Social Problem and Policy Analysis-History and Values: HIV/AIDS

Abstract

The advent of HIV/AIDS since the 1980s has caused a great torment to the people infected as well as those affected by the scourge. From its initial days in America, the virus spread faster because of lack of information about it as researchers began dissecting the mysteries that came with it. Fortunately, scientists were able to know the mode of transmission of the virus in the early 1980s. Progressively over time, the United States has been able to lay policy frameworks that have helped it to contact the disease to some degree. This paper discusses HIV/AIDS as a social problem and the Ryan White Act of 1990 as a policy framework aimed at curbing the scourge.

Section I

Origin

The virus that causes acquired immunodeficiency syndrome (AIDS) has been widely believed to have originated from two species of Chimpanzees called Pan troglodytes troglodytes that inhabit the equatorial forests of the Central African region (Gao et al., 1999). According to Centers for Disease Control and Prevention, CDC (2012), researchers have come to widely believe that simian immunodeficiency virus (SIV) could have been transmitted to human beings before it mutated into the HIV strain that is transmittable between human beings. Gao et al. (1999) added that out of the two types of HIV viruses, HIV-1 and HIV-2, that attack human beings, the origin of HIV-1 has largely remained mysterious. However, Gao et al. (1999) believed that research has sufficiently indicated that the HIV-1 strains that fall in category groups into M, N and O that attack the human population are closely linked to a strain of SIVcpz that is found in Pan troglodytes troglodytes species of chimpanzees found in Central Africa. It is thus believed that the SIV affected Pan troglodytes troglodytes and is the reservoir of HIV-1. It is also widely believed that the people who lived within the Central African region where the SIV carrying chimpanzees inhabit must have been wild game hunters who came into contact with infected blood of the chimpanzees, contracting SIV that mutated into a strain that became capable of destroying the human immune system over a certain duration of time.

In 1986, HIV-2 was identified to affect a section of the human population in West Africa who had developed AIDS, and CDC (2012) added that the virus shares similar modes of transmission as HIV-1. Those who had the HIV-2 virus also showed similar symptoms, although it was noted that their progress to a fully blown AIDS status was slower. CDC (2012) also indicated that those people with HIV-2 in the early phases of contraction showed less infection rates that progressively increased with a lengthening stay of the virus in the body. The prevalence of HIV-2 infection is more than 1 percent in many counties in West Africa. The CDC (2012) added that the first case of a reported HIV-2 infection in the US was done in 1987. The earliest time that scientists believe to have marked the transmission of SIV to human beings is between 1940 to 1950 within the Congo region in Central Africa according to CNN report (1998).

HIV Awareness/Education/Risk Factors

            With the first case of HIV infection being reported, the Heath Resources and Service Administration (HRSA) (n.d.) indicated that the flagship response funds to curtail the problem were initiated in 1986 in the US. Cities like New York, San Francisco, Los Angeles and Miami that were recording the highest numbers of HIV cases at the time benefited from the $ 15.3 million that were made available to combat the scourge at the time (HRSA, n.d.). The advent of HIV in the US, especially in San Francisco that was one of the regions with a high prevalence rate, saw an emergence of activist groups that probably became one of the earliest community response strategies. HRSA (n.d.) noted that San Francisco’s case management models that popularly became known as the San Francisco Model was replicated by other community based groups that became involved with HIV/AIDS management in the US in 1986.

Prerequisite management skills became a necessary tool in ensuring efficiency and optimal utilization of funds that were to be provided by the HRSA AIDS grants. HRSA (n.d.) noted that the Robert Wood Johnson Foundation (RWJF) became a force to reckon with in the fight against the pandemic between 1986 and 1990 when it gave out up to $ 17.2 million in grants to various communities across the nation to emulate the San Francisco Model. HRSA’s involvement in the fight against HIV/AIDS in the US laid the ground work from successive programs including that of the Ryan White Care Act of 1990 (HRSA, n.d.).

In 1988, HRSA started launching awareness programs that espoused on the risks factors that involved prenatal transmission that led to the creation of Demonstrations Grants that were targeted to taking care of children and their families (HRSA, n.d.). The exponential rate at which HIV/AIDS infected many people around the world has forced many stakeholders who are involved in the fight against it to adopt educational measures in fighting HIV/AIDS. According to World Aids Day Report (2011), up to 34 million people around the world have been infected with HIV/AIDS, with each year seeing new infections that is estimated at a million people. Educational programs on HIV/AIDS have been continuously carried out with the aim of ensuring that chances of new infections are prevented. Many of the scourge’s educational content espouse on giving people appropriate level of information to curtail the problem of stigma and other forms of discrimination that have largely affected those who have been infected with the disease worldwide. According to World Bank (1999), educational programs have been focused on the general populations as well as the people at risks groups in order in a variety of settings to ensure that each and everyone in the society is reached with the appropriate level of information.

Ronald Reagan Administration and HIV/AIDS

            Ronald Reagan’s administration came to face HIV/AIDS in its formative years as it took toll within sections of the American population. His administration did little in steering on a path towards research, educational programs and the general preventive and the general treatment measures towards the pandemic in the country (Stolley & Glass, 2009). The popular press and the medical fraternity took a keen interest in discussing HIV/AIDS since 1981 in America, but the former president took another six years to go public on the scourge. Nonetheless, political capitulation at the time and the position of the reactionary religious groups in the US who held to the belief that HIV/AIDS was a punishment from God to those who exhibited homosexuality could have prevented the president from commenting on the scourge (Lee, Kochman, & Sikkema, 2002). Coincidentally, Reagan and his administration compatriots limited the funds that were availed to the CDC to conduct research on the pandemic that was increasing in the number of new infections and death toll as well. The gay communities that were particularly at risk of contracting and spreading the disease faced discrimination from the administration that was held in its Christian views that homosexuality was an outright sin and deserved no intervention.

Bush Administration and HIV/AIDS

            Former President George W. Bush staged relentless efforts at fighting the scourge by amassing support from the Congress as well as giving out funds to combat the scourge across the world. In 2003, the president created an international HIV/AIDS fund called President’s Emergency Plan for AIDS Relief (PEPFAR). The initiative was predominantly intended to commit up to $ 15 billion annually in fighting HIV/AIDS across the sub-Saharan Africa and in the Caribbean region (Denny & Emmanuel, 2008).

Some of the flagship intervention programs that the funds were intended for included; prevention of new infections that were projected to hit up to about 7 million people which would account for 60 percent of the new cases of HIV/AIDS infections in countries affected. Through the funds, the president had also intended to avail antiretroviral drugs to those infected but could not afford the drugs during the time. Part of the money was also targeted at helping those children who have been orphaned because of HIV/AIDS. Part of the funds was also aimed at fighting other diseases like Tuberculosis and Malaria. The administration of the funds was to be undertaken at the Department of State level where a new office of a coordinator was to be established to verse the programs implementation (Denny & Emmanuel, 2008).

Section II

HIV; first known as GRID (Gay – Related Immune Deficiency)

            In the first instances of HIV/AIDS related cases between 1980 and 1981, groups of gay men were reported to show rare cases of Kaposi Sarcoma, a very rare cancer with a low statistics of 20 of such cases from New York and another six cases from California (AVERT, n.d.). In 1981, there were rare cases of Pneumocystis Carinii, a type of pneumonia that is considered to be very rare being recorded in the US. Unfortunately, the rare Kaposi Sarcoma cases that according to the Institute for Human Virology (n.d.) had only been recorded in three instances between 1961 and 1979 were found in homosexual men leading to the early conceptualization of HIV/AIDS as a Gay-Related Immune Deficiency (GRID). This conceptualization viewed the disease as a men only disease since the first instances had only been recorded in the gay men folk in the US.

The earlier position taken on the epidemic changed as a result of the spread of the disease in a non-discriminatory manner, hence being renamed as Acquired Immune Deficiency Syndrome (AIDS). In 1982, it was reported by the Institute for Human Virology (n.d.) that up to 452 cases of HIV/AIDS had been reported across the US, a confirmation that as early as before the 1980s a number of people had contracted the virus that causes AIDS. In the same year, a barely one year old baby who had been reported to have received blood through transfusion succumbed to symptoms that were related to those who had full blown AIDS. The incidence, according to Mortality and Morbidly Report (2001), made a clear case that HIV could be transmitted through multiple ways including unprotected sex with an infected person, mother to child transmission through breastfeeding and blood transfusion. In 1985, Dr. Robert Redfield made a discovery through research that men in gay relations were at the greatest risk of contracting the virus (Institute for Human Virology, n.d.).

HIV/AIDS was originally thought to affect people in the lower income groups, predominantly in the inner city settings. People who exhibited social defiance in their demeanor were esteemed to be particularly at risk of contracting the disease. Some of these groups included: prostitutes, minority groups in the US, IVDU and children of parents hooked on drug abuse and prostitutes. According to Centers for Disease Control, CDC (2012), HIV has disproportionately affected a certain segment of the general population, especially men who have sex with other men (MSM), minority groups of the Latino and African American populations. In 2009 alone, CDC (2012) indicated that up to 61 percent of the new infections in the US were accounted for by MSM while heterosexuals accounted for 27 percent of such infections, and the Injection Drug Users (IDUs) accounted for 9 percent of the new infections and MSM who use IDU accounted for 3 percent. It therefore becomes imperative to note that it is not a farce that the IVDU, MSM, MSM/IDU, heterosexuals and other at risks groups carry the heaviest toll of new HIV/AIDS infections in the US today (Shutton, 2009). The CDC (2012) also reported that the period between 2006 and 2009 saw a steady ascent of the rate of HIV/AIDS infection among the black Americans at a rate of 12.2 percent annually.

In the US, it is not fictitious but an accepted fact based on research findings that some of the minority groups have been adversely affected by the HIV/AIDS scourge. For example, the CDC (2012) indicated that African Americans have accounted for the highest rate of new infections. While their population is estimated to represent about 14 percent of the general US population, the CDC (2012) indicated that the Black community has accounted for an overall 44 percent of the total US population that is affected by the disease by the year 2009. The organization further indicated that Black men posted the highest chance of contracting the virus at six times more likely to contract the virus than white men (CDC, 2012, para 7-8). Elsewhere, CDC (2012) indicated that apart from minority men being at a higher risk of HIV infection, all men, disregarding race and those who fall within the sub categories of MSM, MSM/IDU, the IVDUs and prostitutes, are at increased risk of contracting the disease as compared to the general population.

Lee et al. (2002) argued that being infected or affected by HIV/AIDS predisposes one to stigma from the society as well as internalized stigma from the victim himself or herself. According to Lee et al. (2002), the level of stigma that people with HIV/AIDS face in the US is not severe as it used to be a few decades back. However, Lee et al. (2002) noted that there are still persistent and in fact numerous sources of stigma that face people with HIV/AIDS. The three conducted research has a population sample of 268 people drawn from Milwaukee and Madison, Wisconsin and New York.

Lee et al. (2002) revealed that majority of the newly infected part of the sample population experienced internalized stigma. Some of the internalized stigma that the newly diagnosed people presented includes: finding it hard to accept their condition, inability or slow response to joining HIV support groups, they also suffer the anxiety of spreading the virus to other people. In certain cases, newly diagnosed cases of HIV/AIDS suffered from rejection from their families.

Stigma from the external environment includes social exclusion by the family, friends and workmates in certain cases. Lee et al. (2002) revealed that the HIV mode of transmission greatly contributes to the stigma that the infected faces. Some people believe that those who have gotten HIV/AIDS through promiscuity, prostitution, IDU or MSM have only gotten what they deserve. In such people’s view, HIV/AIDS is presumed as a befitting price for social defiance. The highly transmittable nature and high fatality of HIV/AIDS has also been touted as a contributing factor to its stigmatization (Lee et al., 2002). They also believe that those people who take care of the HIV/AIDS victims are also not immune from developing stigma towards those people who have been infected with the scourge (2002, p. 309).

Section III

A.) Ideologies and Perception on HIV/AIDS

Since the first reported case of HIV/AIDS in America in the 1980s, different historical timelines have seen the society developing different opinions and attitudes towards HIV/AIDS. As a matter of avoiding over generalization on the general society, it would be important to note that they have been divided by opinions on the issue of HIV/AIDS, particularly in the US.

In the 1980s, a majority of people including the medical practitioners believed that the disease was only attacking men who were practicing homosexuality, as the disease’s opportunistic infections like Kaposi Sarcoma were exhibited by men only (AVERT, n.d. ). Very little knowledge had come into existence and some of the affected people continued to donate blood that was transfused to Haemophiliacs who contracted the disease. In general, the early years of the scourge were marked with confusion and general ignorance that led to new infections, including those who got infected through the use of contaminated blood in the hospitals.

Scientific researches in the early 1980s revealed that the virus could be transmitted through contaminated blood during transfusion, contact with the body fluids of an infected person during sex and mother to child transmission (AVERT, n.d.). In 1985, researchers also revealed that men who are having sex with other men had very high risks of contracting and spreading the virus.

The 1980s also marked a period when communities mounted a series of response mechanisms that include educating the infected and the affected on modalities of the disease management. The efforts, according to National Strategy for HIV/AIDS (2010), included mobilizing efforts of the governmental sector, faith based organizations, health industry and the medical experts to come up with comprehensive anti HIV/AIDS strategies in the US. The document further noted that the rate of new infections by the turn of the millennium had dropped to a half way mark (2000, p. 5).

From the 1990s, the US became prohibitive to immigrants who were HIV positive. The American Congress created tough immigration rules that would automatically lead to the deportation of any immigrant found importing HIV/AIDS drugs into the country. In addition, the government started encouraging thorough screening of blood before transfusion. The American government also started active funding of researches aimed at the creation of antiretroviral drugs from the 1990s. Mother to child transmission was greatly reduced through the government sponsored researches that demonstrated that expectant mothers who used antiretroviral drugs had reduced chances of infecting their babies (National Strategy for HIVAIDS, 2010). HRSA (n.d.) noted that between 1991 and 1995, the Comprehensive AIDS Resources Emergency Act passed in the 1990 reenergized the efforts of the stakeholders in the fight against HIV/AIDS; it availed grants that were directed at helping the communities that were affected and those infected with the disease to obtain medication and other essential services.

Intensive educational programs and the availability of drugs to curb the severity and the high rate of progression to AIDS phase has greatly contributed to a reduction in the overall national rate of HIV/AIDS contraction. National Strategy for HIV/AIDS (2010) noted that at present, about 21 percent of those living with HIV/AIDS still do not know their status despite majority knowing their status. Because of the advances that have been made in the treatment and management of the disease, many people in the US no longer look at the scourge as a matter of public health concern (National Strategy for HIV/AIDS, 2010). In the year 2000, the CARE Act was also being reviewed to expand its roles in maximizing uncharted avenues that would ensure that the current intervention programs then were effective in reaching out to everybody with HIV/AIDS who needed the services (HRSA, n.d.).

Despite the milestones that governments have made in curbing the problem of persistent problems of cultural practices, like lack of education and awareness and risky behaviors like promiscuity, the use of IDU has continued to pose hurdles in the fight against the scourge. National Strategy for HIV/AIDS (2010) indicated that in the US, unlike other parts of the world more so in parts of Asia and in the Sub-Saharan Africa, HIV/AIDS remain concentrated within specific locations and certain groups within the wider American society.

The gay community of men in America is estimated at 2 percent of the total male population; they particularly remain one of the most vulnerable populations that need a lot of focus by the ant-HIV/AIDS programs (National Strategy for HIV/AIDS, 2010). Estrine et al. (2011) argued that a significant number of young females among the people of color exhibit a higher tendency of participating in HIV predisposing sexual activities that include coerced sex, sharing sex toys, having sex while under the influence. Part of the reason as to why HIV could be affecting minorities at a higher rate is the problem of poverty that Parker (2002) argued to be an accelerating factor. Additionally, Estrine et al. (2011) stated that the predominant attitude by the society towards homosexuality has potentially exposed many of the gay and lesbian communities to the danger of contracting HIV/AIDS. National Strategy for HIV/AIDS (2010) further indicated that the general commitment to address the problem of the gay community has been far from adequate. Fortunately, concerted efforts by the federal governments and other key stakeholders had led to the creation of effective antiretroviral drugs that can be used in the treatment of those with HIV/AIDS, helping to prolong their lives. HIV/AIDS has thus been transformed from a terminal illness at the beginning to a chronic illness that can be managed (Lee et al., 2002).

B.) Roles of Social Workers

The role of social workers on dealing with the HIV/AIDS has evolved with time since the emergence of the disease. In the 1980s, when HRSA first released the grant funds to fight HIV/AIDS, community based organizations in places like San Francisco had already established advocacy programs that later came to be adopted elsewhere in the US (HRSA, n.d.).

            As new findings about the disease became known through progressive researches in America and elsewhere, social workers incorporated educational and awareness creation programs in their work as well. Through advocacy, social workers focusing on the fight against HIV/AIDS have been able to mobilize resources from different stakeholders in America to fight the scourge. As advocates for common good of vulnerable populations, several of such professionals have fought for the redressing of the plight of the HIV/AIDS’ vulnerable population in America. In HIV grant funds management strategies, San Francisco community based anti-HIV/AIDS programs became one model that was used in educating grantees in financial resources management to curb AIDS (HRSA, n.d.). Chadron State College (n.d.) noted that part of the social worker’s work is to help in educating communities that they serve on resource mobilization and budgeting with the available resources. They also liaise with other stakeholders in concreting efforts to realize similar objectives and in this case, seeing to it that HIV/AIDS does not devastate human populations across the world in utmost severity.

Roles of Social Workers in the 1980s. The period was marked with a general confusion about the disease and the resources to use in the fight against it were still scanty. The main engagement of the social workers at the times was to provide emotional support to those who could get bereaved because of the scourge. There was also a general lack of enough information that could be used in educating people about the disease.

1990s. Social workers had an increasing volume of new information that they used in teaching individuals and families of both the infected and the affected. They engaged communities through advocacy campaigns to effect social changes to avert the exponential rate of infection then. The period also saw an increased growth in the number of grantees that utilized the HRSA AIDS funds to help people at the grass root level (HRSA, n.d.). Social workers around the time continued with the emotional support programs but incorporated educational and awareness creation programs in their work.

2000. During this time, HIV/AIDS had transformed from being a terminal disease to a chronic illness that could be managed through proper medical care and practices. Social workers from the time have been engaged in a collaborative work with other stakeholders to ensure that those living with the disease have access to proper medical cover and housing. They have also worked with HIV/AIDS patients by directing them to local Community Based Organizations (CBO) where they can obtain help. They have also maintained their advocacy work in redressing the plight of vulnerable populations like the gay community in the US as well as continued funding to CBOs that work in addressing service and other needs of the HIV/AIDS infected and affected populations across America (HRSA, n.d.).

Section IV

The major policy that addresses the problem of HIV/AIDS in the US is called the Ryan White Act that came into existence in 1990. The passage of the Ryan White CARE (Comprehensive AIDS Resources Emergency) Act came into force. Ryan, whom the Act is named after, passed on in April 1990 after courageously battling HIV/AIDS after being diagnosed with the disease in 1984 (HRSA, n.d.). The Act has been reauthorized to respond to the dynamic nature of the problem that it was envisioned to fight but has not steered off its main objective of addressing the issue of HIV/AIDS.

The Ryan White Care Act is used across cities, states and within the local CBOs in provision of HIV/AIDS related services. HRSA (n.d.) noted that the program has helped to advance needed service to an estimated one million people annually in the US. The Act is one of the unique healthcare laws in the US because it focuses on a single area of HIV/AIDS by helping to make up for the inadequacies that the other healthcare laws have not taken care of in respect to HIV/AIDS.

The basic primary healthcare needs of those living with HIV but cannot afford the health services required for them are covered by the Act. A small part of the funds under this Act are used to facilitate training as well as in offering technical assistance and financing researches aimed at coming up with the best models of care delivery (HRSA, n.d.).

In regards to the dynamic nature of the disease and the merging different levels of vulnerabilities as well as unique health service needs by deferent population subsets; several programs were created out of the Act to respond to such needs. The different programs that were initiated under the Act became known as five parts, they include:

Part A: Under this part, metropolitan areas that are identified and meet the qualification criterion for being the worst affected with HIV/AIDS are provided with emergency assistance.

Part B: All 50 states are provided with funds including other regions such as: Puerto Rico, Guam, District of Colombia, U.S Virgin Island and the pacific islands under the jurisdiction of the US.

Part C: Extends primary care to those HIV/AIDS patients who are receiving such care services from outpatient clinics.

Part D: Ambulatory care as well as outpatient services are provided to families that have HIV/AIDS patients that include children and infants, youths and women.

Part E: This is an umbrella fund that can cover other programs under the act.

Apart from the five program areas, the Ryan White Care Act also supports researches aimed at coming up with innovative care and service delivery models that can even facilitate the programs further. It also provides funds to be used in training healthcare professionals to be involved in delivering healthcare services to the HIV/AIDS patients. The Act also supports oral healthcare programs for those people with HIV/AIDS. The Act also provides funding to tackling the disproportionate that the disease has on the minority groups in America. At present, the Ryan White Act is funded to a tune of up to $ 2.1 billion annually. The funds are channels to local agencies that work in one or more programs (HRSA, n.d.).

The ideology behind the Ryan White Act of 1990 was an act of honor bestowed upon the late Ryan White, whose desire to go to school at a time when not many people could dare go public with their status was a source of inspiration that would continue with the mission of the program. The fundamental value exposed in the enactment of this Act is that as a nation, concerted efforts in curbing the problem of HIV/AIDS was more valuable than holding on to prejudices that could not help America move forward (HRSA, n.d.).

Section V

            According to HRSA (n.d.), some of the objectives of the policy were to help people with HIV/AIDS who could not afford the drugs and other services to get such services. The Ryan White Act was an ideology that everyone suffering from HIV/AIDS was entitled to treatment irrespective of race or sexual orientation.

The programs provided under this policy include: provision of emergency funds to metropolitan regions that are deemed to be most affected, provision of funds to local CBOs operating in different states to facilitate provision of services, and extension of services to outpatients as well as at home through the ambulatory services. The policy also provides funds for cross discipline education to those who are engaged in delivering services to people living with the virus. The Ryan White Act id is administered through the Department of Health and Human Services (HHS), HRSA, and HIV/AIDS Bureau (HAB). HRSA (n.d.) noted that the federal government delivers its financial aid to local agencies that work on one or more programs under the Act.

The federal government is the main source of funding to the policy and during the Bush administration, the government tried expanding services to everyone having HIV/AIDS but it has not been easy to meet the target (Greenwald & Killelea, 2011). They added that up to 30 percent of the people who are currently living with HIV/AIDS are not insured and therefore, another 59 percent does not receive regular care because of the disability requirement that most Medicaid requires in order for one to benefit. By 2014, as noted by Greenwald and Killelea (2011), many people with HIV/AIDS with low income will afford Medicaid covers as well as the minimum basic cover that is required in all the health plans. The Patient Protection and Affordable Care Act passed in 2010 is poised to remove public and private insurance that has kept most HIV/AIDS patients from buying such policies in order to get services at cheaper costs. Adapting the Ryan White Act into new health insurance policies is inevitable if the government is to achieve the shift to quality preventive care that it looks forward to (Greenwald & Killelea, 2011).

Section VI

            The Ryan White Act has enabled many people who could not afford the high cost HIV/AIDS drugs to get them, hence improving the quality of their lives. Second, it has enabled most vulnerable populations in the metropolitan areas to get access to HIV/AIDS services that they need. The support of research to improve on the quality of care by training care givers also helps in ensuing that the patients are given quality care (Rani, Katz, Min-Sun, & Jan, 1997).

On the contrary, there are number of negative outcomes of the policy. Greenwald and Killelea (2011) noted that the number of people who need the Ryan White Act’s services could be outweighing the resources available since the funding to implement the policy has gone down over the years. Second, a plan could probably not be the best avenue for America to pursue if they have to attain quality preventive measures against the scourge. National Strategy for HIV/AIDS (2010) noted that the problem of HIV will remain so long as the problem of homosexuality persists. According to the Institute of Medicine (U.S.) (2005), the congressional influence on appropriation of the funds is not beneficial to the CBOs since they cannot plan in prior based on uncertainties on the amount of the funds that would be allocated to them.

Conclusion

            From the arguments and theories of its origin, the HIV/AIDS pandemic must have slowly crept in and fast transformed into the killer disease that spelled automatic death to those who contracted it in the initial days when its effect was beginning to take toll across human population in the world. The lay public and the medical world were struck dumbfounded in the 1980s when mostly the gay men started showing the symptoms of what was largely believed to be Kaposi Sarcoma until researches isolated the HIV virus towards the mid 1890s. The new dawn of knowledge marked a new beginning in the understating of how HIV spread. Prior to the period tens of thousands in America and else where in the world could have contracted the virus blood transfusion in hospitals and contacts with body fluids of the infected through the use of sharp medical instruments. During the same period gay men who had largely and devastatingly been infected were apportioned parts of the blame from some quarters within the society describing their predicament as a befitting reward for their ‘evil practice’.

The rising death toll at the time provided an impetus for the community start acting within individual, organizational or governmental efforts to contain the scourge. Social workers have always remained a force to reckon with in the fight against HIV/AIDS. From the 1980s, community response groups from the worst affected metropolitan regions in America rose to provide emotional comfort to those afflicted with the disease. Through the years as more knowledge was availed through researches, social workers have incorporated additional functions in the fight against the pandemic through creation of awareness and advocacy programs. Through the 1990s into 2000s, concreted efforts to contain the disease has enabled people to gain more knowledge and better management of the disease. Today HIV/AIDS has been transformed from being a terminal disease that it was as it advent to a chronic aliment that can be managed to enable the infected take part in socio-economic and political activities just like the uninfected persons.

References

AVERT. (n.d.). The history of HIV and AIDS in America. Retrieved from

http://www.avert.org/aids-history-america.htm

Centers for Disease Control and Prevention/CDC. (2012). HIV in the United States: An overview. Retrieved from http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview.htm

Chadron State College. (n.d.). Social work: Roles of a social worker. Retrieved

from http://www.csc.edu/cpsw/sw/careers/roles.csc

CNN report. (1998). Researchers trace first HIV case to 1959 in the Belgian Congo. Retrieved from http://www.google.co.ke/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CEkQFjAA&url=http%3A%2F%2Fwww.cnn.com%2FHEALTH%2F9802%2F03%2Fearliest.aids%2F&ei=0BTvT-zZL-nY4QSkw4iMDg&usg=AFQjCNGrMuUGE9K5xYsLoCjtOgb4U45EhQ

Denny, C. C., & Emmanuel, E. J. (2008). US Health Aid Beyond PEPFAR: The Mother & Child Campaign. Journal of American Medical Association, 300(17), 2048-2051. Retrieved from doi:10.1001/jama.2008.556

Estrine, S. et al. (2011). Service delivery for vulnerable populations: New directions in behavioural health. New York: Springer Pub.

Gao, F. et al. (1999). Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes.

Nature, 397(6718), 436-41.

Greenwald, R., & Killelea, A. (2011). A new era for HIV health care. Retrieved from http://www.gmhc.org/files/editor/file/r_a_spring11.pdf

Heath Resources and Service Administration (HRSA). (n.d.). The Ryan White HIV/AIDS program: HRSA Funds First AIDS Program at $15.3 Million. Retrieved from

http://hab.hrsa.gov/livinghistory/timeline/1986.htm

Institute of Human Virology. (n.d.). History of HIV/AIDS in the U.S. Retrieved from http://www.jacques.umaryland.edu/hiv_history.html

Institute of Medicine. (U.S.). (2005). Public financing and delivery of HIV/AIDS care.

Washington, DC: National Academies Press.

Lee, R. S., Kochman, A., & Sikkema, K. J. (2002). Internalized stigma among people living with HIV/AIDS. AIDS and Behavior, 6(4), 309-17.

Morbidity and Mortality Report. (2001). HIV and AIDS-United States, 1981-2000. HIV and AIDS in the United States, 50(21), 429-56.

National HIV/AIDS Statery. (2010). Vision for the National HIV/AIDS strategy. Retrieved from http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf

Parker, R. (2002). The global HIV/AIDS pandemic, structural inequalities and the politics of international health. American Journal of Public Health, 92(3), 343-346. Retrieved

from http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.92.3.343

Rani, M., Katz, M. H., Min-Sun, P., & Jan, G. R. (1997) .Meeting the Service Needs of HIV-Infected Persons: Is the Ryan White CARE Act Succeeding? Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology, 14(1), 44-55.

Shutton, M. Y. (2009). Response to the HIV/AIDS crisis among blacks in the United States, 1981-2009. American Journal of Public Health, 99(2), 352-59.

Stolley, K. S., & Glass, J. E. (2009). HIV/AIDS. Santa Barbara, Calif: Greenwood Press.

World Aids Day Report. (2011). Zero new HIV infections, Zero discrimination, Zero Aids-related deaths. Retrieved from http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2216_WorldAIDSday_report_2011_en.pdf

World Bank. (1999). Confronting AIDS: Public priorities in a global epidemic. New York: Oxford University Press for the World Bank.