Controlling AIDS in Cuba: The Logic of Quarantine
New England Journal of Medicine. 1989 Apr 13; 320(15): 1022-1024.
The authors visited Cuba as guests of its Ministry of Health to observe that country's program to limit the spread of human immunodeficiency virus (HIV) infection. Cuba seeks to resolve risk in favor of safety and public health with no presumption in favor of freedom. Education is not a central or dominant feature of the program. The goal is to identify infected persons and bring them under medical control. HIV screening is mandatory, initially targeted at high risk groups and later to be extended to the entire population. Persons identified as HIV infected are quarantined at a sanitorium outside Havana, from which they are permitted chaperoned furloughs. There is disagreement as to the degree of coercion used to enforce the program. Bayer and Healton agree that this policy will limit the toll of HIV infection in Cuba, but only within the context of political and moral values contrary to those of nations for whom prevention is not the only value to be considered. (KIE abstract)
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