When AIDS Began: San Francisco and the Making of an Epidemic

Book Cover......Page 1
Half-Title......Page 2
Title......Page 3
Copyright......Page 4
Dedication......Page 5
Contents......Page 6
Illustrations......Page 7
Tables......Page 8
Preface......Page 9
Acknowledgments......Page 12
Introduction......Page 15
The Sociology of Scientific Knowledge......Page 23
The Social Construction of Reality......Page 29
The Construction of HIV and “Facts Settled by Dispute”......Page 31
The Politics of AIDS: Social Control and the Medicalization of Homosexual Desire......Page 35
Latent Texts......Page 38
Prefiguring AIDS—Gay Men’s Health and Demographics in SF (1974–1980)......Page 43
“A Pneumonia That Strikes Gay Males”......Page 46
The Emergence of a Bureaucracy for AIDS Surveillance in San Francisco [1981]......Page 47
Epidemiology—The San Francisco Cohort Studies......Page 55
The San Francisco General Hospital Cohort: 1982......Page 56
HIV Seroconversion Trends and AIDS Case Projections......Page 57
The San Francisco Men’s Health Study: 1984–1993......Page 58
Risk Factors and Prevention......Page 60
HIV Incidence and AIDS Case Projections......Page 61
The San Francisco City Clinic Cohort: 1978-Present......Page 63
AIDS Cases Reported in July 1981......Page 78
The Earliest AIDS Diagnosis in a Homosexual/Bisexual Man in San Francisco [November 1980]......Page 82
AIDS Cases Reported from August 1981 through December 31, 1981......Page 106
V The Mechanicsof AIDS Surveillance......Page 126
Fieldwork at the ASSB and SFGH, July 1994-May 1995......Page 128
Active AIDS Surveillance: Capturing Cases in the Field......Page 129
Follow-Up at the AIDS Seroepidemiology and Surveillance Branch......Page 136
Documenting and ReportingaNew AIDS Case......Page 137
Establishing Risk for HIV Infection......Page 138
Patient “X”—Diagnosis Cryptosporidiosis......Page 142
Establishing Heterosexual HIV Risks and Resolving NIR Cases......Page 145
Fieldwork in New York City......Page 146
From Surveillance Data to Epidemiological Fact and Public Policy......Page 150
VI AIDS Surveillance Statistics......Page 154
Cumulative AIDS Cases in San Francisco......Page 155
Cumulative AIDS-Related Mortality in San Francisco......Page 160
Changing the Object (AIDS) and Subjects (Cases) of Surveillance......Page 164
Phase I: 1981–1986......Page 165
Phase II: 1987–1992......Page 166
Impact of 1987 Surveillance Definition......Page 167
Geographic Differentials of Presumptive Diagnoses [by Race, Risk, and Sexual Orientation)......Page 168
Differentials of HIV Antibody Testing......Page 169
Sociopolitical Context of 1987 Revision......Page 170
Phase III: 1993-Present......Page 171
Sociopolitical Context of 1993 Revision......Page 172
Impact of 1993 Surveillance Definition: Changing Demographics......Page 174
Amplifying the Epidemic after the Fact......Page 177
“Sitting On News that the Epidemic Is in Decline”......Page 182
The Price of a Premature Commitment to a Single-Virus Cause......Page 191
The MuItifactorial Model: A Profile of Dr. Joseph Sonnabend......Page 195
A Critique of Orthodox AIDS Science......Page 198
Opportunity Costs and Implications of Premature Consensus......Page 202
Competing Ideologies of Public Health......Page 205
Notes......Page 209
Works Cited......Page 265
Index......Page 284