And the Band Played On University of Central Florida Question #1 Based on what you observed in the film or read in the book; clearly articulate and delineate at least three of the sociopolitical factors that influenced public health policy development for HIV/AIDs prevention and control in the United States. Then discuss separately each of the three sociopolitical factors each factor and discussion is equal to three points each.
The three sociopolitical factors that influenced public health policy development for HIV/Aids prevention and control in the United States were identifying early possible ways of spreading the disease, how it affected our blood supply and that to acknowledge the social implications that it could be everyman’s disease. Initially, in the movie there were signs of the disease but they were not sure even what it was. People were dying from a type of pneumonia that was not common; one man had Toxoplasmosis which is a cat’s disease.
Other patients had a low or no T-cell count. As the movie progressed they found a connection with “Patient Zero” and this concept that they called the GRID which stood for Gay Related Immune Deficiency and this term was coined by Bill Kraus who was speaking on behalf of the gay rights in Washington, D. C. in 1980. In the connection with patient zero it is ultimately discovered that there was a flight attendant who was gay who had sexual intercourse with many men who then had sex with others and the doctor’s were able to make the connection with this information.
They were able to trace back to the flight attendant who was patient zero and who he slept with and who all of those people had slept with, so on and so forth. The flight attendant had given him names and they were able to talk to several men who gave names of other men that they had sex with. (Spelling, Vincent & Spottiswoode, 1993). The second factor that helped to form public policy and help with control and prevention was regarding our blood supply. It was discovered that there was an older man who was a hemophiliac who had received many blood transfusions at the University of Colorado Medical Center.
There was also a woman who was an IV drug user who had contracted AIDS. This helped to dispel the myth that it was only a gay disease, but was transported through the blood; therefore our blood supply was at risk. The CDC in Atlanta met in 1983 and motioned to change the name from GRID to AIDS which was Acquired Immune Deficiency Syndrome. However, because of expense the blood banks refused to change testing procedures. Eventually, the blood banks finally agree to test but many people were affected with AIDS virus before that finally took place. (Spelling, Vincent & Spottiswoode, 1993).
One of the big factors early on is that no one wanted to be associated with AIDS due to the fact that it was considered a homosexual man’s disease. There was a lot of fear, denial and anger surrounding this disease. In 1981at the CDC Dr. Guinan asks that a report about an epidemic with gay men had broken out and he wanted it published in the medical journal. The fear of the word “homosexual” was marked off and not used for that article. It took a long time for the realization that this disease could affect everyone from homosexual males, IV drug users, blood transfusion patients, women and even babies.
Even though it was initially considered the disease came from gay men and their sexual practices it crossed all borders as time went on. Still today there is some prejudice regarding AIDS. (Spelling, Vincent & Spottiswoode, 1993). Question #2 How were early victims and contacts identified and located? One example was from a gay flight attendant who had by his own admission had at least 250 partners and that was a conservative number of partners, when he was a patient at NYU Medical Center. Later, the doctors make the connection and tracked him down to ask for names of other men he had slept with. He gave Dr.
Darrow 73 names which at least was a beginning for them to contact other men and from there they could get them names of men or women that they too had slept with. The doctors began to see a common thread of patients who had low T cell counts, rare pneumonia, Kaposi’s sarcoma and other signs/symptoms that they were looking at and trying to make the connection with what this disease entailed as they were sharing information with each other of their findings. (Spelling, Vincent & Spottiswoode, 1993). Question #3 Describe how the events in the film compare with the steps in the epidemiological process described in Maurer and Smith.
There are three types of epidemiological studies that include descriptive, experimental and analytic. (Maurer & Smith, 2009). I think that the descriptive would be the closest to the film. The reason is that the movie talks about those who are affected and different scenarios. One such scenario would be Dr. Francis when he was seeing a woman on her death bed, and she spits blood on his hand and he is scared. He was a key player in that he saw some symptoms and tried to go back and put together pieces of the puzzle of what that meant with other findings, different populations, ages, sex, blood etc.
What was difficult were how many hurdles the medical community had to try and overcome. There was little funding, discriminatory attitudes and a basic belief it did not belong in their back yard. The government was inefficient and slow and much of the red tape left many to suffer and die. They believed that it was a lifestyle choice and that their punishment was just. (Spelling, Vincent & Spottiswoode, 1993). The people who were most affected early on were homosexual men. It did seem to be more prominent in San Francisco where there was a high population of gay men.
The first case was in Copenhagen in 1977, various countries and finally the United States. This disease affected everyone from gay, straight, IV drug users, babies and hemophiliacs. (Spelling, Vincent & Spottiswoode, 1993). It is worthy to note that the homosexual men were engaging in very risky behaviors such as in the bathhouses they were with multiple partners and also engaged in the use of poppers. Gay men also engaged in sex often without protection and even when they tested positive they would still engage in risky behaviors. Kalichman SC; Cain D; Simbayi LC, (2010).
What was your overall reaction after viewing this film/reading this book with respect to the impact on the health care system in the United States? I had never seen the film before so I found it very interesting. Knowing what I know now I look at that film in disbelief that we had to go through all of those hurdles and how many lives were lost. It was a failure to act from the CDC, blood banks, government; the doctor’s fighting with their egos for credit and even those fighting with each other and the politicians who don’t want their careers ruined.
I don’t remember it affecting me much because I am a straight, heterosexual female, but I do remember thinking how scared I was when it first came out. It does not mean however, that I am safe because I am female. I do know that. The money that it cost in the aftermath of inefficiency is probably numbers I can’t imagine. I applaud Dr. Francis in standing up for what he believed was right in the face of his colleagues who fought him the whole way. It must have been a lonely path for him but I believe when you are passionate about something that is when you will prevail, and he did.
I hope that history doesn’t repeat itself and that as humans we can learn from our errors. One impact that I can have as a nurse is to dispel myths and teach the facts about having HIV and living with it. There are still many misconceptions surrounding HIV and since we are in a position to educate, it is our duty to do so. Ojebuyi B. (2009). References Kalichman, S. , Cain, D. , & Simbayi, L. (2010). Behavioral changes associated with testing HIV-positive among sexually transmitted infection clinic patients in Cape Town, South Africa. American Journal of Public Health, 100(4), 714-719. oi:10. 2105/AJPH. 2009. 162602. Maurer, F. A. , Smith, C. M. (2009). Community/public health nursing practice: health for families and populations. St. Louis, MO: Saunders Elselvier Ojebuyi, B. (2009). Increasing people’s knowledge about HIV/AIDS: an investigation into the effectiveness of reading as a communication strategy. Journal of Health Management, 11(3), 473-488. Retrieved from CINAHL Plus with Full Text database Spelling, A. , Vincent, E. D. , (Producers). & Spottiswoode, R. (Director), (1993), And the band played on [Motion picture]. United States: Home Box Office.