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James D. Slack - AIDS and the public work force: local government preparedness in managing the epidemic

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AIDS and the Public Work Force examines the extent to which local governments are prepared to manage the workplace ramifications of the AIDS epidemic. Slack surveyed 526 city managers and mayors across the United States during summer 1989, selecting local government as the focal point because it represents the largest work force in the nation. This study addresses four critical workplace issues relevant to the AIDS epidemic: the legal expectations for coping with AIDS in the work force; practitioners attitudes on the general topic of AIDS, as well as their views on the issues of employee selection and screening, confidentiality of employee health status and citizen contact with employees in the HIV spectrum; the level of local government preparedness in managing the epidemics impact on the work force; and factors that explain the extent of managements response to the workplace ramifications of AIDS. While the law requires employers to protect the civil rights of workers in the HIV spectrum, a notable proportion of city managers and mayors express concerns on key workplace issues. Many practitioners favour HIV antibody testing in the workplace. They question, as well, the wisdom of permitting direct contact between infected employees and the citizenry. These city administrators are torn between the arguments favouring the confidentiality of the employees health condition and those supporting the right of the citizen to know about the workings of government, including disclosure of AIDS-related information about city employees. Practitioners also underestimate the number of workers infected by the disease; based on the number that experts believe to be infected in the general population, practitioners estimates should be six times higher. Most local governments have not developed any formal workplace plans to manage the AIDS epidemic. The ways in which bureaucracy responds to the HIV spectrum in the workplace will give shape to the level of public services available, as well as the manner in which those services are delivered.

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title AIDS and the Public Work Force Local Government Preparedness in - photo 1

title:AIDS and the Public Work Force : Local Government Preparedness in Managing the Epidemic
author:Slack, James D.
publisher:University of Alabama Press
isbn10 | asin:0817305483
print isbn13:9780817305482
ebook isbn13:9780585197876
language:English
subjectAIDS (Disease)--United States, Municipal officials and employees--Health and hygiene--United States.
publication date:1991
lcc:RA644.A25S56 1991eb
ddc:362.1/9697/9200973
subject:AIDS (Disease)--United States, Municipal officials and employees--Health and hygiene--United States.
Page iii
AIDS and the Public Work Force
Local Government Preparedness in Managing the Epidemic
James D. Slack
The University of Alabama Press
Tuscaloosa and London
Page iv
Copyright 1991
The University of Alabama Press
Tuscaloosa, Alabama 35487-0380
All rights reserved
Manufactured in the United States of America
Picture 2
The paper on which this book is printed meets the minimum requirements of American National Standard for Information Science-Permanence of Paper for Printed Library Materials, ANSI Z39.48-1984.
Library of Congress Cataloging-in-Publication Data
Slack, James D., 1952
AIDS and the public work force : local government preparedness in managing
the epidemic / James D. Slack.
p. cm. Includes bibliographical references and index.
ISBN 0-8173-0548-3 (alk. paper)
1. AIDS (Disease)United States. 2. Municipal officials and employees
Health and hygieneUnited Sates. I. Title.
RA644.A25S56 1991
362.196979200973dc20 91-2769
British Library Cataloguing-in-Publication Data available
Page v
TO THE MEMORY OF MY FATHER,
WAYNE DOUGLAS SLACK (19261975).
A PUBLIC SERVANT OF THE VILLAGE
OF SOUTH AMHERST, OHIO.
Page vii
Contents
Preface
ix
1. Overview of the AIDS Crisis
1
2. AIDS and the Public Service
23
3. AIDS and the Law
40
4. Attitudes Toward AIDS in the Workplace
67
5. AIDS Policies and Procedures: The Extent and Causes of Their Adoption
84
6. AIDS and the Public Service Revisited
108
Appendix A. Questionnaire Items
129
Appendix B. Distribution of Sample
132
Appendix C. Correlation Matrices for Variables in Statistical Analyses
133
Appendix D. Selected Examples of AIDS Guidelines
135
Notes
153
Bibliography
169
Index
179

Page ix
Preface
Acquired Immunodeficiency Syndrome (AIDS) is a disease that is spreading to every community and every age group in society. To say that AIDS is an epidemic without cure does not adequately embrace its devastation. The number of teenagers contracting the disease is doubling every 14 months. Since I began writing this book in August 1989, the total number of AIDS cases has increased by 49 percent (104,210 to 154,917), and the number of deaths has increased by 58 percent (60,684 to 95,774). During these few months the case-fatality rate for adults and adolescents also has increased by 7 percent, growing from 58.2 to 62.0. Sadly, these figures will probably be much larger by the time this book is printed and in the bookstores.
Finding a cure for the disease will certainly entail additional, sustained medical and epidemiological research. But because of the stigma that is attached to persons in the HIV spectrum, attention must be given also to key legal, cultural, ethical, and behavioral issues related to the disease. What makes this epidemic unique is that it does more than simply attack the health of the human body. AIDS also challenges the well-being of our society and our fundamental beliefs about appropriate and just means of human interaction. This is true for those individuals in the HIV spectrum, as well as those not directly affected by the disease. It is, therefore, necessary to examine the impact of this disease from a variety of dimensions.
This book examines the extent to which local governments are prepared to manage the workplace ramifications of the AIDS epi-
Page x
demic. This is an important topic because the way bureaucracy responds to the HIV disease in its own workplace will give shape to the level of public services available, as well as the manner in which those services are delivered. Local government is an important focal point because it represents the largest work force in the nation.
There are many people I wish to acknowledge. First and foremost is Jack P. DeSario, professor of political science at Mount Union College. The totality of Professor DeSario's contributions is simply immeasurable. He lent me his intellect throughout this entire research project. He peer-reviewed each chapter and consistently, brutally at times, questioned all of my thoughts, assumptions, methods, conclusions, and even my scholarly
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