AIDS: Epidemiology, Biology, and Culture

Case Western Reserve University

Anthropology

 

Janet W. McGrath

ANT 216

M,W,F: 1:30 p.m.- 2:20 p.m.

Spring 1989

 

Purpose of the Course:

 

This course presents an overview of AIDS as both a biological and socio-cultural phenomenon.  The course will cover a variety of topics, including: what AIDS is, what causes it, who gets it and how to control it.  Special emphasis will be given to exploring socio-cultural responses to the epidemic and to the long and short term consequences of the epidemic.

 

Method of Evaluation:

Midterm exam      30%

      Final exam  40%

      3 essays    10% each

 

Texts:

 

Required:

 

Confronting AIDS. Update 1988. Institute of Medicine, National Academy of Sciences, 1988.

What Science Knows About AIDS. Scientific American Publication, 1989 (note: this book is not available yet)

 

Optional:

 

Confronting AIDS: Directions for Public Health, Health Care, and Research.  Institute of Medicine, National Academy of Sciences, 1986.

Shilts, Randy. And The Band Played On: Politics, People and the AIDS Epidemic.  Viking-Penguin Edition. 1988.

 

Additional readings are on reserve at Freiberger Library.

 

Below is a tentative schedule of topics to be covered over the semester. We may decide to alter this as we proceed, but the dates that exams are scheduled and essays are due will not change.

 

Jan. 9      Introduction

 

Jan. 11     Defining AIDS: The Terms of the Epidemic. Update 1988, ch. 1

 

Jan. 13     The Human Immune System

 

Jan. 16     Retroviruses

 

Jan. 18     Human Immunodeficiency Viruses. Update 1988, pp. 123-136

 

Jan. 20     ISSUES: Is HIV-1 Really the Cause of AIDS?

            ESSAY 1 DUE

 

Jan. 23     Transmission of HIV. Update 1988, pp. 33-46

 

Jan. 25     The Disease(s)

 

Jan. 27     ISSUES: How Is AIDS Really Transmitted

 

Jan. 30     Cofactors for Infection and Disease

 

Feb. 1      Origin and Evolution of the Virus

 

Feb. 3      ISSUES:  Who Should Be Tested?

 

Feb. 6      Epidemiology of AIDS Worldwide. Update 1988, pp. 46-51

 

Feb. 8      Epidemiology of AIDS Worldwide

 

Feb. 10     ISSUES: Ethical Issues of AIDS. Update 1988, pp. 80-89

 

Feb. 13     High Risk Behaviors vs. High Risk Groups

 

Feb. 15     Treatment and Control Strategies. Update 1988, ch 4 and          

pp.136-158

 

Feb. 17     ISSUES:  Condoms!

 

Feb. 20     Epidemiology of Pediatric AIDS

 

Feb. 22     Pediatric AIDS - Guest Speaker:  Dr. Johanna Goldfarb

 

Feb. 24     ISSUES:  Evaluating AIDS Education Materials

 

Feb. 27     REVIEW

 

Mar. 1      MIDTERM EXAM

 

Mar. 3      NO CLASS

 

Mar. 6,8,10VACATION

 

Mar. 13     Antiviral Therapies - Guest Speaker:  Dr. Jonathon Rosenthal

 

Mar. 15     Social and Cultural Responses to Epidemic Diseases

 

Mar. 17     ISSUES: Legal and Ethical Issues in AIDS Control - Guest speaker:  Eileen Roberts

 

Mar. 20     AIDS and Minorities - Guest speaker: Dr. Jacob Gayle

 

Mar. 22     Local Responses to and Resources for AIDS - Guest speaker:  Joseph Interrante

 

Mar. 24     AIDS in IV Drug Users - Guest speaker:  Dr. Richard Stevens

 

Mar. 27     Popular Conceptions and Misconceptions About AIDS

 

Mar. 29     AIDS Education

 

Mar. 31     ISSUES:  Has the Media Done a Good Job Reporting on AIDS?

            ESSAY 2 DUE

 

Apr. 3      Economic Costs of AIDS

 

Apr. 5      Frontline:  Who Pays for AIDS?

 

Apr. 7      NO CLASS

 

Apr. 10     The Politics of AIDS

 

Apr. 12     The Politics of AIDS Research

 

Apr. 14     ISSUES: What Is or Should a Government's Responsibility Be?

            Update 1988, ch. 7,8

 

Apr. 17     Demographic Consequences of AIDS. Update 1988, p. 52

 

Apr. 19     AIDS and Religion

 

Apr. 21     ISSUES:  Is AIDS a Moral Issue?

 

Apr. 24     AIDS in the Year 2000. Update 1988, App. A

 

Apr. 26     REVIEW

            ESSAY 3 DUE

 

FINAL EXAM: WEDNESDAY, MAY 3, 1989 - 8:00 a.m.-11:00 a.m.

 

Assignments and required reading (in addition to Update):

 

Week 1     

Essay 1:  How the AIDS epidemic has affected me personally. 3-5 pages.  Due January 20, 1989

 

The AIDS epidemic, more than any other in recent history, has provoked profoundly personal responses. Some of you may have lost friends or family to AIDS; others may be planning a career in medicine and may be concerned about the impact of AIDS on your career; some of you may be concerned about your current or future sex life. In this short essay, please describe how the AIDS epidemic has affected you personally.  Use this assignment to examine how you feel about AIDS and what is happening as a result of the epidemic. Anything you write will remain confidential.

 

Week 2     

Gallo, R.C. "The First Human Retrovirus." Scientific American 255:88-98, 1986.

Gallo, R.C. "The AIDS Virus." Scientific American 256:46-56, 1987.

"A Rebel Without a Cause for AIDS." Science 239:617-622, March 25, 1988.

"Duesberg Gets His Day in Court." Science 240:279, April 15, 1988.

Duesberg, P. "HIV is not the Cause of AIDS." Science 241:514, July 29, 1988.

Blattner W., R.C. Gallo, and H.M. Temin. "HIV Causes AIDS." Science 241:515, July 29, 1988.

The Cause of AIDS (Letters). Science 242:997-998, November 18, 1988.

 

Week 3     

Lifson, A.R. "Do Alternative Models for Transmission of Human Immunodeficiency Virus Exist?" Journal of the American Medical Association 259:1353-1356, 1988.

 

Week 4

Essex, M. and P.S. Kanki. "The Origins of the AIDS Virus."  Scientific American 259:64-71, October 1988.

Heyward, H.L. and J.W. Curran. "The Epidemiology of AIDS in the U.S."  Scientific American 259:72-81, October 1988.

 

Week 5

Mann, J.M. et al. "The International Epidemiology of AIDS." Scientific American 259:82-89, October 1988.

Walters, L. "Ethical Issues in the Prevention and Treatment of AIDS."  Science 239:597-603, 1988.

 

Week 6

"Condoms for Prevention of Sexually Transmitted Diseases." Morbidity and Mortality Weekly Report 37:133-137.

 

Week 7

"Continuing Jeopardy: Children and AIDS."  A Staff Report of the Select Committee on Children, Youth and Families, September 1988.

 

Essay 2: Review of a popular (i.e. nonscientific) article about HIV and/or AIDS. 3 - 5 pages.  Due March 31, 1989

 

The purpose of this assignment is for you to critically evaluate a popular article about HIV/AIDS.  A critical evaluation involves consideration of the goals of the article, the content, and the quality of the presentation. For this assignment, you will select an article (or two if they are very short) in the popular press about HIV and/or AIDS.  This article can be in any non-scientific publication such as Cosmopolitan, Reader's Digest, People Magazine, Glamour, Ms, Popular Mechanics, or whatever.  Newsweeklies such as Time and Newsweek may be included only if the article is not part of the science/medical columns.  In a short essay, briefly (in a few sentences) summarize the article, then discuss the following:

 

1)  What is the purpose of the article (e.g. to educate, to entertain, to frighten)?

2)  At what audience is the article targeted?

3)  Are the facts presented about HIV/AIDS accurate?

4)  What emotional response does the article elicit or attempt to elicit?

5)  Does this response help or hinder the purpose of the article?

6)  Does the article achieve its purpose?  If so, why and how?  If not, why? 

    What does the article achieve in your opinion?

 

Week 10

Brandt, A.M. "The Syphilis Epidemic and Its Relation to AIDS."  Science 239:375-380, 1988.

Fineberg, H. "The Social Dimensions of AIDS." Scientific American 259:128-134, October 1988. 

Dickens, B.M. "Legal Rights and Duties in the AIDS Epidemic." Science 239:580-586, 1988.

 

Week 11

Rogers, M.F. and W.W. Williams.  "AIDS in Blacks and Hispanics: Implications and Prevention." Issues in Science and Technology (Spring 1987):88-94.

Hopkins, D.R. "AIDS in Minority Populations in the United States." Public Health Reports 102:677-681, 1987.

 

Week 12

Schoepf, B.G. et al. "AIDS in Society in Central Africa: A View from Zaire."  In AIDS in Africa: The Social and Political Impact. N. Miller and R.C. Rockwell, eds. Studies in African Health and Medicine 10:211-235. The Edwin Mellin Press, 1988.

Risse, G.B. "Epidemics and History: Ecological Perspectives and Social Responses." In AIDS: The Burdens of History, pp. 33-36. E. Fee and D.M. Fox, eds. Berkeley: UC Press, 1988.

 

Seven newspaper articles available on reserve

 

Read either:

1) Leishman, K. "Heterosexuals and AIDS." The Atlantic Monthly (February 1987): 39-57.

      OR   

2) "Sex in the age of AIDS." Newsweek (March 14, 1988):42-52.

      AND  

3) "AIDS and the Single Woman." People (March 15, 1988):102-112.

 

Week 13

Bloom, D.E. and G. Carliner. "The Economic Impact of AIDS in the United States." Science 239:604-610, 1988.

 

Essay 3:  Funding Priorities for HIV and AIDS related research and services

    3-5 pages. Due April 26, 1989

 

Your final essay for this semester is an opportunity for you to delineate what you believe should be the priorities for funding of HIV and AIDS related research and services.  We have covered many issues concerning AIDS this semester, and you should have a sense of the areas in which you believe more work should be done.  However, as we all know, money is limited and good research and services programs must compete for dollars.  In order to decide how best to distribute those dollars, we must have a sense of priorities.  What would you designate as the priorities in both research and services.  Why?  Give a thoughtful discussion of why you would focus on certain research and services and not others.

 

Week 14

Shilts, R. "In Cold Blood." Mother Jones, November 1987. (excerpted from And the Band Played On.

Waite, G.  "The Politics of Disease: The AIDS Virus in Africa."  In AIDS in Africa: The Social and Political Impact.  N. Miller and R.C. Rockwell, eds.  Studies in African Health and Medicine 10:145-164. The Edwin Mellin Press, 1988.

 

Week 15

New Model for AIDS in the Third World

 

Week 16

Schram, N. "AIDS: 1991." The Plain Dealer, Sunday, November 16, 1986.