The Social Impact of AIDS in the United States

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National Academies Press, Jan 1, 1993 - Health & Fitness - 322 pages
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"Epidemic" comes from the ancient Greek epi demos, meaning "upon the people or the community". The AIDS epidemic is having a profound effect on Americans and their communities, in areas ranging from public health to religion. As many as 1 million people in the United States may be infected with HIV, the virus that causes AIDS, but its ultimate impact will extend far beyond those individuals and their families. AIDS has been compared with epidemics of the past, most commonly the bubonic plague of the 14th century. Historians say the "Black Death" set the stage for the Reformation and other sweeping changes by altering public attitudes. In our own time, epidemics of cholera and venereal disease gave rise to fundamental changes in our public health system. AIDS is different from previous epidemics in that there is no wave of quick death sweeping through the population. Instead, as persons with AIDS and their loved ones can painfully testify, those infected with HIV know long in advance what will come. And the nation will confront AIDS and its consequences for years. AIDS in the United States also differs from other "democratic" epidemics in its concentration among gay men and intravenous drug users and their sexual partners, with many HIV-positive persons being among the nation's most poor and disadvantaged. The disease characteristics of AIDS have posed challenges to the way we have traditionally delivered health care. It is affecting the nature and structure of voluntarism, as volunteers step in to fill gaps left by decreases in public health funding. The political organization of the gay community has resulted in new policy directions for the use of medical test results, availability ofexperimental drugs, and other privacy and public health issues. In the realm of religion, AIDS has fueled the debate about homosexuality - with some people believing in the "divine retribution" of disease while others mobilize to help people with AIDS and their families. AIDS significantly affects practical issues of law enforcement, raising questions about testing new prisoners and physically separating HIV-infected inmates - who, in New York State, may account for as much as 20 percent of the prison population. Should all pregnant women be tested for AIDS? Should gay partners be treated as married couples for purposes of health insurance and inheritance? How serious is the threat to health professionals caring for AIDS patients? How will we care for AIDS babies? Not only a national medical crisis, AIDS is also raising questions about a wide range of social issues. This important volume will help readers understand the impact of AIDS on social and cultural institutions and how those institutions have responded. With authoritative information, illustrative case studies, and insightful commentary, this even-handed and fact-filled book will guide readers in grappling with these fundamental issues and what they might mean for our future.

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