Public opinion about AIDS before and after the 1988 U.S. government public information campaign

In October, 1987, the Centers for Disease Control mounted a massive public information campaign to alert the public to the dangers of AIDS and to provide information about its transmission and prevention. Using data from two Gallup surveys, one just before the campaign began and the other several months after its conclusion, we examine changes in public information and misinformation about transmission, in concern about AIDS as an epidemic, and in reported behavior to avoid exposure to AIDS. We conclude that although some changes in knowledge did take place, these were essentially a continuation of trends beginning before the public information campaign and continuing well after its conclusion. For these and other reasons, we argue that the effects of the campaign on public information were minimal. However, between 1987 and 1988 there was a small but statistically significant increase in reported condom use, an increase paralleled by increased condom sales between 1986 and 1988. In addition, there was a substantial increase in the number of people expressing concern about AIDS as an epidemic for the population at large. The campaign may well have contributed to both of these changes.     

Issues of confidentiality when working with persons with AIDS

Acquired Immunodeficiency Syndrome (AIDS) has increasingly become a serious public health threat in our contemporary society. The number of cases has grown rapidly since the disease was first reported and the total number of cases has been estimated to be close to 270,000 in the United States alone, according to some sources (Gray, 1988). Many of the affected, their sexual partners and families, will be recipients of social work services. In addition to therapeutic skills for effective intervention, the issues of confidentiality and related legal and ethical implications warrant serious examination and consideration for all clinical social workers working with this population. Specific practice suggestions will be explored.     

AIDS instruction in US schools of social work: 20 years into the epidemic

A survey of 108 accredited master of social work (MSW) programs was conducted to examine curriculum attention to acquired immune deficiency syndrome (AIDS). More than half of the programs (57.4%) offer no HIV/AIDS courses; more than three quarters (87%), however, do provide HIV/AIDS internship experiences. Interestingly, urban schools of social work, areas with higher rates of reported AIDS cases, and larger schools of social work do not offer more formal opportunities for HIV/AIDS education compared to rural schools, areas with lower rates of reported cases, and smaller schools of social work. Students wanting more formal instruction in HIV/AIDS issues, therefore, may not find more opportunities in larger urban schools. Institutes of higher education can be proactive in the continued need for offering HIV/AIDS educational opportunities.     

REVIEWS

Carl, D. (1990). Counseling same-sex couple.
Walker, G. (1991). In the midst of winter: Systemic therapy with families, couple, and individuals with AIDS infection.
Mirkin M. (Ed.). (1990). The social and political contexts of family therapy.
Schaefer, C., & Briemeister, J. (Eds.). (1989). The handbook of parent training.
Perelberg, R.J., & Miller, A.C. (Eds.). (1990). Gender and power in families.
Kaslow, F. W. (1990). Voices in family psychology (Vol.1).
Kaslow, F. W.(1990). Voices in family psychology (Vol.1).
Brown, E. (1991). Patterns of infidelity and their treatment.
Moultrup, D.J. (1990). Husbands, wives, and lovers: The emotional system of the extramarital affair.
Williams, J.M., & Kay, T. (Eds.). (1991). Head injury: A family matter.
Furstenberg, F., Jr., & Cherlin, A.(1991). Divided families: What happens to children when parents part.
Besharov, D. (1990). Recognizing child abuse: A guide for the concerned. Burt, M. (Ed.). (1989). Stepfamilies stepping ahead: An eight-step program for successful family living.
Divorce Support Services, Inc. (1991). Answers:A divorce/separation survival handbook.
Wettheimer, A. (1991). A special scar: The experiences of people bereaved by suicide.
Jesse, R.C. (1990). Healing the hurt: Rebuilding relatinships with your children; a selfhelp guide for parents in recovery.     

Does funding for HIV and sexually transmitted disease prevention matter? Evidence from panel data

Since the onset of the AIDS epidemic, the Centers for Disease Control and Prevention (CDC) has allocated several billion dollars for the prevention of HIV and other sexually transmitted diseases (STDs) in the United States. Using state-level data from 1981 to 1998, the authors found that greater amounts of prevention funding in a given year are associated with reductions in reported gonorrhea incidence rates in subsequent years. The authors conclude that funding for STD and HIV prevention, on the whole, appears to have a discernable impact on the incidence of STDs.     

ANTICIPATORY AND ACTUALIZED IDENTITIES: A Cultural Analysis of the Transition from AIDS Disability to Work

Throughout the course of their lives, many people living with HIV/AIDS have prematurely retired onto AIDS disability. A new trend, however, has swept across the nation. Where once people were getting sick, leaving work, and embracing inevitable death, now, with advances in medical technology, many people with HIV/AIDS are renewing their lease on life and discovering a desire to go back to work. To learn how gay men's identities are impacted as they transition from AIDS disability back to the labor market, I conducted three months of fieldwork at an employment placement agency in San Francisco. During fieldwork I distributed informal questionnaires to 120 gay men and then formally interviewed 10 additional gay men who had either transitioned or were considering transitioning from AIDS disability back to work. Analyses reveal that cultural, structural, and medical contradictions typify the return to work. As gay men experience and live through these contradictions, their identities split into anticipatory and actualized components. By facilitating a reassessment of meanings and values, anticipatory identities cognitively and emotionally prepare individuals as they brave the road back to work. This version of identity represents a romanticized confluence of worker (role) identity, gay (status/master) identity, and overall sense of self (self-concept). Personal experiences with stigma, shame, and discrimination along with complexities of the workplace and medical services, however, prevent the maturation of anticipatory identities when seeking reemployment. This results in loosely coupled and situationally informed actualized identities . The relationship between these two identities suggests that many people living with HIV/AIDS—and indeed others who experience stressful life transitions—face complex choices between quality-of-life issues and the ability to survive according to external cultural and structural constraints.     

HIV/AIDS and return to work: a literature review one-decade post-introduction of combination therapy (HAART)

It has been a little over one decade since the introduction of the first protease inhibitor that ushered in new era of treatment for persons living with human immunodeficiency virus (HIV) and Acquired Immune-Deficiency Syndrome (AIDS). As of the end of 2003, an estimated 37.8 million people worldwide were infected with the HIV. It is estimated that there are 850,000-950,000 persons in the United States living with human immunodeficiency virus (HIV) and that the incident rate is new cases each year. Since AIDS affects so many people of working age in the US, issues of employment, work rehabilitation and AIDS in the workplace have all become major concerns. The paper presents a review of the literature published during a ten year period that is relevant to understanding the various needs and barriers related to work as well as services designed to address them.     

Autocastration and autopenectomy in a patient with transsexualism and schizophrenia

Previous research focusing on changes in gay male sexual practices as a result of AIDS often avoids taking into consideration the meanings which sexual practices have within the gay community. As an alternative, the present study used a content‐analysis of personals advertisements within the personals section of The Village Voice to assess changes in the language gay men use to refer to their sexuality between the years 1978, 1982, 1985, and 1988. A significant increase in personals advertisements suggesting a concern with health is noted from 1982 to 1985. This increase continues from 1985 to 1988. Corresponding in time with these changes are increases in the number of personals advertisements which express a rejection of “stereotypical” presentations of self within the gay community. This rejection is seen as an attempt at self‐affirmation of characteristics perceived by gay men themselves as being desirable at particular historical moments. Implications for the basis of future policy interventions in reaction to AIDS are discussed. Finally, the utility of personals advertisement columns as an indicator of the meanings which people of various sexual preferences attach to their sexuality is discussed.     

Briefly Noted

Last week, the federal Centers for Disease Control (CDC) issues a warning about a cluster of pulmonary illnesses possibly linked to vaping. The cases have primarily been among adolescents and young adults. In some cases the young people had also used cannabis.     

Drivers of workplace discrimination against people with disabilities: the utility of Attribution Theory

The purpose of this paper was to determine what drives workplace discrimination against people with disabilities. These findings are then compared to available literature on attribution theory, which concerns itself with public perceptions of the controllability and stability of various impairments. The sample included 35,763 allegations of discriminations filed by people with disabilities under the employment provisions of the Americans with Disabilities Act. Group A included impairments deemed by Corrigan et al. [1988] to be uncontrollable but stable: visual impairment (representing 13% of the total allegations in this study), cancer (12%), cardiovascular disease (19%), and spinal cord injuries (5%). The controllable but unstable impairments in group B included depression (38%), schizophrenia (2%), alcohol and other drug abuse (4%), and HIV/AIDS (7%). The Equal Employment Opportunity Commission had resolved all allegations in terms of merit Resolutions (a positive finding of discrimination) and Resolutions without merit. Allegations of workplace discrimination were found to center mainly on hiring, discharge, harassment, and reasonable accommodation issues. Perceived workplace discrimination (as measured by allegations filed with EEOC) does occur at higher levels in Group B, especially when serious issues involving discharge and disability harassment are involved. With the glaring exception of HIV/AIDS, however, actual discrimination (as measured by EEOC merit Resolutions) occurs at higher levels for Group A.     

Sinic conundrum: A history of HIV/AIDS in the people's republic of china

China's HIV/AIDS case rate continues to grow despite national and World Health Organization efforts. Reports in Western journals are nearly nonexistent, and what is in print does not provide evidence of the infection's historical progress. I traced progress of the infection since my last report (1991) and based current findings on unobtrusive data [HIV blood screening (assays)] provided by State epidemiology‐prevention stations and on ethnographic interviews conducted with public health officials from the Center for AIDS Surveillance, Chinese Academy of Preventive Medicine, and epidemiology personnel in Beijing, Chengdu, Chongqing, and Shanghai during fieldwork in China in 1992 and 1993. Cultural, social, economic, and political factors involved in China's historical attempts to manage a growing HIV case rate are discussed. Together, data reveal a widening geographic and social distribution of the virus over time, which, in conclusion, should now qualify China's HIV status as epidemic.     

Communalization and Homophile Organization Membership:

This paper applies a sociological perspective to homophile organizational membership in the pre- and post-Stonewall gay community, and now, during AIDS. Focus is on comparing early theories of gay community organizational participation with the genesis, nature, and meaning of gay/AIDS volunteerism as a political statement. By emphasizing how the communalization of AIDS empowered gay people, earlier homophobic vocabularies of analysis are replaced with those that recognize gay pride as the source of organizational membership. Today, self-acceptance by gays leads to the willingness to “bear witness” to People with AIDS in voluntary community based initiatives which join the personal and collective interest in a way that confirms a positive homosexual identity. The theory that communalization empowers by undermining homophobia is supported by data taken for a survey of volunteers at Gay Men's Health Crisis in New York.     

Improving ascertainment of risk factors for HIV infection: results of a group-randomized evaluation

To allow appropriate allocation of prevention and care funding, HIV/AIDS surveillance data must include risk factor information, currently available for less than 70% of cases reported in the United States. The authors evaluated an intervention consisting of provider training and materials to improve risk factor reporting. Facilities were matched prior to randomization to intervention or control, and generalized linear mixed models were used to test for an intervention effect. Twenty-one percent of cases from intervention facilities and 33.4% from control facilities (p = .09) were reported without any risk factor information. The pre-post difference (20.7% for intervention and 36.0% for control) was not significant among HIV cases (p = .11) nor among AIDS cases (p = .12; 21.3% for intervention and 31.1% for control). The methods the authors' evaluated may need to be combined with other approaches and/or alternative classification schemes to significantly reduce the percentage of cases reported to surveillance without risk factor information.     

Zimbabwe's AIDS action programme for schools

AIDS education started very early in Zimbabwe and is now compulsory in all schools. This evaluation documents the development of the primary and secondary school AIDS Action Programme from 1991 to 1998. Six programme aspects were evaluated: programme start-up, planning and management, development of syllabi and materials, teacher training, research, monitoring and evaluation, and co-ordination. The Programme drew on resources from within the existing educational system. Due to broad-based consultation and participation, it was supported by Government and partners. Flexible management ensured implementation of mid-course corrections. It was concluded that school AIDS programmes should stress participatory teaching and learning methods and life-skills training. Curriculum writers and teachers needed training and supervision in participatory techniques. Cluster workshops between district and school levels were needed to strengthen the cascade model of teacher training that had been adopted. Systematic research, monitoring and evaluation were essential, including follow-ups to baseline surveys. The Zimbabwean programme was well-designed, relatively inexpensive and replicable.     

Stories of AIDS: The use of narrative as an approach to understanding in an AIDS support group

This paper shows how the co-creation and telling of narratives helped members of an AIDS support group transform their unique and separate experiences of suffering into shared insights, intense connections and comfort. Examples of narratives are drawn from the author's experience as a co-leader of a support group for gay men living with AIDS. Current literature on group work with persons living with AIDS is embedded in a modernist orientation in which the therapist is the scientist/expert, the client has the problem and the therapist helps the client's through exploring and interpreting the client's story according to a superseding theory (Gergen and Kaye, 1992). This approach emphasizes the need for leaders to maintain objectivity and emotional distance to avoid burnout (Gabriel, 1991; Grossman and Silverstein, 1993; Tunnell, 1991). In contrast, in a post-modern therapeutic approach, there is no privileging of the therapist's narrative and the traditional hierarchical relationship is replaced by a mutual effort as therapist and client together develop stories that translate and transcend experience. Using the AIDS work as illustration, this paper offers a post-modern, narrative approach to group work and shows how persons living with AIDS can use narrative to move beyond finite structures and the limits of life.This paper couldn't have been written without the help of the group members and my co-leader Sally Bowie. I want to thank them and other friends and colleagues-particularly the members of my Philosophy Study Group for their suggestions and support.The paper is dedicated to the memory of Jack, Paul, Mark, Alex, Richard, Hugh, Stan, Tim, Michael and Bill—all members of the group who have died and to Dean who, though not a member of the group, also died of AIDS and like the others—taught me much about dignity and courage, about being gay and about living with AIDS.     

Ethnostatistics and the AIDS epidemic

Ethnostatistics is the study of the social practices surrounding the construction and interpretation of statistics. This paper considers certain ethnostatistical aspects of the official statistics on AIDS cases--the monthly updated figures on AIDS cases supplied by the Department of Health and derived from the English and Scottish voluntary reporting schemes. The paper focuses on problems in the classification of cases according to the route of virus transmission, particularly where multiple risk practices may be reported. Some (but not all) classification problems can be avoided by adopting a cross-tabular format of presentation. The data on reported Scottish AIDS cases are re-analysed in order to illustrate such a cross-tabular representation. These data are the basis for a concluding statement on the difficulties in projecting future heterosexual epidemic spread.     

Anticipating the social consequences of AIDS: A position paper

Even conservative estimates of the future course of AIDS epidemic make clear that only a small fraction of people who ultimately will experience AIDS symptoms now have them and that the spread of the virus will continue for some time to come. This article focuses on the social consequences of the AIDS epidemic, some of which are beginning to be felt. I argue that sociologists have an important contribution to make anticipating the long range social consequences of AIDS. Intelligent planning is impossible without a reduction of uncertainty in what the future might hold. He currently is chair of the Methodology section of the American Sociological Association and vice-chair of the Board of the Directors of the Social Science Research Council. with research interests in gender, kinship, and biosocial science. Her concern for the AIDS epidemic flows from its being a major focus in an interdisciplinary course on human sexuality that she teaches. For the past two years at the San Francisco AIDS Foundation, she has coordinated AIDS prevention programs for women and supervised the development of educational materials. For the past three years she has been actively involved in AIDS-related research.     

Sources of health insurance and characteristics of the uninsured. Analysis of the March 1992 Current Population Survey

Eighty-three percent of nonelderly Americans and 99 percent of elderly Americans (aged 65 and over) were covered by either public or private health insurance in 1991, according to EBRI tabulations of the March 1992 Current Population Survey (CPS). The March 1992 CPS is the most recent data available on the number and characteristics of uninsured Americans. In 1991, 16.6 percent of the nonelderly population--or 36.3 million people--were not covered by private health insurance and did not receive publicly financed health assistance. This number compares with 35.7 million in 1990 (16.6 percent), 34.4 million in 1989 (16.1 percent), and 33.6 million in 1988 (15.9 percent). The most important determinant of health insurance is employment. Nearly two-thirds (64 percent) of the nonelderly have employment-based coverage. Workers were much more likely to be covered by group health plans than nonworkers (71 percent versus 40 percent). Even though workers and members of their families were more likely to be covered by health insurance than nonworkers, 85 percent of the uninsured lived in families headed by workers in 1991, primarily because most people lived in families headed by workers. More than 60 percent of uninsured were in families headed by full-year workers with no unemployment. Nearly all persons who were covered by an employment based-plan received at least some contribution to that plan from their employer. The estimated average annual contribution among those receiving a contribution to employee or family plans was $2,129. Although many individuals in poor families are covered by public health plans, that coverage is far from universal. In 1991, only 52 percent of the nonelderly with income below the poverty line were covered by a public plan--49 percent by Medicaid. The number of children who were uninsured in 1991 was 9.5 million, or 14.7 percent of all children, compared with 9.8 million or 15.3 percent of all children in 1990. Twenty-three percent of children were covered by public health insurance, with 21 percent being covered by Medicaid. In 11 states and the District of Columbia, more than 20 percent of the population was uninsured in 1991. These states and their uninsured rates were the District of Columbia (30.3 percent), Texas (25.3 percent), New Mexico (24.5 percent), Louisiana (23.8 percent), Florida (23.5 percent), Mississippi (22.1 percent), Oklahoma (22.1 percent), Nevada (21.8 percent), California (21.7 percent),Arizona (21.1 percent), Alabama (20.6 percent), and Idaho (20.6 percent).     

HIV Prevention Programs in the Black Church: A Viable Health Promotion Resource for African American Women?

ABSTRACT

Nearly 40 million people worldwide are living with the human immunodeficiency virus (HIV). The Centers for Disease Control report that women account for more than 50% of the existing 40 million HIV/AIDS cases to date. Moreover, African-American women are infected with HIV/AIDS 25 times more often than white women and four times more often than Hispanic women, making HIV/AIDS the leading cause of death for black women ages 25–34. Given the increasing rate of transmission with this population, the purpose of this article was to review the existing literature to investigate the risk factors associated with African-American women with HIV/AIDS and identify an effective method of HIV prevention for them. A discussion of religion and African-Americans in terms of the Black church and its health promotion efforts was also included. The article concludes with a discussion of program elements of HIV prevention programs in the Black church and possible challenges faced for the programs.     

Impairments and perceived competence in persons living with HIV/AIDS

Medical advances have transformed HIV/AIDS from a short-term terminal illness to a long-term chronic condition. Consequently, the disability experience of persons with HIV illness has shifted from issues related to physical well-being to those concerning performance of daily life activities and wider community participation. These changes have necessitated rehabilitation interventions for persons with HIV/AIDS to focus on issues related to enabling participation in all spheres of everyday activities. However, limited information is available on the impairments prevalent in the emergent population of people living with HIV/AIDS and on the impact of these impairments on the person's functional performance and participation in various occupations of daily living. The present study attempted to explore these issues as they are experienced by the emergent population of people living with HIV/AIDS. The purpose of the study was: (1) to explore occupational functioning across various activities, (2) to describe the various impairments prevalent in this population, and (3) to examine the impact of these impairments on the person's perceived occupational competence. Two instruments, the Sign and symptom checklist for persons with HIV disease and the Occupational Self-Assessment were administered to a sample of 35 individuals (Mean age=42.8 yrs.) living in supportive living facilities. Impairments most commonly identified by the participants included: fatigue; fear/worries; difficulty concentrating; muscle aches; and depression. The two primary areas of occupational functioning where participants reported experiencing moderate to severe difficulty included: managing finances and physically engaging in activities which were reported by 67.7% and 35.5% of the participants respectively. No statistically significant correlation was observed between various measures of impairments and the overall measure of perceived occupational competence for the sample of individuals living with HIV/AIDS included in this study.