UNIVERSITY OF CALIFORNIA, SAN FRANCISCO

 

 

BERKELEY * DAVIS * IRVINE * LOS ANGELES * RIVERSIDE * SAN DIEGO * SAN FRANCISCO { “WI = on i SANTA BARBARA * SANTA CRUZ

 

 

SCHOOL OF MEDICINE 400 PARNASSUS AVENUE, ROOM 405
DIVISION OF GENERAL INTERNAL MEDICINE SAN FRANCISCO, CALIFORNIA 94143-0320

MEMORANDUM

TO: Staff

FROM: Jeff and Karen

RE: Minority Report
DATE: September 23, 1991

One of the projects that remains from the Commission’s second year is a report
that focuses on the impact of the HIV epidemic in communities of color. As we
are all aware, the Commission decided to do such a report and release it soon
after the comprehensive report. With the imminent release of America Living
with AIDS, it is time to begin in earnest on the minority report. We will
need everyone’s help. .

Thanks to everyone for taking the time last week to discuss the approach to
this report. I think we can all agree that one of the most important
contributions the Commission can make is to give voice to people whose lives
are affected by HIV, but who otherwise might not be heard. This report can go
a long way toward such an end.

Although the task before us is both complex and sensitive, we have a head
start. The Commission has collected a wealth of information and developed a
level of rapport with individuals and community groups that will help ensure
that the report appropriately acknowledges and addresses concerns raised
across these very diverse communities. What we would like to do first is to

compile and analyze resource materials that can be used to provide substantive
focus and guide us on our way.

Accordingly, the staff--working in pairs--should prepare a 20-25 page .
background paper (including appendix materials) regarding each of the four
relevant communities on which the Commission has conducted focused hearings
and/or site visits over the past year. They include:

Native Americans Jason and Carlton
and Alaskan Natives

African Americans Fran and Joan

Hispanics Patricia and Ellen

Asian-Americans and Nat and Karen
Pacific Islanders

The issue paper should contain roughly the information outlined below.

« Epidemiology - prevalence and incidence of HIV infection and AIDS
cases; underlying risk factors; related health issues (e.g. TB,
STDs, etc.); issues regarding general health status; analysis of
relevant information by age, gender, geography, and economic

status, insofar as data permit. MMWR reports and materials cited
therein are the place to start.

State of the Art/ Literature Review - What do we and don’t we

know about these populations? What information can be summarized
from health services and behavioral research, as well as from

 
other social science literature? What gaps in understanding
remain?

Policy Concerns - What issues specific to the community arise from
the background information? These can range across all of the
general chapter headings found in the comprehensive report, such
as: prevention and education; clinical research; health care; and
financing and health care access. What recurrent themes emerged
from witnesses at hearing and site visits? Are there issues the
community has identified as priority concerns, or issues related
to subpopulations?

Cross-Cultural Themes - Are there issues shared by these various
communities that might help unify the focus in the report, such
as: the heterogeneity found within each of these communities;
distrust of government and science felt by many people of color;
intergenerational conflicts over attitudes toward homosexuality
and drug use.

Testimony - Strong statements made by witnesses, where possible in
“quotable," "sound bite" size. Where this is not possible, views
of witnesses should be summarized in meeting minutes or the like.

Bibliography - The list compiled thus far (see attached) is just a
quick start put together by combining a Medline search with
materials from Commission hearings on all of the groups. More
work needs to be done to refine the search in each community and
to obtain relevant materials from the magazines, newsletters, and
other resources within communities of interest. We should collect
references as we go along (keeping them in the same style that was
used in the comprehensive report).

List of resources - Experts, community-based organizations,
professional associations. Are there people with whom we should
be brainstorming or collaborating?

These issue papers should be ready no later than October 9, 1991. Feel free
to call me: before then; I will be in the office as of October 7th. Karen will
be in charge of the project overall--you can go to her for ideas, help, or
further explanation regarding the format or content of the paper. We would
like to distribute these papers to Dr. Osborn, Harlon Dalton, and Eunice Diaz
as well as any Commissioners who express an interest in getting involved in
the initial phase of this project. The papers will also be circulated in
advance of a meeting of a small group of Commissioners and collaborators to b
held in the office in the second or third week of October.

The background papers will be used to help develop an outline and an approach
to the report by providing a touchstone for discussion. It is anticipated
that a substantial portion of the language of these papers will appear in any
report sent to the full Commission for approval. They should also be a
trustworthy source of data that can be quoted and abstracted as appropriate.
Accordingly, it is important that the papers be prepared with care.

Thanks for your help.

Vee: fos Osborn. , H-d.

 
c:minority.bib 9-18-91

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