AIDS: The Making of a Chronic Disease

In this followup to AIDS: The Burdens of History, editors Elizabeth Fee and Daniel M. Fox present essays that describe how AIDS has come to be regarded as a chronic disease. Representing diverse fields and professions, including epidemiology, history, law, medicine, political science, communications, sociology, social psychology, social linguistics, and virology, the twenty- three contributors to this work use historical methods to analyze politics and public policy, human rights issues, and the changing populations with HIV infections. They examine the federal government's testing of drugs for cancer and HIV and show how the policy makers' choice of a specific historical model (chronic disease versus plague) affected their decisions. A powerful photo essay reveals the strengths of women from various backgrounds and lifestyles who are coping with HIV. A sensitive account of the complex relationships of the gay community to AIDS is included. Finally, several contributors provide a sampling of international perspectives on the impact of AIDS in other nations. When AIDS was first recognized in 1981, most experts believed that it was a plague, a virulent unexpected disease. They thought AIDS, as a plague, would resemble the great epidemics of the past; it would be devastating but would soon subside, perhaps never to return. The media as well as many policy makers accepted this historical analogy. Much of the response to AIDS in the United States and abroad during the first five years of the epidemic assumed that it could be addressed by severe emergency measures that would reassure a frightened population while signaling social concern for the sufferers and those at risk of contracting the disease. By the middle 1980s, however, it became increasingly clear that AIDS was a chronic infection, not a classic plague. As such, the disease had a rather long period of quiescence after it was first acquired, and the periods between episodes of illness could be lengthened by medical intervention. Far from a transient burden on the population, AIDS, like other chronic infections in the past (notably tuberculosis and syphilis), would be part of the human condition for an unknown--but doubtless long--period of time. This change in the perception of the disease, profoundly influencing our responses to it, is the theme unifying this rich sampling of the most interesting current work on the contemporary history of AIDS.