AIDS: Or What I Already Know and What I Hope to Learn

What do I currently know about AIDS?  Quite a lot actually as I came into this class pretty well informed on the subject.  Well, let the listing commence I guess:  I know that AIDS (Acquired Immune Deficiency Syndrome) is a virus that can be passed through sexual contact, between mother and infant through pregnancy and breast feeding, through tainted blood transfusions, and through IV drug users sharing needles.  You can't spread it though casual contract with infected people like hugging them, shaking their hand, or kissing.  I know that the virus infects white blood cells, killing them, and in turn destroying the immune system.  Thus, you can't actually die from AIDS, but from subsequent infections that can attack the body with a weakened or non-existent immune system.  I know there isn't a cure or a vaccine capable of preventing it.  I know the virus came from a mutation in a similar virus that affected chimps and that people who hunted chimps contracted it originally.  I didn't know that it was in the Congo.  Uh, I knew the disease really started popping up in American and Europe in the early 1980s though the virus existed earlier.  I know that AIDS can be fairly successfully kept from passing on through proper condom use.  South East Asia and Sub-Sahara Africa have the highest AIDS rates in the world.  I guess that about sums up what I know.  

I learned most of this on my own from casual conversations with people, some from sex education classes in middle and high school, from my parents and of course from the media.  Most of my knowledge about sexual matters comes and came from my friends and what I see on television and movies and such.  Luckily, I have a pretty good B.S. detector and can filter out the real information from the crap.  

I guess what I want to know about AIDS globally is what current measures are being used to halt its spread and how successful these methods are.  I know that countries are handing out free condoms and using education programs to help control the incidence of AIDS, but I'm curious to know how widespread these measure are, how available they are, how much it's costing to implement, and how successful these measures are in lowing the AIDS rates among the countries that use them.  

As far as surprising information that I have learned, I was surprised to learn how uniform the symptoms of AIDS were across so many different patients, as presented in the Frontline video.  I always thought that AIDS patients could basically get any disease due to their compromised immune system, but the video showed that most in the early 80s had Pneumocystis pneumonia and a rare form of skin cancer that only affected people with poor immune systems.  This was how doctors were able to diagnose AIDS early on and how they were able to discover the disease, by identifying the highly increased rates of the aforementioned diseases.  

Global Disparities in Money Distribution and its Effect on STDs

As I'm sitting here typing this blog on my computer, eating my bowl of generic brand Fruity Pebbles, and listening to the latest Radiohead album, pretty much the last thing going through my mind is that I could possibly die from an STD like AIDS or Syphilis.  This is most likely because I consider myself an asexual (read: virgin) (read: raging virgin), but also in a large part due to the fact that due to the culture in which I live, with easy and for the most part affordable access to health care, and my ability to pay for said health care, STDs just aren't that big of a worry for many Americans.  Sure there are more serious STDs like AIDS or Herpes which can be fatal and/or last your entire life, but we also have numerous prevention methods available to us as well.  However things are much different in the disadvantaged parts of the world.  

In the poorer parts of the world, particularly Sub-Saharan Africa and South East Asia, STDs run rampant.  Unlike us in America, the people in these places don't have access to cheap health care, or even much health care at all.  Furthermore, education about these diseases isn't widespread because disadvantaged countries can't afford it, so people are spreading them unknowingly and if they do get them, they can't do much about it.  Even STDs that are easily treatable and considered a mere nuisance in America, like chlamydia or gonorrhea, are considerable problems in poorer countries passing untreated from person to person and resulting in birth and fertility problems from prolonged exposure.  Even worse, with the lack of education, people in disadvantaged countries lack access to preventative measures like condoms.  So even if they knew about STDs, they couldn't do much about it, other than being totally abstinent, and we all know that isn't going to happen.  So, unless everyone in the third world becomes socially repressed nerds who spend all day playing Dungeons and Dragons, a lot of sex is going to happen and STDs are going to be spread.

Similar events happen in poor areas and disadvantaged population in wealth countries too.  In the Southern United States, particularly in poor Black communities.  Health care access may be suspect in these areas, or if available, the people there may not be able to afford it.  Large cities can act as breeding grounds for STDs.  Individuals may also lack education, or be mistrusting of the health care community for wrongs committed in the past (e.g. the Tuskegee study).  

In any case, problems with STDs stem from a lack of money and until money starts to flow into poorer areas, things aren't going to get much better for the foreseeable future.  

Extra, Extra: STDs in the Media!

Alrighty, after searching though many, many videos I settled upon the video for my discussion on STDs in the media: South Park Season 5 Episode 7: Proper Condom Use.  

(This video contains strong language and other TV-MA situations and very explicit imagery, so be forewarned)

http://www.southparkzone.com/episodes/507/Proper-Condom-Use.html

Anyway, I'm not trying to be overly vulgar or immature in my selection of this particular video for this assignment; I genuinely believe that some of views it presents are valid and given South Park's large teenage/twenty-something audience, its views are a reasonable topic for discussion.

M'kay, through a series of rather disturbing events involving some borderline bestiality, the boys of South Park are found to be lacking in sexual education and after their parents awkwardly try and fail to explain things they decide that the schools should be the ones to teach their children.  Some of the teachers are unhappy with the decision claiming the children are too young at age 8-9, but proceed anyway.  

The clueless teachers resort to scare tactics to indoctrinate the children to use condoms.  After the students express interest in learning sex ed, the teacher retorts, "Fun?  You think this will be fun?  Well let's start with our first lesson shall we?  'Sexually transmitted diseases.'  Because unless you get boys to use condoms you can, and WILL, get an STD from them! [...] Gonorrhea, chylamidia, syphilis, HPV, HIV, Hepatitis B, C, the list goes on.  You think that sex is about fun and games and love?  WRONG!  Sex is about disease!"  After putting the fear of sex into the girls, they get hysterical and avoid the boys at all cost because they boys aren't wearing condoms at all times.  The boys then set out to buy some "Spartan minis" condoms to keep themselves safe from HIV and "studzes" (STDs). 

Things rapidly get out of hand with sex ed soon being taught to the kindergardeners and the boys and girls of the 4th grade having a "Road Warrior" style battle at the end to kill one another and prevent being infected by STDs.  The parents show up and things cool down and the part of the show where everyone learns their lesson commences.  The children realize that STDs can only be contracted from sexual contact and the teachers admonish the parents for not teaching sex to their children themselves: "Sex isn't something that should be taught in text books and diagrams.  Sex is emotional and spiritual; it needs to be taught by family."  

The video does use false information and scare tactics, but uses them satirically to drive home the point that many school sexual education programs resort to scare tactics to cause teens to fear sex and prevent them from having it all together and that many teachers are sometimes not properly educated on the subject of STDs.  The video also used the Kindergardeners to point out that sex education should be taught at an appropriate age saying that kids should be allowed to be kids for a while.  

I generally agree with these points.  Like with what children watch on TV or play in their video games, the parents should be the people primarily responsible for monitoring their children and teaching them the sensitive subject of sex.  School sex ed programs, while they can be useful and present good material, are there for when the parents screw up and the state has to parent their children for them.  A teacher at school should not be the first place a child learns sexual education.  

The media plays a huge role in teaching kids about sex and STDs.  A lot of children will give almost unblinking devotion to the television and conversely, barely keep their eyes open at school.  The problem is that because much of television and movies are fiction, it is hard to get a straight answer on sexual issues.  Some programs might give the honest truth about STDs others may stigmatize them.  Ideally, you hope for the former, but that just isn't going to happen all of the time.  Teens need to be taught proper sexual education at an early enough age so they can make informed decisions.  

A Heartfelt if Somewhat Belated Apology

http://www.cdc.gov/tuskegee/clintonp.htm

For this week's blog we were assigned to read an article from the CDC which was a transcript of President Clinton's apology to the men of the Tuskegee syphilis study.  

For those of you who don't know (and if you're reading this you probably should by now) the Tuskegee syphilis study was an experiment carried out on Black men from Macon County, Georgia who were previously infected with syphilis.  Initially when the study began in 1932, the plan was to test 5 counties for syphilis, catalogue the symptoms and treat the disease with the methods available at the time, which were quite toxic and not completely effective.  However, the project ran into budgetary problems and was altered.  Instead of treating the men, which would be to expensive, researchers would follow the untreated patients around, observe the progress and symptoms of the disease and when "endpoint" had been reached, perform an autopsy.  Almost 400 Black men infected with syphilis became guinea pigs for the 40 years the experiment lasted.  They were purposefully denied treatment, even when an inexpensive and very effective one in the form of penicillin became available in the late 1940s.  Furthermore, the men were often subjected to painful tests, such as spinal taps,  to investigate the progression of the disease.   

However, most find the most horrific aspect of this experiment to be the profound lack of ethics and basic human rights; the men were not even informed of the experiment being performed on them or even that they had syphilis.  The doctors completely abused the trust of the patients and lied to them, their families, and their community.  The men were simply told they had "bad blood" and allowed to carry on their lives while the disease progressed and while they could pass on the disease to their spouses.  

In the end, 28 men died of syphilis, another 100 died of complications due to the disease and many passed it on to their wives.  The study was finally brought to a screeching halt in 1972 when a reporter leaked the story to the press and national outrage ensued.

Flash forward 26 years and here we have the apology by President Clinton (why did it take 26 years?  Who knows, but things like this shouldn't fall out of public view so quickly after they happen, particularly since their effects are still being felt.)  In his apology from the government, Clinton describes the project and the various grievances that occurred within.  He follows this with a promise to never let such a gross ethical violation occur again and describes a 5 point plan to help America achieve these goals.  Among them he lists strengthening cooperation with local communities to restore trust among African Americans, setting up grants at the Tuskegee school for bioethics programs, and extending the charter of the National Bioethics Advisory Commission to October of 1999.  

I felt that President Clinton's apology was sincere and really wanted to take steps to prevent this from ever happening again.  And while regulations on informed consent and human rights in medical experiments have certainly been improved since the Tuskegee experiment, a sense of mistrust remains among the Black community, even now 36 years after the experiment and 10 years after the apology was issued.  Clearly, more needs to be done to restore trust in the government to these people.

Perhaps now that President Obama has taken office, the African American community can start to place some trust again in their government with comfort that they will not be abused or mislead into any harm.  

Small Pox Bioterrorism And YOU!

Well, I suppose I should get the ball rolling on this blog and talk about the potential use of smallpox as a bio terrorism weapon.  

The podcast gives a brief history of the use of smallpox as a biological weapon when it was used by the British to kill Native Americans with whom they were battling for control of a fort.  They handed the Natives blankets previously used by smallpox victims and, lacking any immunity toward the disease, the Native Americans rapidly succumbed to smallpox and it spread amongst their tribe.  

(This was also the basis of an episode of the hilariously un-politically correct South Park in which Native Americans want to demolish South Park to build a highway to their casino and gave the residents blankets used by Chinese people with SARS after they refused to leave.  The outbreak was resolved when the characters learned the "white people cure" to SARS: Robitussin, Sprite, and Chicken Noodle Soup.)  

More relevant today was the mention that the Soviet Union had been building up vast stores of smallpox during the Cold War.  The idea was that they could put a bunch of dried smallpox, which they had cultured from chicken embryos, into a ballistic missile and fire it at a major U.S. city.  Even more concerning today is the fact that smallpox has been eradicated and vaccines are no longer produced in great quantity and administered.  If such a weapon was used it would likely be very effective as most people would lake immunity to smallpox having never been exposed before and because vaccines most likely could not be produced and administered in great enough quantities before many millions of people are infected and/or killed.  

However, this does make me question a few things.  I assume that since this was during the Cold War, that a smallpox ballistic missile would most likely be a political weapon than a really practical one.  Sure it could be used to hit a city and kill many of it's inhabitants, but like nuclear weapons, this is mainly a deterrent weapon to threaten your enemy with in order to keep the from hitting you first in fear of retaliation.  It just seems like nuclear weapons would do the trick just fine.  I guess that's why you never heard of a biological arms race.

Though since the collapse of the Soviet Union, the main role that a smallpox weapon takes is as an agent of terrorism.  Yeah, it could kill a bunch of people, but if it can also scare the hell out of people without being used, it's a pretty effective weapon.  

Similarly, anthrax could be used as a biological weapon as well.  Due to public heath efforts, anthrax has mostly been eradicated in the developed world and is fairly rare elsewhere.  Since it too is not a major concern of most health care professionals, large quantities of vaccine are not available.  In the event of an attack, most people would probably be vulnerable, unable to get vaccinated in time.  Luckily, treatments are available in the form of antibiotics, but they must be administered quickly.  Again, large quantities may not be available.  

The best course of action if you're really afraid of these weapons would probably be to get vaccinated, otherwise, just try to think happy thoughts.