Acquired Immune Deficiency Syndrome

Author:Jeffrey Lehman, Shirelle Phelps
 
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A disease caused by the human immunodeficiency virus (HIV) that produces disorders and infections that can lead to death.

Acquired immune deficiency syndrome (AIDS), a fatal disease that attacks the body's immune system making it unable to resist infection, is caused by the human immunodeficiency

What Causes AIDS?and What Does Not?

Since the first case was identified in 1981, acquired immune deficiency syndrome (AIDS) has grown into an epidemic that has taken approximately 500,000 lives in the United States alone. The Joint UNITED NATIONS Programme on HIV/AIDS estimates that at the end of 2002 there were 42 million people living with HIV/AIDS worldwide. During 2002, AIDS caused the deaths of an estimated 3.1 million people. At this time, women were increasingly affected by AIDS; it was estimated that women comprised approximately 50 percent or 19.2 million of the 38.6 million adults living with HIV or AIDS worldwide. No cure has been found, although existing treatment employing multiple drugs has made some gains in prolonging life and reducing pain. Despite the limits of medical science, however, much is known about the disease. It is caused by the human immunodeficiency virus (HIV). Transmitted by bodily fluids from person to person, HIV invades certain key blood cells that are needed to fight off infections. HIV replicates, spreads, and destroys these host cells. When the body's immune system becomes deficient, the person becomes AIDS-symptomatic, which means the person develops infections that the body can no longer ward off. Ultimately, a person with AIDS dies from diseases caused by other infections. The leading killer is a form of pneumonia.

Most of the fear surrounding AIDS has to do with its most common form of transmission: sexual behavior. The virus can be passed through any behavior that involves the exchange of blood, semen, or vaginal secretions. Anal intercourse is the highest-risk activity, but oral or vaginal intercourse is dangerous too. Thus, federal health authorities recommend using a condom?yet they caution that condoms are not 100 percent effective; condoms can leak, and they can break. Highly accurate HIV testing is widely available, and often advisable, since infected people can feel perfectly healthy. Although the virus can be contracted immediately upon exposure to it, symptoms of full-blown AIDS may take up to ten years to appear.

In addition to sexual behavior, only a few other means of HIV transmission exist. Sharing unsterilized needles used in drug injections is one way, owing to the exchange of blood on the needle, and thus intravenous drug users are an extremely high-risk group. Several cities have experimented with programs that offer free, clean needles. These programs have seen up to a 75 percent reduction in new HIV cases. Receipt of donations of blood, semen, organs, and other human tissue can also transmit HIV, although here, at least, screening methods have proved largely successful. Childbirth and breast feeding are also avenues of transmission, and thus children of HIV-positive mothers may be at risk.

The medical facts about HIV and AIDS are especially relevant to the law. Unless exposed in one of a few very specific ways, most people have nothing to fear. Casual contact with people who are infected is safe. Current medical knowledge is quite strong on this point: no one is known to have caught the virus by sitting next to, shaking the hand of, or breathing the same air as an infected person. For this reason, U.S. law has moved to protect the CIVIL RIGHTS of HIV-positive and AIDS-symptomatic persons. Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 (1994) prohibits discrimination against otherwise qualified disabled individuals, including individuals with a contagious disease or an infection such as HIV or AIDS. The AIDS quilt, on display in Washington, D.C., has become a well-known symbol of support for victims of AIDS and their families. Families and supporters of victims of AIDS create a panel to commemorate that person's life and that panel is joined with others from around the country to create the quilt.

FURTHER READINGS

Barnett, Tony, and Alan Whiteside. 2003. AIDS in the Twenty-First Century. New York: Palgrave Macmillan.

Farmer, Paul. 2003. Pathologies of Power: Health, Human Rights, and the New War on the Poor. Berkeley: Univ. of California Press.

CROSS-REFERENCES

Discrimination.

virus (HIV), which is communicable in some bodily fluids and transmitted primarily through sexual behavior and intravenous drug use.

READING, WRITING, AND AIDS

Teaching young people about AIDS is an enormously popular idea. Since the late 1980s, Gallup Polls have revealed that over 90 percent of respondents think public schools should do so. Agreement ends there, however. In the 1990s, more angry debate focused on AIDS education than on any issue facing schools since court-ordered busing in the 1970s. The core question of the debate is simple: What is the best way to equip students to protect themselves from this fatal disease? The answers may be miles apart. For one side, "equipping" means advocating the only sure means of protection, sexual and drug abstinence. For the other, it means supporting abstinence along with knowledge of sexual practices, the use of clean drug needles, and the use of prophylactics (condoms), which are distributed in some schools. Between these positions lie a great many issues of disagreement that have bitterly divided school districts, provoked lawsuits, and cost high-ranking Washington, D.C., officials their jobs.

Sex is an old battleground in public education. Liberals and conservatives argued over it in the decade following the sexual revolution of the 1960s, initially over whether sexual issues should be discussed in schools. After all, earlier generations who went to public schools learned mainly about reproductive organs. As new classes began appearing in the late 1970s, children learned about the sexual choices people make. If liberals appeared to win the "sex ed." debate, growing social problems helped: rises in teen pregnancies and sexually transmitted diseases secured a place for more explicit school health classes. The much greater threat of AIDS pushed state legislatures into action. By the mid-1990s, AIDS prevention classes had been mandated in at least 34 states and recommended in 14. But the appearance of even more explicit teaching has reinvigorated the sex ed. debate.

Supporters of a comprehensive approach say AIDS demands frankness. Originating in comprehensive sex ed. theory, their ideas also came from pacesetting health authorities such as former surgeon general C. EVERETT KOOP. Arguing in the mid-1980s that AIDS classes should be specific and detailed and taught as early as kindergarten, Koop countered conservative arguments by saying, "Those who say 'I don't want my child sexually educated' are hiding their heads in the sand." This position holds that educators are obligated to teach kids everything that can stop the spread of the disease. "What is the moral responsibility?" Jerald Newberry, a health coordinator of Virginia schools, asked the Washington Times in 1992. "I think it's gigantic." Abstinence is a part of this approach, but expecting teens to refrain from having sex was considered by many to be unrealistic given some studies that show that nearly three out of four high school students have had sex before graduation. Thus, the comprehensive curriculum might well include explaining the proper use of condoms, discussing homosexual practices, describing the sterilization of drug needles, and so on.

Abstinence-only adherents think being less frank is being more responsible. They view sexuality as a moral issue properly left for parents to discuss with their children and one that lies beyond the responsibilities of schools. The conservative columnist Cal Thomas spoke for this viewpoint when he argued that parents "have lost a significant right to rear their children according to their own moral standards." Other objections come from religious conservatives who oppose any neutral or positive discussion of homosexuality. Koop, for example, was blasted for allegedly "sponsoring homosexually oriented curricula" and "teaching buggery in the 3rd grade." In addition to voicing moral objections, critics say comprehensive sex ed. is generally a failure because it encourages a false sense of security among teens that leads to experimentation with sex or drugs. "We have given children more information presumably because we think it will change their behavior, and yet the behavior has gotten worse, not better," said Gary Bauer, president of the Family Research Council.

Each side accuses the other of deepening the crisis. Comprehensive approach supporters think abstinence-only backers are moral censors, indifferent to pragmatic solutions. The liberal People for the American Way attacked "a growing wave of CENSORSHIP ravaging sexuality education" that promotes only "narrow" curricula. It mocked such abstinence-only programs as Teen Aid and Sex Respect, both of which have brought threats of legal action from the AMERICAN CIVIL LIBERTIES UNION and Planned Parenthood. The conservative American Enterprise Institute asserted that liberal programs only prod students toward bad choices: "There has been a transition from protection to preparation." Neither side can agree on any data, other than to point out that the problems of AIDS and teen sexuality have appeared to worsen.

Nowhere are the two sides more split than on the issue of condoms. Schools in at least 23 cities sought to distribute condoms during the mid-to late-1990s. The assumption was that since students will have sex anyway?despite warnings not to?they had better be protected. Conservatives see this position as a cop-out in two ways: it sells values short and it undermines parental authority. In 1992, in Washington, D.C., critics erupted over a decision by the Public Health Commission to...

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