How far have we come in the fight against AIDS since the Institute of Medicine released Confronting AIDS: Directions for Public Health, Health Care, and Research in 1986? This updated volume examines our progress in implementing the recommendations set forth in the first book. It also highlights new information and events that have given rise to the need for new directions in responding to this disease.

Contents

• Committee for the Oversight of AIDS Activities
• Preface
• Acknowledgments
• Executive Summary
• 1. Introduction
• 2. HIV Infection and Its Epidemiology
  • HIV: The Etiologic Agent of Aids
  • Proportion of Infected Individuals Who Will Develop Aids
  • The Spectrum of HIV Infection
  • Modes and Efficiencies of HIV Transmission
  • Prevalence and Incidence of HIV Infection in the United States
  • AIDS Cases in the United States
  • The Demographic Impact of AIDS
  • Future Research Needs
  • References
• 3. Understanding the Course of the Epidemic
  • The Uses of Models
  • Data Needs
  • References
• 4. Altering the Course of the Epidemic
  • Features of Public Health Programs
  • Antidiscrimination Protections
  • Education
  • HIV Antibody Screening and Testing
  • Other Public Health Measures
  • Aids and IV Drug Abuse
  • Resources
  • References
• 5. Care of Persons Infected with HIV
  • Care Needs of Special Patient Groups
  • Health Care Providers
  • Health Care Costs for HIV-Related Conditions
  • Financing Health Care for HIV-Related Conditions
  • References
• 6. The Biology of HIV and Biomedical Research Needs
  • HIV Biology
  • Drug Development and Testing
  • Vaccine Development and Testing
  • Rountable on Drugs and Vaccines
  • Animal Models of AIDS
  • Resources
  • Funding for Research
  • References
• 7. International Aspects of AIDS and HIV Infection
  • The Who Global Programme on AIDS
  • Rationale for U.S. International Involvement
  • The U.S. Contribution to International Efforts
  • References
• 8. A National Commission on HIV Infection and AIDS
• Appendix A Summary and Recommendations from Confronting AIDS: Directions for Public Health, Health Care, and Research
• Appendix B CDC Classification System for HIV Infections and Revised Case Definition for AIDS
• Appendix C Correspondents
• Appendix D Biographical Notes on Committee Members

Support for this project was provided in part by the National Research Council (NRC) Fund, a pool of private, discretionary, nonfederal funds that is used to support a program of Academy-initiated studies of national issues in which science and technology figure significantly. The NRC Fund consists of contributions from several sources: a consortium of private foundations, including the Carnegie Corporation of New York, the Charles E. Culpeper Foundation, the William and Flora Hewlett Foundation, the John D. and Catherine T. MacArthur Foundation, the Andrew W. Mellon Foundation, the Rockefeller Foundation, and the Alfred P. Sloan Foundation; the Academy Industry Program, which seeks annual contributions from companies that are concerned with the health of U.S. science and technology and with public policy issues with technological content; and the National Academy of Sciences and the National Academy of Engineering endowments. Additional funds were provided by The Merck Company Foundation and by the U.S. Public Health Service and Health Care Financing Administration (contract number ASU-000001–07-S).

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The National Academy of Sciences was established in 1863 by Act of Congress as a private, nonprofit, self-governing membership corporation for the furtherance of science and technology, required to advise the federal government upon request within its fields of competence. Under its corporate charter the Academy established the National Research Council in 1916 and the National Academy of Engineering in 1964.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.