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INTE 398 Final: Ffar 291/Inte 398 Winter 2018 - Final Exam Study Guide Long Essays

Interdiscip St
Course Code
INTE 398
Karen Herland
Study Guide

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Part 3 Long Essays
1-The first week of class you were asked if governments should spend more money on HIV
treatment or HIV prevention. What did you answer then? What would you answer now, and
why? (You can keep the same answer but explain how what you learned this term supports your
My peers have made some very good arguments until now, but I mostly agree with Jessica. The
reading mentioned that part of the sustainable development goal is to end the AIDS epidemic by
2030. To be able to do so, as Jessica said, the numbers must decrease quicker than they are now
so available funds should be used to prevent the illness as much as possible by making tools,
education, measures and medication available for everyone. However, the lecture mentioned
that just under 25% of available funds are going to prevention currently, which means that
treatment makes up by far the bulk of spending. The decision to either prioritize treatment or
prevention depends on each country’s goals and resources available, but if the aim is truly to end
the AIDS epidemic, more emphasis needs to be put on prevention. Although, I strongly think that
treatment is just as important as prevention because over 37 million people are living with the
virus as of 2014, so it is important to treat it in order to avoid spreading it. To end the cycle, it
takes both treatment and prevention, but prevention is key.
After going through the course, my answer remains the same, but not for the same reasons
Near 37 million ppl living w hiv globally in 2014 - now over 37
Around half (16 mil) have access to med to help them w the impact
15.8 mil ppl living w hiv were accessing antiretroviral therapy as of june 2015
-Antiretroviral therapy (ART) is the combination of several antiretroviral medicines used to slow
the rate at which hiv makes copies of itself (multiplies) in the body. A combination of 3 or more
antiretroviral medicines is more effective than using just one medicine (monotherapy) to treat hiv
17.1 mil ppl living w hiv dot ko the are liig the irus
Brazil - huge portion spent on treatment
Makes sense bc since almost effective treatment was made available, the brazilian gvt made a
concrete specific decision to make treatment available at gvt expense to anyone needing it
They are the ONLY country that has done so from as early as treatment was available
Most money spent on making sure treatment gets there to the ppl needed
Vietnam & Belarus - allocate very little money to treatment, prefer focusing on prevention, think long-
Might be bc few cases found early, so fewer and fewer ppl to treat initially
So trying to prevent long term prob by dev over time
Treatment vs prevention decision - finding that balance gonna be dictated by any gvt, approach to public
health pros, set of oers, resoures, if ot uh researh ouit i outr doest ake sese
to allocate money there like ex in Nigeria in Kenya
But if do have the resources to support and encourage research like Russia and Thailand, then makes
more sense
Partly depends on infrastructures you have in place, what issues are raised when hiv becomes apparent
as public health issue in particular nation or country, and what are long term goals (priorities)
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Trying to understand impact of hiv is financially
Prevention makes much more sense, paying in short term is more cost efficient than paying
in long term
BUT must ask yourself what do those abstract prevention costs provide vs the real concrete
impact that resource treatment and care offers to ppl living currently w hiv
These are decisions gvts make, ppl make in terms of determining what kinds of resources they need and
what they wanna have going forward
*reason to treat is that by increasing treatment, more ppl have undetectable viral load so less
chances of transmitting the disease
-fact that treatment may be within reach helped combat resignation and despair that they faced an
imminent death sentence
-ppl were not so much dying of virus as they were dying of neglect and indifference
-AIDS becoming a "chronic manageable infection" was a real possibility w treatment now
*but as dying diminished, so did the perception of AIDS as a crisis
BUT prevention is still key
In order to decrease the incidence of hiv, gotta make sure that no one gets transmitted to start w
Why is Prevention so Difficult?
-hard for many reasons
-first, HIV prevention, by its nature, requires the engagement of sectors
-need a bunch of ppl at the table (docs, churches, legal practitioners)
-if docs want smth, but churches say that disagrees w values so need docs and churches
AGREEING if strong influences in particular area of the world
-second, the solutions required can challenge personal values (including the values held by
implementers and those needed to champion prevention)
-those personal values often get translated in gvt policy as ppl w values are the ones that make
the policy so stumbling
-third, as w prevention of any disease or illness, treatment of the acute crisis can produce immediate
results, compared w prevention of the root cause, which achieves results over yrs and decades
-bc HIV can be dormented for so long and need treatment, easier to provide treatment and see
immediate improvement to immediate impact - bc impact isnt concrete/measurable so hard to
see ho a didt get ifeted so harder to deo tha seeig this a ppl got sik ad got
med (that is easy to measure)
-it's a more abstract change, involves lot of ppl, challenges beliefs systems and hard to make prevention
work long term
Prevention as Easy as ABC
-one of campaigns
-Abstinence for youth, including the delay of sexual debut and abstinence until marriage
-Being tested for HIV and being faithful in marriage and monogamous relationships
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-long term, until death having sex life w that partner
-not entirely realistic approach
-very few couples that together young remain together until lifetime
-Correct and consistent use of condoms for those who practice high-risk behs
-failed somehow the A and B so reduced to the C - thats ho odel uderstood
-ABC starts w abstinence, so best response to HIV in some areas was to have no sex at least until
-abstinence educ remains acceptable standard for HIV prevention
-epetatio that its the priar sg
Unintended Consequences
-some seem as unrealistic, over the top so for some ppl makes it more possible/likely that they will
distance themselves, disbelieve, dismiss the info bc seems exaggerated or unrealistic
-some studies suggest that bc of this tendency, fear based campaigns play on emos and concerns of the
already anxious, not necessarily the ppl that most likely to be impacted or more vulnerable
-if prone to be anxious, this extreme advertising can make them feel more vulnerable
1.Denial: If ppl believe that the harmful consequence is unlikely, they may discount or deny the info
2.Othering: the target audience thinks that the msg isn't directed at them
-for ex, older gay men may rationalize that the target audience is younger gay men
3.Ridiculing: occurs when a person thinks the msg is absurd and, consequently, ignores it
4.Minimizing: occurs when ppl think that the neg outcome is exaggerated and therefore don't respond
to the msg
-for ex, younger ppl are more likely to not have a sense of their own mortality
5.Aoidae: ppl a aoid the sg altogether. Ppl dot eessaril at their ies halleged ad
may simple tune out
***be careful to not show something that ppl will perceive and stigmatize HIV even more
-expanded priorities to include implementation, effectiveness, and the effect of combination prevention
at the pop lvl
-WHOs four-pronged strategy for PMTCT recommends: primary HIV prevention in women of
childbearing age; prevention of unintended pregnancies in women with HIV infection; prevention of HIV
transmission from women with HIV to their infants via use of antiretroviral drugs; and provision of
treatment, care, and support to women with HIV and to their families.
-Structural interventions can reduce high-risk behaviours, STIs, and known mediators of risk, including
gender inequality and intimate partner violence
-behavioural strategies were essential, but not sufficient, components of comprehensive HIV prevention
ad that ehaioural strategies theseles eed to e oiatios of approahes at ultiple leels of
-the need for strong and well directed leadership to keep HIV prevention at the forefront of social policy
and action is esp crucial bc of:
-the many controversies associated w sex and drug use (things that hard to talk about)
-the long time lag btwn HIV infection and the appearance of illness, and
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