HIV_AIDS

H I V / A I D S ???

And It Doesn't Stop ...

I suppose that at some point, someone will point out the cold hard facts of HIV and AIDS. Now is as good a time as any to, at least, get people thinking about options. Options is such a generic word, so let me clarify. Due to the deadly and contagious nature of AIDS, it must be controlled. So, in this context, the term 'options' refers to recognizing the extreme steps that may need to be taken to halt the spread of AIDS. Back to the discussion.

First, let's all be clear, HIV is deadly to the person infected, and, second, costly to the balance of society. Except for those people that constantly dream of the miracle cure, I'm sure that there aren't many people that will argue with the first point, so skipping to the second point, it becomes more of a question of recognizing and defining the costs. Cost can be broken down into the three primary categories, 1) medical, 2) emotional, and 3) infection exposure.

Before proceeding, please understand that I recognize that there are cases where the infection can go into remission thanks to the health, excercise and diet of the person infected, however, even in remission, the contagious nature of any disease is not eliminated. The issue is the spread of the disease and the cost of the disease in terms of the growing population of people infected. This is not a small problem in just the United States; this is a potential world wide disaster waiting to happen.

The discussion of the cost in terms of medical and emotion relates to the need to control the disease, nothing else. Today, we talk about polio and how the disease was stopped. I still have a scar on my arm from the inoculation. The disease was stopped by making everyone immune to the disease and, without victims, the disease died away. At other times in the past, when a particularly virulent strain of the measles was encountered, the response by the medical community was the quarantine of the infected people until the contagious period was passed. Yet, for some reason, the response to the AIDS epidemic was been more a lack of response. Perhaps this is due to the speed of the disease, measles would swoop into a community, infecting, immobilizing many and killing the young and infirm. The physical effects of polio were frightening to watch, whereas the effects of AIDS is a slow degeneration of the resistive efforts of the body until there is no turning back. I suppose that quarantine is out of the question, considering the two primary points, 1) there is the question of personal freedom, and, 2) there is no reason to believe that the contagious period ever passes.

Medical costs relate to the costs of:
     - drugs: drug purchase, drug deployment, drug development, drug scarcity, etc
     - medical oversight: nurses, doctors, technicians, monitoring, testing, etc
     - medical facilities: hospitals, beds, needles, etc
     - no, this list in not inclusive, but simply pointing out all of the things involved.
In addition to the utilization of these items, creating a scarcity, is the actual cost involved and who is paying the bill. Like so many things in this country, the cost is not paid by the person actually being cared for, two conditions occur: 1) insurance pays the bill (and insurance companies get the money for the bills from the people that pay for the insurance, you and me), or, 2) the cost is carried by the taxpayer. Yes, the taxpayer. This is due to the basic rule that no one can be denied medical attention, even if they can't pay for it. Indigent cases are handled by every hospital, some only on an emergency basis, some long term, but these cases are paid for by the taxpayers. No, I am not advocating that AIDS victims should not receive medical attention, this discussion relates to the spread not the existing cases.

Emotional costs relate to the effects of family, friends, co-workers, and everyone else that goes through the process of watching someone else die as a result of something that should have been controlled. Yes, I am of the opinion that this disease should have been controlled. By control, I don't mean cured, I refer to stopping the spread. There is no way to gauge the costs associated with the loss of someone due to AIDS, often times the final costs in terms of personal loss can never be identified, however, if you have ever had someone that you cared about die, regardless of the cause, then there is a general understanding of the frustration of the loss.

Lastly, is the cost of the virus spread. Once again, the costs can never be known without making some assumptions regarding how many people will become infected and die in the future, let's not go there. Instead, let's consider the options for halting the disease. First consider all of the conditions for the spread to occur. Generally, this is not an airborne infection or an infection that is caused by casual contact. In essence, we have eliminated the conditions for the common cold, so where does this come from? There are three basic sources of infections: 1) re-use of needles (i.e. entering the body directly into the blood stream), 2) use of contaminated blood, and 3) sexual intercourse with someone infected. Yes, of course there are other options but the above can provide a significant starting point.

Please bear in mind that the purpose of the program is to stop the spread, without regard to healing those people already infected, which may or may not happen in their lifetimes. Conditions one above can be dealt with by providing free needles, or the hardcase attitude, don't give them needles and let them die off. Anyone using a dirty needle may not contribute much to the gene pool anyway. Condition two requires additional testing on all levels by the blood distribution network and is probably underway at this time. The third condition relates to almost anyone, anywhere, however, this condition requires participation by the uninfected with the infected. The problem is the identification of the infected by the uninfected prior to the physical intimacy. The program is a national, perhaps later worldwide, identification program of anyone that is diagnosed with AIDS. In order to stop the spread, this identification must be permanently marked directly on the skin, i.e. a tattoo. Second, a national educational program would be implemented to inform potential participants what to look for and under what conditions to be cautious. Yes, I know this seems extreme, however, please consider that when someone knows they are infected and, without prior warning, engage in sexual intercourse with someone that is not infected, isn't this the same as criminal murder, i.e. engaging in an act which will result in the dealt of another. The program is simple: first, failure to permit the markings to be placed on the body is a crime, second, to know to be infected and not take the needed steps to complete the marking process is a crime, third, attempting to remove or removing markings without medical approval is a crime, fourth, all doctors, clinics and health insurance companies must report anyone diagnosed with AIDS, fifth, a nationwide clinic program is established to provide free tests for AIDS, and sixth, an educational program is developed to teach potential participants to search for the markings prior to any sexual intercourse. The marking would be standard symbol tattooed at a specific point of the body that could be hidden under most clothing, however, since sexual intercourse assumes a certain level of intimacy, the uncovering of the specific point of the body may not seem that invasive.

Yes, I know all the arguments about privacy, etc., yet which responsibility is greater, protecting the general public or protecting the individual. In addition, it's not like anyone would need to know if the infected person didn't have sexual intercourse once infected.