AIDS: The Making of a Chronic Disease

Janice L. Westenhouse, MPH; Dean F. Echenberg, MD, PhD
JAMA. 1992;268(19):2712-2713. doi:10.1001/jama.1992.03490190116044.
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The sudden appearance of the acquired immunodeficiency syndrome (AIDS) in the early 1980s, its rapid spread, and its devastating consequences gave experts many reasons to make historical analogies to the plagues of the distant past. The infectious disease model was the basis for much of the AIDS policy made during the 1980s, with the emphasis on disease surveillance and containment. It was against this backdrop that Elizabeth Fee and Daniel M. Fox published their first compilation of essays, AIDS: The Burdens of History, in 1988.

As AIDS moves into its second decade, however, its predominant features, from both a health policy and clinical perspective, no longer resemble those of an infectious disease, but rather those of a chronic disease. Owing mainly to advances in medical therapies, the most pressing issues to be dealt with now are medical management and health care availability. This shift in historical perception from AIDS as


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