AIDS, like Pandora's box, has unleashed and focused issues upon our twentieth century society that have caused apprehension and anticipation. This text presents realistic approaches to the prevention of HIV infection by looking at health and behavior from an environmental perspective. The text demonstrates that health cannot be separated from the total environment if we are to be effective in planning for health and HIV prevention. The view of AIDS as simply a bio-medical problem is challenged, and individual responsibility for health is enlarged. Those making decisions about HIV prevention need to respond to and attempt to understand complex social and cultural issues like sexuality, drug use, and alternative lifestyles to be effective. The Environmental Contexts of AIDS begins with the history of AIDS, focusing on North America. Behavior change is viewed as essential, so precepts of health promotion and health belief models used to predict motivation and risk behavior are discussed. Particular environments are examined with chapters on the general public, homosexuals/bisexuals, drug users, adolescents/street youths, and women/minorities/special needs groups. Finally, the implications of an environmental perspective are reviewed. This book is essential reading for AIDS researchers, public health administrators and policymakers, health care practitioners, and sociologists.

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.

Cover -- Contents -- List of Figures -- Preface -- Acknowledgments -- Abbreviations -- Introduction: "No One Dies of AIDS"--1. Social Ecology of Health -- 2. HIV Lifeways -- 3. Historical Spaces and Contemporary Epidemics -- 4. Landscapes of HIV -- 5. Health Ecologies within Dynamic Systems -- 6. States of Health -- Notes -- References -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- R -- S -- T -- U -- V -- W -- Y -- Z

This wide-ranging volume reviews the experience and treatment of HIV/AIDS in rural America at the clinical, care system, community, and individual levels. Rural HIV-related phenomena are explored within healthcare contexts (physician shortages, treatment disparities) and the social environment (stigma, the opioid epidemic), and contrasted with urban frames of reference. Contributors present latest findings on HIV medications, best practices, and innovative opportunities for improving care and care settings, plus invaluable first-person perspective on the intersectionality of patient subpopulations. These chapters offer both seasoned and training practitioners a thorough grounding in the unique challenges of providing appropriate and effective services in the region. Featured topics include: Case study: Georgia’s rural vs. non-rural populations HIV medications: how they work and why they fail Pediatric/adolescent HIV: legal and ethical issues Our experience: HIV-positive African-American women in the Deep South Learning to age successfully with HIV Bringing important detail to an often-marginalized population, HIV/AIDS in Rural Communities will interest and inspire healthcare practitioners including physicians, nurse practitioners, physician assistants, pharmacists, case managers, psychologists, social workers, counselors, and family therapists, as well as educators, students, persons living with HIV, advocates, community leaders, and policymakers.

Europe's "Black Death" contributed to the rise of nation states, mercantile economies, and even the Reformation. Will the AIDS epidemic have similar dramatic effects on the social and political landscape of the twenty-first century? This readable volume looks at the impact of AIDS since its emergence and suggests its effects in the next decade, when a million or more Americans will likely die of the disease. The Social Impact of AIDS in the United States addresses some of the most sensitive and controversial issues in the public debate over AIDS. This landmark book explores how AIDS has affected fundamental policies and practices in our major institutions, examining: How America's major religious organizations have dealt with sometimes conflicting values: the imperative of care for the sick versus traditional views of homosexuality and drug use. Hotly debated public health measures, such as HIV antibody testing and screening, tracing of sexual contacts, and quarantine. The potential risk of HIV infection to and from health care workers. How AIDS activists have brought about major change in the way new drugs are brought to the marketplace. The impact of AIDS on community-based organizations, from volunteers caring for individuals to the highly political ACT-UP organization. Coping with HIV infection in prisons. Two case studies shed light on HIV and the family relationship. One reports on some efforts to gain legal recognition for nonmarital relationships, and the other examines foster care programs for newborns with the HIV virus. A case study of New York City details how selected institutions interact to give what may be a picture of AIDS in the future. This clear and comprehensive presentation will be of interest to anyone concerned about AIDS and its impact on the country: health professionals, sociologists, psychologists, advocates for at-risk populations, and interested individuals.

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.