Sex, Health, and AIDS
Spring 1999
Professor Susan Craddock and Dr. Sally Stevens
The University of Arizona
HIV/AIDS has been a recognized phenomenon now for almost twenty years. Its impactcontinues to be widespread and profound, raising a number of important questions atvarious levels of analysis. Has sex changed in the 90s? Have concerns about health andpersonal safety shifted for college students today? How has AIDS impacted the way we seeourselves and others? How has it changed our vision of other countries? This course willoffer explorations of HIV and AIDS from a variety of perspectives, including its biologyand pathology, its impact on communication and sexual practices among college students,the social and economic causes of HIV/AIDS in the United States and elsewhere in theworld, and the politics of medical research and health care funding.
Other than disseminating information, the purpose of the course is to challenge commonlyheld perceptions about the origins, causes, and social constructions of AIDS; to examinethe reasons why people might not change behaviors that put them at a health risk; and totackle the difficulties of policy formation and community action. As such, the classoffers a forum for developing critical thinking and problem solving skills through thereading material, class discussions, numerous short writing assignments, workshops, androle-playing exercises.
Course structure: The course is designed with a Monday and Wednesday lecture and a Fridayworkshop. Lectures will actually be constituted largely by class discussion of readingmaterials and writing assignments, and the workshops will offer a variety of exercisesgeared toward group problem solving, critical analysis, and the discussion of issuesextending from those addressed in the Monday and Wednesday reading materials.
Attendance: This course is set up to elicit as much student participation as possible. Thedegree to which it works depends on how much you work. Attendance is obviously a keyelement of being able to participate actively, and is required. More than threeunexplained absences will result in a ten percent reduction of your grade.
Grade breakdown:
Midterms 15% x 2 = 30%
Final 30%
Writing Assignments 5% x 5 = 25%
Poster 10%
Participation 5%
All Students: Three of the five writing assignments and the first midterm occur in thefirst half of the course. These will allow you to have a good assessment of your progressin the course before the drop deadline.
The midterms and final exam will consist primarily of short answer questions and one totwo longer essay questions requiring synthesis of reading materials and your own criticalanalysis of the topics under review.
All writing assignments, including midterms and finals, will be graded according to thedegree to which you have been able to synthesize and incorporate assigned readingmaterials (where appropriate), to present these in a thoughtful and cohesive manner, andto articulate your own critical assessments of the topics at hand. Thus not only contentbut writing style and cohesiveness will be assessed.
Honors Students: Two writing assignments will be required of you that ask you to assess toa greater degree the debates characterizing particular areas of the HIV/AIDS arena. Theseassignments will come in place of two of the regular writing assignments. They willconstitute two five-page papers in which you will write reactions to two of the key issuesdiscussed in class; these issues will be of your choosing in consultation with theprofessor(s). These papers will involve reading at least two extra articles on the subjectyou choose, and writing a cohesive essay summarizing the arguments contained in thereading and your own well-thought out reaction to these arguments. Discussing your ideasand research progress with the professors is encouraged.
I. Introduction
Jan 13, Wed.
1. Overview of course
Readings: R. Keeling, M.D., "HIV and Higher education: From isolation toengagement," in Liberal Education; AAC&U
Special Reprint on Higher Education and Health, 1996; K. Douglas et al "Results fromthe 1995 national college health risk behavior survey," in Journal of AmericanCollege Health.46, 1997:55-66
Jan 15, Fri.
1. Questionnaire: Knowledge, Behavior, Perception.
2. Personal Ranking: How do you rank HIV among other health and life issues?
Jan 18, Mon: No Class - Martin Luther King Holiday
II. History of the Epidemic
Jan 20, Wed
1. Global overview (with maps, statistics, graphs), and demographics of HIV/AIDS in U.S.(who has AIDS, how are statistics gathered, etc.)
Readings: Bondaart, "Overview of the AIDS Epidemic"
Writing Assignment: How has the HIV epidemic affected you or someone you know: howhas it changed your behavior, if any; how has it changed the way you see others? DueMonday.
Jan 22, Fri
1. Take a stance on the following issue(s): All homosexuals should be tested for HIV. AIDSoriginated in Africa. Discussion will follow.
Jan 25, Mon
1. Origins theories
Readings: Rosalind Harrison-Chirumuuta and Richard Chirumuuta, "AIDS fromAfrica: A case of racism vs. science?" in G. Bond, J. Kreniske, I. Susser, and J.Vincent, AIDS in Africa and the Caribbean, Westview 1997:165-180; J.Phillipe Rushton, "Population Differences in Susceptibility to AIDS: An EvolutionaryAnalysis," Social Science and Medicine 28:12, 1989:1211-1220.
Jan 27, Wed
1. Origins, cont'd: the politics of origins—theories in the U.S. and globally.
Readings: Randall Packard and Paul Epstein, "Medical research on AIDS inAfrica: a Historical perspective," in E. Fee and D. Fox, eds., AIDS: The Makingof a Chronic Disease., University of California 1992:346-376.
Writing Assignment: Go to the red notebook containing listserv summaries ofarticles on HIV and AIDS. Choose one entry, go to the library and find the article, readit and write a summary and opinion. Due Wednesday.
Jan 29, Fri
1. Film: History of AIDS epidemic
III. Biological Aspects
Feb 1, Mon
1. Definition of the virus and its pathology. Guest speaker
Feb 3, Wed (Sally Stevens)
1. Biological aspects of HIV/AIDS, cont'd. Transmission of HIV: a) blood-to-blood; b)sexual transmission; c) mother to fetus transfer.
Readings: Sally Stevens, "The Sexual transmission of HIV;" (unpublishedmanuscript); Stephen Koester, "The process of drug injection," in T. Rhodes andR. Hartnoll, eds., AIDS, Drugs and Prevention: Perspectives on Individual andCommunity Action, Routledge 1996.
Feb 5, Fri
1. Slide show: Sexually transmitted diseases.
IV. Communication (Guest speaker: Lee Ann Hamilton, Student Health)
Feb 8, Mon
1. Communication at the personal level; communicating about sex.
Readings: Hortensia Amaro, "Love, sex, and power: considering women'srealities in HIV prevention," in American Psychologist, June 1995:437-447.
Feb 10, Wed
1. The norms of communication on campus - alcohol, drugs, and sex.
Reading: Deborah Cohen and Linda Lederman, "Navigating the freedoms of collegelife: Students talk about alcohol, gender, and sex," in N. Roth and L. Fuller, eds., Womenand AIDS, The Harrington Park Press 1998:101-127.
Feb 12, Fri
1. Role playing (Lee Ann)
2. Film: No Such Love
Feb 15, Mon
1. Safe Sex (Lee Ann, guest lecturer)
Readings: TBA
V. Representation
Feb 17, Wed
1. AIDS in the media: what does reporting cover? what does it miss? how does it frame theissues surrounding HIV and AIDS?
Readings: Stephen Klaidman, "How well the media report health risk" T.Cook and D. Colby, "The mass-mediated epidemic: the politics of AIDS on the nightlynetwork news," Fee and Fox, AIDS: The Making of a Chronic Disease,University of California 1992:84-122.
Writing assignment: Come in to class on Friday with a newspaper or other mediadepiction of HIV, AIDS, or related issues. Write two to three pages on, and be prepared todiscuss the following: its interpretive framework, the questions its asks, the questionsit does not ask, its influence in your opinion on public thinking about sex, HIV,homosexuality, ethnicity, etc.
Feb 19, Fri
1. Discussion of newspaper articles.
Feb 22, Mon
1. Sexuality, deviancy, and the politics of AIDS representation
Readings: Meyrick Horton with Peter Aggleton, "Perverts, inverts, and experts:The cultural production of an AIDS paradigm," in AIDS: Social Representations,Social Practices: 74-99.
Feb 24, Wed
1. Official depictions of AIDS: Public Health Campaigns
Readings: Sander Gilman, Picturing Health and Illness, Chapter 6,"The beautiful body and AIDS," Johns Hopkins University Press 1995:115-172.
Slide show on public health posters produced by U.S. and other countries
Feb 26, Fri
1. Get into teams, begin thinking about poster designs
March 1, Mon
1. Midterm #1
March 3, Wed
1. Discussion of midterms.
March 5, Fri
1. Bring in posters, share and discuss
VI. Social and Political Contexts
March 8, Mon
1. Political economy of AIDS in the U.S., I: poverty, the inner city
Readings: Merrill Singer, "AIDS and the health crisis of the U.S. urbanpoor," in Social Science and Medicine.39,7, 1994:931-948.
March 10, Wed
1. Political economy of AIDS in the U.S., II: social inequity and the economy of AIDS
Readings: M. Clatts, "Poverty, drug use, and AIDS: Converging issues in thelife stories of women in Harlem," in Wings of Gauze: Women of Color and theExperience of Health and Illness, Wayne State University Press 1993:312-339; EvelynnHammonds, "Seeing AIDS: Race, gender, and representation," in N. Goldstin and J.Manlowe, The Gender Politics of HIV/AIDS in Women, NYU Press 1997:113-126; M. Raffaelli and M. Suarez-Al-Adam, "Reconsidering the HIV/AIDS prevention needs ofLatino women in the United States," in N. Roth and L. Fuller, eds., Women andAIDS, The Harrington Park Press 1998:7-42
March 12, Fri
1. Group project: After being assigned a role (real estate financier, public healthofficial, church leader, homeless advocate), get into groups and come up with a communityAIDS prevention and treatment program aimed at poor inner city communities.
March 15-19: Spring Recess
March 22, Mon
1. Political economy of AIDS in the U.S., III: women and the new demographics of HIV.
Readings: USAID Office for Women in Development, "Report in Brief: Newdirections in HIV/AIDS Prevention: A report on the women and AIDS research program finalconference."
N. Goldstein and Manlowe, "Introduction," from Goldstein and Manlowe, Eds., TheGender Politics of HIV/AIDS in Women, NYU Press 1997:1-11.
Bill Rodriguez, "Biomedical models of HIV and women," in Goldstein and Manlowe,Eds., The Gender Politics of HIV/AIDS in Women, NYU Press 1997:42.
"Women, HIV and AIDS: Some facts and figures," fromhttp://www.avert.org/womenaid.htm
"United States HIV/AIDS Statistics," U.S. Public Health Service Statistics,http://www.avert.org/usastatg.htm
March 24, Wed
1. How has AIDS impacted the way we see each other?: constructions of disease,constructions of vulnerability
Readings: P. Treichler, "Beyond Cosmo: AIDS, identity, and inscriptions ofgender," in Camera Obscura: A Journal of Feminism and Film Theory, 28,1992:21-76.
Writing Assignment: Find a story in a newspaper that covers AIDS in the U.S., AIDSin American cities, women and AIDS, etc. and critique the article using some of the toolslearned the past few weeks. Due Wednesday.
March 26, Fri
1. Speaker panel: drug addicts tell their stories.
March 29, Mon
1. Global overview of AIDS, I: Outmigration in Southeast Africa and its impact on HIV/AIDS
Reading: Wiseman Chijere Chirwa, "Aliens and AIDS in southern Afirca: TheMalawi-South Africa debate," in African Affairs 97, 1998:53-79.
March 31, Wed
1. Global overview, II: Thailand
Guest Speaker: Wayne Weible
Readings: Maria Wawer, Chai Pokhisita, Uraiwan Kanungsukkasem, AnthonyPramualratana and Regina McNamara, "Origins and working conditions of female sexworkers in urban Thailand: Consequences of social context for HIV transmission," SocialScience and Medicine 42,3, 1996:453-462.
Writing assignments due.
April 2, Fri
1. Get into groups and discuss possibilities for U.S. intervention into the AIDS epidemicinternationally. Discuss options at both the federal level and at a bilateral,non-government level. What might a viable grass roots, NGO program look like for Thailandor East Africa? Should the U.S. incorporate AIDS assistance into international aidfunding?
April 5, Mon
1. Global overview, III: India, South America
Reading: Sheena Asthana and Robert Oostvogels, "Community participation in HIVprevention: Proglems and prospects for community-based strategies among female sex workersin Madras," Social Science and Medicine 43,2, 1996:133-148.
Hilary Surratt and James Inciardi, "Drug use and risks for HIV/AIDS among indigentwomen in Rio de Janeiro, Brazil," from Sally Stevens and Harry Wexler, Eds., Womenand Substance Abuse: Gender Transparency, Haworth Press 1998:1-12.
April 7, Wed
1. Share/discuss the outcomes of Friday's exercise.
April 9, Fri
1. Midterm #2
IV. Legal, Ethical, Policy Issues
April 12, Mon
1. Discuss Midterms #2.
Overview of legal, ethical, and policy issues that impact HIV risk behavior.
Reading: Sally Stevens and John Bogart, "Reducing HIV risk behavior of druginvolved women: Medical, social, economic, and legal constraints."
April 14, Wed
1. Clinical trials for HIV - exclusionary and inclusionary criteria.
Reading: Sally Stevens, "The history and development of the AIDS/HIV crisis inthe United States: Medical treatments, clinical trials and inclusionary criteria,"unpublished paper.
April 16, Fri
1. Guest speaker: John Bogart, "Reducing HIV risk."
April 19, Mon
1. Individual freedom versus public health welfare Readings: AIDS Policy and the Law, Sept20 1996 issue.
Writing Assignment: Write a reaction to the statement that all HIV-positive casesshould be reported by name to a State Health Department. What sort of legal and ethicaldoors does this or could this open? Due Wednesday.
April 21, Wed
1. Discuss your writing assignments.
April 23, Fri
1. Revisiting the questionnaire of the first day: How does behavior change?
April 26, Mon
1. HIV testing: blood tests, home kits, Roche. What are their advantages? What are theirproblems from an individual or public health perspective?
Readings: Cindy Patton, Inventing AIDS, Routledge Press 1990, Chapter 2,"Media, testing, and safe sex education: controlling the landscape of AIDSinformation," pp. 25-49.
April 28, Wed
1. HIV testing, cont'd: Confidential vs. anonymous testing; mandatory testing andmandatory reporting; Contact tracing; Duty to warn.
Reading: B. Gerbert et al, "HIV-infected health care professionals: Publicopinion about testing, disclosing, and switching," in Archives of Internal
Medicine.
Center for Women Policy Studies, "Mandatory HIV testing of pregnant women - athreat to the reproductive rights of all women," January 1997; Anna Forbes,"Names will never hurt you?" POZ, February 1998 (4).
April 30, Fri
1. PCHD/CDI speaker
May 3, Mon
1. Treatments, health care issues: How optimistic should we be with the new cocktails'?How should they be funded? Does this lead to new risk taking? What about the developmentof drug-resistant strains of HIV?
Reading: Chandler Burr, "Of AIDS and altruism," U.S. News and WorldReport April 6, 1998:60-61; B. Lindsey, "Peer education: a viewpoint andcritique, Journal of American College Health.45, 1997:187-189.
May 5, Wed
1. Wrap up and review for final.