Go~erni~ent Puh/irrrtion.s Rerien,, Vol. 16, pp. 157-I 7 I. 1989 Printed in the USA. All rights reserved.
U.S. GOVERNMENT
INFORMATION
DIANA GONZALEZ Government
Publications
Copyright
0277.9390189 $3.00 + .OO 0 1989 Pergamon Press plc
POLICY AND THE AIDS EPIDEMIC
KIRBY* and TONY A. HARVELL**
and Maps Department, Otto G. Richter Library, Coral Gables. FL 33124. USA
University
of Miami, P.O. Box 248214,
Abstract - The authors discuss the role of the United States government in disseminating information on Acquired Immune Deficiency Syndrome (AIDS) to the general public. They look at the history of AIDS-related information, its format, content, and scope. They assert that this information is essential for targeting and evaluating control and prevention efforts at all levels. It is concluded that libraries (in particular, the federal depository library program) have been underutilized in providing AIDS information to the public. Although this program may not reach all persons at high risk for contracting AIDS, libraries can serve as resource centers for educating the general public and preventing an irrational response to the disease.
INTRODUCTION In his report on Acquired Immune Deficiency Syndrome, C. Everett Koop urges all Americans to be informed about AIDS, its transmission, risks of infection, and prevention [ 11. The Surgeon Generd’s Reporr on AIDS accomplishes two major objectives: (a) Through publication of a Surgeon General’s report to the people of the United States on AIDS, the office of the U.S. Public Health Service assumes a major responsibility for monitoring and disseminating to the public the most current and accurate medical and scientific information. The Surgeon General urges all physicians to join him in assuming leadership in fighting to control AIDS by educating themselves, their patients, and the public [2]; (b) The Surgeon General’s Report on AIDS presents broad goals for eradicating one of the most socially crippling barriers to dealing effectively with the disease - fear. Fear is the greatest obstacle to combating AIDS because it prevents those at risk from seeking information that could be vital to stop the further spread of the disease; fear is the main culprit in the increasing number of suicides among HIV-infected persons, and it is fear for their patients’ rights to privacy that keeps many physicians from disclosing the names of persons with AIDS (PWAs) to state surveillance officials [3]. Irrational fear may also cause reprisals against families such as a case in Florida. where elementary-school-age children were expelled from school and their house burned because the children became infected with the AIDS virus from a blood transfusion [4]. By discussing AIDS in a straightforward manner, and by looking to the future for answers to present health concerns, the Surgeon General’s Report is one in a growing number of health information sources currently available for use by the public free of charge through the federal depository library program.
*Diana Gonzalez Kirby first joined the University of Miami in 1978 as a research assistant in the Department of Psychiatry at the Medical School. She received the MA in anthropology from the University of Florida and the MLS from the University of Maryland. Prior to her current position, she was an Associate at the National Library of Medicine in Bethesda, Maryland. **Tony A. Harvell has been a documents librarian for I5 years. He has been active in documents work at the state and local level. He is currently doing graduate work in International Relations at the University of Miami.
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THE INITIAL
RESPONSE
TO AIDS
Acquired Immune Deficiency Syndrome is a disease caused by the HIV virus (human immunodeficiency virus), which attacks the immune system [5,6]. The impact of AIDS on the public is great in terms of lives lost and resources spent, but the future toll of the disease figures to be even more disastrous as the infection spreads among a larger percentage of the general population, including heterosexual men and women and children born to infected mothers. The disease is not restricted to the United States, where there were an estimated 1 to 1.5 million HIV-infected individuals in 1986; from this estimate it is projected that a total of 365,000 Americans will have contracted AIDS by the end of 1992 [7]. Estimates place the number of HIV-infected persons worldwide at 5 to 10 million, and AIDS has been reported in more than 100 countries, especially in Africa, where over 90 percent of cases have occurred through heterosexual transmission, equally divided among men and women [8]. Current data indicate that the largest percentage of PWAs in the United States is among young homosexual or bisexual men (66 percent), followed by intravenous drug abusers (17 percent), and homosexual male intravenous drug users (8 percent). The remaining nine percent are heterosexual men and women and pediatric patients infected by the transfusion of contaminated blood or blood products, by sexual contact, or prenatally 191. Because a large proportion of HIV infections is transmitted sexually, public health education and prevention efforts aimed at the general public have become controversial news items. Mass media attention on the disease has focused on the need for effective preventive techniques, an approach that is endorsed by the U.S. Public Health Service through the Surgeon General’s Report on AIDS [lo]. However, this approach has received criticism from more than one visible AIDS organiza“Cure AIDS Now” founder and director, Bob Kunst, a tion. According to Florida-based dispropo~ionately small amount of money currently allocated by the federal government or being raised by celebrity fund-raisers goes to direct treatment programs and services for PWAs. “Their approach,” says Kunst of fund-raisers and the federal government, “is this: without the cure, all we need is education. But for the people with the disease, it’s a death sentence. As a result, an entire underground has developed to help the sick” [ 111. Despite Kunst’s plea, education continues to be perceived as the major weapon against the spread of AIDS. In its report to the American Medical Association (AMA), for example, the Board of Trustees of the AMA recommended that the communications industry develop voluntary guidelines for public service announcements regarding AIDS in consultation with federal, state, and local health care workers and government officials [12]. In the United States, “numerous private and publicly funded organizations, medical societies, AIDS advocacy, and support groups are distributing health education pamphlets, research monographs, and publishing books, articles, and newsletters in an attempt to share information about AIDS throughout the health professional community” [ 131. FEDERAL
POLICY
ON AIDS INFORMATION
Within the U.S. government, the role of providing information about AIDS to the public has been assumed by the U.S. Public Health Service primarily through the AIDS Clearinghouse and the National AIDS Hotline administered by the U.S. Centers for Disease Control (CDC), by the publication of bibliographies, and by the U.S. Health Resources and Services Administration AIDS Education and Training Centers Program (TEC) and Area Health Education Centers Program (AHEC) [14]. The main channel for distributing government publications on AIDS is the federal depository library system of 1,400 member libraries throughout the U.S. and its territories. This network has
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1898 to disseminate government information, including health information, and information about AIDS is no exception. However, much of the early information about AIDS was aimed at the medical community rather than the general public, such as the reports contained in Morbidity and Mortality Weekly Report, a publication “that tends to emphasize who gets sick and how many new cases there are,” and whose information is often couched in technical language [ 151. The first government agency that began covering the epidemiology of AIDS was the CDC. The CDC began its coverage of AIDS in 1981, although it reported on the possible association between the weakened immune system and the incidence of opportunistic disease in five young homosexual men in 1979 [16]. The first title on AIDS that was directed to the general public was published years after the outbreak of AIDS cases [ 171. It was really not until 1986, when there were 12,248 cases of AIDS in the United States, that the first substantial publication about AIDS aimed at the general public, the Surgeon General’s Report on AIDS, was distributed to depository libraries. Thus, “the United States responded too slowly to AIDS,” and the government was slow in getting this information out [18]. In fact, the Reagan administration displayed an unwillingness to respond quickly to the AIDS epidemic, and U.S. health officials including the Surgeon General were sharply criticized by health officials in other countries for failing to undertake a national public education campaign as had already been done in Europe. To remedy this, the Surgeon General and the Centers for Disease Control produced and distributed a copy of Understanding Aids, an eight-page brochure, to every household in the United States. The brochure was the centerpiece of a multimillion-dollar public education campaign on AIDS, and it represents an unprecedented move by Congress in its approval of the mass mailing to 107 million households. This effort was not without its critics, and conservatives in the Reagan administration killed a previous effort at mass mailing. Critics argued that it was a costly and inefficient way to reach those most at risk for AIDS, chiefly inner-city members of minority groups, but the pamphlet discusses AIDS in a frank and factual manner and it focuses on eliminating misunderstandings about the disease. It is aimed at people with a seventh grade education and has been described as “ . . a chatty document, not a medical seminar, and indeed, not a sermon” [19]. To promote public awareness of the brochure, television public service announcements were sent to networks to advertise the mailing, and additional operators were added to the toll-free national AIDS hotline to handle the 1.5 million new calls anticipated during the mailing period [20]. The mass mailing of the AIDS brochure is a step in the right direction, but more is needed in the way of establishing a national policy on AIDS information. In the Interim Report of [he Presidential Commission on the Human Immunodeficiency Virus, James Watkins identifies several obstacles to the effective coordination of a national policy on AIDS information, including serious flaws in the flow and access of information about AIDS. In his recommendations to President Reagan, Watkins calls for the federal government to establish a central database and hotline for linking the public, health practitioners, and PWAs with fast and accurate information about the disease and its treatment [21]. It is interesting to note that except for academic health sciences libraries (that may have direct access to depository library materials through their affiliation with an academic depository library), the Interim Report makes no mention of the depository library system as a mechanism for distributing up-to-date information about AIDS treatment and research. This lack of recognition poses some very real concerns about the mission of depository libraries on the one hand, and the mission of the Surgeon General to inform the public about AIDS on the other. It would seem that the Surgeon General is hampered in his role as public health educator if one of the chief means for distributing health-related publications - the depository library system is overlooked as an information channel within a national policy on AIDS information. In addition to problems in the information flow, access to information also has been hindered by been used since
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built-in delays that interfere with the free exchange of scientific information among researchers who often must compete for limited funds [22]. Consequently, efforts to provide information about AIDS early in the course of the epidemic failed because, according to medical researchers, “[there was] not a good process for assessing the implications of scientific knowledge” [23]. Fierce competition among scientists racing to discover the cause of AIDS, such as the highly publicized dispute involving AIDS virus discoverers at the National Cancer Institute and the Institut Pasteur in Paris, has frustrated attempts toward the effective treatment and control of HIV [24]. The press quickly detected and homed in on the scientific debate, and since the beginning of the AIDS epidemic media response to AIDS has generally been irrational [25]. Rather than taking the opportunity to educate the public, the print media has focused on the sensational aspects of AIDS by labelling it “the creeping threat, the plaque, specter, scourge, public enemy, deadly agent, or mysterious killer.” and by doing so, further stigmatizing its victims [26]. It comes as no surprise then, that societal response to persons with HIV and AIDS remains apathetic at best, and violent at worst. This response, which is largely based on fear and ignorance regarding the disease. must be blamed in part on the mass media for failing to provide the facts to the public. Media attention to the disease has nevertheless raised public awareness of AIDS. According to a 1983 Gallup opinion poll, 77 percent of those polled had heard or read about AIDS: the results of a second Gallup poll two years after the first shows that the proportion of respondents who had heard or read about AIDS increased to 95 percent [27]. In 1987, virtually everyone (more than 99 percent) had at least heard about AIDS [28], and most Americans are aware of the modes of transmitting HIV, with 90 percent believing “it is very likely that a person will get AIDS from having sex with a person who has AIDS or from sharing hypodermic needles for intravenous drug use with someone who has AIDS” [29]. Public awareness of a test to detect antibodies to the AIDS virus in the blood is high. Almost three-fourths of those polled have heard of the blood test; however, many of the respondents erroneously believe that the blood test reveals that a person has or will get AIDS. Despite continued gains in public awareness regarding AIDS, there also continues to be a great deal of misinformation about the disease, including the belief that AIDS is a “white disease” that afflicts mostly homosexual men, and that it can spread through casual, that is, non-sexual contact, and by donating blood [30]. These and other beliefs may be at the root of the current lack of community support for organizations which provide direct health and home care services to PWAs. In Miami, which ranks third in the number of AIDS cases nationwide, an AIDS referral center aimed at Hispanics was turned away from two prospective sites after neighboring businesses complained [3 11. “Everybody is so hysterical about AIDS . . that’s why we need the [referral] center in our community. People need to know they cannot get AIDS from casual contact,” said the director of the nonprofit agency La Ligua Hispana Contra el SIDA (the Hispanic League Against AIDS), in reaction to the community’s irrational response [32]. To this end. the U.S. Public Health Service and the American Red Cross launched a joint mass media campaign in 1985 “to inform the American public about the cause, modes of transmission, and other aspects of AIDS” [33]. From 1983 through 1986, the Public Health Service spent $40 million in direct expenditures to inform and educate the public and groups at high risk by coordinating and mobilizing federal, state and local agencies. In fiscal year 1988, the President’s budget amounts to $103.9 million in requests for this activity [34]. These funding allocations have and will continue to provide for the use of the mass media in disseminating information about AIDS research, treatment, and prevention to the public. This is highly warranted given that the public turns to the media for general information on AIDS [35]. Most people rely on television, newspapers, and magazines for general information on AIDS, followed by radio, brochures, fliers, pamphlets, and word of mouth. Only when their information
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needs become more pressing do Americans turn to physicians and other health professionals specific information on the detection, treatment, and research on AIDS. THE ROLE OF THE FEDERAL
DEPOSITORY
for
LIBRARY
The most crucial statistic that concerns those in the information business involves the use of libraries by persons seeking information about AIDS. Current research indicates that Americans underutilize libraries and the national toll free AIDS hotline as sources of information on AIDS [36]. In a survey of library access to AIDS information, librarians expressed concern over the “adequacy of information on AIDS relative to patron needs and general community education” [37]. The failure of the government information system to reach those at high risk, including young homosexual and bisexual men, intravenous drug abusers, and pregnant women infected with the AIDS virus, is voiced by a librarian from the federal depository library system, whose remarks may be indicative of the prevailing attitudes among most government publications librarians: “People have lost faith in the U.S. government . . . and even though we are a depository library, [the public does] not think the information is complete or accurate . . . government should do a better job of informing the public that [depository libraries] do have information [about AIDS]” [38]. Indeed, a search in the Monthly Catalog of United States Government Publications online (see the list below) shows the depth and range of AIDS information reaching depository libraries [39]. The format and content of these publications range from bibliographies to data on epidemiology, etiology, legislation, prevention, public information, public policy, research, and treatment. The information contained in publications such as these represents a particular stage in combatting the AIDS epidemic and reflects U.S. government policy toward the allocation of funds and human resources in the effective control of AIDS [40]. The use of U.S. government information about AIDS is as varied as the titles suggest. Among the main users of the CDC data, for example, are state health department officers who must allocate scarce resources to state and local agencies in charge of delivering health care services to HIV-infected persons and PWAs, including referral, detection, counseling, and treatment. Public school officials also utilize epidemiological data on the outbreak of HIV and AIDS in order to design and evaluate school health education programs aimed at reducing the spread of the disease among future generations. In Miami, Florida, students at a local high school designed and distributed a booklet on AIDS using information they wrote away for and gleaned from U.S. government sources [41], and librarians in at least one academic library designed a user’s guide to finding information on AIDS in the library’s U.S. Government Publications Department [42]. Public education efforts such as these rely on the increasing number of printed materials on AIDS, including posters, leaflets, booklets, and reports that are available to the public free of charge, usually up to 50 copies, from the U.S. Superintendent of Documents [43]. However, despite efforts to reach the public with AIDS information through telephone hotlines, information clearinghouses, and the unprecedented mass mailing of a brochure about AIDS to every household in the country, it is not certain that targeted high-risk groups would necessarily be reached [44]. Also, it is not clear whether intravenous drug abusers or homosexual/bisexual men are necessarily the groups visiting libraries. On the other hand, libraries might well be better equipped to reach the general public not at risk of HIV infection, and whose irrational response to the AIDS epidemic often has,.resulted in misunderstanding and discrimination directed at individuals infected with HIV. Since there is no cure for AIDS, “the stigma that accompanies a diagnosis of AIDS, based on fear and society’s attitude toward intravenous drug abusers, homosexuals and bisexuals, presents a factor beyond the control of the infected individual or medicine” [4.5]. Until massive shifts in societal attitudes take place, PWAs and HIV-infected persons have reason to continue to be fearful. Loss of job, family, loved ones, and health, including life itself, are
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consequences facing the sick every day. Programs designed to inform and educate persons at risk, as well as other segments of the population who are less likely to be informed about the disease, can have a significant impact in the prevention of AIDS. Education and information can help curtail the spread of preventable diseases like AIDS in that the AIDS virus is transmitted almost exclusively by behaviors that people can modify [46]. Toward this end, the only way to improve community response to AIDS is to provide the public with information by mobilizing and coordinating federal, state, and local resources, private and public agencies to produce and distribute public service announcements, establish referral centers and hotlines, as well as issue mass mailings of information materials such as those which can be obtained from the U.S. government. CONCLUSION One of the aims of this article is to assert that information is essential for targeting and evaluating control and prevention efforts at all levels, for predicting future health care needs, and for understanding where the HIV and AIDS epidemic is headed [47]. Furthermore, since at present there is no cure for AIDS, informing the public about AIDS and about preventive behaviors “is the most effective means of curtailing” the further spread of the disease [48], and information and educational programs are essential controls that should be exercised freely [49]. The U.S. government is the world’s largest publisher, and an increasing number of new U.S. government publications on AIDS reaches depository libraries across the nation every day. Libraries are “one of the many avenues open to individuals seeking information” and they can join forces with the U.S. government to help raise public awareness of AIDS by providing free access to the published record [SO]. However, all libraries must become more visible as potential sources of AIDS information in light of the fact that nearly 75 percent of public library federal depositories are in communities of 200,000 or less, and 89.9 percent of academic library depositories are in communities with populations not exceeding 500,000 persons, while the incidence of AIDS is highest in metropolitan areas of at least one million persons, such as San Francisco, New York City, and Los Angeles [51]. The library can serve as a center for all materials related to AIDS information and education in a confidential and non-judgmental manner. Together with a national policy on AIDS information, such as the one recommended by the Presidential Commission on AIDS, libraries can play an important role in educating the general public about HIV infection and the particular concerns of PWAs or HIV infection by facilitating access to information on treatment, testing, and other issues related to this health crisis. NOTES 1. U.S. Public Health Service, The Surgeon General’s Report on AlDS (Washington, DC: U.S. Government Printing Office. 1986). 3. 2. C. Everett Koop. “Physician Leadership in Preventing AIDS,” Joiournal of the ~~e~~~a~Medical Association 258 (October 16, 1987): 21 I I. 3. Rosemary Goudreau, “Fear Keeps Many AIDS Cases Under Wraps,” Miami Herald, (Sunday, 21 Feb. 1988), A-20. 4. Goudreau, A-20. virus type III); and LAV (Iymphadenopa~y associated virus). 5. Also known as HTLV-III (human T-lymphotropic 6. Surgeon General’s Report on AIDS, 11. 7. Los Angeles Times Service, “365,000 in U.S. Will Have AIDS By 1992, Experts Say. ” Miami Herald (5 June 1988), A-17. Syndrome: An Interim Report,” Journul of the American 8. “Prevention and Control of Acquired Immunodeficiency Medical Association 258 (16 October 1987): 2097. Syndrome,” 2097. 9. “Prevention and Control of Acquired Immunode~ciency Syndrome,” 2097. 10. “Prevention and Control of Acquired Immunodeficiency 11. David Villano, “What Causes Bad Blood Between Two Groups Fighting the Same Villain? Money, Of Course,” Neux
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Times, Miami’s Neuzs and Arts Weekly (9-15 March 1988). 4. 12. Journal of the American Medical Associarion, (16 October 1987), 2097-9. 13. U.S. Presidential Commission on the Human Immunodeficiency Virus Epidemic, Interim Report (Washington, DC: U.S. Presidential Commission on the Human Immunodeficiency Virus Epidemic, 1988), 43. 14. Presidential Commission on Human Immunodeficiency Virus Epidemic, 43. 15. Edward Albert, “Acquired Immune Deficiency Syndrome: The Victim and the Press, ” in Studies in Communications; New and Knovvledge, Thelma McCormack ed., (Greenwich, CT: JAI Press, 1986), 139. 16. “Pneumocystis Pneumonia - Los Angeles,” Morbidi? and Mortality Weekly Report, (5 June 1981), 250-2. 17. U.S. National Institutes of Health, Acquired Immune Deficiency Syndrome (Bethesda, MD: U.S. National Institutes of Health, 1983). 18. Gregory Spears, “AIDS Panel: Beef Up Laws to Fight Bias,” Miami Herald (3 June 1988), Al 19. Sandra G. Boodman, “HHS AIDS Brochure: Frank, Explicit and Ready to Be Mailed,” The Washingron Posr, (May 5 1988), A-21. 20. U.S. Centers for Disease Control, “Understanding AIDS: An Information Brochure Being Mailed to All U.S. Households.” Morbidity and Morlalih, Weekly Report (6 May 1988), 261. 21. U.S. Presidential Commission on the HIV Epidemic. 44. 22. Edward N. Brandt, Jr., “Implications of the Acquired Immunodeficiency Syndrome for Health Policy,” Annuls of Internal Medicine 103 (November 1985): 772. 23. Brandt, 772. 24. Brandt, 772. 25. Albert, “Victim and the Press,” 155. 26. Albert, 155. 27. “AIDS: The Public Reacts,” Public Opinion 8 (December/January 1986): 34. 28. Deborah A. Dawson, Marcie Cynamon, and Joseph E. Fitti. “AIDS Knowledge and Attitudes for September 1987: Provisional Data from the National Health Interview Survey,” NCHS Advancedata, (Bethesda, MD: U.S. National Center for Health Statistics), no. 148, 2. 29. Dawson et al., 2. 30. Dawson ef al., 2. 31. Karen Branch, “AIDS Center Can’t Find Home,” Miami Herald, (29 March 1988), D-l 32. Branch, D-1. 33. Morbidi and Mortality Weekly Report, (9 January 1987). 819. 34. U.S. Public Health Service, AIDS InformationlEducation Plan fo Prevent and Conrrol AIDS in rhe United Stares (Bethesda, MD: U.S. Public Health Service, 1987), 4. 35. Dawson et al., “AIDS Knowledge,” 4-5. 36. Dawson ef al., 4-5. 37. Edmund F. Santa Vicca, “AIDS in the Minds of Librarians: Opinion, Perception, and Misperceptions,” Library Journal 112 (15 February 1987); 113. 38. Santa Vicca, 113. 39. Even though the Government Printing Office database online reflects depository distribution (for the most part), other non-depository, government-produced information on AIDS is available on microfiche through the American Statisticul Index. 40. cf. Scott G. Burgh, “United States Federal Government Documents on Acquired Immune Deficiency Syndrome (AIDS),” Collecrion Building 8:4. 40-9. 41, Jill M. Singer, “Students Distribute Article About AIDS,” Miami Herald, (24 March 1988, Neighbors Section), 3. 42. Diana Gonzdlez Kirby, Acquired Immune Deficiency Syndrome (AIDS): A Select Bibliography of Sources in the Government Publications and Maps Department, (Coral Gables, FL: University of Miami, 1988). 43. These materials may be obtained by calling the toll-free AIDS Hotline: I-800-342-AIDS. In addition, audiovisual materials aimed at the general public, for health care workers, and for policemen, firefighters, and other emergency personnel are also available from the National Audiovisual Center by calling customer service at (301) 763-1896. 44. U.S. Centers for Disease Control, “Understanding AIDS: an Information Brochure Being Mailed to All Households,” 262. 45. Journnl of the American Medical Association, (16 October 1987), 2098. 46. Morbidity and Mortality Weekly Report, (37, suppl. S-2 1988). 1, 47. Morbidiv and Mortaliry Weekly Report, (18 December 1987). 18. 48. Santa Vicca, “Minds of LibraAans,” 113. 49. Brandt, “Implications,” 772. 50. Santa Vicca, “Minds of Librarians,” 113. 51. Peter Hemon, Charles R. McClure, and Gary P. Purcell, GPO’s Deposirory Library System (Norwood, NJ: Ablex, 19831, 83, 93.
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and T.A.
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PRINTING OFFICE PUBLICATIONS 1988, DIALOG FILE 66
ON AIDS, 1976-MAY
BIBLIOGRAPHY Abrams, Estelle J. and Karen Patrias. AIDS Bibliography, 1987-87: 2697 Citations. Bethesda, MD: U.S. Department of Health and Human Services, National Library of Medicine, 1987. HE 20.3614/6: 1987-2. Evans, Joanna W. Acquired Immune Deficiency Syndrome (AIDS). Washington, DC: U.S. Library of Congress, 1985. LC 33.10: 85-11. Kenton, Charlotte. Human T-cell LeukemialLymphoma Virus (HTLV), January 1982 through September 1984, 234 citations. Bethesda, MD: U.S. Department of Health and Human Services, National Library of Medicine, 1985. HE 20.361412: 84-33. Korda, Holly, et al. An Annotated Bibliography of Scientific Articles on AIDS for Policymakers. Washington, DC: U.S. Department of Health and Human Services. 1987. HE 20.1 l/2: AC 7. Patrias, Karen and Christine Parker. HTLV-III Antibody Testing: Eflcacy and Impact on Public Health: January 1984 through June 1986: 420 Citations in English. Bethesda, MD: U.S. National Library of Medicine, 1986. HE 20.3614/2: 86-6. U.S. Centers for Disease Control. CDC Reports on Acquired Immunodeficiency Syndrome (AIDS). Atlanta. GA: U.S. Centers for Disease Control, 1984AIDS reprints from MorbidiQ and Mortality Weekly Report. HE 20.7009/a: AC 7; HE 20.7009/a: AC 7/981 - yr.; HE 20.7009/a: AC 7191981-86. U.S. National Library of Medicine. Acquired Immunodejiciency Syndrome (AIDS). Bethesda, MD: U.S. Department of Health and Human Services, 1983-1988. Superseded in 1988 by Current Bibliographies in Medicine [HE 20.36 1S/2: yr-no] HE 20.3614/2: yr-no. EPIDEMIOLOGY Graves, Edmund and Mary Moien. Hospitalization for AIDS: United States, 1984-85. Hyattsville, MD: U.S. National Center for Health Statistics, 1987. HE 20.6202: AC 7. Hammett, Theodore M. AIDS in Prisons and Jails: Issues and Options. Washington, DC: U.S. Department of Justice, National Institute of Justice, 1986. J 28.24: Ai 2. Henrichsen, Colleen. NIH Study Finds that Hospital Workers’ Risk of Acquiring AIDS From Patients is Very Low. Bethesda, MD: U.S. National Institutes of Health, 1987. HE 20.3038: AC 7. Peterman, Thomas A., D. Peter Drotman and James W. Curran. Epidemiology of the Acquired Immunodeficiency Syndrome (AIDS). Rockville, MD: U.S. Department of Health and Human Services. 1986. HE 20.7031: AC 7. Quinn, Thomas C., et al. AIDS in Africa: An Epidemiologic Paradigm. Atlanta, GA: U.S. Centers for Disease Control, 1986, reprinted 1987. HE 20.7031: AC 7/6. U.S. Bureau of Health Care Delivery and Assistance. Division of Maternal and Child Health.
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Report of the Surgeon General’s Workshop on Children with HIV Infection and Their Families: AIDS. Rockville, MD: U.S. Department of Health and Human Services, 1987. HE 20.9102: C 43/3. U.S. National Cancer Institute. Immunologic Abnormalities Among D.C. Homosexuals with Contacts from High-risk AIDS Areas. Bethesda, MD: U.S. National Cancer Institute, 1985. HE 20.3182/3: H 75/985. U.S. National Institute of Justice. Acquired Immunode$ciency Syndrome in Correctional Facilities: A Report of the National Institute of Justice and the American Correctional Association. Bethesda,MD: U.S. Department of Health and Human Services, 1986. HE 20.7009/a: AC 713. U.S. Public Health Service. Acquired Immunodefciency Syndrome (AIDS) Among Blacks and Hispanics, United States. Bethesda, MD: U.S. Department of Health and Human Services, 1986. HE 20.7009/a: AC 715. U.S. Public Health Service. Human T-lymphotoropic Virus Type III: Lymphadenopathy-associated Virus Antibody Prevalence in U.S. Military Recruit Applicants. Rockville, MD: U.S. Department of Health and Human Services, 1986. HE 20.7009/a: H 88/5. ETIOLOGY
Karlsberg, Florence S. Viruses in Cancer and AIDS: HTLV, the Human-Cell Leukemia-Lymphoma Virus Family. Bethesda, MD: U.S. National Cancer Institute, 1984. HE 20.3182: V 81; HE 20.3182: V 81/986. Peterman, Thomas A. and James W. Curran. Sexual Transmission of Human Immunodefciency Virus. Atlanta, GA: U.S. Centers for Disease Control, 1986, reprinted 1987. HE 20:7031: H 88. U.S. National Cancer Institute. Genetic Structure of AIDS Virus Now Mapped. Bethesda, MD: U.S. Natianal Cancer Institute, 1985. HE 20.3182/3: G 28. U.S. Public Health Service. Human T-lymphotropic Virus Type IIIILymphadenopathy-associated Virus: Agent Summary Statement. Rockville, MD: Public Health Service, 1986. HE 20.7009/a: H 88/6. LEGISLATION
U.S. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the Environment. Acquired Immune Deficiency Syndrome (AIDS): Hearing before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, Ninety-eighth Congress, Second Session, September 17, 1984. Washington, DC: U.S. Government Printing Office, 1985. Y 4.En 213: 98-185. U.S. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the Environment. AIDS Issues: Hearings before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, Ninety-ninth Congress, First Session, on Research and Treatment far Acquired Immune Deficiency Syndrome, July 22, 198.5; Protection of Confidentiality of Records of Research Subjects and Blood Donors, July 29, 198.5; Cost of AIDS Care and Who is Going to Pay, November 1, 1985. Washington, DC: U.S. Government Printing Office, 1986. Y 4.En 213: 99-45. U.S. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the
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Environment. Condom Advertising and AIDS: Hearing before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundredth Congress, First Session, February 10, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.En 213: 100-l. U.S. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the Environment. Nonhospital Care for AIDS Victims: Hearing before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, Ninety-ninth Congress, Second Session, March 5, 1986. Washington, DC: U.S. Government Printing Office, 1987. Y 4.En 213: 99-137. U.S. Congress. House. Committee on Energy and Commerce. Oflice oj’Technology Assessment’s Findings on the Public Health Service’s Response to AIDS: Joint Hearing before a Subcommittee of the Committee on Government Operations and the Committee on Energy and Commerce, House of Representatives, Ninety-ninth Congress, First Session, February 21, 198.5. Washington, DC: U.S. Government Printing Office, 1985. Y 4.G 7417: T 2213. U.S. Congress. House. Committee on Government Operations. Intergovernmental Relations and Human Resources Subcommittee. AIDS Drug Development and Related Issues: Hearing before a subcommittee of the Committee on Government Operations, House of Representatives, Ninetyninth Congress, Second Session, July 1. 1986. Washington, DC: U.S. Government Printing Office, 1986. Y 4.G 7417: D 84120. U.S. Congress. House. Committee on Government Operations. Federal and Local Governments’ Response to the AIDS Epidemic: Hearings before a subcommittee of the Committee on Government Operations, House of Representatives, Ninety-ninth Congress, First Session, Jul) 3; September 13: and December 2, 1985. Washington, DC: U.S. Government Printing Office, 1986. Y 4.G 7417: AC 712. U.S. Congress. House. Committee on Government Operations. Federal Response to AIDS: Hearings before a subcommittee of the Committee on Government Operations, House of Representatives, Ninety-eighth Congress, First Session, August I and 2, 1983. Washington, DC: U.S. Government Printing Office, 1983. Y 4.G 7417: AC 7. U.S. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee. The Federal Response to the AIDS Epidemic: Information and Public Education: Hearing bejtire a subcommittee of the Committee on Government Operations, House of Representatives, One Hundredth Congress, First Session, March 16, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.G 7417: AC 713. U.S. Congress. House. Committee on Government Operations. Employment and Housing Subcommittee. Need for Immediate OSHA Regulations to Protect Health Care Workers from AIDS: Hearing before a subcommittee of the Committee on Government Operations, House of Representatives, One Hundredth Congress, First Session, July 23, 1987. Washington, DC: U.S. Goverment Printing Office, 1987. Y 4.G 74/7: Oc l/10. U.S. Congress. House. Committee on the Budget. Ad Hoc Task Force on AIDS. AIDS Crisis as Related to the Federal Budget: Hearing before the Ad Hoc Task Force on AIDS oj-the Committee on the Budget, House of Representatives, One Hundredth Congress, First Session, October 8, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.B 85/3: AH 100-I. U.S Congress. House. Committee on Veterans’ Affairs. Subcommittee on Hospitals and Health Care. Acquired Immune Deficient! Syndrome (AIDS) and the Veterans’ Administration:
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Hearing before the Subcommittee on Hospitals and Health Care of the Committee on Veterans’ Affairs, House of Representatives, One Hundredth Congress, First Session, June 17, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.V 6413: 100-19. U.S. Congress. House. Committee on Veterans’ Affairs. National Commission on Acquired Immune Deficiency Syndrome Act: Report (to accompany H.R. 2881 . . . referred jointly to the Committee on Energy and Commerce, and the Committee on Veterans’ Affairs) (including cost estimate of the Congressional Budget OfJice). Washington, DC: U.S. Goverment Printing Office, 1987. Y 1.1/8: loo-245/pt. 1. U.S. Congress. House. Committee on Veterans’ Affairs. Subcommittee on Hospitals and Health Care. Operational Aspect of AIDS Research and Medical Care within the Veterans’ Administration: Hearing before the Subcommittee on Hospitals and Health Care of the Committee on Veterans’ Affairs, House of Representatives, One Hundredth Congress, First Session, October 30, 1987. Washington, DC: U.S. Government Printing Office, 1988. Y 4.V 6413: 100-35. U.S. Congress. House. Committee on Veterans’ Affairs. Subcommittee on Hospitals and Health Care. Operational Aspects ofAIDS Research and Medical Care within the Veterans’ Administration: Hearing before the Subcommittee on Hospitals and Health Care of the Committee on Veterans’ Affairs, House of Representatives, One Hundredth Congress, First Session, August 21, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.V 6413: 100-26. U.S. Congress. House. Select Committee on Children, Youth and Families. AIDS and Teenagers: Emerging Issues: Hearing before the Select Committeee on Children, Youth, and Families, House of Representatives, One Hundredth Congress, First Session, June 18, 1987. Washington, DC: U.S. Government Printing Office, 1988. Y 4.C 4312: AC 712. U.S. Congress. House. Select Committee on Children, Youth and Families. AIDS and Young Children: Emerging Issues: Hearing before the Select Committee on Children, Youth, and Families, House of Representatives, One Hundredth Congress, First Session, Hearing held in Berkeley, CA, February 21, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.C 4312: AC 7. U.S. Congress. House. Select Committee on Narcotics Abuse and Control. Heroin and Cocaine Trafficking and the Relationship between Intravenous Drug Use and AIDS (New York): Hearing before the Select Committee on Narcotics Abuse and Control, House of Representatives, Ninety-ninth Congress, First Session, November 28, 1985. Washington, DC: U.S. Government Printing Office, 1986. Y 4.N 16: 99-l-6. U.S. Congress. House. Select Committee on Narcotics Abuse and Control. Pediatric AIDS Hearing: Hearing before the Select Committee on Narcotics Abuse and Control, House of Representatives, One Hundredth Congress, First Session, July 27, 1987. Washington, DC: U.S. Government Printing Office, 1988. Y 4.N 16: 100-l-10. U.S. Congress. Senate. Committee on Appropriations. Subcommittee on Defense. Acquired Immune Deficiency Syndrome (AIDS): Hearing before a subcommittee of the Committee on Appropriations, U.S. Senate, Ninety-ninth Congress, Second Session: Special Hearing, Department of Defense. . . Washington, DC: U.S. Government Printing Office, 1986. Y 4.Ap 612: S. hrg. 99-686. U.S. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies. Acquired Immune Deficiency Syndrome Research Funding: Hearing before a subcommittee of the Committee on Appropriations, U.S. Senate, Ninety-ninth Congress, First Session: Special Hearing, Department of Health and Human Services, Nondepartmental Witnesses. Washington, DC: U.S. Government
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Printing Office, 1986. Y 4.Ap 612: S. hrg. 99-433. U.S. Congress. Senate. Committee on Labor and Human Resources. AIDS Epidemic: Hearing before the Committee on Labor and Human Resources, U.S. Senate, One Hundredth Congress, First Session, January 16, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.L 11/4: S. hrg. 100-38. U.S. Congress. Senate. Committee on Labor and Human Resources. Acquired Immune Deficiency Syndrome (AIDS): Hearing before the Committee on Labor and Human Resources, U.S. Senate, Ninety-ninth Congress, Second Session, on Examining What Can or Should be Done to Erudicate and Prevent the Spread of AIDS, April 16, 1986. Washington, DC: U.S. Government Printing Office, 1986. Y 4.L 1114: S. hrg. 99-940. U.S. Congress. Senate. Committee on Labor and Human Resources. Acquired Immune Deficiency Syndrome Service Coordination Act of 1986: Report (to accompany S. 2345). Washington, DC: U.S. Government Printing Office, 1986. Y 1.1i.5: 99-337. U.S. Congress. Senate. Committee on Labor and Human Resources. Acquired Immunodejiciency Syndrome Research and Information Act of 1987: Report (to accompany S. 1220). Washington, DC: U.S. Government Printing Office, 1987. Y 1.1/5: 100-133. U.S. Congress. Senate. Committee on Labor and Human Resources. AIDS Research: Hearing before the Committee on Labor and Human Resources, Senate, One Hundredth Congress, First Session, on Reviewing Progress being Made in AIDS Research, May 15, 1987. Washington, DC: U.S. Government Printing Office, 1987. Y 4.L 1 l/4: S. hrg. 100-266. PREVENTION Francis, Donald P. and James Chin. The Prevention of Acquired Immunodeficiency Syndrome in the United States: An Objective Strategy for Medicine, Public Health, Business, and the Community. Rockville, MD: U.S. Public Health Service, 1987. HE 20.7031: AC 715. U. S. Centers for Disease Control. Acquired Immunodeficiency Syndrome, AIDS: Recommendations and Guidelines, [November 1982 - mo./yr.]. Atlanta, GA: U.S. Centers for Disease Control, 1984- . HE 20.7008: AC 7; HE 20.7009/a: AC 7/2/982 - yr. U.S. Centers for Disease Control. Guidelines for AIDS Prevention Program Operations. Atlanta, GA: U.S. Centers for Disease Control, 1987. HE 20.7308: AC 7. U.S. Centers for Disease Control. Public Health Service Plan for the Prevention and Control of Acquired Immune Deficiency Syndrome (AIDS). Atlanta, GA: U.S. Centers for Disease Control, 1985, reprinted 1987. HE 20.2: AC 714. U.S. Centers for Disease Control. Public Health Service Guidelines for Counseling and Antibody Testing to Prevent HIV Infection and AIDS. Atlanta, GA: U.S. Centers for Disease Control, 1987. HE 20.7009/a: H 88/7. U.S. Centers for Disease Control., Recommendations for Assisting in the Prevention of Perinatal Transmission of Human T-lymphotropic Virus Type III Lymphadenopathy-associated Virus and Acquired Immunodefciency Syndrome. Atlanta, GA: U.S. Centers for Disease Control, 1985. HE 20.7009/a: H 88. U.S. Centers for Disease Control. Recommendations for Prevention of HIV Transmission in
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Health-care Settings. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, 1987. HE 20.7009/a: H 88/8. U.S. Food and Drug Administration. Tips on Avoiding AIDS. Rockville, MD: U.S. Department of Health and Human Services, 1988. HE 20,4010/a: AC 7/2. U.S. National Institute of Allergy and Infectious Diseases. AIDS: Practical Applications for Nurses and Social Workers. February 24, 1987. Bethesda, MD: U.S. National Institute of Allergy and Infectious Diseases, 1987. HE 20.3252: AC 7. U.S. Public Health Service. Summary: Recommendations for Preventing Transmission of Infection with Human T-lymphotropic Virus Type IIIILymphadenopathy-associated Virus in the Workplace. Rockville, MD: Public Health Service, 1985, reprinted 1986. HE 20.7009/a: H 88/2. PUBLIC INFORMATION Dawson, Deborah A., Marcie Cynamon and Joseph E. Fitti. AIDS Knowledge and Attitudes: Provisional Data’afrom the National Health Interview Survey: United States, August. Hyattsville, MD: U.S. National Center for Health Statistics, 1987. HE 20.6209/3: 146; HE 20.6209/3: 148. U.S. Center for Prevention Services. AIDS Resource List. Atlanta, GA: U.S. Department of Health and Human Services, 1987. HE 20.7312: AC 7. U.S. Centers for Disease Control. What You Should Know About AIDS: Facts About the Disease: How to Protect Yourself and Your Family: What‘to Tell Others: An Important Message from the U.S. Public Health Service, Centersfor Disease-Control. Atlanta, GA: U.S. Centers for Disease Control, 1987. HE 20.7002: AC 7. U.S. Department of Education. AIDS and the Education of Our Children: a Guide for Parents and Teachers. Washington, DC: Department of Education, 1987. ED 1.8: AC 7; ED 1.8: AC 7/988. U.S. Department of Health and Human Services. Straight Facts about AIDS. Washington, DC: U.S. Department of Health and Human Services,. 1987. [l] leaf. HE 20.3038: AC 712. U.S. National Institutes of Health. Acquired Zmmune Deficiency Syndrome. Bethesda, MD: U.S. National Institutes of Health, 1983. HE 20.3038: Im 6/2. U.S. National Institutes of Health. Sindrome de la Deficiencia Adquirida de Immunidad. Bethesda, MD: U.S. National Institutes of Health, 1983,_Spanish language version of HE 20.3038: Im 6/2. HE 20.3038: Im 6/2/Spanish. U.S. Public Health Service. Facts about AIDS. Rockville, MD: U.S. Department of Health and Human Services, 1985HE 20.2: AC 7; HE 20.2: AC 7/year-no. U.S. Public Health Service. Surgeon General’s Report on Acquired Immune Deficiency Syndrome. Washington, DC: U.S. Department of Health and Human Services, 1986. HE 20.2: AC 713; HE 20.2: AC 713lSpanish. U.S. Veterans Administration. Technical Advisory: Acquired Immune Deficiency Syndrome. Washington, DC: U.S. Veterans Administration, 1986. VA 1.22: 13-19.
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Hammett, Theodore M. AIDS and the Law Enforcement Officer: Concerns and Policy Responses. Washington, DC: U.S. National Institute of Justice, 1987. J 28.23: AC 7. Hammett, Theodore M., Monique Sullivan and Taylor McNeil. AIDS in Correctional Facilities: Issues and Options. Washington, DC: U.S. Department of Justice, National Institute of Justice [with Abt Associates], 1987 [2nd ed. with 1986 update]. J 28.23: Ai 2/986lupdate; J 28.23: Ai 2lupdate; J 28.23: Ai 21987; J 28.23: AC 71987; J 28.23: AC 7/987/update. Matthews, Gene W. and Verla S. Neslund. The Initial Impact of AIDS on Public Health Law in the United States, 1986. Atlanta, GA: U.S. Department of Health and Human Services, 1987. HE 20.7031: AC 7/4. Rowe, Mona, Caitlin Ryan and Constance Thomas. AIDS, a Public Health Challenge: State Issues, Policies, and Programs. Washington, DC: U.S. Public Health Service, 1987. HE 20.2: AC 7/5/v. 1-3. U.S. Congress. Office of Technology Assessment. Review of the Public Health Service’s Response to AIDS. Washington, DC: U.S. Congress. Office of Technology Assessment, 1985. Y 3.T 22/2: 11 H 34. U.S. Department of State. The USSR’s AIDS Disinformation Campaign. Washington, DC: U.S. Department of State, 1987. S 1.126/3: AC 7. U.S. Public Health Service. AIDS Information Bulletin: the Public Health Service Responds to AIDS. Rockville, MD: U.S. Public Health Service, 1985. HE 20.3: AC 712. RESEARCH Anderson, Linda. NCI’s AIDS Research Program. Bethesda, MD: National Cancer Institute, 1987. HE 20.3182: AC 712. Anderson, Linda. Research on Development of an AIDS Vaccine. Bethesda, MD: National Cancer Institute, 1987. HE 20.3182: AC 7. U.S. Department of Health and Human Services and World Health Organization. ZIIZnternational Conference on Acquired Immunodefciency Syndrome: June I-5, 1987. Washington, DC: U.S. Department of Health and Human Services, 1986. 1 folded sheet. HE 1.2: AC 7. U.S. National Cancer Institute. AIDS Drug Development at NCI. Bethesda, MD: U.S. National Cancer Institute, 1988. HE 3182: AC 7/4. SUBSTANCE
DEPENDENCE
Petrakis, Peter L. Acquired Immune Deficiency Syndrome and Chemical Dependency: Report of a Symposium. Rockville, MD: U.S. Department of Health and Human Services, National Institute on Alcohol Abuse and Alcoholism, 1987. HE 20.8302: AC 7. TESTING Tsang, Victor C. W., et al. Enzyme-linked
Immunoelectrotransfer
Blot Technique (Western Blot)
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for Human T-lymphotropic Virus Type IlIlLymphadenopathy-Associated Virus (HTLV-IIIILAV) Antibodies. Atlanta, GA: U.S. Centers for Disease Control, 1986. HE 20.7008/3: 15. Tsang, Victor C. W., George E. Bers and Kathy Hancock. Enzyme-linked Immunoelectrotransfer Blot (EZTB). Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, [ 1985?]. HE 20.7031: En 9. U.S. Center for Drugs and Biologics. Compliance Program Reference: Inspections of Licensed and Unlicensed Blood Banks (Compliance Program 7342.001) and Inspections of Source Plasma Establishments (Compliance program 7342.002). Rockville, MD: U.S. Center for Drugs and Biologics, 1985. HE 20.4202: C 73/2. U.S. National Institutes of Health. The Impact of Routine HTLV-III Testing on Public Health. Bethesda, MD; U.S. Department of Health and Human Services, 1986. HE 20.3046: 6/5. TREATMENT Anderson, Linda. Progress on the Treatment of AIDS. Bethesda, MD: National Cancer Institute, 1987. HE 20.3182: AC 7/3. Manhaney, Francis X., Jr. New Drug Therapy Developed for Pneumonia in AIDS Patients. Bethesda, MD: U.S. National Cancer Institute, 1987. HE 20.318213: P 74. U.S. Center for Prevention Services. 1985 STD [Sexually Transmitted Diseases] Treatment Guidelines. Atlanta, GA: U.S. Department of Health and Human Services, 1986. HE 20.7308: Se 9/4. U.S. National Institute of Mental Health. Coping with AIDS: Psychological and Social Considerations in Helping People with HTLV-III Infection. Rockville, MD: U.S. Department of Health and Human Services, 1986. HE 20.8102: AC 7.