"In An Epidemic of Uncertainty, Jenny Trinitapoli advances a new model for studying social life by emphasizing something that social scientists routinely omit from their theories, models, and measures--what people know they don't know. The book takes Malawi's ongoing AIDS epidemic as its entry point for understanding the stakes of uncertainty. After a four-decades-long battle, new infections are down and AIDS-related mortality has declined. But in the wake of pandemic AIDS, an epidemic of uncertainty persists; at any given point in time, half the population doesn't know their HIV status. The author argues that AIDS-related uncertainty is measurable, pervasive, and impervious to biomedical solutions. The consequences of uncertainty are pertinent to multiple domains of life including relationship stability, fertility, health, and well-being. Even as HIV is transformed from a progressive, fatal infection to a chronic and manageable condition, the accompanying epidemic of uncertainty remains central to understanding social life in this part of the world. This book is based on a ground-breaking longitudinal study that documents how the lives of young adults in Balaka, Malawi, unfold over a ten-year period. Trinitapoli also makes three general contributions: first, a demography of uncertainty and a set of theoretical and empirical tools for integrating what people know they don't know into social-scientific models of human behavior; second, a decade-long longitudinal study articulating what demographic approaches have to offer the social sciences; and third, an expansive attitude toward the empirical, which brings longitudinal survey data to life by incorporating accounts of uncertainty and its resolution through ethnography designed to capture population chatter and gossip in Balaka"--

The first comprehensive empirical account of how religion affects the interpretation, prevention, and mitigation of AIDS in Africa, the world's most religious continent.

A decade-long study of young adulthood in Malawi that demonstrates the impact of widespread HIV status uncertainty, laying bare the sociological implications of what is not known. An Epidemic of Uncertainty advances a new framework for studying social life by emphasizing something social scientists routinely omit from their theories, models, and measures–what people know they don’t know. Taking Malawi’s ongoing AIDS epidemic as an entry point, Jenny Trinitapoli shows that despite admirable declines in new HIV infections and AIDS-related mortality, an epidemic of uncertainty persists; at any given point in time, fully half of Malawian young adults don’t know their HIV status. Reckoning with the impact of this uncertainty within the bustling trading town of Balaka, Trinitapoli argues that HIV-related uncertainty is measurable, pervasive, and impervious to biomedical solutions, with consequences that expand into multiple domains of life, including relationship stability, fertility, and health. Over the duration of a groundbreaking decade-long longitudinal study, rich survey data and poignant ethnographic vignettes vividly depict how individual lives and population patterns unfold against the backdrop of an ever-evolving epidemic. Even as HIV is transformed from a progressive, fatal disease to a chronic and manageable condition, the accompanying epidemic of uncertainty remains fundamental to understanding social life in this part of the world. Insisting that known unknowns can and should be integrated into social-scientific models of human behavior, An Epidemic of Uncertainty treats uncertainty as an enduring aspect, a central feature, and a powerful force in everyday life.

Now an award-winning documentary feature film The search for a “patient zero”—popularly understood to be the first person infected in an epidemic—has been key to media coverage of major infectious disease outbreaks for more than three decades. Yet the term itself did not exist before the emergence of the HIV/AIDS epidemic in the 1980s. How did this idea so swiftly come to exert such a strong grip on the scientific, media, and popular consciousness? In Patient Zero, Richard A. McKay interprets a wealth of archival sources and interviews to demonstrate how this seemingly new concept drew upon centuries-old ideas—and fears—about contagion and social disorder. McKay presents a carefully documented and sensitively written account of the life of Gaétan Dugas, a gay man whose skin cancer diagnosis in 1980 took on very different meanings as the HIV/AIDS epidemic developed—and who received widespread posthumous infamy when he was incorrectly identified as patient zero of the North American outbreak. McKay shows how investigators from the US Centers for Disease Control inadvertently created the term amid their early research into the emerging health crisis; how an ambitious journalist dramatically amplified the idea in his determination to reframe national debates about AIDS; and how many individuals grappled with the notion of patient zero—adopting, challenging and redirecting its powerful meanings—as they tried to make sense of and respond to the first fifteen years of an unfolding epidemic. With important insights for our interconnected age, Patient Zero untangles the complex process by which individuals and groups create meaning and allocate blame when faced with new disease threats. What McKay gives us here is myth-smashing revisionist history at its best.

In 1992, Dr. Ross A. Slotten signed more death certificates in Chicago—and, by inference, the state of Illinois—than anyone else. As a family physician, he was trained to care for patients from birth to death, but when he completed his residency in 1984, he had no idea that many of his future patients would be cut down in the prime of their lives. Among those patients were friends, colleagues, and lovers, shunned by most of the medical community because they were gay and HIV positive. Slotten wasn’t an infectious disease specialist, but because of his unique position as both a gay man and a young physician, he became an unlikely pioneer, swept up in one of the worst epidemics in modern history. Plague Years is an unprecedented first-person account of that epidemic, spanning not just the city of Chicago but four continents as well. Slotten provides an intimate yet comprehensive view of the disease’s spread alongside heartfelt portraits of his patients and his own conflicted feelings as a medical professional, drawn from more than thirty years of personal notebooks. In telling the story of someone who was as much a potential patient as a doctor, Plague Years sheds light on the darkest hours in the history of the LGBT community in ways that no previous medical memoir has.

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.

During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease. During this period of great uncertainty, decision-making regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system. The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was doneâ€"and recommends what should be done to produce better outcomes in the face of future threats to blood safety. The committee frames its analysis around four critical area: Product treatmentâ€"Could effective methods for inactivating HIV in blood have been introduced sooner? Donor screening and referralâ€"including a review of screening to exlude high-risk individuals. Regulations and recall of contaminated bloodâ€"analyzing decisions by federal agencies and the private sector. Risk communicationâ€"examining whether infections could have been averted by better communication of the risks.