UNIV 245: AIDS
Fall, 2001; CRN: 12243 MWF 10-10:52, Coleman 220
Registered Professor:
Dr. Carl Milofsky (CM), Coleman 201, 73468; milofsky@ Sociology
Partner Professors:
Dr. Dee Casteel (DC) Chemistry 308 7-3675 casteel@ Chemistry
Dr. Dave Pearson (DP) Biology 207 7-1135 pearson@ Immunology
Dr. Marie Pizzorno (MP) Biology 205 7-3084 pizzorno@ Virology
Dr. Marc Schloss (MS) Coleman 204 7-3474 schloss@ Anthropology
Dr. Amy Wolaver (AW) Coleman 170 7-1699 awolaver@ EconomicsIn this course we will attempt to examine the subject of AIDS from as many points of view as possible. We will delve into the history of other diseases and epidemics, the biology of HIV - the virus that causes AIDS, how the immune system functions and why it fails during AIDS, therapeutic drug development and distribution, and how we as a society, both nationally and internationally, have dealt with this disease. These topics will be interspersed throughout the semester, to keep things varied and interesting. In the end our goal is to demonstrate that AIDS is a complex problem that needs the tools of many disciplines, both from the natural and social sciences, to help us fully understand it.
Class Assignments % of Grade
Writing Assignments (3-5 pp) 5% each, 20% total
Debate (performance) 10%
Debate (written assignments) 10%
Midterm Exam 20%
Final Exam 20%
On-Line Quizzes (Web site) 10%
Participation/Attendance 10%
Writing Assignments and Class Discussions
Several short (3-5 page) papers on the topics outlined in the syllabus will be due approximately every 2 weeks on a Friday. We will use these papers as the basis for class discussions.
Student Debates
You will be placed into teams based on topics you express an interest in on a questionnaire given during the first few weeks of the semester. Each team will then choose a topic and the point of view that they will debate. Over the course of the semester there will be several assignments that will assist you in preparing your debates. After the actual debate, which will also involve participation from the rest of the class, each team will write up a final paper detailing the information they presented and backing up their viewpoint on the topic. The debate questionnaire that will be distributed in class on August 31 is given on the course website. You might want to look at the questionnaire before you have to list your debate topic preferences.
Required Textbooks
The following books have been ordered for the Bookstore or may be purchased through your own book purchasing source:
Abraham Verghese, My Own Country (New York: Vintage 1994)
Hung Fan, Ross F. Conner, and Luis P. Villarreal, AIDS: Science and Society. Third Edition (Jones and Bartlett, 2000)
Additional Selected Readings
Reserve readings are listed at the end of the syllabus. Within the class schedule, only the last name of the author from the reserve list is given. That name is what will be listed on the ERES list of readings. These readings will be posted on E-Reserves at:
http://eres.bucknell.edu/coursepage.asp?cid=231&page=01
at least 5-10 days prior to the class meeting in which they will be discussed. You must enter the password for the class (password=AIDS) to gain access to the ERES readings. You must also use your mouse to select the "accept" button if you hope to get access. If you just hit <return> it will not give you access. An advantage of this system is that you can now access the ERES readings from off-campus.
Class Schedule
Aug 29 CM: Introduction to the course. Review of the syllabus. The social context of AIDS
**Reading** Students should be well along in reading Verghese which was assigned as summer reading. It's fast reading, so if you have not begun, you should plunge into it.
Aug 31 CM: Ethical issues related to the challenges of confidentiality.
Debates survey. Students must answer questionnaire and rank the questions in terms of which are their preferred debate topics.**Writing** Ethan's dilemma from Verghese. Writing assignment #1 on course website. Debates survey.
Sept 3 MP: Introduction to epidemiology: Emerging Infections.
**Reading** R.M. Henig. Why new viruses emerge (pp3-36). In The dancing matrix - how science confronts emerging viruses (New York: Alfred A. Knopf 1993).
Sept 5 CM: Plague and group panic
**Reading** Fan, Conner, and Villereal, Ch. 2
and Eleanor Smith Bowen, Return to Laughter, pp. 238-282 (New York: Anchor Books 1964).Sept 7 MP: History of Microbiology and Virology (no reading assigned)
Sept 10 CM: The Morality of Disease
**Reading** Nancy Tomes, "Moralizing the Microbe: The Germ Theory and the Moral Construction of Behavior in the Late-Nineteenth-Century Antituberculosis Movement." Pp. 271-294 in Allan M. Brandt and Paul Rozin (eds.), Morality and Health (New York: Routledge 1997).
Sept 12 Discussion of our feelings and experiences in the aftermath of the Tuesday bombings.
CM: Symbolism of disease. The first reading for today has direct relevance to our national reactions to the bombings. Rather than rolling them back to Friday for discussion, let us treat them as "meditations" and move on.
**Reading** Palmer, S. (1997). "AIDS metaphors and body symbols" (pp 1-20). In AIDS as an apocalyptic metaphor in North America, Toronto: University of Toronto Press.
and Palmer, S. (1997). "A Virus in the Popular Imagination." (pp 146-166). In AIDS as an apocalyptic metaphor in North America, Toronto: University of Toronto Press.Sept 14 CM: Personal experience with AIDS
Debate team assignments will be given out.
**Writing** Writing Assignment #2 on Course Website.
Sept 17 DC Everything you need to know about chemistry in 45 minutes.
Sept 19 Visit from Art McTighe, pathologist, Evangelical Hospital. Epidemiology: Discovery of the cause of AIDS
**Reading** (Both available on ERES): First reading (and most important): Centers for Disease Control, Mortality and Morbidity Weekly Report, Vol. 50, #21; June 1, 2001 available at http://www.cdc.gov/mmwr/PDF/wk/mm5021.pdf
Second Reading (skim this; science students may want to read it more carefully but don't beat yourself up to understand every word):Hans L. Tillmann, M.D., Hans Heiken, M.D., Adriana Knapik-Botor, Stefan Heringlake, M.D., Johann Ockenga, M.D., Judith C. Wilber, Ph.D., Bernd Goergen, Ph.D., Jill Detmer, B.S., Martin McMorrow, M.Sc., Matthias Stoll, M.D., Reinhold E. Schmidt, M.D., and Michael P. Manns, M.D., "Infection with GB Virus C and Reduced Mortality among HIV-Infected Patients", New England Journal of Medicine Volume 345:715-724 September 6, 2001.Sept 21 MP Introduction to cell biology
**Reading** No Readings; handouts will be provided in class.
Sept 24 DP Introduction to the immune system
**Reading** Gistav J.V. Nossal, "Life, Death and the Immune System." Scientific American, v. 269 (3): 53-62 (Sept. 1993).
Sept 26 DP Immune system: Illness and Infection
**Reading** Irving L. Weissman and Max D. Cooper, "How the Immune System Develops", pp 65-71, and Charles A. Janeway, Jr., "How the Immune System Recognizes Invaders", Scientific American, v. 269 (3):73-79 (Sept. 1993).
Sept 28DP Immune system
**Reading** Philippa Marrack and John W. Kappler, "How the Immune System Recognizes the Body." Scientific American, v. 269 (3):81-89 (Sept. 1993).
and William E. Paul, "Infectious Diseases and the Immune System." Scientific American, v. 269 (3): 91-97 (Sept. 1993)).
Oct 1 DP Immune system
**Reading** Warner C. Greene, "AIDS and the Immune System." Scientific American, v. 269 (3): 99-105(Sept. 1993).
Oct 3 DP Immune system
**Reading** David Baltimore and Carole Heilman, "HIV Vaccines: Prospects and Challenges", Scientific American (July, 1998) pp 98-103.
Oct 5 Review Immune System Section; talk about midterm exam.
** Writing** Assignment #3; practice science analytic essay midterm question
Oct 8 AW Why we don't have enough vaccines
**Reading** Sachs, Jeffrey, Michael Kremer, and Amar Hamoudi, "The Case for a Vaccine Purchase Fund". Center for International Development, Harvard University, Policy Anaysis, unpublished document.
Oct 10 Midterm Exam
Oct 12 AW The economics of risky behavior
**Reading** Philipson, T.J. and R.A. Posner, "An economic model of risky sexual behavior." Ch. 1 in Philipson and Posner, Private Choices and Public Health: The AIDS Epidemic in Economic Perspective. (Cambridge, MA: Harvard University Press 1993).
and; Christensen, K. "Economics without money: Sex without gender: A critique of Philipson and Posner's Private Choices and Public Health: The AIDS Epidemic in an Economic Perspective. Feminist Economics 4(2): 1-24 (1998).
Oct 15 Fall Break
Oct 17 CM Managing drug abuse and other risky behavior.
**Reading** Turner, C.F., Miller, G.G. and Moses, L.E.. AIDS and IV drug use (pp186-214). In AIDS: Sexual Behavior and Intravenous Drug Use (Washington, D.C.: National Academy Press 1989)
Oct 19 Visit from sociologist John Messer.
**Reading** Fan, Conner, and Villereal, Chs 10 and 11
Oct 22 MP Basic molecular biology
**Reading** Fan, Conner, and Villereal, pp 48-61
Oct 24 MP Basic virology
**Reading** Fan, Conner, and Villereal, pp 61-74
Oct 26 MP HIV replication
**Reading** Fan, Conner, and Villereal, pp 79-110
Oct 29 DC Drugs (a handout will be provided)
**Reading** (If you have not gotten through it) Chapter 5, pp 79-110 in Fan, Conner, and Villarreal.
**Writing** As you read Chapter Five, make a list of all the drugs mentioned in that chapter and what the drug is used for.Oct 31 DC Drugs
**Reading** To Be Assigned
Nov 2 AW Mother-child transmission of HIV.
** Writing** Assignment #4. Find the assignment on the Course Web page.
**Reading** Cohen, J. "The mother of all HIV challenges." Science v. 288: 2160-2163 (June, 2000).
Nov 5 AW Pharmaceutical pricing
**Reading** PBS Online Newshour, "The Price of AIDS", February 21, 2001. A panel on economic issues surrounding AIDS drugs. A NewsHour with Jim Lehrer Transcript. Participants: Joelle Tanguy, Doctors without Borders, Jeffrey Sachs, economist at Harvard and with the WHO Commission on Macroeconomics and Health, Glaudine Mtshali, South Africa's health representative to the U.S., Canada, and Brazil, and Shannon Herzfeld, Sr., Vice President for International Affairs, RhRMA (the American drug makers' lobbying group.)
and PBS Online Newshour, "Indian Pharmaceuticals," March 15, 2001. A NewsHour with Jim Lehrer Transcript.Nov 7 MP? Opportunistic infections.
**Writing** This is the writing assignment linked to the debates and will be part of your grade for the debates section of this course. Look for an explanation of the assignment on the Writing Assignments Page of the course website. Write an annotated bibliography summarizing what you have found researching your debate topics. Although students are working on teams, we expect each person to do independent research on the topic. This is the place where that individual work will be recorded and graded. Both electronic and paper copies are required.
Nov 9 Debate #1
Nov 12 Debate #2
Nov 14 Debate #3
Nov 16 Debate #4Nov 19 Debate #5
Nov 21 Thanksgiving Break
Nov 23 Thanksgiving Break
Nov 26 CM The political economy of AIDS
**Reading** Stanley Aronowitz, "Against the liberal state. ACT-UP and the emergence of postmodern politics." Pp 125-144 in The Death and Rebirth of American Radicalism (New York: Routledge 1996).
Nov 28 AW The market rationale vs. ethical control in health care.
**Reading** Thomas Rice, "Equity and Redistribution."
Ch. 5 of The Economics of Health Reconsidered. (Chicago: Health Administration Press 1998)Nov 30 AW & CM Insurance, health care financing, and distributional justice.
**Reading** D.W. Light, "Excluding More, Covering Less: The Health Insurance Industry in the U.S.," pp 464-477 in Phil Brown (ed.), Perspectives in Medical Sociology, 2nd Edition (Prospect Heights, IL: Waveland Press 1996).
Dec 3 Richard Conviser to Class
**Reading** Conviser, R., S. Gamliel, and L. Honberg. "Health-based payment for HIV/AIDS in Medicaid managed care programs." Health Care Financing Review 19 (3): 63-81 (Spring 1998). (from OCLC Firstsearch on line)
Evening: Richard Conviser talk; attendance expected.Dec 5 MS Culture and disease in nonwestern countries.
**Reading** First: Read the handout provided in class. If you were not in class, pick up a copy from the envelope outside Prof. Milofsky's office, Coleman 201. Read the handout before you read the article listed below. The article below is an analysis of a case study, that of Manno (a name). The handout is a somewhat longer and more complete version of the case study. Note that in some copies of the handout, pages are out of order. Put them in order before you read the material!
Second, go to the ERES website for ANTH 227 (password=anthro) and read the material labeled: Sending Sickness (Farmer).
Dec 7 AW World patterns of AIDS incidence
**Reading** MAP (Monitoring the AIDS Pandemic). Summary of the Durban Monitoring the AIDS Pandemic Network Symposium. (unpublished document)
Also, read the following which cannot be accessed from ERES:
http://www.census.gov/ipc/www/hivdurbn.htmlDec 10 MS Disease, bodies, and culture.
**Reading** Go to the ERES site for CAPS429 (password=anthro). Read the selection titled Plastic Teeth Extraction (Weiss).
Dec 13-20 Final Exams