineation of societal problems. Undertaking a discourse analysis, I identify eight dominant discourses of TasP and STOP HIV/AIDS that include: provincial and international support for TasP and lack of federal leadership in HIV/AIDS; TasP, a 'paradigm shift' and a 'game changer;' TasP as beneficial to the individual and society; human rights and harm reduction; proof and certainty; failure of current prevention efforts; risk discourses; and, finally, universal treatment. I also identify five alternative discourses: holistic understanding/social determinants of health; stigma and discrimination; rights discourse: GIPA, informed consent and self-determination; coercion/criminalization and alternative risk discourse. Through a lens of governmentality, I explicate two overarching and simultaneous discursive strategies in realizing the objective of decreasing the spread of HIV in B.C. The first strategy acts on individuals living with HIV/AIDS, encouraging individuals to take up antiretroviral therapy. The second strategy acts on the general population, informing the population that HIV is a problem, and that treating people living with HIV/AIDS is the best way to protect society as a whole. There are various techniques within these two strategies. These discursive events have immense consequences for the uptake of health policies and programs by the public. The dominant and alternative discourses of TasP impact HIV policy and practice and specifically the individuals living with HIV and AIDS who are the subjects and targets of these initiatives.

This report represents the Interministry Committee's initial response to the British Columbia Framework for action on HIV/AIDS. It first expands on information & government actions described in the framework, reviews the current status of HIV and AIDS in the province, and discusses the role of the Committee, including its principles, goals, and objectives. It then presents an overview of existing HIV/AIDS-related policies & programs of various ministries & governments, including the federal government. The final section sets out future directions for HIV/AIDS-related policies & programs in British Columbia under the following broad headings: prevention & education; care, treatment, & support; research & training; and leadership & co-ordination of efforts. The appendix includes a list of goals & objectives under the Framework.

This document provides a framework for coordinated and cooperative action concerning HIV/AIDS in B.C. It focuses on education and prevention, treatment, and research. It also includes a provincial HIV/AIDS strategy work plan for 1991-92.

This document begins with an overview of the HIV epidemic in British Columbia and an outline of objectives & strategies of the province's response to this epidemic. Part 2 sets out the case for investment in HIV prevention & care and section 3 presents an epidemiological review of HIV & AIDS in British Columbia that shows how the single epidemic of the 1980s has become a series of epidemics affecting different groups of people. Part 4 reviews current HIV/AIDS initiatives & lessons from other jurisdictions, then presents a vision & guiding principles for the provincial HIV/AIDS strategy. Key strategies & objectives are listed under goals related to prevention, care, treatment & support, and co-ordination & co-operation, and the impact of the strategy on health care costs & on health programming is discussed. Part 5 outlines the roles & responsibilities of government, health authorities, & others in implementing the strategy. The final part lists indicators & data sources used to monitor progress in reaching the goals of the strategy. A glossary is appended.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.

One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

Much has happened since the first appearance of AIDS in 1981: it has been identified, studied, and occasionally denied. The virus has shifted host populations and spread globally. Medicine, the social sciences, and world governments have joined forces to combat and prevent the disease. And South Africa has emerged as ground zero for the pandemic. The editors of HIV/AIDS in South Africa 25 Years On present the South African crisis as a template for addressing the myriad issues surrounding the epidemic worldwide, as the book brings together a widely scattered body of literature, analyzes psychosocial and sexual aspects contributing to HIV transmission and prevention, and delves into complex intersections of race, gender, class, and politics. Including largely overlooked populations and issues (e.g., prisoners, persons with disabilities, stigma), as well as challenges shaping future research and policy, the contributors approach their topics with rare depth, meticulous research, carefully drawn conclusions, and profound compassion. Among the topics covered: The relationship between HIV and poverty, starting from the question, "Which is the determinant and which is the consequence?" Epidemiology of HIV among women and men: concepts of femininity and masculinity, and gender inequities as they affect HIV risk; gender-specific prevention and intervention strategies. The impact of AIDS on infants and young children: risk and protective factors; care of children by HIV-positive mothers; HIV-infected children. Current prevention and treatment projects, including local-level responses, community-based work, and VCT (voluntary counseling and testing) programs. New directions: promoting circumcision, vaccine trials, "positive prevention." South Africa’s history of AIDS denialism. The urgent lessons in this book apply both globally and locally, making HIV/AIDS in South Africa 25 Years On uniquely instructive and useful for professionals working in HIV/AIDS and global public health.

This book provides an overview of the current epidemiology of the HIV epidemic among young people in Eastern and Southern Africa (ESA) and examines the efforts to confront and reduce the high level of new HIV infections amongst young people. Taking a multi-dimensional approach to prevention, the contributors discuss the many challenges facing these efforts, in view of the slow progress in curbing the incidence of HIV amongst young people, focusing particularly on the structural and social drivers of HIV. Through an examination of these issues, chapters in this book provide valuable insights on how to mitigate HIV risk among young people and what can be regarded as the catalysts to mounting credible policy and programmatic responses required to achieve epidemic control in the region. The contributors draw on examples from a range of primary and secondary data sources to illustrate promising practices and challenges in HIV prevention, demonstrating links between conceptual approaches to prevention and lessons learnt from implementation projects in the region. Bringing together social scientists and public health experts who are actively engaged in finding effective solutions, the book discusses ‘which interventions works’, ‘why they work’, and the limitations and gaps in our knowledge to curb the pandemic amongst young people. As such it is an important read for researchers focusing on HIV/AIDS and public health. The Open Access version of this book, available at https://www.taylorfrancis.com/books/e/10.4324/9780429462818 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.