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Public Health Strategies for Confronting AIDS Legislative and Regulatory Policy in the United States

Larry O. Gostin, JD
JAMA. 1989;261(11):1621-1630. doi:10.1001/jama.1989.03420110097031.
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THE acquired immunodeficiency syndrome (AIDS) epidemic poses a serious threat to public health, but its impact goes far beyond health. The burden of disease falls predominantly on disfavored populations—intravenous drug users, homosexuals, and prostitutes. Moreover, racial minorities are disproportionately represented in these groups.1,2

Many argue that governmental and public health officials have failed to implement strong measures in deference to the civil liberties of high-risk groups.3 Others argue that society has overreacted to the epidemic and imposed penalties and discriminatory treatment that would never have occurred if the primary targets of intervention were more popular.4 Not surprisingly, these two contradictory viewpoints are espoused by groups at opposite ends of the political spectrum. A deeper dimension of the AIDS epidemic, then, is political, and it is manifested in legislation.

The volume and content of state AIDS legislation has increased considerably since earlier reports.5,6 Legislation related to AIDS


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