[sci.med.aids] high risk group

liz@AI.MIT.EDU (Liz A. Highleyman) (10/14/90)

I used to agree with the previous poster in being upset about the
prevalence of the notion of high risk groups.  It is the orthodoxy
within the AIDS activist movement that there are no high risk
groups, only high risk behaviors.  Lately, though I have come to
re-evaluate this.

Since the car analogy has popped up here recently, I will continue
it:

  Someone who drives frequently, and who drives on congested high-
  ways at high speeds is at more risk of an automobile fatality
  that someone who on occasion drives at 30mph through the suburbs.
  This does not mean, of course, that the latter cannot be killed
  in a car accident, nor that s/he should not take precautions.
  But it seems clear that the former person is at higher risk.

Part of the reason for my change in attitude is the fact that as
people (the dreaded `general population') learn more about AIDS,
contradictory info and all, they are becoming more skeptical.
When people are told that a married midwest heterosexual suburban
couple is just as much at risk and should take equal precautions
to an IV drug user in New York city, they do not believe it, and
this impacts their willingness to believe anything else AIDS
educators may tell them.

Perhaps when trying to educate the larger public, we need to
think about using different methods and a different vocabulary
than we did/do to educate specific groups like gay men, or
inner city women.  It is easier, of course, to aim one blanket
campaign that many specific targeted ones.  And it makes sense
that with limited resources we would aim that campaign with the
most at-risk people in mind.  But I am starting to think that
doing so is causing AIDS educators to lose credibility.

What do others think?

-Liz

rob@mtdiablo.Concord.CA.US (Rob Boldbear) (10/15/90)

In article <40106@shemp.CS.UCLA.EDU> liz@AI.MIT.EDU (Liz A. Highleyman) writes:
>I used to agree with the previous poster in being upset about the
>prevalence of the notion of high risk groups.  It is the orthodoxy
>within the AIDS activist movement that there are no high risk
>groups, only high risk behaviors.  Lately, though I have come to
>re-evaluate this.
>
>Since the car analogy has popped up here recently, I will continue
>it:
>
>  Someone who drives frequently, and who drives on congested high-
>  ways at high speeds is at more risk of an automobile fatality
>  that someone who on occasion drives at 30mph through the suburbs.
>  This does not mean, of course, that the latter cannot be killed
>  in a car accident, nor that s/he should not take precautions.
>  But it seems clear that the former person is at higher risk.

The analogy falls a little flat. I assume the groups Liz would
be using here would be "frequent freeway commuters" and "occasional
local drivers". Those groups are ad hoc based on the behavior that's
risky. That's fine. To bring this back to risky behavior, you'd
have to redefine the high risk groups in terms of the risky behavior,
e.g. "unsterilized needle sharers", "unprotected sex participants."

However ...

I think there is *some* use to talking about high risk groups in
certain circumstances. A gay man living in a large city is more
likely to get HIV infected than a woman living in a rural town
who performs the same sexual acts with the same amount of risk
as the gay man, simply because the gay man's partners are more
likely to be infected than the woman's.

The concept of high risk groups is useful in a practical way
in allocating limited resources for combatting the epidemic.
-- 
Rob Bernardo                             Mt. Diablo Software Solutions    _ /
email: rob@mtdiablo.Concord.CA.US        phone: (415) 827-4301           <_/><
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	    "There is no right 'not to be offended'." -Bob Culmer