Epidemic Control M easures for AIDS: A Psychosocial
T he epidem ic o f acquired im m une deficiency syndrom e (AIDS) is unprece den ted in recent medical history. T he increasing incidence o f the typically fatal syndrom e, its transmissibility th rough sexual and blood contact, and the continuing lack o f either an effective vaccine or cure have created a broad series o f challenges.1 Despite the relatively rapid isolation o f the etiologic agent, hum an im m unodeficiency virus (HIV, form erly re ferred to as H TLV - III/LA V), and the developm ent o f antibody detection assays,2,3 many o f these challenges are predom inantly psychosocial in nature. Some are well recog nized; for exam ple, increasing attention is being paid to the extent and d e te r m inants o f behavioral changes required to reduce H IV infection4’5 and to the com plex social and psychological needs o f those diagnosed with AIDS o r who are H IV seropositive.6,7 A nother set o f issues, largely unrecognized in the medical or social science literature, deals with the relationship o f those at risk for AIDS to the b roader social and political environm ent. As the m ajority o f AIDS cases have occurred in socially stigmatized g roups-homosexually ac tive men, intravenous d ru g users, and im m igrants-it is not surprising that there have been attributions o f blame and countercharges o f discrim ination. T h ere has been little scientific discussion o f this phenom enon, its origins, and possible consequences.