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Involuntary Sterilization Among Hiv-Positive Garifuna Women From Honduras Seeking Asylum In The United States: Two Case Reports, Holly G. Atkinson, Deborah Ottenheimer

Publications and Research

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events …

Slides: Session 3: Decision-Making And The Energy Poor, Andrew Yager

2012 Energy Justice Conference and Technology Exposition (September 17-18)

Presenter: Andrew Yager, United Nations Department of Economic and Social Affairs, Division for Sustainable Development

33 slides

Ethical Challenges Of Preexposure Prophylaxis For Hiv, Jonathan S. Jay, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

On July 16, 2012, emtricitabine/tenofovir (Truvada) became the first drug approved by the US Food and Drug Administration for preexposure prophylaxis (PrEP) of human immunodeficiency virus (HIV) for adults at high risk. While PrEP appears highly effective with consistent adherence, effective implementation poses ethical challenges for the medical and public health community. For PrEP users, it is necessary to maintain adherence, safe sex practices, and routine HIV testing and medical monitoring, to maximize benefits and reduce risks. On a population level, comparative cost-effectiveness should guide priority-setting, while safety measures must address drug resistance concerns without burdening patients' access. Equitable distribution …

Fighting The Axis Of Illness: Hiv/Aids, Human Rights, And U.S. Foreign Policy, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Racism Or Realpolitik? U.S. Foreign Policy And The Hiv/Aids Catastrophe In Sub-Saharan Africa, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

"Geographical Morality" Revisited: International Relations, International Law, And The Controversy Over Placebo-Controlled Hiv Clinical Trials In Developing Countries, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

The Epidemics Of Injecting Drug Use And Blood-Borne Disease: A Public Health Perspective, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

In this article, the author first examines the mechanism by which blood-borne disease is transmitted through sharing of injection equipment. Thereafter, he presents a public health strategy for reducing multi-person use of contaminated injection equipment. This strategy includes: repealing or modifying current laws and regulations making possession and distribution of sterile injection equipment a criminal offense; implementing syringe exchange programs to expand access to new syringes for users of injection drugs; and counseling, education, and treatment targeted to injecting drug users (IDUs), including those in the prison and health care system. The objective of a public health approach is not …

The Resurgent Tuberculosis Epidemic In The Era Of Aids: Reflections On Public Health, Law, And Society, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The resurgence of tuberculosis and the rise in drug-resistant cases is neither inexplicable nor unexpected, but rather is the predictable outcome of a complex configuration of biological, social, and behavioral factors that have converged in America over the past decade. This article examines the biological, social, and behavioral causes of the epidemic, and suggests a comprehensive public health strategy for curtailing tuberculosis and other infectious diseases. When thoughtfully conceived, public health strategies can be implemented that are consistent with the limitations that both constitutional law and disability law place on the authority of the state. While traditional concepts of public …

The Interconnected Epidemics Of Drug Dependency And Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Drug dependence and human immunodeficiency virus (HIV) are America's two most pressing epidemics, interconnected by a cycle of urban poverty, physical dependence and a culture of sharing needles and syringes. Extant political strategies to curb these interconnected epidemics involve two traditional approaches. The first--law enforcement and interdiction--is designed to limit the supply of illicit drugs to the marketplace. This strategy is advanced by broad criminal sanctions against importing, selling, distributing, medically prescribing, or possessing illicit drugs or drug paraphernalia. The second strategy to combat the drug and HIV epidemics involves reducing the demand for illicit drugs. Education, counseling, and treatment …

A Decade Of A Maturing Epidemic: An Assessment And Directions For Future Public Policy, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The author's goal in this article, is not merely to propose public health strategies for the future, but also to examine why government has been so slow, so equivocal, in its public health response to the acquired immune deficiency syndrome (AIDS) epidemic. He argues that there has been a fundamental ambivalence in perceptions of the epidemic. For some, AIDS is perceived as a disease, with sympathy for sufferers. Once AIDS is viewed as a disease, like other catastrophic diseases, it follows that public policy will be based upon science and epidemiology--health education, research and treatment.

For others, AIDS is caused …

The Politics Of Aids: Compulsory State Powers, Public Health, And Civil Liberties, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article argues that compulsory public powers are justified only if they meet the following criteria: there is a significant risk of transmission of the acquired immune deficiency syndrome (AIDS) virus; the public health response is efficacious in preventing a primary mode of transmission of the virus; the economic, practical, or human rights burdens are not disproportionate to the public health benefits; and the public health power is the least restrictive alternative that would prevent viral transmission.

The author carefully examines the levels of risk posed by behavior which can potentially transmit human immunodeficiency virus (HIV), and demonstrates that compulsory …

Hospitals, Health Care Professionals, And Aids: The "Right To Know" The Health Status Of Professionals And Patients, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This article addresses why patients and health care professionals (HCPs) with human immunodeficiency virus (HIV) should have autonomy and privacy rights to choose whether to consent to an HIV test and to disclose their serologic status. It also demonstrates that the risk of HIV transmission in health care settings is exceedingly low, that it is probably lower than other well-accepted risks taken by patients and professionals, and that there are other less intrusive ways to further reduce the risk. The article concludes that knowledge of a patient's serologic status is unlikely to reduce risk, since no effective action could be …

The Nucleus Of A Public Health Strategy To Combat Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Since acquired immune deficiency syndrome (AIDS) was first identified in I98I, its rate of spread among a primarily young and vibrant population has chilled the medical and lay communities. Today, the public response is sober and oriented toward the examination of specific policies that could lessen the impact of the disease. After six years' experience it is now feasible to propose a strategy for combating AIDS. Consensus around the policies outlined in this article should form the nucleus of the public health strategy to combat AIDS before the intervention of an effective vaccine or treatment.