The Origin and Diffusion of AIDS: A View from Medical Geography.

The integration of the history and geography of diseases is essential to understanding and revealing a true picture of epidemiology and disease patterns as they are today. This is particularly true for the current pandemic of the Acquired Immunodeficiency Syndrome (AIDS). The complexity and capabilities of the disease agent, the Human Immunodeficiency Virus Type 1 (HIV-I), generate increasing concern about this fatal disease. Thus far, treatment merely temporarily extends lives of the victims, and hope for a vaccine against infection remains remote. Understanding the mechanisms and patterns of the origin and diffusion of the infection and disease are central to developing appropriate intervention strategies for controlling its spread. In this paper an overview of AIDS is presented from the perspective of medical geography. Characteristics of the virus and the mechanisms of infection are described, and, using available evidence, an attempt is made to piece together the spatial-temporal patterns of the disease. Theories about the African origin and its diffusion there are discussed and pathways out of Africa to other parts of the world presented. Specific attention is directed to the spatial diffusion of AIDS within the United States. Cultural, social, behavioral, economic, political and transportation factors play important roles in the current and historical spatial patterns of AIDS. The historic importance of this disease and the complex of geographic factors necessary to its understanding require the interest and cooperation of a broad range of geographic specialties. We hope this paper informs and stimulates discussion among geographers to undertake this effort. [ABSTRACT FROM AUTHOR]