HIV and the Blood Supply: An Analysis of Crisis Decisionmaking / Edition 1

HIV and the Blood Supply: An Analysis of Crisis Decisionmaking / Edition 1

by Lauren B. Leveton, Harold C. Sox, Michael A. Stoto, Committee to Study HIV Transmission Through Blood and Blood Products
     
 

ISBN-10: 0309053293

ISBN-13: 9780309053297

Pub. Date: 10/05/1995

Publisher: National Academies Press

During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease.

During

Overview

During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease.

During this period of great uncertainty, decisionmaking regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system.

The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was done--and recommends what should be done to produce better outcomes in the face of future threats to blood safety.

The committee frames its analysis around four critical area

  • Product treatment--Could effective methods for inactivating HIV in blood have been introduced sooner?
  • Donor screening and referral--including a review of screening to exlude high-risk individuals.
  • Regulations and recall of contaminated blood--analyzing decisions by federal agencies and the private sector.
  • Risk communication--examining whether infections could have been averted by better communication of the risks.

Product Details

ISBN-13:
9780309053297
Publisher:
National Academies Press
Publication date:
10/05/1995
Edition description:
New Edition
Pages:
352
Product dimensions:
6.00(w) x 9.00(h) x 1.13(d)

Table of Contents

Executive Summary 1(18)
Introduction
19(6)
HIV Infection via Blood Transfusion
21(1)
The Committee's Charge
22(2)
Organization of the Report
24(1)
The U.S. Blood Supply System
25(32)
Introduction
25(1)
Blood and Blood Products
25(9)
Blood Collection Organization
34(2)
Professional Associations
36(2)
Hemophilia Organizations
38(3)
Role of the U.S. Public Health Service
41(6)
Blood and Blood Product Regulation
47(4)
Regulatory Authority of the FDA
51(2)
Summary
53(4)
History of the Controversy
57(24)
Introduction
57(3)
The Risk of AIDS
60(10)
Immediate Responses to Evidence of Blood-Borne AIDS Transmission
70(4)
Reconsidering the Evidence: Further Attempts to Formulate Policies
74(2)
Research Activities
76(5)
Product Treatment
81(20)
Introduction
81(2)
Critical Time Period: 1970-1983
83(9)
Analysis and Conclusions
92(3)
Summary
95(1)
Afterword
96(5)
Donor Screening and Deferral
101(34)
Introduction
101(2)
Donor Screening Practices
103(2)
Analysis and Findings
105(17)
Conclusions
122(6)
Afterword
128(7)
Regulations and Recall
135(34)
Introduction
135(1)
Framework of Analysis
136(6)
Findings and Conclusions
142(18)
Influence and Responsibilities of Other Organizations
160(3)
The Advantages of Marginal Thinking
163(3)
Summary
166(3)
Risk Communication to Physicians and Patients
169(38)
Introduction
169(1)
Framework for Analysis
170(5)
Risk Reduction Options
175(6)
Case Studies
181(11)
Obstacles to Communication
192(9)
Conclusions
201(6)
Conclusions and Recommendations
207(116)
General Conclusions
207(10)
Recommendations
217(22)
APPENDIXES
A Individuals Interviewed by the Committee
239(4)
B Individuals Providing Oral and Written Testimony
243(4)
C Chronological Summary of Critical Events, National Hemophilia Foundation (NHF) Communications, Knowledge Base, Risk Assessment, Clinical Options, and NHF Actions
247(16)
D Key Documents Provided to the Committee
263(40)
E Glossary of Acronyms and Terms
303(12)
F Committee and Staff Biographies
315(8)
Index 323

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