AIDS as a Public Health Issue

University of Miami

Department of Anthropology

 

Douglas Feldman, Ph.D.
EPH 521

Wednesday, 4:30 p.m.-6:20 p.m. 
Spring 1990

 

Purpose: To examine AIDS as a public health issue, including material on HIV epidemiology, etiology, treatments, sociocultural factors, political aspects, legal issues, policy formulation, and medical ethics. The course will primarily cover AIDS in North America and Africa, with some attention to other geographical areas.

 

Course Grade: Regular attendance, promptness, and preparedness are required of all students.

 

            Midterm         20%

            Class Participation and Preparedness          20%

            Final Exam  30%

            Paper            30%

 

Required Texts:

 

1)    Feldman, Douglas A. and Thomas M. Johnson, eds. The Social Dimensions of AIDS: Method and Theory. New York: Praeger, 1986.

2)    Bateson, Mary Catherine and Richard Goldsby. Thinking AIDS: The Social Response to the Biological Threat. Reading, MA: Addison-Wesley, 1988.

3)    Miller, Norman and Richard C. Rockwell, eds. AIDS in Africa: The Social and Political Impact. Lewiston, NY: The Edwin Mellen Press, 1988.

 

Course Schedule and Required Reading:

 

Jan. 17            Introduction, Overview of Aids and HIV Infection

 

Jan. 24            Guest speaker: Dr. James Schultz, University of Miami

"Epidemiology of AIDS (Part I)"

 

Readings:

 

Feldman and Johnson, Introduction, ch. 3,4,5.

Anonymous. "Contaminated syringes lead to nosocomial HIV in Soviet Union."  Hosp. Infect. Cont. 16(8):100-101, August 1989.

Barnes, D.M. "Health Workers and AIDS: Questions Persist." Science 241(4862):161-162, July 8, 1988.

Levy, R.M., et al. "Neuroepidemiology of acquired immunodeficiency syndrome."  Jour. Acq. Imm. Def. Synd. 1(1):31-40, 1988.

Piot, Peter, et al. "AIDS: an international perspective." Science 239(4840):573-579, February 5, 1988.

 

Jan. 31            Epidemiology of AIDS (Part II), etiology of HIV-1 and HIV-2, co-factors for enhanced HIV susceptibility and disease progression, transmission, policy issues relating to epidemiology of AIDS, immunology and virology.

 

Readings:

 

Bateson and Goldsby, ch. 1-5

Macklin, Eleanor D. (ed.) AIDS and Families, ch. 1. New York: Harrington Park Press, 1988.

 

Feb. 7AIDS treatments and experimental drugs; policy issues relating to treatments; status of hospital care for AIDS patients.

Guest speaker:  Dr. Paula Sparti, private practice physician "AIDS Treatments"

 

Readings:

 

Bateson and Goldsby, ch. 6.

Grieco, M.H., et al. "Open study of AL-721 treatment of HIV-infected subjects with generalized lymphadenopathy syndrome: An eight week open trial and follow-up. Antiviral Res. 9:(3):133-190, 1988.

Shilman Chang, R., and H.W. Yeung. "Inhibition of growth of human immunodeficiency virus in vitro by crude extracts of Chinese medicinal herbs."  Antiviral Res. (3):163-176, 1988.

Taravella, S. "Insurer to train, pay family attendants." Modern Health Care 1(31):38, August 4, 1989.

Yarchoan, R. et al. "In vivo activity against HIV and favorable toxicity profile of 2, 3' -Dideoxyinosine." Science 245:412-415, July 28, 1989.

Feldman and Johnson, ch. 14, 15.

 

Feb. 14            AIDS and the law, AIDS-related community-based organizations, AIDS-related discrimination, AIDS in prison.

 

Guest speaker:  Mr. Samuel Blum, Chair, Health Crisis Network "Legal Aspects of HIV Infection."

 

Readings:

 

Jager, Hans (ed.) AIDS and AIDS Risk Patient Care, ch. 5. New York: HalstedPress, 1988.

Bayer, Ronald. Private Acts, Social Consequences: AIDS and the Politics of Public Health, chs. 2,6. New York: The Free Press, 1989.

 

Feb. 21            MIDTERM

 

AIDS in the American family, AIDS and adolescence.

 

Readings:

 

Macklin, Eleanor D. AIDS and Families, ch. 5. New York: Harrington Park Press, 1989.

Jaffe, L.R., et al. "Anal intercourse and knowledge of acquired immunodeficiency syndrome among minority group female adolescents." Jour. Pediatrics 112(6):1005-1007, June 1988.

Overby, K.J., B. Lo, and I.F. Litt. "Knowledge and concerns about acquired immunodeficiency syndrome and their relationship to behavior among adolescents with hemophilia." Pediatrics 83(2):204-210, February 1989.

Rickert, V.I., et al. "Adolescents and AIDS: Females' attitudes and behaviors toward condom purchase and use." Jour. Adoles. Health 10(4):313-316, July 1989.

Zenilman, J. "Sexually transmitted diseases in homosexual adolescents."  Journal of Adolescent Health Care 9(2):129-138, March 1988.

 

Feb. 28            REVIEW OF MIDTERM TEST

 

AIDS in Africa (Part I)

 

Guest speaker: Dr. Emilio Mantero-Atienza "Nutritional Deficiency among HIV Seropositive Men."

 

Readings:

 

Miller and Rockwell, Introduction, Part I, Part II, Part III (Haq, Good).

Dworkin, B.M., et al. "Abnormalities of blood selenium and glutathroneperoxidase activity in patients with acquired immunodeficiency syndrome and AIDS-related complex." Biol. Trace Elem. Res. 15:167-177, January-April 1988.

 

Mar. 7AIDS in Africa (Part II)

 

Guest speaker: Dr. Bill Chitalu "AIDS in Zambia."

 

Readings:

 

Miller and Rockwell, Part III, (Merrit et al., Greely, Waite), Part IV (Brokensha, Green, Conant).

 

Mar. 21            Behavioral change and risk reduction, AIDS in the gay community.

 

Guest speaker: Dr. James Shultz, University of Miami "Behavioral Intervention - Cohort Studies."

 

Readings:

 

Feldman and Johnson, Ch. 7,8.

Bateson and Goldsby, Ch. 8.

Becker, M.H., J.G. Joseph.  "AIDS and behavioral change to reduce risk: A review." American Journal of Public Health 78(4):394-410, April 1988.

Golombok, S., J. Sketchley, and J. Rust. "Condom failure among homosexual men." Jour. Acqd. Immune Def. Syndrome 2(4):404-409, August 1989.

Rhame, Frank S. "More on 'safe sex'." New England Jour. of Medicine 318(26):1760-1, June 30, 1988.

Schechter, M.T., et al. "Patterns of sexual behavior and condom use in a cohort of homosexual men." American Journal of Public Health 78(12):1535-8, December 1988.

Siegal, Karolynn, et al. "Patterns of change in sexual behavior among gay men in New York City." Archives of Sexual Behavior 17(6):481-497, December 1988.

St. Lawrence, J.S., et al. "Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities." Pub. Health. Rep. 104(4):391-395, July-August, 1989.

Thomas, R.M., et al. "Risk of AIDS among workers in the 'sex industry': Some initial results from Scottish study." Brit. Med. Journal 299(6692):148-149, July 15, 1989.

Whyte, John. "Teaching safe sex." New England Journal of Medicine 318(6):387, February 11, 1988.

 

Mar. 28            AIDS in Europe, Asia, and Latin America

 

Guest speaker: Dr. Richard Beach, University of Miami "AIDS in Central America."

 

Readings:

 

Feldman and Johnson, Ch. 6.

Bateson and Goldsby, Ch. 7,9,10.

Broom, N.D., and C.E. Rickett.  "The ethics of safe sex." New Zealand Medical Journal 1001(859):823-826, December 14, 1988.

Des Jarlais, D.C., and S.K. Friedman. "AIDS and IV drug use." Science 245(4918):578, August 11, 1989.

Drucker, E., and S.H. Vermund. "Estimating population prevalence areas with high rates of intravenous drug use: A model of the Bronx in 1988." Amer. Jour. of Epidemiology 120(1):133-142, July 1989.

Holzhauer, J.D. "AIDS testing in the health care setting." Issues Law Med. 4(3):345-357, 1988.

 

Apr. 4AIDS education, AIDS among intravenous drug users, HIV testing, HIV reporting, and contact tracing, ethics of AIDS.

 

Guest speaker: Ms. Marilyn Volker, Director of Education, Health Crisis Network "AIDS Education in South Florida."

 

Apr. 11            AIDS and the media, AIDS research.

 

Guest speaker:  Dr. Frank Stitt, University of Miami "Methodological Issues in AIDS Clinical Research."

 

Apr. 18            AIDS-related health beliefs and behavior, the politics of AIDS, AIDS social services.

 

Guest speaker:  Mr. Robert Kunst, Executive Director, Cure AIDS Now  "AIDS as a Political Issue."

 

Apr. 25            Conclusion, Summary, Review

 

May 2            READING DAY

 

May 9Final Exam.  All papers due.