Parallels with Other Diseases
HIV is not unique as an infectious agent. More than 60 infectious diseases are reportable in various states and are a common part of public health practice. HIV is less difficult to work with and control than many other diseases because it is less easily spread. Diseases that may be spread through casual respiratory contact, for example, can be much more difficult to prevent and control. Tuberculosis was controlled before it was treatable. Other diseases with carrier states must be managed without definitive therapy. Standard public health such as public education, screening, and contact tracing also are effective in the control of HIV.
Fear is both a problem and an opportunity in disease control. Public hysteria can make rational disease control measures impossible. Yet without some level of fear, it is impossible to keep the public and their elected representatives interested in disease control. During the polio epidemics of the 1930s and 1940s, people canceled group meetings of all kinds, threw away food because a fly had lighted on it, and defied school attendance laws. The advent of Salk’s vaccine brought the polio epidemics and the associated hysteria to an end. Less than 30 years later, it is difficult to maintain proper levels of immunization against measles because parents believe the disease is eradicated and do not have their children immunized.