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  1. 1

    The AIDS pandemic: a global emergency.

    Bolton R

    New York, New York/Montreux, Switzerland, Gordon and Breach, 1989. xi, 117 p.

    This is a collection of articles by different authors writing about the AIDS pandemic from an anthropological perspective. Chapters are included on metaphors of sex and deviance in the representation of disease; the social classification of AIDS in U.S. epidemiology; sexual behavior and the spread of AIDS in Mexico; surveys on the prevalence of HIV infection in central and eastern Africa; strategies for dealing with AIDS based on those used for hepatitis B; the role of a community-based health education program in the prevention of AIDS; preventing AIDS contagion among intravenous drug users; human rights and public health; the legal status of AIDS in the workplace in the United States; and the politics of AIDS at the microlevel, using the example of a gay rights ballot measure proposed in Houston, Texas, in 1985.
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  2. 2

    The politics of funding for AIDS and the impact on other STD programs.

    Wertheimer W

    In: International Health in the 1990s: Directions in Research and Development, NCIH Southern Regional Conference, Chapel Hill, North Carolina, October 29-31, 1987, selected proceedings, coordinated by Maureen Heffernan. Washington, D.C., National Council for International Health, 1988 Spring. 123-6.

    The issue of AIDS and all Sexually Transmitted Diseases (STDs) is now caught in the middle of a struggle to shape public opinion, and future funding of education services and research depends, to a large degree, on the outcome of that struggle. The issue is very sensitive, being involved with sex and fear. It has been highly politicized in the US because of several factors. 1) The public's education on the issue came mainly through the press, often making it unbalanced and sensational. 2) The public gets mixed signals: they are told that there is nothing to fear from a person with AIDS at work place or at school, but also read that many doctors and dentists avoid AIDS patients. 3) Federal government policy decisions on the issue often seem to be political, not coming from its medical experts. 4) The typical victim is among the disenfranchised of our society, and blaming the victim is a common reaction. Society has been unwilling to accept the reality of sexually transmitted diseases, as is clearly reflected in the way the government has allocated government funds. The challenge to America is to create an atmosphere that allows rational policy. 1) More and better information dissemination is critical; other countries are way ahead of the US in this matter. 2) The issue of heterosexual transmission should be put in proper perspective. 3) Professional training in all aspects of STDs and AIDS research, care and prevention needs to be vastly expanded. 4) The AIDS issue should be placed in the broader context of STDs and other public health problems to avoid all types of unhealthy competition among special interests.
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  3. 3

    AIDS, power, and reason.

    Bayer R


    This article outlines some of the potential societal consequences of the acquired immunodeficiency syndrome (AIDS) epidemic. The epidemic hit the US after a long process of affirming certain rights to privacy and decriminalization of certain victimless private acts. Now US society is faced with the possibility of having to alter private behavior to halt the advance of a very serious disease. From a liberal point of view, measures designed to restrict personal freedom must be justified by a strong showing that no other path exists to protect the public health. The public health departments in the 2 US cities most affected have shown remarkable restraint in the face of demands for very strong measures to control the infection's spread, including strict quarantines, mostly on the part of conservative elements and press. Actually, the practical aspects of separating great numbers of people (adequate testing, transportation, feeding and housing, forcible containment), preclude this solution, even assuming these people were not overwhelmingly opposed. An alternative suggestion: mass screening, would also present immense logistical and civil-liberties obstacles, even in modified versions, i.e. government-mandated workplace testing, and mass-screening with the sole purpose of education and counseling would be inconceivable: the logic leads inevitably to mass quarantine. Quarantine or similar control exerted over AIDS-antibody positive individuals who continue to behave in ways exposing others to infection risk (e.g. male and female prostitutes) has historical precedents, but would probably have little impact on the epidemic, especially since it would not affect those who, in private, continue to engage in dangerous behavior. Mass education, though legally, morally, and politically palatable, has often not shown results in campaigns to eliminate other types of dangerous behavior. However, innovative efforts especially by gay community groups to educate for safe sex seem to have been dramatically successful.
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  4. 4

    Quarantine and the problem of AIDS.

    Musto DF


    This artical discusses the concept of quarantine and social and attitudinal manifestations of it through history, with a view towards preparing for the likely societal reaction to acquired immunodeficiency syndrome. Will public fears surrounding the AIDS epidemic spur public efforts for a quarantine? AIDS is prevalent among groups traditionally held in low esteem (homosexual men, and intravenous drug users), engaging in practices that are or have been illegal, and shares characteristics with diseases historically inspiring quarantines: leprosy, where the church took a role in the quarantine ritual; bubonic plague, where the breath, contact, and even gaze of victims were suspect; yellow fever, which in the US inspired much debate over the relative benefits of quarantine or environmental cleanliness, with quarantine often winning out at the expense of cleanliness; cholera, which killed 1000s in New York City in 1832 despite immense powers given to the Board of Health to control shipping and transportation; and tuberculosis, which, like AIDS, has a long latent period and period and period of contagiousness when the patient can continue to be in contact with the community. Irrational beliefs associating the use of certain drugs with ethnic groups (e.g. opium with Chinese; marijuana with Mexicans); as well as a perceived threat to racial purity of contact with these groups have often inspired restrictive immigration laws and discriminatory practices. AIDS has shown potential for spreading outside of traditional risk groups. History also shows that quarantines are often attempted over the objections of the contemporary medical establishment. Reminders of the past ineffectiveness of quarantines and an improved knowledge of AID's characteristics should help protect against irrational fears prompting a quarantine.
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