AIDS -- Copyright -- PREFACE -- ACKNOWLEDGMENTS -- NOTE ON AUTHORSHIP -- Contents -- SUMMARY -- Monitoring The Spread Of HIV And Aids -- Statistics On Aids -- Statistics On HIV Infection -- Cdc's Family Of HIV Seroprevalence Surveys -- National Seroprevalence Survey -- Assuring Confidentiality -- Sexual Behavior And Aids -- Same-Gender Sex Among Men -- Teenage And Adult Heterosexuals -- Female Prostitution -- Research And Data Needs -- Data On Sexually Transmitted Diseases -- IV Drug Use And Aids -- Limiting The Spread Of HIV Infection -- Facilitating Change In Health Behaviors -- Evaluating Interventions -- Randomized Field Experiments -- Resources For Evaluation -- Overcoming Barriers To Research And Intervention -- Barriers To Research -- Collaborative Research -- Social Barriers To Intervention -- PART I UNDERSTANDING THE SPREAD OF HIV INFECTION -- 1 Monitoring The Epidemic's Course -- PREVALENCE AND INCIDENCE OF HIV INFECTION -- Uses Of HIV Prevalence And Incidence Data -- Prevalence Data -- Monitoring Trends -- Incidence Data -- Variation In Estimated Hiv Prevalence For Selected Groups -- Homosexual and Bisexual Men. -- IV Drug Users. -- Hemophiliacs. -- Heterosexual Partners of Persons with HIV Infection or at Recognized Risk. -- Patients at General Care Hospitals. -- Newborn Infants and Women of Reproductive Age. -- Prostitutes. -- Tuberculosis Patients. -- Heterosexuals Without Known Risk Factors.12 -- Variation by Age. -- Variation by Gender. -- Variation Among Blacks, Whites, and Hispanics. -- Geographic Spread of the Epidemic. -- Uncertainties About HIV Prevalence -- Principles And Methods Of Estimating Prevalence -- Probability Samples -- Full Coverage Of The Sample -- Accurate Testing -- Combining Results -- THE 1989 HIV SURVEILLANCE SYSTEM -- Surveillance Of Iv Drug Users -- Sentinel Hospital Surveillance.

Surveys Of STD And TB Clinics And Clinics Serving Women Of Reproductive Age -- Data Management -- Neonatal Screening -- ESTIMATES OF NATIONAL HIV PREVALENCE AND INCIDENCE -- The Components Model -- The Epidemiological Model -- Sample Survey Method -- CONCLUSION -- Attributes Of An HIV Monitoring System -- Other Uses Of Data On HIV -- References -- 2 Sexual Behavior And Aids -- STATUS OF THE RESEARCH FIELD -- NEEDED DATA -- Data Needed To Understand The Epidemic's Future Course -- Data Needed To Understand The Epidemic's Dynamics -- THE KINSEY STUDIES -- Quality Of The Kinsey Data -- The Interviews -- Sampling -- Utility Of The Kinsey Data -- Kinsey And The Issue Of Sexual Normality -- After The Kinsey Studies -- TRENDS IN HETEROSEXUAL BEHAVIOR IN ADOLESCENCE AND YOUNG ADULTHOOD -- Kinsey's Findings -- Studies After Kinsey -- Further Trends During The 1970s -- ADULT HETEROSEXUAL BEHAVIORS -- Details Of Survey Execution -- 1988 General Social Survey -- Los Angeles Times Survey -- Survey Results -- Condom Use And Risk Perception -- Special Studies -- Couples Study Data -- White And Afro-American Women In Los Angeles -- TRENDS IN SEXUAL BEHAVIOR AMONG PERSONS OF THE SAME GENDER -- The Kinsey Research -- From Kinsey To The AIDS Epidemic -- 1970 Kinsey Institute Data On Same-Gender Sexual Behavior -- Research On Same-Gender Male Sex Since The Onset Of The Aids Crisis -- Trends In Same-Gender Sexual Behavior -- Anal Intercourse -- Condom Use -- Other Sexual Activities -- Celibacy, Monogamy, And Multiple Partners -- FEMALE PROSTITUTION -- Social Context Of Prostitution -- Prostitution And Aids -- The Customers Of Prostitutes -- METHODOLOGICAL CONSIDERATIONS IN SURVEYS OF SEXUAL BEHAVIOR -- Accuracy Of Self-Reported Data On Sexual Behavior -- Sampling Gay And Bisexual Men -- Developing Reliable Survey Instruments -- Measurement Time Frames.

Interviewer Versus Self-Administered Assessments -- Behavioral Specificity -- Reliability And Validity Of Measures -- Sample Coverage -- ANTHROPOLOGY'S PERSPECTIVE ON HUMAN SEXUAL BEHAVIOR -- From 1929 To The 1970s -- The 1980s Prior To AIDS -- Anthropological Research Since Aids -- CONCLUSIONS AND RECOMMENDATIONS -- BIBLIOGRAPHY -- 3 AIDS and IV Drug Use -- DRUG-USE BEHAVIORS THAT TRANSMIT HIV -- Sharing Drug Injection Equipment -- Social Context Of Needle-Sharing -- Initiation into Drug Use. -- Adolescent IV Drug Use. -- Friendship Networks and Intimate Relationships. -- Shooting Galleries. -- Mechanics Of Drug Use And Sources Of Contamination -- The Syringe. -- The Needle. -- The Cooker. -- The Cotton. -- The Rinse Water. -- Frequency Of Injection -- Polydrug Use -- Sexual Behaviors And IV Drug Use -- Toward A Better Understanding Of Risk-Associated Behaviors -- RISK REDUCTION AMONG IV DRUG USERS -- Changes In Injection Behavior -- Changes In Sexual Behavior -- Toward Reducing Risk-Associated Behavior Among IV Drug Users -- CONDUCTING RESEARCH ON IV DRUG USE -- Research Traditions -- Investigating Risk-Associated Drug Behaviors -- Methods -- Convenience Samples -- Self-Reported Information -- Toward Better Quality Data -- MEASURING THE SCOPE OF THE PROBLEM -- Prevalence Of IV Drug Use -- Definition Of An IV Drug User -- Techniques For Estimating The Total Number Of IV Drug Users -- National Aggregates Of State Estimates -- Consumption And Turnover Rates Among IV Drug Users -- Modeling The IV Drug-Using Population: Constraints And Limitations -- Prevalence Of AIDS And HIV Infection Among IV Drug Users -- CONCLUSION -- Bibliography -- PART II INTERVENING TO LIMIT THE SPREAD OF HIV INFECTION -- 4 Facilitating Change In Health Behaviors -- EDUCATION PROGRAMS -- The Role Of Education And Knowledge In Preventing The Spread Of Hiv Infection.

The Function Of Fear In Health Messages -- The Role Of The Media -- Risk Perception -- Adoption And Diffusion Of Innovations -- MOTIVATING AND SUSTAINING BEHAVIORAL CHANGE -- Self-Efficacy -- Altruism -- HIV Antibody Testing -- Sustaining Behavioral Change -- Assessing Change -- Impediments To Individual Action: The Example Of Condom Use -- SOCIAL SUPPORT FOR BEHAVIORAL CHANGE -- Family, Group, And Community Beliefs -- Community-Level Intervention Programs -- Impediments To Effecting Behavioral Change -- In-Groups Versus Out-Groups: Creating Distance From Risk -- IV Drug Users -- Female Prostitutes -- Innovative And Controversial Approaches To Behavioral Change -- Sterile Needle Programs -- Education Programs For Teenagers -- THE ROLE OF PLANNED VARIATIONS AND EVALUATION -- References -- 5 Evaluating The Effects Of AIDS Interventions -- DIMENSIONS OF EVALUATION -- Program Objectives -- Program Design -- Program Implementation -- Defining And Measuring Outcomes -- Inferring Results: The Value Of Controlled Experiments -- Constraints On Evaluation -- RANDOMIZED FIELD EXPERIMENTS -- Examples -- Benefits And Costs Of Well-Designed Experiments -- Threshold Conditions For Randomized Experiments -- Does Present Practice or Policy Need Improvement? -- Is There Significant Uncertainty About The Effectiveness Of The Proposed Treatment? -- Are There Acceptable Alternatives to Randomized Experiments? -- Will The Results Of The Experiment Be Used To Improve Practice Or Policy? -- Voluntary Participation -- Organizations As The Treatment Unit In Field Experiments -- SPECIAL CONCERNS OF EVALUATION IN THE CONTEXT OF HIV INFECTION AND AIDS -- Target Groups -- Information Base -- Objectives Of AIDS Intervention Programs -- Ethical Issues -- Attrition And Noncompliance -- Measurement And Observation -- IMPLEMENTING GOOD EVALUATIONS -- Bibliography.

PART III IMPEDIMENTS TO RESEARCH AND INTERVENTION -- 6 Barriers to Research -- COLLABORATION IN RESEARCH -- FEDERAL RESEARCH PERSONNEL -- Immediate Needs -- Future Needs -- References -- 7 Social Barriers To Aids Prevention -- SOCIAL RESPONSE TO EPIDEMICS -- COMMUNICATING ABOUT SEX -- BARRIERS TO ACTION: RECENT EXAMPLES -- Condom Advertising On Network Television -- Communicating With Inoffensive Language -- Federal AIDS Education Efforts -- Communicating Facts Versus Moral Suasion -- Reflecting Values Versus Imposing Them -- HISTORICAL LESSONS -- The Effects Of Epidemics On Poor People And Minorities -- Stigma -- Defining Stigma -- Effects Of Stigmatization -- Stigma And The Aids Epidemic -- Legal Status Of Homosexual Behaviors -- Toward Dispelling Stigma -- References -- APPENDIXES -- Appendix A The Committee's Recommendations -- Monitoring The Epidemic's Course -- Human Sexual Behavior And AIDS -- AIDS AND IV DRUG USE -- FACILITATING CHANGE IN HEALTH BEHAVIORS -- EVALUATING THE EFFECTS OF AIDS INTERVENTIONS -- BARRIERS TO RESEARCH -- Appendix B Supplemental Data -- BACKGROUND PAPERS -- ON THE ACCURACY OF ESTIMATES OF NUMBERS OF INTRAVENOUS DRUG USERS -- What Is The Definition Of Intravenous Drug User? -- What Definitions Are Used In The "Review"? -- What Population Definition Was Used For Estimating Seroprevalence? -- How Were Numbers Of Ivdus Estimated? -- Overview -- Aggregation Of State Agencies' Estimates -- Illinois And Chicago -- California And Los Angeles -- New York State And New York City -- National Estimates -- Lange's Approach -- Newmeyer's Ratio Estimate -- Conclusions -- References -- MONITORING THE SPREAD OF HIV INFECTION -- Current Estimates -- Proportional Model -- Multiplicative Model -- Temporal Distribution Model -- Proposal -- Requirements -- Limitations Of Samples Of Convenience -- Design Considerations -- Overview.

Sample Size And Efficiency.