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Viewing contemporary history from the perspective of the AIDS crisis, Jennifer Brier provides rich, new understandings of the United States' complex social and political trends in the post-1960s era. Brier describes how AIDS workers--in groups as disparate as the gay and lesbian press, AIDS service organizations, private philanthropies, and the State Department--influenced American politics, especially on issues such as gay and lesbian rights, reproductive health, racial justice, and health care policy, even in the face of the expansion of the New Right.Infectious Ideasplaces recent social, cultural, and political events in a new light, making an important contribution to our understanding of the United States at the end of the twentieth century.

The aftermath of Hurricane Katrina has placed a national spotlight on the shameful state of healthcare for America's poor. In the face of this highly publicized disaster, public health experts are more concerned than ever about persistent disparities that result from income and race.This book tells the story of one groundbreaking approach to medicine that attacks the problem by focusing on the wellness of whole neighborhoods. Since their creation during the 1960s, community health centers have served the needs of the poor in the tenements of New York, the colonias of Texas, the working class neighborhoods of Boston, and the dirt farms of the South. As products of the civil rights movement, the early centers provided not only primary and preventive care, but also social and environmental services, economic development, and empowerment.Bonnie Lefkowitz-herself a veteran of community health administration-explores the program's unlikely transformation from a small and beleaguered demonstration effort to a network of close to a thousand modern health care organizations serving nearly 15 million people. In a series of personal accounts and interviews with national leaders and dozens of health care workers, patients, and activists in five communities across the United States, she shows how health centers have endured despite cynicism and inertia, the vagaries of politics, and ongoing discrimination.

Preaching Prevention examines the controversial U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) initiative to abstain and be faithful as a primary prevention strategy in Africa. This ethnography of the born-again Christians who led the new anti-AIDS push in Uganda provides insight into both what it means for foreign governments to export approaches to care and treatment and the ways communities respond to and repurpose such projects. By examining born-again Christians support of Ugandas controversial 2009 Anti-Homosexuality Bill, the books final chapter explores the enduring tensions surrounding the message of personal accountability heralded by U.S. policy makers.Preaching Prevention is the first to examine the cultural reception of PEPFAR in Africa. Lydia Boyd asks, What are the consequences when individual responsibility and autonomy are valorized in public health initiatives and those values are at odds with the existing cultural context? Her book investigates the cultures of the U.S. and Ugandan evangelical communities and how the flow of U.S.-directed monies influenced Ugandan discourses about sexuality and personal agency. It is a pioneering examination of a global health policy whose legacies are still unfolding.

This commentary introduces a special section of AJPH on the Supplemental Nutrition Assistance Program (SNAP), the US government’s largest antihunger program and third-largest antipoverty program. SNAP demonstrably lifts adults, children, and families out of poverty, thereby constituting a vital component of this nation’s public health safety net. Despite its well-documented benefits, SNAP is under political and budgetary siege, mainly from congressional representatives and lobbying groups opposed to a federal role in welfare. In part, SNAP is protected from total annihilation by its unusual authorizing legislation—the Farm Bill. This commentary provides a brief overview of the political history of SNAP and its Farm Bill location as background to the deeper analyses provided in this series of articles.

Since the early days of the AIDS epidemic, many bizarre and dangerous hypotheses have been advanced to explain the origins of the disease. In this compelling book, Nicoli Nattrass explores the social and political factors prolonging the erroneous belief that the American government manufactured the human immunodeficiency virus (HIV) to be used as a biological weapon, as well as the myth's consequences for behavior, especially within African American and black South African communities. Contemporary AIDS denialism, the belief that HIV is harmless and that antiretroviral drugs are the true cause of AIDS, is a more insidious AIDS conspiracy theory. Advocates of this position make a \"conspiratorial move\" against HIV science by implying its methods cannot be trusted and that untested, alternative therapies are safer than antiretrovirals. These claims are genuinely life-threatening, as tragically demonstrated in South Africa when the delay of antiretroviral treatment resulted in nearly 333,000 AIDS deaths and 180,000 HIV infections -- a tragedy of stunning proportions. Nattrass identifies four symbolically powerful figures ensuring the lifespan of AIDS denialism: the hero scientist (dissident scientists who lend credibility to the movement); the cultropreneur (alternative therapists who exploit the conspiratorial move as a marketing mechanism); the living icon (individuals who claim to be living proof of AIDS denialism's legitimacy); and the praise-singer (journalists who broadcast movement messages to the public). Nattrass also describes how pro-science activists have fought back by deploying empirical evidence and political credibility to resist AIDS conspiracy theories, which is part of the crucial project to defend evidence-based medicine.

This essay reflects upon the last thirty-five years of public health law. Part One begins by discussing the growth and maturation of the field of public health law since the 1980s. Part Two examines current challenges facing public health law, focusing on those posed by the conservative legal movement and a judiciary that is increasingly skeptical of efforts to use law to improve health and mitigate health inequities. Part Three discusses potential responses to the increasingly perilous judicial climate, including thoughts that emerged from a convening held on the subject by the Act for Public Health Partnership in May 2024.

Indiana, a large rural state in the Midwestern United States, suffered the worst North American HIV outbreak among injection drug users in years. The Indiana state government under former Governor and current US Vice President Mike Pence fueled the HIV outbreak by prohibiting needle/syringe exchange and failed to take substantive action once the outbreak was identified. This failure in public health policy parallels the HIV epidemics driven by oppressive drug laws in current day Russia and is reminiscent of the anti-science AIDS denialism of 1999–2007 South Africa. The argument that Russian President Putin and former South African President Mbeki should be held accountable for their AIDS policies as crimes against humanity can be extended to Vice President Pence. Social and behavioral scientists have a responsibility to inform the public of HIV prevention realities and to advocate for evidence-based public health policies to prevent future outbreaks of HIV infection.

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, examiningHow 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.

Successful control of any dangerous epidemic requires: (i) early understanding of the epidemiology of the disease and (ii) rapid applications of preventive interventions. Through the lack of both policy and financial support, the United States Centers for Disease Control (CDC) was severely handicapped during the early years of the AIDS epidemic. Senior staff of the Reagan Administration did not understand the essential role of Government in disease prevention. Although CDC clearly documented the dangers of HIV and AIDS early in the epidemic, refusal by the White House to deliver prevention programs then certainly allowed HIV to become more widely seeded. As much of the international health community relies on CDC for up-to-date prevention advice, these actions by the White House surely increased the spread of HIV around the world. To respond better to future epidemics, we need to understand the deadly forces that inhibited CDC at that time.

The President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003, is widely recognized as one of the most ambitious and successful bilateral programs ever implemented to address a single disease. Part of the program's success is attributable to the participation of the private sector, working in partnership with the US and local governments and implementing organizations to maximize the reach and effectiveness of every dollar spent. We examined key public-private partnerships that grew out of PEPFAR to identify features that have made them effective. For example, PEPFAR's Supply Chain Management System took advantage of private industry's best practices in logistics, and a partnership with the medical technology company BD (Becton, Dickinson and Company) improved laboratory systems throughout sub-Saharan Africa. We found that setting ambitious goals, enlisting both global and local partners, cultivating a culture of collaboration, careful planning, continuous monitoring and evaluation, and measuring outcomes systematically led to the most effective programs. The Office of the US Global AIDS Coordinator and PEPFAR should continue to strengthen their capacity for private-sector partnerships, learning from a decade of experience and identifying new ways to make smart investments that will make the most efficient use of taxpayer resources, expand proven interventions more rapidly, and help ensure the sustainability of key programs. [PUBLICATION ABSTRACT]