4266.0: Tuesday, November 14, 2000 - 4:35 PM

Abstract #11431

AIDS: Legacies for and challenges to public health practice in the US

Jean Flatley McGuire, PhD, HIV/AIDS Bureau, Massachusetts Department of Public Health, 250 Washington Street, Boston, MA 02108, 617-624-5303, jean.mcguire@state.ma.us

Background: The first two decades of the AIDS epidemic in the US have shaped considerable changes in public health administration and practice. However, expanding caseloads, changing reimbursement systems, and mobilization fatigue threaten the longterm viability of these practice changes. Improved chronicling and assessment of the public health practice impact of HIV/AIDS is crucial for informing future administrative and service delivery developments. Methods: Literature and regulatory review of AIDS-related public health practice changes. Results: New public health frameworks, partnerships, and roles have emerged in response to the acute and unanticipated demands of HIV disease. New or altered frameworks include: anti-discrimination as a public health response; harm reduction strategies as primary and secondary prevention; ecologies of risk as templates for intervention; and wellness and adherence support as components of comprehensive care. Evolving partnerships have brought together previously distant disciplines and practice arenas, including legal advocates and public health professionals, clinical researchers and primary care practitioners, and behavioral and clinical scientists. New roles have emerged for consumers, peers, and volunteers in health education and service delivery while governmental agencies have assumed new obligations as convenors, consensus builders, and coordinators of community planning. Lessons learned: Many of these changes have been iterative in their development, responsive to specific population, problem, or geographic needs. Some have been codified in federal and state regulatory and statutory requirements. Most have prompted both considerable innovation and new burdens in public health practice environments. Ongoing examination of these changes and their contributions is necessary to assure successful translation into future practice.

Learning Objectives: Participants will learn to identify public health practice and administrative changes resulting from the HIV/AIDS epidemic. Additionally, participants will be able to characterize resulting opportunities and dilemmas for public health practitioners

Keywords: Public Health Administration, HIV/AIDS

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA