Sociology of HIV/AIDS: Global and U.S. Experiences of Epidemic
SC077: Spring 2011
Tuesdays/Thursdays 3:00-4:20
Campion 235
Instructor: Shelley White
Office: McGuinn 410D
Email: mlwhite@bc.edu
Office Hours: Thursdays 1:15-2:45
And by appointment
Course Description
This course explores the social dimensions of global and U.S. experiences of HIV/AIDS. We examine the
social forces that impact and determine the course and experience of the epidemic as we also explore the
impact that the epidemic has had on communities and cultures worldwide. The course surveys 1) the history
and epidemiology of the epidemic; 2) the social construction of the disease; 3) the impact upon and response
from particularly affected communities and social groups; 4) social issues in testing, treatment and
prevention; and 5) the politics of governmental, non-governmental and grassroots responses to the disease.
As a core course, the class will include the following:
Perennial Questions: The HIV/AIDS epidemic teaches us a great deal about society and about ourselves as
global citizens. Through our readings, research, class discussions, and personal reflections, we will be
challenged to consider the following questions: How do we understand HIV, disease, and related social
phenomenon within the broad social system of structural determinants (i.e. social, political, economic, and
environmental)? How is HIV/AIDS socially constructed in society and what role have governments, health
organizations, educational systems, religious institutions, health activists, citizens and others played in
shaping and challenging these understandings of disease? What obligations do societies and individuals have
to respond to HIV/AIDS and other epidemic diseases? How do we understand the concepts of innocence,
morality, blame, stigma and bystanding in the context of global disease? Finally, what are the possibilities
for change, and how might governments, non-governmental institutions, communities, and individuals shape
effective responses to HIV/AIDS?
Historical Perspective: In order to create deep understandings of the contemporary picture of HIV/AIDS, we
must employ a lens that is, in the words of Paul Farmer, “historically deep and geographically broad.” We
begin our course by exploring an in-depth history of the HIV/AIDS epidemic in the U.S. and globally. We
consider how early responses and key decisions by those in power shaped the future course of HIV/AIDS.
We also consider the rich history of social movements which have challenged and shaped not only
HIV/AIDS, but deeply entrenched cultural understandings of difference and disease.
Cultural Diversity: Culture has a tremendous influence on disease transmission, prevention approaches,
understandings of health and illness, and personal and political responses to disease. HIV/AIDS, as an
infectious disease long associated with taboo topics of sexuality and drug use, has been deeply stigmatized
and surrounded by cultural myths and misperceptions. In this course, we attempt to disentangle these, and to
understand the various ways in which culture shapes and is shaped by the HIV/AIDS epidemic. We also,
SC077: Spring 2011: Page 1
contrary to the early, oft-repeated mantra that “AIDS does not discriminate,” aim to understand HIV/AIDS as
a disease of inequality. We explore how existing class, gender, sexuality, race and other inequalities have
shaped diverse experiences of HIV/AIDS around the world, and how HIV/AIDS has disproportionately
affected those already disadvantaged in our domestic and global social systems.
Personal Philosophy: This course continually grapples with the question of how a largely preventable
disease has evolved to be one of the most catastrophic epidemics of our times. In 1998, shortly before his
death, Jonathan Mann challenged us, stating: "Our opportunity is historic. For when the history of AIDS and
the global response is written, our most precious contribution may well be that at a time of plague we did not
flee, we did not hide, we did not separate ourselves." Many have called for global action on AIDS, and at
many historical moments, global and U.S. efforts have fallen short. In exploring this complex history and the
contemporary global epidemic, students will be asked to consider their own personal and moral
commitments, their understandings of human rights obligations, and their values around concepts of global
citizenship. Through our readings, research, class discussions, and written assignments, students are also
encouraged to develop their own skills of critical analysis, in questioning existing understandings of
epidemic and response, and imagining new approaches to change.
Methodology: Through our readings and research, this course exposes us to various methodological
approaches employed in sociology, public health, economics, and political science. These include both
qualitative and quantitative approaches, including epidemiological studies, ethnographic and interview-based
research, case studies, household survey research, cross-cultural and comparative analyses, policy analyses
and others. We will examine the ways in which various theoretical approaches shape the perspectives of our
authors, and will consider the limits of academic knowledge production.
Writing component: Students will be encouraged to develop their writing and critical analysis skills through
two written paper assignments. The first will allow students to research HIV/AIDS in a particular country,
and to analyze the factors that have shaped local experiences of epidemic and response. In the second paper,
students will explore a topic of interest related to the social, political, and/or economic aspects of HIV/AIDS.
Students will also produce occasional short, written homework assignments and personal written reflections
that engage the reading materials and course content.
Required Texts
Ryan White: My Own Story (1992) by Ryan White and Ann Marie Cunningham.
Race Against Time (2006) by Steven Lewis.
AIDS in the 21st Century: Disease and Globalization (2006) by Tony Barnett and Alan Whiteside.
Global AIDS: Myths and Facts (2003) by Alexander Irwin, Joyce Millen and Dorothy Fallows.
HIV and AIDS in Africa: Beyond Epidemiology (2004) edited by Ezekiel Kalipeni, Susan Craddock, Joseph
R. Oppong, and Jayati Ghosh.
SC077: Spring 2011: Page 2
Course Requirements and Grading
Paper 1: Country Study
Paper 2: Issue Analysis
Final Exam (Take Home)
Short Homework Assignments & Quizzes
Attendance and Course Preparation*
Due February 24th
Due April 14th
Due May 5th
Assigned Periodically
25%
25%
25%
15%
10%
*Please note that there is one required evening session for the course, on March 23rd from 7:00-9:00 PM.
Attendance for this session will be counted as double.
Policy on Papers and Exams
Papers are due on the date indicated above, at the start of the class session. Extensions are granted only on
rare occasions, and with proper documentation (i.e. medical note, Dean’s note). For late papers, one full
grade is deducted for each week the paper is late (i.e. for the first week late, the maximum grade is B+). If a
paper is due Tuesday, it is considered one week late if it is not collected during the class session, whether it is
passed in on Wednesday, Thursday, Friday or any day until the following Tuesday.
Please print* out your papers, review them for quality, and hand them in during class. Papers will be
accepted by email only in unusual circumstances, and with prior permission.
*I encourage you to print double-sided if possible to save paper.
Academic Integrity
Students should be familiar with, and carefully follow, the Boston College Policy on Academic Integrity,
found at: http://www.bc.edu/offices/stserv/academic/resources/policy.html#integrity. When writing papers,
be sure to cite any material that is not your own as well as any material you have previously written, whether
direct quotes or concepts and ideas.
Academic Support
Students requiring accommodations for success in this course should see me, and should contact the Office
of Disability Services: http://www.bc.edu/offices/odsd/disabilityservices.html. The Connors Family
Learning Center is also available for tutoring and academic support:
http://www.bc.edu/libraries/help/tutoring.html
Technology
Use of laptop computers and cell phones during class is not permitted, except with prior permission. Please
see me if you require the use of a laptop for note taking. Students are expected to check their BC email
account regularly for class announcements and assignments.
Readings and Class Schedule
Readings are assigned on a weekly basis. Please come to class each week, on Tuesday, having read the
material for the week. Our tentative course schedule is provided below, though this schedule may change as
we move through our semester.
SC077: Spring 2011: Page 3
Tentative Schedule of Readings and Assignments
Part I: History and Overview of Epidemic
WEEK 1: January 18 and 20
Introduction and Course Overview
Overview of HIV/AIDS Epidemic; Basics of HIV Transmission
Readings: 71 pgs
• Irwin, et al – HIV/AIDS Basics (4 pgs)
• Barnett/Whiteside – Chapters 1 & 2 (67 pgs)
Optional Readings:
• Irwin, et al – Myth 1: AIDS and Africa (18 pgs)
WEEK 2: January 25 and 27
A History of the Epidemic: Creating a Timeline
Readings: 287 pgs
• Ryan White – Entire Text, through Afterword (287 pgs)
WEEK 3: February 1 and 3
Understanding Stigma
AIDS in Africa
Readings: 113 pgs
• Herek, Gregory M. 2005. “AIDS and Stigma.” Pp.121-129 in The Sociology of Health and
Illness: Critical Perspectives. 7th ed. Edited by Peter Conrad. New York, NY: Worth
Publishers. [E-Reserve] (6 pgs)
• Kalipeni, et al – Chapter 23 (5 pgs)
• Barnett/Whiteside – Chapter 5 (32 pgs)
• Lewis – Chapters 1 & 2 (36 pgs; 34 pgs)
Optional Readings:
• Lewis – Chapter 3 (38 pgs)
Part II: Social Causation and Social Construction
WEEK 4: February 8 and 10
Understanding Impact/ Measuring an Epidemic
Social Causation of Disease
Readings: 96 pgs
• Irwin, et al – Myth 2: Dangerous Behavior (22 pgs)
SC077: Spring 2011: Page 4
•
•
•
Link, Bruce G. and Phelan, Jo. 1995. “Social Conditions as Fundamental Causes of Disease.”
Journal of Health and Social Behavior 35: 80-94. [E-Reserve] (14 pgs)
Ecological Model of Health [Hand-Out] (2 pgs)
Barnett/Whiteside – Chapters 3 & 6 (30 pgs; 28 pgs)
WEEK 5: February 15 and 17
Identity and Inequality: Race, Class and Gender
Social Constructions of Disease
Readings: 119 pgs
• Kalipeni, et al –Intro & Chapters 1, 3, & 6 (11 pgs; 14 pgs; 9 pgs; 15 pgs)
• Lewis – Chapter 4 (36 pgs)
• Farmer, Paul. 1999. “Invisible Women.” Pp. 59-93 in Infections and Inequalities: The Modern
Plagues. Berkeley and Los Angeles, CA: University of California Press. [E-Reserve] (35 pgs)
Optional Readings:
• Kalipeni, et al – Chapters 8, 9, 12, 14 (12 pgs; 10 pgs; 8 pgs; 13 pgs)
• CDC. 2008. “HIV/AIDS Among Women.” Available on-line at:
http://cdc.gov/hiv/topics/women/resources/factsheets/pdf/women.pdf (7 pgs)
• CDC. 2009. “HIV/AIDS Among African Americans. Available on-line at:
http://cdc.gov/hiv/topics/aa/resources/factsheets/pdf/aa.pdf (2 pgs)
WEEK 6: February 22 and 24
Identity and Inequality: Sexuality and Drug Use
Social Constructions of Disease
Readings: 68 pgs
• Kalipeni, et al – Chapters 10, 11 & 20 (10 pgs; 12 pgs; 12 pgs)
• Donovan, Mark C. 1996. “The Politics of Deservedness: The Ryan White Care Act and the
Social Constructions of People with AIDS.” Pp. 68-85 in AIDS: The Politics and Policy of
Disease, Edited by Stella Z. Theodolou. Upper Saddle River, NJ: Prentice Hall. [E-Reserve] (17
pgs)
• Donovan, Mark C. 1999. “A Tough Sell: The Political Logic of Federal Needle-Exchange
Policy.” Pp. 353-368 in Power in the Blood: A Handbook on AIDS, Politics and
Communication. Edited by William N. Ellwood. London: Psychology Press. [E-Reserve] (15
pgs)
• Egelko, Bob. 2009. “U.S. Repeals Funding Ban for Needle Exchanges.” San Francisco
Chronicle, December 18. Available on-line at: http://articles.sfgate.com/2009-1218/news/17331688_1_needle-exchange-programs-needle-exchanges-clean-needles (2 pgs)
Optional Readings:
• CDC. 2009. “HIV and AIDS among Gay and Bisexual Men.” Available on-line at:
http://www.cdc.gov/NCHHSTP/newsroom/docs/FastFacts-MSM-FINAL508COMP.pdf (3pgs)
• Avert. “Injecting Drugs, Drug Users and HIV and AIDS.” Available on-line at:
http://www.avert.org/injecting.htm (7 pgs)
• CDC. 2005. “Access to Sterile Syringes.” Available on-line at:
http://www.cdc.gov/idu/facts/aed_idu_acc.htm (3 pgs)
SC077: Spring 2011: Page 5
•
•
CDC. 2005. “State and Local Policies Regarding IDUs Access to Sterile Syringes.” Available
on-line at: http://www.cdc.gov/idu/facts/aed_idu_pol.htm (3 pgs)
CDC. 2005. “Syringe Exchange Programs.” Available on-line at:
http://www.cdc.gov/idu/facts/aed_idu_syr.htm (3 pgs)
Due February 24: Paper 1 – Country Study
Part III: Human Rights, Development and Economy
WEEK 7: March 1 and 3
Households, Families and Children
Readings: 86 pgs
• Barnett/Whiteside – Chapters 7 & 8 (13 pgs; 28 pgs)
• Kalipeni, et al – Chapters 19 (20 pgs)
• de Bruyn, Maria. 2002. “Reproductive Choice and Women Living with HIV/AIDS.” Ipas.
Available on-line at: http://www.ipas.org/Publications/asset_upload_file116_3009.pdf (25 pgs)
Optional Readings:
• Kalipeni, et al – Chapter 22 (11 pgs)
SPRING BREAK: March 7 – 11
WEEK 8: March 15 and 17
HIV/AIDS and Human Rights
Readings: 77 pgs
• Universal Declaration of Human Rights. Available on-line at:
http://www.un.org/Overview/rights.html (2 pgs)
• United Nations. “Background and Summary of the Guidelines (International Guidelines on
HIV/AIDS and Human Rights) PLEASE READ PAGES.13-19 of PDF (7 pgs)
• Farmer, Paul. 2005. “On Suffering and Structural Violence: Social and Economic Rights in the
Global Era.” Pp. 29-50 in Pathologies of Power: Health, Human Rights, and the New War on
the Poor. Berkeley and Los Angeles, CA: University of California Press. [E-Reserve] (21 pgs)
• Kalipeni, et al – Chapter 18 (11 pgs)
• AIDS.org. “HIV Travel/Immigration Ban: Background/Documentation.” Available on-line at:
http://www.aids.org/atn/a-128-03.html (12 pgs)
• UNAIDS. 2010. “UN Secretary-General applauds the removal of entry restrictions based on
HIV status by United States of America and Republic of Korea.” January 4. Available on-line
at:
http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2010/20100104_t
ravelrestrictions.asp (2 pgs)
• Elliot, Richard. 2002. “Criminal Law, Public Health, and HIV Transmission: A Policy Options
Paper.” Canadian HIV/AIDS Legal Network. Available on-line at:
http://data.unaids.org/publications/IRC-pub02/jc733-criminallaw_en.pdf PLEASE READ
PAGES 5-14 (9 pgs)
SC077: Spring 2011: Page 6
•
•
National Public Radio. 2009. “Should HIV be Criminalized?” Available on-line at:
http://www.npr.org/templates/story/story.php?storyId=105118629 (~13 pgs, or listen to audio)
Additional Reading TBA
WEEK 9: March 22 and 24
Labor and the Economics of HIV
HIV/AIDS and Development
***March 23rd: Required Evening Session: 7:00-9:00 PM***
Readings: 116 pgs
• Barnett/Whiteside: Chapters 9, 10 & 11 (24 pgs; 28 pgs; 25 pgs)
• Kalipeni, et al – Chapters 15 & 21 (11 pgs, 13 pgs)
• Rosen, Sydney and Simon, Jonathon L. 2003. “Shifting the Burden: The Private Sector’s
Response to the AIDS Epidemic in Africa.” Bulletin of the World Health Organization 81(2):
131-137. Available on-line at:
http://info.worldbank.org/etools/docs/library/57496/Shifting%20the%20burden%20of%20HIV%
20-%20AIDS.pdf (11 pgs)
• Rolbein, Seth. 2010. “What the Tea Leaves Say.” Bostonia. Winter-Spring 2010. Pp. 30-35. (4
pgs)
Part IV: Politics of Response
WEEK 10: March 29 and 31
Governance and Policy
Readings: 107 pgs
• Barnett/Whiteside – Chapters 12 (26 pgs)
• Irwin, et al – Myth 3: Corruption & Myth 4: Prevention vs. Treatment? (18 pgs; 14 pgs)
• Lewis – Chapter 5 (46 pgs)
• Global Fund. “About the Global Fund.” Available on-line at:
http://www.theglobalfund.org/en/about/ (1 pg)
• Global Fund. “History.” Available on-line at: http://www.theglobalfund.org/en/history/?lang=en
(1 pg)
• Global Fund. “How the Global Fund Works.” Available on-line at:
http://www.theglobalfund.org/en/how/?lang=en (1 pg)
WEEK 11: April 5 and 7
Treatment, Medication Access, and Global Trade
Readings: 96 pgs
• Conrad, Peter. 2005. “The Meaning of Medications: Another Look at Compliance.” Pp.150-162
in The Sociology of Health and Illness: Critical Perspectives. 7th ed. Edited by Peter Conrad.
New York, NY: Worth Publishers. [E-Reserve] (10 pgs)
• Irwin, et al – Myth 5: Obstacles to AIDS Treatment; Myth 6: Vaccines & Myth 7: Profits vs.
Health (14 pgs; 8 pgs; 20 pgs)
SC077: Spring 2011: Page 7
•
•
•
Bond, Patrick. 1999. “Globalization, Pharmaceutical Pricing, and South African Health Policy:
Managing Confrontations with U.S. Firms and Politicians.” International Journal of Health
Services 29(4): 765-792. [E-Reserve] (28 pgs)
Greene, Melissa Fay. 2006. “Chapter 28.” Pp. 183-206 in There Is No Me Without You. New
York, NY: Bloomsbury. [E-Reserve] (15 pgs)
WTO. 2001. “Declaration on the TRIPS Agreement and Public Health.” Available on-line at:
http://www.wto.org/english/thewto_e/minist_e/min01_e/mindecl_trips_e.htm (1 pgs)
WEEK 12: April 12 and 14
Sex Education and Behavior Change
Readings: 93 pgs
• Siplon, Patricia D. 2002. “Dueling Models of AIDS Prevention: Harm Reduction and
Abstinence.” Pp. 67-92 in AIDS and the Policy Struggle in the U.S. Washington, DC:
Georgetown University Press. [E-Reserve] (23 pgs)
• Lindberg, Laura Duberstein, John S. Santelli, and Susheela Singh. 2006. “Changes in Formal
Sex Education: 1995-2002.” Perspectives on Sexual and Reproductive Health 38(4): 182-189.
[E-Reserve] (7 pgs)
• Avert. “President’s Emergency Plan for AIDS Relief.” Available on-line at:
http://www.avert.org/pepfar.htm (15 pgs)
• Skolnik, Richard L. 2007. “Culture and Health.” Pp. 97-112 in Essentials of Global Health.
Sudbury, Massachusetts: Jones and Bartlett. [E-Reserve] (15 pgs)
• Human Rights Watch. 2005. “Summary” (pp.1-5) and “Recommendations” (pp.6-12) in The
Less They Know, the Better: Abstinence-Only HIV/AIDS Programs in Uganda. March 25.
Available on-line at:
http://www.crin.org/docs/resources/treaties/crc.40/Uganda_hrw_aids_ngo_report.pdf (12 pgs)
• Kirby, Douglas. 2008. “Success in Uganda: An Overview of Uganda’s Campaign to Change
Sexual Behaviors and Decrease HIV Prevalence, 1986-1995.” ETR Associates. Available online at: http://programservices.etr.org/base/documents/Uganda-ExecSummary.pdf (21 pgs)
Optional Readings:
• Kalipeni, et al – Chapter 13 (16 pgs)
• The United States President’s Emergency Plan for AIDS Relief. 2009. “PEPFAR Overview”
Available on-line at: http://www.pepfar.gov/press/81352.htm (2 pgs)
Due April 14: Paper 2 – Issue Analysis
WEEK 13: April 19 (No Class April 21)
Global Commitment
Readings: 46 pgs
• Porpora, Douglas V. 1992. “The Banality of Evil.” Pp. 15-38 in How Holocausts Happen: The
United States in Central America. Philadelphia: Temple University Press. [E-Reserve] (18 pgs)
• Eliosoph, Nina. “The Mysterious Shrinking Circle of Concern.” Pp. 1-22 in Avoiding Politics:
How Americans Produce Apathy in Everyday Life. [E-Reserve] (22 pgs)
• Kaiser Family Foundation. 2009. “Views on the U.S. Role in Global Health Update.”
Available on-line at: http://kff.org/globalhealth/upload/8013.pdf (6 pgs)
SC077: Spring 2011: Page 8
Part V: Social Movements and Social Change
WEEK 14: April 26 and 28
Global Activism and Health
Readings: 80 pgs
• Irwin, et al –Myth 10: Nothing We Can Do (18 pgs)
• Stockdill, B.C. “AIDS, Multiple Inequalities, and Activism”. Pp. 1-24 in Activism against AIDS:
At the Intersections of Sexuality, Race, Gender, and Class. [E-Reserve] (23 pgs)
• Gamson, Josh. 1989. “Silence, Death, and the Invisible Enemy: AIDS Activism and Social
Movement ‘Newness.’” Social Problems, 36(4): 351-367. [E-Reserve] (16 pgs)
• Mbali, Mandisa. “The Treatment Action Campaign and the History of Rights-Based, PatientDriven HIV/AIDS Activism in South Africa.” Center for Civil Society, University of KwaZuluNatal. [E-Reserve] (23 pgs)
WEEK 15: May 3 and 5
A Way Forward
Readings: 77 pgs
• Irwin, et al – Myth 8: Limited Resources & Myth 9: Nothing to Gain (17 pgs; 12 pgs)
• Barnett/Whiteside – Chapters 13 & 14 (32 pgs; 16 pgs)
Due May 5: Final Take-Home Exam
Useful Websites
Kaiser Family Foundation
http://www.kff.org
http://www.kaisernetwork.org
UNAIDS
www.unaids.org
The Body
www.thebody.com
Avert
http://www.avert.org/
The Global Fund
http://www.theglobalfund.org/
AIDS Education Global Information System
(AEGiS)
http://www.aegis.com/
World Health Organization
http://www.who.int/en/
Centers for Disease Control and Prevention
www.cdc.gov
HIV InSite
http://hivinsite.ucsf.edu/
Health Resources and Services Administration:
HIV/AIDS Bureau
http://hab.hrsa.gov/aboutus.htm
SC077: Spring 2011: Page 9