Europe's "Black Death" contributed to the rise of nation states, mercantile economies, and even the Reformation. Will the AIDS epidemic have similar dramatic effects on the social and political landscape of the twenty-first century? This readable volume looks at the impact of AIDS since its emergence and suggests its effects in the next decade, when a million or more Americans will likely die of the disease.

The Social Impact of AIDS in the United States addresses some of the most sensitive and controversial issues in the public debate over AIDS. This landmark book explores how AIDS has affected fundamental policies and practices in our major institutions, examining

• How America's major religious organizations have dealt with sometimes conflicting values: the imperative of care for the sick versus traditional views of homosexuality and drug use.
• Hotly debated public health measures, such as HIV antibody testing and screening, tracing of sexual contacts, and quarantine.
• The potential risk of HIV infection to and from health care workers.
• How AIDS activists have brought about major change in the way new drugs are brought to the marketplace.
• The impact of AIDS on community-based organizations, from volunteers caring for individuals to the highly political ACT-UP organization.
• Coping with HIV infection in prisons.

This clear and comprehensive presentation will be of interest to anyone concerned about AIDS and its impact on the country: health professionals, sociologists, psychologists, advocates for at-risk populations, and interested individuals.

Contents

• Panel On Monitoring The Social Impact Of The AIDS Epidemic
• [The National Academies]
• Committee On AIDS Research And The Behavioral, Social, And Statistical Sciences
• Acknowledgments
• 1. Introduction and Summary
  • Epidemics, Impacts, And Responses
  • General Findings And Conclusions
  • Specific Findings And Conclusions
  • Technical Note
  • References
• 2. The Practice of Public Health
  • Historical Approaches To Disease Control And "Exceptionalism"
  • HIV Testing
  • Reporting And Contact Tracing
  • Quarantine, Isolation, And Criminal Prosecution
  • State And Local Public Health Practice
  • Conclusions
  • References
• 3. Health Care Delivery and Financing
  • The Health Care System As A Service Provider
  • The Health Care System As Employer
  • The Health Care System As A Market
  • Health Care Financing
  • Conclusions
  • References
• 4. Clinical Research and Drug Regulation
  • Historical Perspective
  • The First Decade Of Aids
  • Current Issues And Practices
  • Conclusions
  • References
• 5. Religion and Religious Groups
  • Religious Doctrines And Traditions
  • Early Response To The Epidemic
  • Official Statements And Local Activities
  • Conclusions
  • References
• 6. Voluntary and Community-Based Organizations
  • The Origins Of Community-Based Service Organizations
  • Who Volunteers And Why
  • Volunteers And What They Contribute
  • The Rise Of Advocacy
  • Volunteers And Community-Based Organizations In The Second Decade
  • Conclusions
  • References
• 7. Correctional Systems
  • Who Are The Prisoners
  • The Burden Of HIV Disease In Prisons
  • Medical Treatment
  • Transfer And Release Concerns
  • Conclusions
  • References
• 8. Public Policies on Children and Families
  • Newborns And Children
  • Legal Recognition Of Unmarried Couple Relationships
  • Conclusions
  • References
• 9. The HIV/AIDS Epidemic in New York City
  • Course Of The Epidemic
  • The Two Epidemics
  • Public Health And Health Care
  • Correctional Systems
  • Impact Of HIV/AIDS On Women, Children, And Families
  • Religion: Conflict Over Condoms And Aids Education For Young People
  • Conclusions
  • References
• Appendixes
  • A Biographical Sketches
  • B Participants in Panel Activities

The project that is the subject of this report was supported by the Public Health Service, U.S. Department of Health and Human Services; the Lilly Endowment, Inc.; and the Sierra Foundation.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their competences and with regard for the appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.