Medical Issues: HIV in the U.S.

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Table of Contents

Abstract
Case Study
Problem
Analyzing the Context
Explore options
Apply the relevant ethical decision process
Implementing the Plan
Conclusion
Reference List

Abstract

People with HIV in the U.S. have limited access to private healthcare insurance or are subject to extreme abuses in their monthly payments. This is due to their association as being “high risk” clients due to the various health complications that arise as a result of HIV.

In fact, studies such as those in the article “HIV in the USA: pushing past the plateau” (2013) reveal that on average only one in five people in the U.S. with HIV have private health insurance with nearly 30% of those with the disease having no coverage whatsoever (i.e. no Medicare or Medicaid). Despite this data, there are actually numerous initiatives to help people with the disease.

Medicaid, Medicare, the Ryan White HIV/AIDS Program as well as other federal programs offer substantial assistance in helping people with HIV. The main problem is the fact that those with the disease are often stigmatized which makes them more hesitant to apply for federally funded programs for help (HIV in the USA–pushing past the plateau, 2013).

In a review of this ethical issue, I plan to use the deontological perspective which will focus on the right of HIV sufferers to equal healthcare as well as their right to refuse it.

Case Study

In examining the current methods of medical assistance available to individuals with HIV, it was shown that the U.S. government has the following federally funded programs:

AIDS Drug Assistance Program (ADAP)
ADAP Plus (Primary Care)
HIV Home Care Program
ADAP Plus Insurance Continuation Program (APIC)

From this, it can be seen that, on a legislative level, people who have HIV are treated the same as any other individual that has a long term degenerative condition (Moyer, 2013). There are well-funded programs that they can avail of which enables HIV sufferers to live a relatively normal life without succumbing to the complications associated with HIV due to a lack of medical care.

However, the problem is that despite the sheer amount of federally funded programs available as well as other options through Medicare, Medicaid, and private foundations, nearly 30% do not have any form of public medical coverage and only one in five has private medical insurance.

The Moyer (2013) study which examined the prevalence of HIV in the U.S. and the processes utilized to combat it revealed that while the provision of care was equal to all patients (HIV or not), the social stigma associated with contracting HIV makes people more reluctant to reveal that they have it. Moyer (2013) explains that the issue is related to the fact that people with HIV are often connoted as engaging in activities that are “shameful” and thus resulted in them contracting HIV in the first place.

Such activities are often depicted as drug use, engaging the services of a prostitute or other such activities. This negative social connotation regarding the activities of people with HIV creates issues related to people being reluctant to get tested, to get help or even register for insurance due to the fear that it would be found out that they have HIV.

Problem

The current issue surrounding HIV/AIDs treatment in the U.S. is not that the government is providing insufficient services to help people with HIV. Instead, the problem is one of the social stigmatization associated with having HIV and how this prevents people from seeking help in the first place.

Hodder et al. (2013) further explains that unlike cases of obesity where the issue is more of a psychological rather a physical one (i.e. foregoing a proper and healthy diet and instead eating a calorie-rich unhealthy diet), people who contract HIV often do so unknowingly and not as a result of any action or behavior on their part (Hodder et al, 2013).

For example, Hodder et al. (2013) state that the HIV in the U.S. is often passed unknowingly from mother to offspring as a direct result of infection from the father who in turn received it from his parents.

Other cases of contracting HIV often come as a result of normal sexual conduct between two willing partners in a long term committed relationship with one of the partners contracting HIV through a previous partner who was also unaware that they had HIV (Adekeye et al., 2012). In cases such as these, consequentialism as an ethical framework to judge the treatment method cannot be implemented since in most cases those who contract HIV do so doing perfectly normal actions and contract it unknowingly.

Analyzing the Context

When examining the issue, it becomes immediately obvious that the problem is more of a lack of social understanding than it is of a lack of sufficient treatment methods. Adekeye et al. (2012) explain that the U.S. government fully understands that those who contract HIV often do so without prior consent and, as a result, provides the necessary medical care since it would be the most ethical practice to do. Under deontological ethics, the morality of an action is judged based on its adherence to a certain set of rules.

In the case of HIV sufferers, they did not contract HIV out of their own accord and, as such, do have a right to access the same level of medical care as any other patient (Pellowski et al., 2013). The issue though is that even if they have the right to healthcare, the reluctance to access it impedes the government’s capacity to help monitor and control it. Thus, in order to solve the problem which is more of a social acceptance issue, a sociological solution must be devised.

Explore options

Taking the deontological position on ethics into consideration, the fact that people who have HIV are reluctant to deal with their problem through federally funded programs and thus increase the likelihood of spreading the disease is still ethical since it is within a citizen’s right to refuse medical care.

As such, in order to resolve such an issue, it would be necessary to implement some form of “normalcy” to convince people to apply for such programs. One method would be to create an online community, similar to Facebook, which is exclusive to people with HIV. Through such a community, people suffering from HIV will be able to get the acceptance they desire resulting in a greater likelihood of going for government services to help them deal with their problem.

Apply the relevant ethical decision process

Under consequentialism, it is stated that the consequences of one’s conduct are the basis behind the basis of the rightness or wrongness of the conduct itself. Taking this into consideration, the fact that people with HIV are reluctant to seek assistance and treatment which in turn helps to spread the disease is unethical due to the thousands that could die from getting infected.

However, when taking the deontological position on ethics into consideration, people with HIV still have the right to refuse care since it is within their right to accept or refuse medical care when given the choice. As such, it would be wrong to force any form of required registry or medical care on someone with HIV and instead it would be more appropriate to implement some means of social acceptance over their current medical condition so that they will not be as reluctant to hide it.

Implementing the Plan

The proposed online social network that focuses specifically on people with HIV in the U.S. would be completely free. It helps people with the disease to contact one another, develop support groups, create awareness regarding possible medical assistance they can get and also enables the government to track cases of HIV in the U.S. Promotion of the site can be conducted through sponsored advertisements on the internet as well as on local television stations.

By creating substantial local awareness of the site, this increases the likelihood that people would actually use it and seek the help of other people with the same condition. The site itself would also contain multiple links and information tidbits that would help people to know more about the various types of care and assistance that are available to people with their condition.

Conclusion

Overall, through the proposed method that was discussed in this paper, this can help to increase the likelihood of people with HIV availing of the government’s numerous services to help them deal with the disease.

Reference List

Adekeye, O. A., Heiman, H. J., Onyeabor, O. S., Hyacinth, H. I., & Kissinger, P. (2012).

The New Invincibles: HIV Screening among Older Adults in the U.S. Plos ONE, 7(8), 1-9.

HIV in the USA–pushing past the plateau. (2013). Lancet, 382(9889), 285.

Hodder, S. L., Justman, J., Hughes, J. P., Jing, W., Haley, D. F., Adimora, A. A., &… El- Sadr, W. M. (2013). HIV Acquisition Among Women From Selected Areas of the United States. Annals Of Internal Medicine, 158(1), 10-18.

Moyer, V. A. (2013). Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement. Annals Of Internal Medicine, 159(1), 51-60.

Pellowski, J. A., Kalichman, S. C., & Adler, N. (2013). A Pandemic of the Poor: Social Disadvantage and the U.S. HIV Epidemic. American Psychologist, 68(4), 197-209.

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