The following is a true story, with names changed. Bridgett met Albert when she was 17 and he was 24. He was very clean and good-looking, and when they became sexually active he refused the use of condoms, saying that he knew he was HIV free. After living together for a year, they went to donate blood and were informed that the test showed that both of them were HIV positive. Later, Albert's brother told Bridgett that Albert had known that he carried HIV for two years before she met him, and that he had previously infected another young woman.

• Should Albert be punished in any way for his actions since he knew he was HIV positive?
• Should Albert be quarantined? Should his other known sexual partners be informed?
• Should Bridgett be quarantined? What about her possible future sexual partners?
• If Albert had not known in advance that he was HIV positive but did live a high risk lifestyle would he still be held liable for infecting Bridgett with HIV?

A physician in Tucson had a young couple as patients who were experiencing marital problems. The wife left for another man and the couple divorced. This new man was HIV+, and the woman also became infected. After his death, she returned to Tucson and her physician began treating her for HIV infection. Her ex-husband came to the same physician for a physical and mentioned that he had begun dating his ex-wife again. The physician was unable to warn the man that his ex-wife was now HIV+ since they were not married and any communication about the woman would have violated right-to-privacy laws. What do you think the physician should have done?

In 1986, Uganda's President Yoweri Museveni has spearheaded an aggressive anti-AIDS policy. Every government department issues anti-AIDS warnings; sex is discussed openly in explicit terms; roadside billboards promote safe sex; and foreign-financed non-government organizations are given virtually free reign to educate people about the disease. Since 1992, the level of infection among young pregnant women has been in decline (Nature Medicine. 5, 963. 1999). Compared to Uganda, do you think our society does an adequate job of educating its citizens about HIV and AIDS? If not, what improvements do you think are needed?

Do you agree or disagree with the following statement: "When you share fluid with someone, you are also sharing fluid with everyone they have previously shared with." Explain your answer.

Do individuals who test positive for HIV have an obligation to notify any of the following people?

• People with whom they share living space
• Current sexual partners
• Former sexual partners
• Doctors
• Teachers
• Coworkers

You and your partner have been practicing safe sex for since the beginning of your sexual relationship two months ago. You both agree to an HIV test, and the results are negative for both of you. How will this influence your behavior? The ELISA that you received detects the presence or absence of antibodies against HIV. Antibodies can take one to six months to develop after exposure to HIV. During this time between exposure and antibody production the virus can reproduce rapidly and the amount of virus present in body fluids is high. How does this information influence your behavior?

More than 90% of HIV infected people live in developing countries and do not have access to anti-HIV medications. Drug companies spend $10 -100 million to develop current anti-HIV drugs, and must recoup that money, making it difficult for them to provide the drugs at low cost. Which of the following actions should be taken to increase access to treatment for most of the world's HIV+ individuals?

• Governments join to provide tax breaks to multi-national corporations which develop and manufacture anti-HIV drugs.
• The World Bank provides loans to developing countries to purchase drugs to treat HIV.
• The US Government purchases drugs and distributes them to developing countries.
• What other alternatives might increase access to HIV treatment?

Drug treatments now allow many HIV+ individuals to live longer and maintain a higher quality of life. Current anti-HIV drugs must be taken multiple times daily on a careful schedule and often cause severe side effects in people who otherwise may feel completely healthy. If patients don't adhere to their drug regimens, they increase the rate at which drug resistant strains of HIV develop. Should patients be monitored for adherence to drug regimens and/or whether they are developing drug resistant virus?

Should HIV infected individuals have the right to the same type of medical insurance as others who do not have HIV? Should society be made to help pay their costs? What if some HIV patients continue high-risk behavior that exposes them to more infectious agents, increasing the costs of their treatments?

Assuming that the online fluid exchange activity mimics the transfer of HIV through a population, why might we want to identify the original HIV carriers? In the online exercise, fluid exchange with an HIV+ individual automatically infects the other partner, although in real life this is not necessarily true. Different behaviors carry varying risks of HIV transmission. How might knowledge of rates of HIV transmission through specific activities change your approach to determining original HIV carriers within a population?

Education about HIV and AIDS is the first step in prevention. What role should public schools in the US play in educating children about HIV and AIDS? At what age should this education begin?