Fw: HIV epidemic needs social focus: medical journal article FWD

H. C. Covington (ach1@sprynet.com)
Sun, 7 Jun 1998 23:28:33 -0500


http://www.ama-assn.org:80/special/hiv/newsline/reuters/05222982.htm
FWD  Arch Fam Med 1998+ADs-7:214-217  Reuters Health Information

+ACI-It is a cruel irony that drugs and prostitution are cheaper and more
readily available to the homeless and the working poor of inner cities in
the United States than are shelter and medical treatment.+ACI- -- from article
below


HIV EPIDEMIC NEEDS SOCIAL FOCUS


WESTPORT, May 22 (Reuters) - Poverty plays a major role in the AIDS
epidemic, according to an article in the May/June issue of the Archives of
Family Medicine. The authors believe that efforts to control the AIDS
epidemic in the US and worldwide have been hindered by a failure to address
the social, cultural, and economic factors that contribute to the
transmission of HIV.

Drs. Arthur M. Fournier and Cynthia Carmichael of the University of Miami
School of Medicine in Miami Beach, Florida, believe that a +ACI-social
prevention+ACI- strategy is called for to focus on the socioeconomic influences
involved in HIV transmission. Some of these include +ACI-...the status of
women, prostitution, drug use in poor populations, the role of prisons,
economic factors that disrupt families, and cultural attitudes.+ACI-

Worldwide, a woman's risk of HIV infection is inversely correlated with her
economic status, they explain, and prostitution, which is also highly
correlated with drug use, is an economic survival strategy among the poor.
Other important factors in the HIV epidemic are political unrest, famine
and socioeconomic influences that disrupt family bonds.

+ACI-The intersecting epidemics of crack cocaine use and HIV infection among
the poor in the inner cities of the United States is one of the most
well-documented examples of the  relationship between socioeconomic factors
and the spread of HIV,+ACI- they continue. +ACI-It is a cruel irony that drugs and
prostitution are cheaper and more readily available to the homeless and the
working poor of inner cities in the United States than are shelter and
medical treatment.+ACI-

A +ACI-fresh approach+ACI- to the HIV epidemic is needed in the US that includes
the recognition of these socioeconomic facts. Not all of these social
prevention measures would be costly, Drs. Fournier and Carmichael add. Some
of these include implementation of +ACI-...education and legal and policy
changes to elevate the status of women+ADs- the decriminalization of
homosexuality+ADs- the end of discrimination against gays...and the promotion
of monogamous or oligamous homosexual and heterosexual relationships.+ACI-

The authors also stress the importance of the role of practicing physicians
in this process. Along with knowledge and skill, they believe that
physicians need to get involved in patient advocacy, political activities,
and community leadership.

Arch Fam Med 1998+ADs-7:214-217

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