Goss, D., & Adam-Smith, D. (1995). Organizing AIDS: Workplace and organizational responses to the HIV/AIDS epidemic. London: Taylor & Francis Ltd.
My hope for selecting this book was that it would offer insights into HIV/AIDS related inequities at various levels throughout an organization. I was looking for information regarding discrimination both to how organizations treated their internal employees, as well as perhaps those who are not employed by a given organization, i.e. how an organization might operate within a community that had high infection rates. Perhaps I had high expectations, reading too much into the title, as this isn’t exactly what I did find from reading the book. Taking less of a problem/solution aspect, it didn’t seem to have much of a bias, in terms of what would be considered a positive response or a negative response, but rather reported on “defensive” responses and “constructive” responses. While I guess these could be viewed by the reader as having a negative and positive tone, I feel as though the authors made a conscious effort to use non-judgmental language, making the read more of an analytical reporting, looking at various responses and their effects, without attempting to make a persuasive argument that one type of response was more beneficial than another.
The book starts out by offering a very brief introduction to the epidemic, transmission risks, and the workplace as an arena for discrimination before jumping into the two categories of responses that it designates. Defensive responses are defined as those that “defines AIDS as a threat to organizational stability and objectives and calls for more or less sophisticated methods to detect and control those who are perceived to be ‘carriers’ of the virus” (Goss, 1995, p. 10). Constructive responses “reject the rhetoric of threat and views AIDS as a challenge to an organization’s commitment to supporting human rights and equality of opportunity, a challenge to be faced through positive action rather than protectionism” (Goss, 1995, p. 11).
While the two natures of these definitions are explored in detail throughout the main pages of the book, not much new information was identified for me. The pages basically continued with examples and details of each type of response and what happened within a given organization when they practiced it. There is one useful table in the book that has an overview of how the two types of responses differ, as shown through various types of organizational policies.
Table 1.1 (Goss, 1995, p. 55)
|Orientation towards people with HIV/AIDS||Defensive policy||Constructive policy|
|Language||Conditional; Emphasis on “threat” and “protection”; Victim-centered and disempowering.||Unconditional; Emphasis on positive image; Empowering.|
|Procedure||Exclusionary; Surveillance; Control.||Non-exclusionary; System support.|
|Authority||Primacy of managerial prerogative.||Emphasis on consultation; Consent required for most decisions.|
|Training/education||Information-giving model||Information-giving plus community-oriented approaches.|
|Cooperation with other organizations||Minimal, perhaps trade unions informed but not involved at early stages.||Early involvement of community based organizations and trade unions.|
This table gives a pretty good overview of the responses and the policies they drove; policies that were common back in 1995. Fortunately, there are very few identifiable organizations today that are still operating under a defensive model. There are many reasons for this, none of which could be covered in a book fifteen years old. The main reason for the reduction in organizational discrimination has been the medical advances around antiretroviral drug therapies. With these medical advances, those infected with HIV often live regular, healthy lives much longer than those previously. The likelihood that they will miss work for being sick or for multiple doctor appointments has decreased dramatically, at least until they reach a stage far enough in the disease that they are unable to continue working anyway. The ADA Act in the United States also made it illegal to discriminate against those with HIV, which had a huge impact by eliminating official defensive policies.
However, this book did not touch on third world countries at all, where infection rates are much higher and antiretroviral drugs are less common. This is what I was truly hoping to find when I selected this book for review. The main takeaway that I got from this assignment is that there is a complete lack of relevant, recent, published information (at least in terms of books or articles) on the current status of the HIV/AIDS epidemic and organizational responses. While there is plenty to be read about what non-profit organizations are seeing and doing to combat the disease itself, I was unable to find any scholarly articles or other books that focused primarily on discrimination or inequities perpetuated by employers or by organizations within a community. However, I don’t believe that means that it doesn’t exist; it just happens to be occurring under the radar, in an era where most of the developed world no longer views AIDS as a relevant threat.