Sandra Crouse Quinn

Belief in AIDS as a Form of Genocide: Implications for HIV Prevention Programs for African Americans.

The purpose of this article is to examine factors associated with belief that AIDS is a form of genocide and trust in federal government reports on AIDS in a cross-sectional sample of 1,054 black church members. Reports in both the professional literature and mass media have documented fears that AIDS is a form of genocide unleashed on black Americans, and distrust of reports on AIDS.Results from this study demonstrate that a substantial number of participants believe that belief in genocide is not accounted for by levels of AIDS knowledge. Belief in genocide may be a modern urban legend that need not be a barrier for AIDS education. Implications for development of AIDS education sensitive to the cultural context of African Americans are described.

HIV, AIDS, and childbearing : public policy, private lives

Part I: Medical and Public Health Issues 1. The Epidemiology of HIV and AIDS in Women 2. The Clinical Course of HIV Infection in Women 3. Gynecologic and Obstetrical Issues in HIV-Infected Women 4. Health Prospects for Children Born to HIV-Infected Women 5. Psychosocial Issues for Children Born to HIV-Infected Women 6. Access to and Utilization of Health Services by HIVB-Infected Women 7. Drug Use, HIV Status and Reproduction Part II: Legal Issues 8. Legal Challenges: State Intervention, Reproduction, and HIV-Infected Women 9. Reproductive Choice and Reality: An Assessment of Tort Liability for Health-Care Providers and Women with HIV-AIDS 10. Perinatal Drug Use: State Interventions and the Implications for HIV-Infected Women Part III: Ethical and Social Issues 11. Clinical Counseling and the Problem of Autonomy-Negating Influence 12. The Moral Right to Have Children 13. Reproductive Choices of Adolescent Females with HIV/AIDS 14. Moral Multiculturalism, Childbearing, and AIDS Part IV:Voices from the Community 15. Practices and Opinions of Health Care Providers Serving HIV-Infected Women 16. In Womens Wards: The Values and Life Experiences of HIV-Infected Women Part V: Conclusion 17. HIV Infection and Childbearing: A Proposal for Public Policy and Clinical Practice - The Working Group

Community organizing for health promotion in the rural south: An exploration of community competence

Community organizing, an approach to health promotion that has the potential to address the social and environmental roots of poor health while maintaining a high degree of citizen participation and control, is a promising strategy for addressing the health needs of the rural South. This study, through qualitative analysis of 11 in-depth interviews with community organizers, examines how community organizing is being used for health promotion in rural North Carolina. It explores the mechanisms through which community organizing efforts increase community competence, which include strengthening contacts between people, providing an organizational framework through which people can receive skills training, unifying communities behind a common mission, maintaining community control, and creating opportunities for success.

Light on the Shadow of the Syphilis Study at Tuskegee

n the 1940s, with the disclosure that Nazi doctorshad conducted experiments on humans, the termresearch crime appeared for the first time. MostAmericans believed such abuses could never hap-pen here. On a hot day in July 1972, however, the na-tional front-page news described an experimentsponsored by the U.S. government. In Macon County,Alabama, a large group of Black men had gone un-treated for syphilis. Over 4 decades, as some of themdied, the U.S. government went to great lengths to en-sure that the men in the Tuskegee Study were deniedtreatment, even after penicillin had become the stan-dard of care in the mid-1940s (PrimeTime Live, 1992;Jones, 1993).Jones (1993) provides the definitive history of theTuskegee Study of Untreated Syphilis in the NegroMale, the longest nontherapeutic experiment on humanbeings in the history of medicine and public health.Conducted under the auspices of the U.S. Public HealthService (PHS), the study was originally projected tolast 6 months but wound up spanning 40 years, from1932 to 1972. The men were never told that they hadthe sexually transmitted disease. The 600 Black men inthe study (399 with syphilis and a control group of 201)were the sons and grandsons of slaves (PrimeTimeLive, 1992). In Macon County, Alabama, most Blackpeople had never been seen by a doctor. When publichealth announcements were made in churches and cot-ton fields about a way to receive free medical care, themen showed up in droves. Little did they know the highprice they would pay over the next 4 decades as theywere poked and prodded by an endless array of govern-ment medical personnel (PrimeTime Live, 1992). Thegoal of the study became to observe the participants tothe predetermined “end point”—autopsy. To ensurethat their families would agree to this final procedure,the government offered burial insurance up to

Professional Development of Health Educators through a Community Diagnosis Training Experience: Observations and Perspectives

50.The study did not stop until Peter Buxtun, a formerPHS venereal disease investigator, shared the truthaboutthestudy’sunethicalmethodswithanAssociatedPress reporter. Congressional hearings on the studycontributed to legislation on guidelines to protect hu-man participants in research. Fred Gray, a civil rightsattorney, filed a

AIDS and HIV Testing: Implications for Health Education

1.8 billion class action lawsuit that re-sulted in a

FREIMUTH AND QUINN RESPOND

10 million out-of-court settlement for thevictims, their families, and their heirs (Gray, 1998).These facts about the Tuskegee Study have receivedextensive coverage in both the mass media and profes-sional literature (Gamble, 1997; Gamble & Fletcher,1996; Gray, 1998; Guinan, 1993; Jones, 1992; Jones,1993; Quinn, 1997; Thomas & Quinn, 1991).CASTING LIGHT ON THE TUSKEGEE STUDYThe details this article brings to light, how-ever—how the study began and how it developed to be -come a metaphor for research abuse—are less familiarto public health practitioners. The Chicago-based Jul-ius Rosenwald Fund was a philanthropic organizationdedicatedtothepromotionofthehealth,education,and

African Americans' views on research and the Tuskegee Syphilis Study.

Teaching health educators to work effectively with communities is a critical task today. This article will describe how a community diagnosis course, an intensive field experience through which graduate students in health behavior and health education conduct a community assessment, helps students in their development as community health educators. Existing literature on the professional preparation of health educators and the writings of students who have completed the course demonstrate the professional skills that students gain through the experience. Students develop cultural competence, come to a more sophisticated understanding of their relationship to communities and their professional role as health educators, gain experience working effectively as part of a team, and learn specific skills in conducting needs assessments, gathering and analyzing qualitative and quantitative data, and building collaborative efforts.

Teaching community diagnosis: integrating community experience with meeting graduate standards for health educators

Abstract Since the Elisha and Western Blot test for Human Immunodeficiency Virus became available in 1985, policies on the use of HIV testing and standard public health measures such as partner notification programs have been implemented. Currently, legislative requirements regarding HIV testing vary from anonymous, voluntary testing to confidential testing. Other states require mandatory testing for certain populations. Some states require reporting names of HIV-positive individuals to the state public health authority. According to the Intergovernmental Health Policy Project AIDS Reports, some states are reconsidering their legislative statutes on testing. Mandatory testing, contact tracing/partnernotification, and reporting of names of HIV-positive individuals are all options already implemented or being considered. The purpose of this article is to make health educators aware of the issues raised by the possible move from anonymous testing to confidential testing. Additionally, the implications of rep...

Perceptions of public health

Eliminating racial and ethnic health disparities requires a multidisciplinary approach, including scholarship on the contribution of intelligence (IQ) to health outcomes as described by Batty and Deary. We agree with his conclusion that “proactive involvement of health care providers in the provider–client interaction . . . might reduce health differentials.” However, his reliance on IQ to make his claim places limits on our comprehensive health communication focus and minimizes important social determinants of health. Batty and Deary present evidence that IQ and health status are strongly correlated. While correlation is not causation, a potential relationship in some individuals is no surprise, given that both IQ measures and health status are dependent on social and cultural determinants. In fact, Neisser and colleagues state, “All social outcomes result from complex causal webs in which psychometric skills are only one factor.” 1(p96) This statement is consistent with a conclusion from Taylor et al.’s study on smoking cessation, also cited by Batty and Deary: “[O]ur data suggest that once variance in social class and deprivation was taken into account the effect of childhood IQ on smoking cessation was no longer significant.”2(p465) Populations suffering from disparities have been blamed for the lack of success of many interventions and labeled pejoratively as “hard to reach,” “obstinate,” “recalcitrant,” and “chronically uninformed.”3 The practice of negatively labeling groups with health disparities is counterproductive. If we focus on strengths rather than weaknesses and shift the responsibility for eliminating disparities from the individuals affected to the professionals with the responsibility of reaching them, we may make a greater contribution toward closing the gap. Over the years, we have raised awareness about the problem of low health literacy, and progress is being made in adapting health communication materials to populations with lower literacy levels. Information must be functional in people’s lives before we can expect them to value and use it. Furthermore, social determinants of health disparities extend beyond the individual level to include exposure to environmental hazards; socioeconomic factors, including education, income, and employment opportunities; discrimination; neighborhood conditions; access to health services; and lifestyle choices.4 These factors constitute the web of causation in which IQ may be but one thin thread. Therefore, health communication strategies must address multiple determinants in order to be effective in eliminating disparities.