1989 Reviews

Review of The AIDS Disaster: The Failure of Organizations in New York and the Nation. By Charles Perrow and Mauro F. Guillen. New Haven, Conn.: Yale University Press, 1991

Bearman, Peter Shawn

Ten years have passed since AIDS was first recognized by the Centers for Disease Control. In this short period, 160,000 Americans have been diagnosed with AIDS, and 110,000 have already died. At current rates, 30 people die from AIDS every day, and, every 15 minutes, somebody is diagnosed as having AIDS. Somewhere between 1.5 and 2.5 million Americans now carry the HIV virus that leads to AIDS. The AIDS cases we see now are the result of risks people took five or 10 years ago. The AIDS cases we will see in the year 2000 will be a result of risks people have taken (i.e., having unprotected sex and sharing needles) over the past couple of years. These are the basic facts, and it is in this context that Charles Perrow and Mauro F. Guillen have written The AIDS Disaster. The transmission of the HIV virus can be prevented simply-by using latex condoms during sex and by using clean needles for the injection of intravenous (IV) drugs. And as the authors note, condoms and bleach (to sterilize needles) are available in most drug stores at marginal cost. Thus the fact that the HIV virus continues to spread reflects a profound failure-the failure of organizations responsible for education and for outreach, but also the failure of individuals. Since it is reasonable to believe that if organizations had responded quickly and appropriately to AIDS in the first years of the epidemic (1981-84), the crisis we confront today would be significantly less severe, Perrow and Guillen argue that we must understand why organizations failed in order to respond to the challenges of AIDS today.