In a review of 21 studies from the United States and other countries, researchers found that condom distribution programs, particularly in venues where people meet sex partners, increased their use. Importantly, the condom availability program was paired with extensive advertising that attempted to spread the message that wearing a condom still meant satisfying sex, not just health benefits. During my time overseeing this program from 2011 to 2017, we distributed tens of millions of condoms per year.
Rather than mandate condom use in places where people meet for sex, as the Thai government did with brothels in the 1990s, the New York City Health Department chose to flood bars, nightclubs and bathhouses with condoms starting in 2007. How do you promote the use of masks without mandates, for example? Many people say they do not enjoy wearing condoms during sex, even though using them lowers disease risk.
that extends the reach of disease prevention and lowers barriers to prevention tools holds important lessons for the future management of Covid-19 in the United States. testing as a routine part of a fun sex life. We launched a public awareness campaign to encourage H.I.V. testing to any teenager or adult seeking care for any ailment, and to offer testing at gay bars and clubs. Lamas, a pulmonary and critical-care physician, investigates whether genetics are at play.įor example, in New York City, where I led the city’s infectious disease programs, we required emergency departments to offer H.I.V. Markham Heid, a health and science journalist, details why several considerations, all valid, lead to different opinions among scientists.ĭaniela J. Why don’t experts agree about the necessity of another booster?.Carroll, the chief health officer of Indiana University, details several alternative measures for fighting Covid.Ī group of scientists who study how viruses evolve explains what might be in store. What’s next after the end of mask mandates?Īaron E.Opinion Conversation Questions surrounding the ongoing Covid-19 pandemic, as well as vaccines and treatments. tools and services, such as testing, treatment and condoms, so widely accessible and acceptable that individuals would have to actively choose not to use them. was now no longer considered an emergency, public health officials began embracing what became known as “structural” approaches to prevention. infections have remained stubbornly high nationally. has progressively moved into the background of public concern, even though new H.I.V. prevention strategy away from broad-scale public awareness campaigns to focused H.I.V. The period of widespread fear began to ebb after the advent of highly effective drug therapy in 1996, and, in 2003, the C.D.C. Nevertheless, the transition of TB to a problem of immigrant communities meant that, while public health officials and hospitals continued to struggle with treating the disease, elected officials no longer felt an urgency to address it, and federal funding mostly declined in real dollars year over year.Ī more instructive example for Covid-19 is what happened with H.I.V. Immigrants with TB often require substantially more resources to manage, given that they are often uninsured, undocumented and suspicious of government agencies. Over the next decade, these funds succeeded in significantly lowering TB among U.S.-born residents, but infections remained high among immigrant communities. In the late 1980s and early 1990s, outbreaks of drug-resistant tuberculosis caused lethal outbreaks leading to huge infusions of funding to the Centers for Disease Control and Prevention and local health departments. In the United States, public health practitioners have been through this cycle before. As the virus continues to mutate, and elected officials choose not to impose mask, vaccine or test mandates, policymakers must identify a middle ground of approaches that are both likely to protect health and be broadly acceptable. At the same time, federal funding to the Covid response is dwindling to the point that the government’s ability to buy new vaccines is threatened. A recent survey found that just 19 percent of Americans surveyed rate the coronavirus outbreak as a very big problem for the country. This is fundamentally what it means for a disease to becomes endemic: People with power, privilege and resources no longer view themselves at risk and consider it a problem primarily of “vulnerable populations.” But instead, we must live in a parallel universe in which preventing and managing Covid-19 remains a daily focus when everyone else seems to have moved on. Like everyone else, health officials and providers like me wish the epidemic would end.
Throughout the Covid-19 pandemic, there’s been a refrain among infectious disease experts: You may be done with the virus, but the virus is not done with you.