And the Band Played On: Nursing Policy Development Essay

Introduction

The film, And the Band Played On, traces the history of AIDS including how it began to kill people in Africa, its first signs and symptoms among gay population, prostitutes, and drug users in the US, and the efforts by the CDC to contain it. However, the movie also reveals some of the sociopolitical factors that shaped the public health policy development for the prevention of this pandemic. It was only when the disease began to affect the privileged in the US that the government stopped ignoring it and started considering it a serious public health issue.

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1.

Based on my observations from the film, some of the sociopolitical factors responsible for influencing public health policy development for HIV/AIDS prevention and control in the US include .the lack of political goodwill from the Reagan administration to fund AIDS prevention programs, the prevalence of HIV virus among the racial minorities, and the high number of deaths registered. With many organizations and the White House silent on the way forward, groups of researchers at the CDC concerned that if not contained the epidemic would eliminate entire populations pushed hard to discover the nature of the virus, how it spreads, and how to reduce its impact on populations. Moreover, the fact that the virus was spread through sexual or blood contact and its high prevalence among the racial and ethnic minorities and gay men influence policymakers to do something to come up with HIV/AIDS prevention and control in the US. Also, when the disease started taking more lives including the privileged and less marginalized in the American society, policymakers were compelled to do something about it.

2.

From the film, early victims and contacts of HIV/AIDS were identified and located by visiting clubs and brothels, taking blood samples from the victims, and asking the victims questions about how they might have contracted the disease. However, this is totally different in 2017 because back then, there were less invasive technologies and means of handling such cases. Back then, people were also less knowledgeable about the dangers associated with direct contact with the blood of victims of the disease and this to an extent fueled the spread of the HIV virus. For instance, some people got the virus through blood transfusions from infected persons. Not anymore. In the present day, victims and contacts are identified and located through using less invasive technologies and blood testing. Furthermore, victims of HIV/AIDS are currently identified through the public health data and information available on the ways through which the virus spreads.

3.

One of the examples of epidemiological models in public health is the epidemiologic triangle or triad. According to Poundstone, Strathdee, and Celentano (2004), epidemiology refers to the study of how health outcomes and the determinants of these outcomes are distributed among a population. Hence, epidemiology is premised on the basic assumption that public health events and diseases are not merely random occurrences in a population; rather, there are various risk factors that make some members of the population to be at a greater risk of contracting a disease than other members.

4.

Some of the components of the epidemiologic triangle model of disease occurrence include an environment, a susceptible host, and an external agent. There is always an interplay and interrelationship among these factors in various ways to produce diseases such as HIV/AIDS. To begin with, an agent refers to the virus, pathogen, or infectious microorganism, parasite, or bacterium which is the root cause of a disease. From the video, after years of trial and error research, the CDC found that HIV /AIDS was caused by a virus spread through physical contact with the blood of victims. The CDC doctors analyzed the patterns of infection among the affected populations and found its prevalence among gays and patients who had received infected blood through transfusion (Spelling & Vincent, 2014). According to Spelling and Vincent (2014), this finding made them conclude that the disease must be caused by an infectious virus as it possessed characteristics of a viral disease. On the other hand, the host refers to the victim who is at risk of being infected by the disease. From the video, this component of epidemiology was identified by studying the risk factors that put some people at a greater risk of being exposed and infected by the HIV virus than others. The main risk factor identified in the video by Spelling and Vincent (2014) is sex or blood transfusion with infected blood. The host included prostitutes and gays because they engaged in unprotected sex with multiple partners (Spelling & Vincent, 2014). Lastly, the environment under this epidemiological model is the extrinsic factors responsible for influencing the agent's exposure to the pathogen. From the video, some of the factors identified as responsible for putting people at greater risk of infection by the HIV virus included limited access to prevention, socioeconomic factors, and homosexuality.

5.

After viewing this film, my overall reaction regarding the impact on the healthcare system in the US was that US healthcare system is that the initial response of the US government to the HIV/AIDS outbreak shaped the future of healthcare in the US. Realizing that HIV/AIDS was no longer a gay disease, the US government was compelled to increase funding for HIV/AIDS research by the CDC and other public health organizations. The discovery of the epidemic has forever changed the US healthcare system's approach to epidemics.

Compared to the historical perspective of HIV emergence, the contemporary situation of HIV in the US is totally different. For instance, when the virus emerged, most US hospitals and research facilities lacked the necessary resources and funding and hence impeding efforts to identify its epidemiology and how to contain its spread. However, this is not the case anymore since currently, HIV/AIDS research has become more extensive, comprehensive, and effective. Moreover, unlike the situation when HIV first emerged in the US, currently people are more aware and knowledgeable about this disease and hence the infection rates are lower than before. As Moore (2011) asserts, HIV epidemiology has changed to a significant extent in the US over the past three decades since it is no longer just a disease of gays but one with diverse geography.

Conclusion

In summary, the movie And the Band Played On is a quintessential reflection of the historical, social, and political context of HIV/AIDS, research efforts to know more about the virus causing this epidemic, and the eventual breakthroughs. However, the film also indicates how poor funding and lack of political goodwill from the US government threatened to derail efforts to identify the HIV virus, prompting policymakers to intervene.

References

Moore, R.D. (2011). Epidemiology of HIV infection in the United States: Implications for linkage to care. Clinical Infectious Diseases, 52(2), 20-213. Doi: https://doi.org/10.1093/cid/ciq044

Poundstone, K.E., Stratthdee, S.A., & Celentano, D.D. (2004). The social epidemiology ofhuman immunodeficiency virus/acquired immunodeficiency syndrome. Epidemiologic Reviews, 26(1), 22-35. doi: https://doi.org/10.1093/epirev/mxh005

Spelling, A., & Vincent, E.O. (2014, February 3). And The Band Played On 1993. [Video File].Retrieved April 17, 2018, from https://www.youtube.com/watch?v=ua5RrxvfVJU