and the changed lives of many others touched by the disease. And behind the individual lives are the manifold ways in which a variety of institutions and practices have been affected by the epidemic.

In 1987 the National Research Council of the National Academy of Sciences established the Committee on AIDS Research in the Social, Behavioral, and Statistical Sciences. Two of the committee's reports, AIDS: Sexual Behavior and Intravenous Drug Use (Turner, Miller, and Moses, 1989) and AIDS: The Second Decade (Miller, Turner, and Moses, 1990), reviewed and evaluated a wide range of social and behavioral science research relevant to HIV/AIDS prevention, education, and intervention. In the course of preparing those reports, the committee noted that many of the social consequences of the epidemic were not being studied in any systematic way. It judged that systematic study would be beneficial in predicting the course of the epidemic's path through U.S. society and in formulating policies to deal with it. Thus, in 1989 the committee established the Panel on Monitoring the Social Impact of the AIDS Epidemic, with the general mandate to study the social impact of the epidemic and to recommend how it could be monitored in order to contribute to the formulation of policies that might effectively deal with it. In the course of its work, the panel, with the agreement of the parent committee and the several federal agencies that were sponsoring its work, modified this mandate and deleted the plan to recommend systems for monitoring.

This report is an unusual undertaking for the National Research Council. Its objective is to form a picture of the effects of the AIDS epidemic on selected social and cultural institutions in the United States and to describe how those institutions have responded to the impact of the epidemic. No attempt has been made to write a comprehensive history—there are not yet adequate studies of the epidemic upon which to base such an effort. Instead we have been selective in looking at those institutions for which sufficient information is available to describe impact and response. These descriptions cannot be considered complete and authoritative; but we do believe they suggest a pattern that should be of concern to the country and command the attention of policy makers attempting to deal with the epidemic over the next decade.

EPIDEMICS, IMPACTS, AND RESPONSES

The impact of AIDS has many dimensions, only a few of which are captured in official statistics or analysis by the research community. The numbers of AIDS cases and HIV infection count as an impact: cumulatively, they state the effect on the population of the United States and on particular subpopulations. Each case has many dimensions—personal, professional, and institutional—through the many social organizations that touch



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