HIV: The invisible epidemic of the United States healthcare system
TL;DR: It is argued that the HIV epidemic in the United States is considerably more widespread than is officially reported and theUnited States healthcare system provides an additional pressure that simultaneously discriminates against and ignores the very people it should be targeting most.
Abstract: We argue that the HIV epidemic in the United States is considerably more widespread than is officially reported. The occasional reports of outbreaks in cities like Washington DC, comparison with other countries in the developed world and our mathematical models, all point to the conclusion that the number of people living with HIV, but not AIDS, in the United States is more than four times larger than the current estimate. Although there are many reasons that HIV-positive individuals may not be aware of their serostatus, we argue that the United States healthcare system provides an additional pressure that simultaneously discriminates against and ignores the very people it should be targeting most.
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TL;DR: In this article, the authors studied perinatal and infant health service use by Mexican-American women and non-Hispanic white women and their infants enrolled in Arizona's Medicaid program and explored characteristics associated with use of health services.
Abstract: Objectives. —Lack of health insurance and a regular source of medical care are barriers affecting use of health services by Mexican Americans. We studied perinatal and infant health service use by Mexican-American women and non-Hispanic white women and their infants enrolled in Arizona's Medicaid program and explored characteristics associated with use of health services. Design. —A descriptive comparative study that used data collected from office records, birth certificates, and household interviews. Setting. —Participants resided in the state's most populous county and were enrolled in the Arizona Health Care Cost Containment System, a health maintenance organization—oriented Medicaid demonstration project. Subjects. —Random sample of 308 Mexican-American mother-infant dyads and 312 non-Hispanic white mother-infant dyads. The women were enrolled before the sixth month of pregnancy and for 60 days post partum; their infants were continuously enrolled throughout their first year. Outcome Measures. —Timing and number of prenatal visits and a modified Kessner Index, postpartum visits, number and purpose of office visits during the infants' first year, and immunizations received. Results. —Mexican Americans averaged fewer prenatal visits than non-Hispanic whites (8.6 vs 10.2 visits) and were less likely to have "adequate" care (41.1% vs 52.8%). Both groups of mothers are well below the 68% of women nationally who receive adequate prenatal care. Controlling for important socioeconomic status and cultural characteristics, ethnicity had a strong independent effect on the number of prenatal visits and adequacy of prenatal care. Mexican-American infants made fewer visits (8.2 vs 9.8) and completed fewer age-appropriate immunizations than non-Hispanic whites. Conclusions. —Health insurance and a regular source of care are insufficient conditions for ensuring adequate use of maternal and child health services by Mexican-American Medicaid enrollees. Factors associated with their less frequent use of these preventive health services include higher numbers of children, transportation problems, and less assistance from their support system. ( JAMA . 1994;272:297-304)
26 citations
TL;DR: Wang et al. as discussed by the authors analyzed the long-term trends of HIV/AIDS incidence by gender in China and the U.S. between 1994 and 2019, and observed an oscillating trend of the age-standardized incidence rate (ASIR) in China, and an increasing ASIR trend in the U.,S. population.
Abstract: Although the human immunodeficiency virus (HIV) caused one of the worst epidemics since the late 20th century, China and the U.S. has made substantial progress in tackling its HIV and AIDS epidemic. However, the trends of HIV and AIDS incidence remain unclear in both countries. Therefore, this study aimed to highlight the long-term trends of HIV/AIDS incidence by gender in China and the U.S. population. It may helpful to assess the impact/role of designed policies in control of HIV/AIDS incidence in both countries. The data were retrieved from the Global burden of disease (GBD) database. The age-period-cohort (APC) model and join-point regression analysis were employed to estimate the age-period-cohort effect and the average annual percentage change (AAPC) on HIV incidence. Between 1994 and 2019, we observed an oscillating trend of the age-standardized incidence rate (ASIR) in China and an increasing ASIR trend in the U.S. Despite the period effect in China declined for both genders after peaked in 2004, the age effect in China grew among the young (from 15-19 to 25-29) and the old age groups (from 65-69 to 75-79). Likewise, the cohort effect increased among those born in the early (from 1924-1928 to 1934-1938) and the latest birth groups (from 1979-1983 to 2004-2009). Whereas in the U.S., the age effect declined after it peaked in the 25-29 age group. People born in recent birth groups had a higher cohort effect than those born in early groups. In both countries, females were less infected by HIV than males. Therefore, besides effective strategies and awareness essential to protect the young age groups from HIV risk factors, the Chinese government should pay attention to the elderly who lacked family support and were exposed to HIV risk factors.
11 citations
01 Jan 2016
TL;DR: In this paper, the authors propose a solution to solve the problem of the problem: this paper ] of unstructured data, which is also referred to as data augmentation.
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8 citations
01 Jan 2014
TL;DR: Three biological applications showing the use of impulsive differential equations in real-world problems and the existence and uniqueness of T-periodic solutions are presented, and how stability changes when varying the immune response rate, the impulses and a certain nonlinear infection term are shown.
Abstract: Impulsive differential equations are useful for modelling certain biological events. We present three biological applications showing the use of impulsive differential equations in real-world problems. We also look at the effects of stability on a reduced two-dimensional impulsive HIV system. The first application is a system describing HIV induction-maintenance therapy, which shows how the solution to an impulsive system is used in order to find biological results (adherence, etc). A second application is an HIV system describing the interaction between T-cells, virus and drugs. Stability of the system is determined for a fixed drug level in three specific regions: low, intermediate and high drug levels. Numerical simulations show the effects of varying drug levels on the stability of a system by including an impulse. We reduce these two models to a two-dimensional impulsive model. We show analytically the existence and uniqueness of T-periodic solutions, and show how stability changes when varying the immune response rate, the impulses and a certain nonlinear infection term. The third application shows how seasonal changes can be incorporated into an impulsive differential system of Rift Valley Fever, and looks at how stability may differ when impulses are included. The analysis of impulsive differential systems is crucial in developing more realistic mathematical models for infectious diseases.
7 citations
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TL;DR: This paper explored the race and gender dimensions of violence against women of color and found that the experiences of women of colour are often the product of intersecting patterns of racism and sexism, and how these experiences tend not to be represented within the discourse of either feminism or antiracism.
Abstract: Over the last two decades, women have organized against the almost routine violence that shapes their lives. Drawing from the strength of shared experience, women have recognized that the political demands of millions speak more powerfully than the pleas of a few isolated voices. This politicization in turn has transformed the way we understand violence against women. For example, battering and rape, once seen as private (family matters) and aberrational (errant sexual aggression), are now largely recognized as part of a broad-scale system of domination that affects women as a class. This process of recognizing as social and systemic what was formerly perceived as isolated and individual has also characterized the identity politics of people of color and gays and lesbians, among others. For all these groups, identity-based politics has been a source of strength, community, and intellectual development. The embrace of identity politics, however, has been in tension with dominant conceptions of social justice. Race, gender, and other identity categories are most often treated in mainstream liberal discourse as vestiges of bias or domination-that is, as intrinsically negative frameworks in which social power works to exclude or marginalize those who are different. According to this understanding, our liberatory objective should be to empty such categories of any social significance. Yet implicit in certain strands of feminist and racial liberation movements, for example, is the view that the social power in delineating difference need not be the power of domination; it can instead be the source of political empowerment and social reconstruction. The problem with identity politics is not that it fails to transcend difference, as some critics charge, but rather the opposite- that it frequently conflates or ignores intra group differences. In the context of violence against women, this elision of difference is problematic, fundamentally because the violence that many women experience is often shaped by other dimensions of their identities, such as race and class. Moreover, ignoring differences within groups frequently contributes to tension among groups, another problem of identity politics that frustrates efforts to politicize violence against women. Feminist efforts to politicize experiences of women and antiracist efforts to politicize experiences of people of color' have frequently proceeded as though the issues and experiences they each detail occur on mutually exclusive terrains. Al-though racism and sexism readily intersect in the lives of real people, they seldom do in feminist and antiracist practices. And so, when the practices expound identity as "woman" or "person of color" as an either/or proposition, they relegate the identity of women of color to a location that resists telling. My objective here is to advance the telling of that location by exploring the race and gender dimensions of violence against women of color. Contemporary feminist and antiracist discourses have failed to consider the intersections of racism and patriarchy. Focusing on two dimensions of male violence against women-battering and rape-I consider how the experiences of women of color are frequently the product of intersecting patterns of racism and sexism, and how these experiences tend not to be represented within the discourse of either feminism or antiracism... Language: en
15,236 citations
"HIV: The invisible epidemic of the ..." refers background or result in this paper
...Understanding that many of these categories overlap is critical to determining the status of the epidemic (Crenshaw, 1991)....
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...…people who are poor, racialised or outside the heterosexual norm, then those satisfying more than one of these 88 r 2010 Macmillan Publishers Ltd. 1477-8211 Social Theory & Health Vol. 8, 1, 83–94 descriptions may have different outcomes than those who only fit one category (Crenshaw, 1991)....
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...The results are similar for the Hispanic population (Shapiro et al, 1999), some of whom are undocumented immigrants, with little access to health care or English-only services (Crenshaw, 1991)....
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...descriptions may have different outcomes than those who only fit one category (Crenshaw, 1991)....
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01 Jan 2005
TL;DR: The authors discusses structural intersectionality, the ways in which the location of women of color at the intersection of race and gender makes their real experience of domestic violence, rape, and remedial reform qualitatively different from that of white women.
Abstract: Contemporary feminist and antiracist discourses have failed to consider the intersections of racism and patriarchy. To overcome this difficulty, an original approach is suggested here: that of intersectionality. In the first part, the paper discusses structural intersectionality, the ways in which the location of women of color at the intersection of race and gender makes their real experience of domestic violence, rape, and remedial reform qualitatively different from that of white women. The focus is shifted in the second part to political intersectionality, with the analysis of how both feminist and antiracist politics have functioned in tandem to marginalize the issue of violence against women of color. Finally, the implications of the intersectional approach are addressed within the broader scope of contemporary identity politics.
11,901 citations
TL;DR: In many instances, instead of destabilizing the assumed categories and binaries of sexual identity, queer politics has served to reinforce simple dichotomies between heterosexual and everything "queer" as mentioned in this paper.
Abstract: In many instances, instead of destabilizing the assumed categories and binaries of sexual identity, queer politics has served to reinforce simple dichotomies between heterosexual and everything “queer.” An understanding of the ways in which power informs and constitutes privileged and marginalized subjects on both sides of this dichotomy has been left unexamined. Theorists and activists alike generally agree that it was in the early 1990s that we began to see, with any regularity, the use of the term “queer.” This term would come to denote not only an emerging politics, but also a new cohort of academics working in programs primarily in the humanities centered around social and cultural criticism. Only by recognizing the link between the ideological, social, political, and economic marginalization of punks, bulldaggers, and welfare queens can we begin to develop political analyses and political strategies effective in confronting the linked yet varied sites of power in this country.
1,178 citations
"HIV: The invisible epidemic of the ..." refers background in this paper
...…benefit in reducing the sharing of needles (Jaffe, 2004), and prison projects fought for awareness that the government was the same source of power in denying both wealthy gay men and incarcerated men’s and women’s access to drugs and conditions needed to combat HIV and AIDS (Cohen, 1997)....
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...Needle exchange programs proved to have a measurable benefit in reducing the sharing of needles (Jaffe, 2004), and prison projects fought for awareness that the government was the same source of power in denying both wealthy gay men and incarcerated men’s and women’s access to drugs and conditions needed to combat HIV and AIDS (Cohen, 1997)....
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...Organisations such as ACT UP formed coalitions that crossed boundaries of sexuality, race and income to challenge the dominant constructions of who deserved care (Cohen, 1997)....
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...ACT UP (AIDS coalition to unleash power) formed a coalition to fight US government inaction on AIDS, including needle exchange and prison projects (Cohen, 1997)....
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Book•
01 Jan 1997
1,020 citations
Journal Article•
752 citations
"HIV: The invisible epidemic of the ..." refers background in this paper
...…syphilis experiments in African American men or the court-ordered implanting of Norplant (an intravenous birth control method that can only be inserted and removed by doctors) in women on welfare has led to considerable distrust of the medical system by poor, racialised women (Roberts, 1997)....
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...Furthermore, the United States has a history of medical criminalisation of people on welfare, especially women with children, who have received negative attention as so-called ‘welfare mothers’ (Roberts, 1997)....
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...Policies of sterilisation of Puerto Ricans, Tuskegee syphilis experiments in African American men or the court-ordered implanting of Norplant (an intravenous birth control method that can only be inserted and removed by doctors) in women on welfare has led to considerable distrust of the medical system by poor, racialised women (Roberts, 1997)....
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...The infant death rate for African Americans in the United States exceeds that of Costa Rica, Cuba and Singapore as well as most industrialised countries (Roberts, 1997)....
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