“the Littlest Victims”: Pediatric Aids And The Urban Ecology Of Health In The Late-Twentieth-Century United States

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Doctor of Philosophy (PhD)
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History and Sociology of Science
Children's Health
Pediatric AIDS
Public Health
Urban History
Environmental Health and Protection
Public Health Education and Promotion
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Chernesky, Jason M

“The Littlest Victims” tells the untold history of children with AIDS, their families, and their caregivers while examining the structural causes, rise, and decline of pediatric AIDS in the U.S. from the 1950s through the early 2000s. This history complements and complicates the grand narrative of AIDS in the United States, one largely focused on how gay men and AIDS activists coped with, and influenced, the nation’s response to AIDS. Not only did HIV-AIDS affect children differently, pediatric AIDS disproportionately affected families of color living in poor urban environments. In this respect, the history of pediatric AIDS is inseparable from how Americans perceived and responded to urban poverty in the late twentieth century. My dissertation thus explores the relationship between HIV-AIDS, families of color, and the urban spaces in which pediatric AIDS was most prevalent. It argues that the physical and social environments that structured the experiences of families of color living in poor urban neighborhoods defined the realities and perceptions of pediatric AIDS. Pediatric AIDS arose from the post-World War II urban geographies of concentrated poverty, racialized segregation, and urban-renewal policies, creating an ecology where HIV-transmission proliferated in the late 1970s and early 1980s. Then, as pediatric AIDS gained scientific, public health, cultural, and political visibility during the mid 1980s and early 1990s, it became inextricably linked to the real and imagined problems of the “inner city.” This cultural framing of pediatric AIDS profoundly influenced the way Americans understood and responded to the disease among children and their families. From the late 1980s to the early 2000s, teams of nurses navigated the complexities of caring for sick children alongside the problems of poverty that challenged caregivers in the home and hospital. During those same years, the advent of antiretroviral medications proved effective in drastically reducing the transmission of HIV in utero and at birth. However, the success of such biomedical solutions to pediatric AIDS had a paradoxical effect: the “medical-progress” narratives that accompanied these advances unintentionally undermined community-based efforts to address the larger social, economic, and environmental factors that put children at risk for HIV-AIDS in the first place.

David S. Barnes
Cynthia A. Connolly
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