AIDS Epidemic and Quarantining

AIDS Epidemic and Quarantining

AIDS (acquired immunodeficiency syndrome) has remained a global health issue since its emergence over three decades ago. This disease is caused by an enveloped retrovirus called the human immunodeficiency virus. Over 38 million people are currently living with the virus worldwide. The disease burden is greatest in Africa, with over two-thirds of active cases coming from the continent. Advancement in antiretroviral therapy has provided the much-needed relief in mortality rates, as evident in the reduction of mortality rates. In the wake of the AIDS epidemic, various public health provisions were invoked across many nationalities in an attempt to curb the spread of this disease and minimize mortalities attributable to this disease. The imposition of quarantine became apparent in some of these nationalities in the early phase of the epidemic (Fernando, 2018). This paper seeks to discuss the AIDS epidemic, highlighting the ethical concerns that were evident upon the invocation of various public health measures, benefits realized from this, relatable legislation and standards, as well as the medication and treatment options available to treat the disease. Do you need urgent assignment help ? Get in touch with us at eminencepapers.com. We endeavor to provide you with excellent service.

Quarantine impositions are a crucial public health provision targeted at curtailing the spread of diseases with a potential of outbreaks. The emergence of highly transmissible diseases has seen the invocation of such public health orders across many nationalities (Fang et al., 2020). Whereas the benefits of this public order are apparent and that significant establishment of control has been realized by the imposition of this public health order, questions still arise on the ethicality of this order (Spitale, 2020). The imposition of quarantines has been thought to constitute personal liberty diminution.

According to Upshur R., 2003, the framework to which quarantine should be imposed as a public health order should follow four provisions. The first provision is that the decision to quarantine should only be made if the benefits attributable to these freedom restrictions are indispensable to the harm incurred by individuals within the society as a result of these restrictions. Secondly, quarantine impositions should always be in the least coercive manner and not be done in a manner that produces public resentment. Thirdly, the decision to quarantine imposition should be transparent, drawing members of the public to whom these impositions directly affect. Lastly, there should be an element of reciprocity between the authorities and the people. The people’s role in this regard should be to be able to accept inconveniences attributable to the quarantine process.

Quarantining, however, does not, in some circumstances, meet some of these criteria as adopted by Upshur R. First, there has been evidence of the use of coercion and excess force during the implementation of these provisions. Additionally, reciprocity and transparency are not always apparent. The public is usually not informed of the impending move by governments to impose quarantine, and their input is, in most cases, not invited. Furthermore, during quarantine sessions, access to basic needs remains a challenge. All these surmount the suppression of human liberty and remain a critical ethical concern. However, the justification of quarantine impositions is often rooted in the moral public health obligation of ensuring no harm. Quarantines are always imposed upon a scientific establishment that the disease in question has the potential to cause harm to the general public.

During the AIDS epidemic, mixed reactions were elicited on the ethicality of quarantining and its effectiveness in containing the spread of the disease. Varied strategies were utilized across states within the U.S. and across many nationalities. There was also an apparent scientific gap in the effectiveness of quarantining in containing the spread of the disease (Bayer & Fairchild-Carrino, 2012). Another complexity that arose in quarantining during the AIDS epidemic was the criterion to be utilized in imposing quarantines since AIDS, unlike airborne diseases, is a behaviorally transmitted infection, and the target population for quarantine would be challenging to define. Moreover, quarantining in the AIDS epidemic was further complicated in the U.S. by the provisions of civil liberty defined in the Constitution (Giubilini et al., 2017). Due to a combination of all these and the realization of other cost-effective measures, these proposals were later dismissed in the U.S.

Quarantining has achieved considerable public benefits in the wake of disease outbreaks. Quarantine imposition has been effective in the protection and restoration of public health. According to Giubilini et al. (2017), the transmission of highly infectious diseases can be minimized by the implementation of a series of measures, such as early detection of the disease among the infected, contact tracing, and timely isolation and quarantine measures. This has been the case in various outbreaks and has been instrumental during the recent pandemics (Giubilini et al., 2017). The significance of quarantine and isolation is that they enable the termination of a chain of transmission that would have otherwise devastated the general public.

Quarantine also contributes to the enhancement of human and national security. Human and national security is dependent on an individual’s health and safety. Quarantine reinforces this by ensuring freedom from infectious diseases that would otherwise affect human health and ultimate human safety. Destabilization attributable to the emergence of infectious diseases has been evident in human suffering, socioeconomic instabilities, and consequential national insecurity. The impact is felt by governments, who experience losses due to economic disruptions resulting from these outbreaks (Giubilini et al., 2017). The results are usually seen in impoverished nations with minimal capabilities to promote the health of their people. Quarantine has not shown significant benefits in controlling the AIDS pandemic (Bayer & Fairchild-Carrino, 2012). Whereas this conclusion may be attributable to the initial unwillingness of most state governments to adopt it as a public health strategy, findings from states that rolled it out were not satisfactory.

Specific laws exist at the state and federal levels that regulate public health provisions of quarantine. The Commerce Clause of the U.S. Constitution accords the federal government with the authority to invoke quarantine regulation when the need arises. The constitution grants the Department of health and Human Services (HHS) to prevent the entry and spread of infectious diseases by ensuring the operationalization of quarantine stations at all ports of access into the U.S. Accordingly, the establishment of standards utilized in the examination of all persons destined to the U.S as well as to administer interstate quarantine regulations that oversee the movement of persons across states and quarantines anyone perceived as a public health risk.

Additionally, the law oversees the establishment and operationalization of the Center for Disease Control (CDC), which is targeted at the early detection of infectious diseases as well as the development of strategies utilized in combating these public health threats. The CDC is also tasked with the responsibility of communicating to the public in time on apparent public health threats and advising them on methods they can use to curtail these threats. The states also have containment regulations such as quarantine and isolation that are targeted at minimizing the spread of infectious diseases. States often work with the federal government to ensure containment of various public health threats.

Since its emergence, scientific research on AIDS has enabled a better understanding of the disease process, its etiology, symptoms as well as therapeutic approaches effective in its management. The development of highly effective antiretroviral therapies has enabled significant reductions in mortality rates. So far, several medications have been developed to combat the spread of the disease. These medications have been classified according to their mechanisms of action and include nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), Protease Inhibitors (P.I.s), Fusion Inhibitors, CCR5 antagonists, Integrase inhibitors, Post Fusion inhibitors, and Pharmacokinetic enhancers. Examples of drugs under NRTIs include emtricitabine, tenofovir, zidovudine, abacavir, and lamivudine. NNRTIs include nevirapine, efavirenz and etravirine. PIs include ritonavir, darunavir, dolutegravir, atazanavir, saquinavir and fosamprenavir. CCR5 antagonists include Maraviroc, Post Fusion Inhibitors include Ibalizumab, Fusion inhibitors include enfuvirtide, and pharmacokinetic enhancers include Cobicistat (Bhatti et al., 2016). All these drugs are FDA-approved for the management of HIV/AIDS.

Drugs utilized in AIDS effectively reduce the viral load in patients but do not completely eradicate the virus from the human body. Therefore, these drugs are used for a lifetime in patients with a positive diagnosis of HIV. Subsequently, these drugs are fairly tolerated in the body, but some side effects may be apparent in some individuals. These adverse reactions range from mild to severe and often warrant discontinuation or stoppage of the suspected drug. Hypersensitivity reactions, anemia, hepatic toxicity, hypertriglyceridemia, thrombocytopenia, pancreatitis, and peripheral neuropathy are some of the most common adverse drug reactions reported for various antiretroviral drug regimens.

Fixed-dose combinations of antiretrovirals have been developed to reduce the pill burden in patients on antiretroviral therapy. The establishment of FDCs greatly improved medication adherence and consequently enhanced the prognosis of patients with HIV/AIDS. Medications utilized in the management of HIV/AIDS have been used either for Post post-exposure prophylaxis (PEP) of HIV/AIDS, Preexposure of HIV/AIDS, or Highly Active Antiretroviral Therapy (HAART). PEP is requested after a possible exposure to the virus. This therapy is month-long and utilizes the conventional regimen used in active disease. Contrastingly, PrEP is requested for high-risk persons who are yet to be exposed to the virus, such as discordant couples and commercial sex workers, among others. Medication used in preexposure prophylaxis includes emtricitabine and tenofovir in a fixed-dose combination. PEP and PrEP are aimed at preventing the spread of the disease, while HAART is initiated in patients with a positive diagnosis of HIV/AIDS.

AIDS remains a global health concern three decades after its emergence. Public health strategies of quarantining and isolation have not conceived satisfactory results in the containment of this disease despite showing remarkable results in other conditions. Quarantine is a key public health provision that is targeted at curtailing the spread of an infectious disease. Quarantine has attracted several debates on the ethicality of its use as a public health measure to curtail the spread of the disease, with many arguing that it suppresses human liberty. However, quarantine impositions have always been done per ethical provisions. The AIDS epidemic clearly indicates that some public health provisions such as isolations and quarantine may not be applicable in minimizing the spread of some infectious diseases. Other cost-effective strategies such as public education can produce better results in curtailing the spread of some diseases. To date, a better understanding has been achieved on the disease. The development of highly effective antiretroviral drugs has significantly reduced mortality attributable to AIDS.

 References

Bayer, R., & Fairchild-Carrino, A. (2012). AIDS and the limits of control: public health orders, quarantine, and recalcitrant behavior. American Journal Of Public Health, 83(10), 1471-1476. https://doi.org/10.2105/ajph.83.10.1471

Bhatti, A., Usman, M., & Kandi, V. (2016). Current Scenario of HIV/AIDS, Treatment Options, and Major Challenges with Compliance to Antiretroviral Therapy. Cureus. https://doi.org/10.7759/cureus.515

Fang, Y., Nie, Y., & Penny, M. (2020). Transmission dynamics of the COVID‐19 outbreak and effectiveness of government interventions: A data‐driven analysis. Journal Of Medical Virology, 92(6), 645-659. https://doi.org/10.1002/jmv.25750

Fernando, D. (2018). The AIDS Pandemic: Searching for a Global Response. Journal Of The Association Of Nurses In AIDS Care, 29(5), 635-641. https://doi.org/10.1016/j.jana.2018.06.004

Giubilini, A., Douglas, T., Maslen, H., & Savulescu, J. (2017). Quarantine, isolation, and the duty of easy rescue in public health. Developing World Bioethics, 18(2), 182-189. https://doi.org/10.1111/dewb.12165

Spitale, G. (2020). COVID-19 and the ethics of quarantine: a lesson from the Eyam plague. Medicine, Health Care, And Philosophy, 23(4), 603-609. https://doi.org/10.1007/s11019-020-09971-2

Upshur R. (2003). The ethics of quarantine. The virtual mentor : VM, 5(11), virtualmentor.2003.5.11.msoc1-0311. https://doi.org/10.1001/virtualmentor.2003.5.11.msoc1-0311

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AIDS Epidemic and Quarantining

TOPIC
Thesis statement
Discuss the ethical concerns surrounding your topic. In addition, feel free to address any cases in the media.
Discuss the benefits (include important data and statistics) related to your topic.
Discussion laws, standards, and legislation (or lack thereof) related to your topic
Discuss Medications, treatments
Conclusion
APA Style in-text citations and references where appropriate