AIDS as a social phenomenon

AIDS is an infectious but also a social disease. Next to the major epidemiological question on the natural history of AIDS, important problems have been posed in various fields of social, political, ethical and legal areas extending far beyond traditional medical interest. These create polarization among public, politicians, press and also among physicians. As the situation changes, the gravity of the disease has become more prominent and the consensus on the effectiveness of the means used and proposed is not yet achieved. Social phenomena depend on societal values, the perception of fear and menace of disease to individuals versus perception of the collectivity. Among major risk groups this fear influenced by various ideologies and societal goals, is more pronounced than the response of the society warrant. It is not one of condemnation but of tolerance, and sympathy and has been directed not toward deterring people in engaging in certain kinds of sexual behaviour, but toward doing this with minimum risk. Conflict between the perception of rights (individual versus collective) is bound to grow although it is easy to distinguish in law legitimate epidemiological needs and their possible misuse. The present position of the main risk groups is changing in various ways. The reluctance of society to address openly issues of sexual behaviour has disappeared. There is rapidly accumulating knowledge on the social influence in the spread of the disease, but as yet, scant information on the influence of social factors on the control efforts and effectiveness of preventive behavioural strategies. The effects AIDS will have on the complex social structures in general, on health structures in particular, and on the problems which might shape future attitudes, values and morals cannot be delineated with any degree of precision but only vaguely guessed as the disease progresses now and into the next century.