HIV and the Blood Supply:: An Analysis of Crisis Decisionmaking

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National Academies Press, Oct 5, 1995 - Medical - 352 pages
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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.
  

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Contents

EXECUTIVE SUMMARY
1
INTRODUCTION
19
THE U S BLOOD SUPPLY SYSTEM
25
HISTORY OF THE CONTROVERSY
57
PRODUCT TREATMENT
81
DONOR SCREENING AND DEFERRAL
101
REGULATIONS AND RECALL
135
RISK COMMUNICATION TO PHYSICIANS AND PATIENTS
169
CONCLUSIONS AND RECOMMENDATIONS
207
Figures
220
A Individuals Interviewed by the Committee
239
Chronological Summary of Critical Events National Hemophilia
247
Key Documents Provided to the Committee
263
E Glossary of Acronyms and Terms
303
F Committee and Staff Biographies
315
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