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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.

Two case studies shed light on HIV and the family relationship. One reports on some efforts to gain legal recognition for nonmarital relationships, and the other examines foster care programs for newborns with the HIV virus. A case study of New York City details how selected institutions interact to give what may be a picture of AIDS in the future.

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.

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CHOICE Review

This report outlines the effects of the AIDS epidemic on selected social and cultural institutions in the US and describes how those institutions have responded to the impact of the epidemic. The most general conclusion of the report is that the epidemic's impact has hit institutions hardest where they are weakest--serving the most disadvantaged people. Because the epidemic is not spreading uniformly throughout the population, but is highly localized in poor and minority communities that may be ignored by the general population and by public policy, AIDS has not significantly altered the structures or directions of the social institutions that were studied. Major social institutions have ignored the effects of the epidemic because affected groups are socially marginalized. HIV/AIDS, therefore, will "disappear," not because it has been eliminated but because those who continue to be affected by it are socially invisible, beyond the sight and attention of the majority population. The conclusion might be that institutions have an obligation to respond adequately and effectively to the epidemic by providing care, education, and social support to these disadvantaged communities. Faculty; professional. J. M. Howe; VA Medical Library, San Francisco