Looking at factors that reach beyond the individual reveals very telling information about how humanity and, we in the west, are dealing with the pandemic. Some interesting factors come out when we look at income as a Determinants of Health relating to HIV. Determinants of health are the leading factors that contribute in aggregate to health status in an individual or populations. Determinants include: income, education level, living environment, personal behavior, health care access, genetics and social/cultural issues.
Dr. Katherine Hankins Chief Scientific Advisor at the United Nations AIDS directorate in Geneva, points out that the correlation between HIV and poverty [ which we are already aware of] is the greatest where the divide between the have’s and the have not’s is relatively greater. That is saying that the greater the difference in income between the rich and the poor, the greater the incidence of HIV and the poorer the quality of life with HIV. At the poverty end of the spectrum, there are competing demands for very limited funds such as food, shelter and schooling for children. As a result adherence to any possible medical regimen, good diet relaxation and rest all suffer, and with that the individual.
Harm Reduction refers to a set of interventions designed to diminish the individual and societal harms associated with any potentially harmful activity such as with 'recreational' drug use, including the risk of HIV. In Canada and elsewhere those interventions that we know will help to reduce the transmission of HIV, i.e. work positively to prevent HIV infection, are heavily and unduly influenced by preconceived notions of morality. That is to say, that the methods of harm reductions are in activities that are judged by some to be immoral and harm reduction is seen as some sort of approval of those behaviours and must be avoided, obviously at the cost of people getting infected with HIV and often, because they are at the poverty end of the economic spectrum, AIDS and an earlier death.
An example of this is the resistance to needle exchange programs in Canadian prisons when all international and national studies show a positive impact with regard to HIV and no negatives such as an increase in drug use, use of needles as weapons, etc. Another is the refusal to support safe tattooing even after a government website said that all evaluations of their own study on safe tattooing were positive in outcome. No reason was given for refusing to continue the safe tattooing project. A final example is the continuing determination of the federal government to shut down Insite – the controversial medically supervised safe injection site for drug injectors in Vancouver. This model has been used to great and positive effect all over Europe and our Government would rather see people die than offer a safer way to manage their addictions.
I will not editorialize this time…. You know my stand on life versus drug use!.
No comments:
Post a Comment