Facing Up to AIDS

Home economics has traditionally concerned itself with the well-being of families. Such concern and commitment have guided Extension home economists into politically charged and vitally significant arenas, including that of social policy. Within that arena, home economists seek to influence public policy so it fortifies families and enhances their durability. In the development of policies that buffer families against the impact of AIDS, however, Extension home economics is visibly absent.

AIDS affects more than the infected individual. Because it also attacks the well-being of families by draining their relationships, resources, and psychic, spiritual, and social energies, the development of family-sensitive policies is essential. These policies must acknowledge the impact of HIV infection on human relationships and provide the support needed by families to cope effectively with the care and education of their members. Clearly, the land-grant university is a powerful vehicle through which Extension home economics faculty can serve as leaders who influence all levels of policy development: federal, state, community, worksite, and family.

The Centers for Disease Control reported that by October 1991, a total of 128,289 American men, women, and children had died from AIDS. The number of women with AIDS has increased tremendously, reaching 20,309 by November 1991. HIV-infected women are the major source of infection in infants. Currently, a reported 3,372 American children have AIDS and a clear disproportion of them are black and Hispanic. Among U.S. college- age individuals (ages 20-24), 6,609 males and 1,336 females have AIDS.1

No state in the country is unaffected by HIV. Considering that about 10% of all Americans know someone with AIDS, it can be assumed that in every county in every state there are likely to be people who have HIV-infected family members or friends.

Given that assumption, Extension home economists must ask what they can do to make their communities more supportive environments for families of people with AIDS. Without a doubt, it will be from these supportive hometowns that responsive social policies will emerge.

In an effort to become visible in the AIDS family policy arena, the Oregon CES developed a publication2 that presents two case studies of families and encourages readers to think about how their communities would react. Both families are struggling to care for a loved one who has AIDS-one is a prominent family in the community whose gay son has contracted AIDS. The other is a grandmother in a small coastal community whose HIV-infected daughter has just given birth to an infant showing symptoms that meet the definition of AIDS. In addition, the publication outlines some of the challenges these families face.3 They must:

• Adjust to the life-threatening diagnosis of someone they love.
• Deal with their fears of contracting AIDS.
• Accept the disclosure of a family member's gay identity.
• Accept the disclosure of a family member's drug use.
• Accept that their child was sexually active.
• Manage conflict inside the family.
• Confront a time-limited need for emotional reconciliation with the ill family member.
• Begin to grieve many impending losses.
• Shift family roles.
• Provide emotional support and physical care to the ill member.
• Manage the multiple difficulties of the health care system.

The publication further suggests ways individuals can help families in the community whose members are infected with HIV. Extension programs and publications that address family issues relative to AIDS can serve a critical need in our communities. Participation in AIDS education will also broaden our target audiences and refute once again the myth that the work of home economists is to teach cooking and sewing.

Footnotes

1. "HIV/AIDS Surveillance Report (Altanta, Georgia: Center for Disease Control, November 1991).

2. Jan Hare, "Building Community Support for Families of People with AIDS," EC1372 (Corvallis: Oregon State University Extension Service, 1991).

3. K. Tiblier, G. Walker, and J. Rolland, "Therapeutic Issues When Working with Families of Persons with AIDS," in AIDS and Families, E. Macklin, ed. (New York: Haworth Press, 1989).