THE PECULIAR EPIDEMIC, PART-I - SOCIAL RESPONSE TO AIDS IN ALAMEDA COUNTY

The morbidity and mortality caused by epidemics threaten social functi oning of complex societies. Societies mount a social response to epide mics in order to contain the potential damage from uncontrolled diseas e. Despite the threat posed by epidemics, social and contextual 'vulne rabilities' often impede efforts to contain epidemics. The AIDS epidem ic provides an example of a 'peculiar' epidemic, in which threat to so cial welfare failed to provoke adequate social efforts at containment. In order to examine the miscarriage of epidemic response, we intervie wed 31 AIDS providers in Alameda County, California, about the develop ment of their AIDS-related services. According to the people interview ed, epidemic response in the County was marred by stigma associated wi th AIDS, lack of adequate funding, difficulties in building collaborat ive effort in a fragmented care system, and other political and social problems. In spite of these obstacles, social mobilization enabled di rectors of a wide variety of health care agencies to incorporate care and prevention into their services. The findings support the concept t hat 'vulnerabilities' can derail epidemic response, making widespread social mobilization an essential tool for epidemic control. The discus sion centers on the implication of these findings for the theoretical understanding of social response to epidemics.