The Human Immunodeficiency Virus (HIV) remains one of the greatest challenges facing health policy makers. Despite the development and implementation of diverse prevention frameworks, the issue of HIV continues to persist. A broad spectrum of legal, administrative, cultural, and economic factors are relevant to resolving the policy dilemmas surrounding HIV. Unfortunately, policy makers frequently lack a unilateral consensus on what they should accomplish to bring their policy ideas to life.
One of the key reasons why this group is vulnerable and deserves an immediate policy solution is because HIV affects millions of people in the U.S. The Centers for Disease Control and Prevention confirm that, every year, approximately 40,000 people become HIV-infected (Palen, Levy, Wilensky, & Kates, 2004). Furthermore, even in the presence of numerous prevention initiatives, national HIV incidence and prevalence do not change (Palen et al., 2004). Finally, the American society witnesses the growing scope of risk behaviors, which further translate into increased risks of HIV infection (Palen et al., 2004). Together, these factors create an extremely challenging social and health environment that necessitates an urgent policy response.
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Based on what Palen et al. (2004) write, I would describe the policy problem as the absence of a standardized HIV prevention services framework that would cover all population layers and vulnerable groups. In other words, most medical institutions avoid incorporating HIV prevention into the list of their standard services. According to Palen et al. (2004), the Institute of Medicine recommends developing new policy initiatives to ensure that HIV prevention becomes an integral element of standard care in public and private health institutions. Unfortunately, the current state of the policy issue is too broad and needs to be narrowed down and refined.
Apparently, it is not enough to say that HIV prevention must exemplify an integral component of medical care in the U.S. In fact, the concept of “HIV prevention” encompasses numerous meanings, services, and options (Palen et al., 2004). Therefore, the current understanding of HIV prevention may vary widely across healthcare institutions. Policy makers must necessarily define the activities to be included in the HIV prevention framework, as well as the criteria of its effectiveness and efficacy. Also, the boundaries of HIV prevention must be explicitly defined to avoid duplication of healthcare efforts and unnecessary expenses.
Palen et al. (2004) provide a detailed comprehensive description of the legal, financial, and organizational issues related to HIV prevention. They focus on the analysis of the present-day legal environment, which is quite conducive of delivering and financing a variety of HIV prevention services (Palen et al., 2004). Unfortunately, fiscal, organizational, and system-wide pressures continue to impede the provision of HIV-prevention services to beneficiaries (Palen et al., 2004). The authors are particularly thorough in their analysis of the organizational and financial factors that create barriers to preventing HIV at a national scale.
Simultaneously, Palen et al. (2004) seem to ignore the administrative and cultural hurdles that may become a serious obstacle to implementing the most promising policy initiatives. The issue of patient consent to undergo HIV assessment and prevention also deserve attention. Finally, Palen et al. (2004) fail to provide any specific recommendations to create better synergy of clinical and social service resources that would enhance clients’ access to HIV prevention services.
What can make the case stronger is the use of clients’ accounts as to whether and how they can or cannot access HIV prevention opportunities that are available to them. Such information could inform the delivery of more specific policy solutions to the problem of HIV prevention in the U.S. healthcare system. These primary accounts could also point to the gaps in the preventative care delivery that are hidden from the policy eye. They would bring the health care system closer to its users, thus creating a holistic and realistic picture of the selected problem.
