Angela Aidala

Cost and threshold analysis of housing as an HIV prevention intervention

The Housing and Health study examines the effects of permanent supportive housing for homeless and unstably housed persons living with HIV. While promising as an HIV prevention intervention, providing housing may be more expensive to deliver than some other HIV prevention services. Economic evaluation is needed to determine if investment in permanent supportive housing would be cost-saving or cost-effective. Here we ask––what is the per client cost of delivering the intervention, and how many HIV transmissions have to be averted in order to exceed the threshold needed to claim cost-savings or cost-effectiveness to society? Standard methods of cost and threshold analysis were employed. Payor perspective costs range from

Social Change, Gender Roles, and New Religious Movements*

9,256 to

A Longitudinal Investigation of Drug Use and Work Patterns among Middle-Class, White Adults

11,651 per client per year; societal perspective costs range from

Communes as seeking better family? A misleading explanation

10,048 to

Changing Drug Use Patterns and Treatment Behavior

14,032 per client per year. Considering that averting a new case of HIV saves an estimated

Communes and Changing Family Norms Marriage and Life-Style Choice Among Former Members of Communal Groups

221,365 in treatment costs, the average cost-saving threshold across the three study cities is 0.0555. Expressed another way, if just one out of every 19 Housing & Health intervention clients avoided HIV transmission to an HIV seronegative partner the intervention would be cost-saving. The intervention would be cost-effective if it prevented just one HIV transmission for every 64 clients served.

Food Is Medicine

The relationship between gender role ambiguities and new religious movements is explored by an analysis of religious and nonreligious communes utilizing both survey and ethnographic data. The existence of a single, morally absolute set of definitions and specific rules concerning sexuality and gender roles distinguishes religious from secular communal movements. Participants in religious groups are characterized by uncertainty about rather than outright rejection of traditional gender roles, and low tolerance for ambiguity. Findings are discussed within a broader explanatory framework which emphasizes the significance of lifestage and gender roles for understanding the interrelationships among structural change, cultural fragmentation and social movement participation. A recurrent phenomenon on the historical landscape is the periodic upsurge of movements sweeping in their condemnation of the society that surrounds them and offering alternative communities of moral regeneration and social fellowship. Such times of countercultural protest are characterized by relatively sudden economic, social, and demographic changes that have eroded the taken-for-granted legitimacy of prevailing institutions (Yinger, 1982). Where and when traditional understandings and values no longer fit emerging realities, large cracks appear in the consensus underlying existing social arrangements and prophets and visionaries can command the attention of more than a few passersby. Religious movements flourish as competing visions of a New Moral Order receive enthusiastic support. In periods of major social and cultural disjuncture, religious as well as many secular movements have a communitarian focus-oriented to the establishment of actual communities of co-enthusiasts. Within small, well-bounded communities of likeminded others, new values, goals, and role behaviors can be socially defined and consensually affirmed (cf. Bennett, 1975; Bestor, 1950; Cohn, 1970; Darin-Drabkin, 1962; Zablocki, 1980).

Stabilizing the HIV/AIDS workforce: Lessons from the New York City experience

This article explores the relationship between drug use and patterns of living and working for a sample of middle-class, white “baby boomers” who have lived in communal households. A longitudinal investigation was initiated in the mid-1970s with 806 persons and followed up in 1986–1987 with 79% of these subjects. During interviews, the subjects supplied data related to their work and financial status, work-related attitudes and behavior, life status, and histories of drug use (i.e., types of drugs used, and quantity, frequency, and duration of use). The results indicate that neither chronic nor current use of marijuana or alcohol had adversely affected the subjects occupational status and achievement in middle adulthood, although a relationship was found between daily alcohol consumption and delaying marriage and childbearing. The authors warn against extrapolating the results for this unique sample to the larger population, but note the implications they have for future research.

Changes in Moral Judgments among Student Populations: 1929-1983.

Using data from a longitudinal study of ideology in urban communal living groups, this paper reexamines the thesis that the commune is an alternative family form sought by individuals striving for a better kind of family life. While family-oriented themes are often mentioned by communitarians, only a minority of communes in the sample were found to be specifically family focused in values and collective goals. Individuals in urban communes differ from their non-communitarian peers less in their orientation toward the family than in the comprehensiveness of their estrangement from all institutions. Rather than seeking alternative family forms, they were found to have been seeking social support for a broad range of non-conventional beliefs and role choices. Communal groups, which flourish at times of high flux and lack of consensus in social values, represent a quest for well-integrated, circumscribed consensus in response to the unravelling of broader social unity.

Religion and Spirituality Among Persons Living with HIV

This chapter will report changing drug involvements and treatment needs in a community representative sample of nonHispanic urban Black Americans. The study group has been followed for 20 years to date. Indi-viduals in the study group were selected in the late 1960s because they were adolescents residing in the Central Harlem health district of New York City. The first section of the chapter includes a discussion of drug use patterns, focusing on changes that appeared as the sample moved from postadoles-cence (aged 18–23 yr) to young adulthood (ages 26–31). Discussion in the second section turns to drug treatment issues. Attention is directed there, specifically, to pathways into and outcomes of treatment for heroin abuse.