How to Survive a Plague: Representations of HIV/ AIDS

Introduction.

How to Survive a Plague: Representations of HIV/ AIDS is a seven week course engaging students in an interdisciplinary approach to the study of Acquired Immune Deficiency Syndrome (AIDS). Students will explore the cultural and social implications of AIDS in addition to learning about the underlying science of the immune system, autoimmune disorders, and pharmaceutical treatments and therapies. This course is geared to Biology and Chemistry majors, especially students pursuing the Public Health minor or the Peace, Justice and Human Rights concentration. Prerequisites include a year of introductory Biology and a year of Organic Chemistry (or consent from the professor).

Outline of Lessons.

Week 1: HIV/ AIDS Narratives

Class I -- Background of HIV-AIDS

1. In preparation for class, students have read Millenium Approaches in Tony Kushner’s play Angels in America

2. Class time

   1. Short presentation on history of AIDS in the United States (15 minutes)

      1. What is HIV? What is AIDS?

      2. History of the AIDS epidemic and it’s effect on the gay community

      3. Public response

      4. Scientific response

   2. Students split into groups of four and discuss the Angels in America using several discussion prompts (15 minutes)
   3. Independent, written reflection (10 minutes)
   4. Large group discussion directed by Barometer activity (25 minutes)
   5. Watch the following clips as a class:

   6. 1. https://www.youtube.com/watch?v=1LKJ5ZzzL0w

      2. https://www.youtube.com/watch?v=5oWu7FR-hZ0

      3. https://www.youtube.com/watch?v=hGbdJYHR0Fk

   7. Large group, student-initiated discussion (30 minutes)
3. Homework: Read Perestroika in Tony Kushner's Angels in America

Class II -- AIDS Today: Causes and Patterns

1. Class time

   1. First 45 minutes of class devoted to small and large group discussion about Kushner’s play, exploring character development, interaction, and context within our historical knowledge of the AIDS epidemic.

   2. Show the following clips:

      1. https://www.youtube.com/watch?v=nejZuRbR-os

      2. https://www.youtube.com/watch?v=BmhGFtjudJE

   3. Large group Discussion

      1. Who does HIV-AIDS affect?

      2. Structural Inequality and AIDS

   4. Last 15 minutes of class devoted to writing a great thesis

      1. Each student will write down three topics they would like to explore for their final paper and a sample thesis for one topic.

      2. Submit to professor by the end of class

2. Over the weekend there will be a class trip to Philly to see a production of Angels in America

3. Homework:

   1. One paragraph reflection on field trip

   2. Read selected chapters in Basic Immunology: Functions and Disorders of the Immune System by Abul K. Abbas

Week 2. The Immune System.

Class III -- The Basics

1. Class time

   1. 1.5 hour lecture covering

      1. innate immune system

      2. adaptive immune system

      3. immune response

      4. immunological memory

2. Homework:

   1. Question Set on the immune response and immunological memory

   2. Read selected chapters covering autoimmunity in Basic Immunology: Functions and Disorders of the Immune System by Abul K. Abbas

 

Class IV -- Immunodeficiency and Autoimmunity

1. Class time

   1. 1 hour lecture about Immunodeficiency and Autoimmunity

   2. Last 30 minutes of class devoted to reviewing how to construct a good outline (in preparation for the class final)

      1. Professor will choose one thesis (collected last week) to use as a sample to create an outline for the courses final research paper that will fuse both analytical and science writing.

      2. Entire class will outline this potential paper together.

1. Homework:

   1. Question Set about Autoimmunity.

   2. Read short chapter on autoimmunity in textbook

   3. Read  2 of these 4 journal articles. Prepare for class discussion.

      1. Miedema, Frank, Matthijs Tersmette, and Renéa.w Van Lier. "AIDS Pathogenesis: A Dynamic Interaction between HIV and the Immune System." Immunology Today 11 (1990): 293-97. ScienceDirect. Web. 10 Mar. 2015.

      2. Jay, Paul. "The T4 Gene Encodes the AIDS Virus Receptor and Is Expressed in the Immune System and the Brain Maddon." Cell 47.3 (1986): 333-48.ScienceDirect. Web. 10 Mar. 2015.

      3. Ziegler, John L., and Daniel P. Stites. "Hypothesis: AIDS Is an Autoimmune Disease Directed at the Immune System and Triggered by a Lymphotropic Retrovirus." Clinical Immunology and Immunopathology 41.3 (1986): 305-13. ScienceDirect. Web. 10 Mar. 2015.

      4. Ascher, M. S., and H. W. Sheppard. "AIDS as Immune System Activation: A Model for Pathogenesis." Clinical & Experimental Immunology 73 (1988): 165-67. NCBI. Web. 10 Mar. 2015.

Week 3. Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome.

Class V -- HIV and the Immune System

1. 45 minute lecture about HIV/AIDS and the immune system

2. Journal Review Discussions (30 minutes)

   1. Round A → Student small group discussions about journal articles (divided into groups based on the first article they read)

   2. Round B → Student small group discussions about journal articles (divided into groups based on the second article they read)

3. Last 15 minutes of class devoted to large group discussion where each group will summarize the purpose and findings of the articles they read and why it is important within the context of AIDS in the world.

4. Homework:

   1. Read 2 of these 4 journal articles

      1. Royce, Rachel A., Arlene Seña, Willard Cates, and Myron S. Cohen. "Sexual Transmission of HIV." New England Journal of Medicine 336.15 (1997): 1072-078. Web. 10 Mar. 2015.

      2. Zhang, Z. "Sexual Transmission and Propagation of SIV and HIV in Resting and Activated CD4 T Cells."Science 286.5443 (1999): 1353-357. Science. Web. 10 Mar. 2015.

      3. Pilcher, Christopher D., Hsiao Chuan Tien, Joseph J. Eron Jr., Pietro L. Vernazza, Szu‐Yun Leu, Paul W. Stewart, Li‐Ean Goh, and Myron S. Cohen. "Brief but Efficient: Acute HIV Infection and the Sexual Transmission of HIV." The Journal of Infectious Diseases 189.10 (2004): 1785-792. Web.

      4. Fleming, D. T., and J. N. Wasserheit. "From Epidemiological Synergy to Public Health Policy and Practice: The Contribution of Other Sexually Transmitted Diseases to Sexual Transmission of HIV Infection."Sexually Transmitted Infections 75.1 (1999): 3-17. Web.

   2. Prepare for class discussion.

Class VI -- Sexual Transmission

1. 45 minute lecture about Sexual Transmission of HIV

2. Journal Review Discussions (30 minutes)

   1. Round A → Student small group discussions about journal articles (divided into groups based on the first article they read)

   2. Round B → Student small group discussions about journal articles (divided into groups based on the second article they read)

3. Last 15 minutes of class devoted to large group discussion where each group will summarize the purpose and findings of the articles they read and why it is important within the context of AIDS in the world.

4. Homework:

   1. Read selected chapters in John McMurry’s Organic Chemistry on Electrophilic Addition to Alkenes and Diels Alder reactions

   2. Complete Problem Set on electrophilic addition and Diels Alder. Collaboration with other students is encouraged.

Week 4. Azidothymidine (AZT): Synthesis, Use, and Social Effects

Class VII -- Organic Chemistry and AIDS

1. 45 minute lecture on electrophilic addition reactions, the Diels Alder reaction, and organic synthesis

2. Student collaboration in groups of three to complete worksheet of electrophilic addition alkenes (15 minutes).

3. 15 minutes, as a class, going over the mechanism of the organic synthesis of AZT (the first drug used to treat AIDS).

4. Homework:

   1. Study for Test (next class)

Class VIII -- Test

In-class test that covers:

1. Innate immune system

2. Adaptive immune system

3. Immune response

4. Immunological memory

5. Immunodeficiency

6. Autoimmunity

7. Electrophilic Addition Reactions

8. Diels Alder Reaction

9. Short essay on a topic of your choosing about HIV Sexual transmission (in response to in-class journal discussions)

No Homework!

Week 5. Treatment of HIV/AIDS Poster

Class IX  -- Overview of current HIV/ AIDS treatments

1. 45 minute lecture about current HIV/AIDS treatments

   1. History

   2. Underlying science

   3. Effects

   4. Cultural and social implications of the treatments

2. Students placed in groups of 3 and will take the rest of class to research a topic for a poster presentation about a specific AIDS treatment or therapy.

   1. Poster presentation must include

      1. Abstract

      2. Introduction (including History of the Drug)

      3. Organic Synthesis

      4. Biological Effects and Complications

      5. Social Context

   2. Each group’s topic must be approved by the professor by the end of class.

3. Homework:

   1. Research topic for poster

   2. Begin drafting sections for poster presentations

 

Class X -- Poster Preparation

1. Students will finish researching and writing up sections in class and begin poster assembly.

   1. Materials such as poster boards, glue, scissors, and cardboard paper will be provided

   2. Students will also have the option of creating a PowerPoint document

2. Homework:

   1. Finish making posters (or PowerPoint presentations)

   2. Prepare the oral presentation with your group.

Week 6. Posters and Public Health

Class XI -- Poster Symposium!

1. Students will present posters to the entire class

2. Question and Answer Section at the end of each presentation

3. Science faculty and other students (who do not have class) are welcome to attend as well

4. Homework is to Relax!

 

Class XII -- Governmental and Non-Governmental Organization Responses to HIV/AIDS

1. In-class documentary screening of David France’s 2012 documentary How to Survive a Plague (110 minutes)

   1. Link to the trailer: https://www.youtube.com/watch?v=wwhFS1mUaVY

2. Large group discussion focused on activism and public health, ethics behind the drive to get “drugs into bodies”, and what current health activism looks like today. (20 minutes)

3. Homework:

   1. Draft a detailed outline (with a complete introductory paragraph) of final paper

   2. Send completed outline to peer editing group, comprised of 3 students

   3. Read and make comments on the other two outlines in your group.

Week 7. Final Research Paper.

Class XIII -- Horizon of Significance

1. Large group discussion about Angels in America within the context of human rights, public health, and how narratives can enact change on the scientific community. (20 minutes)

2. Professor-led discussion about how to write a good conclusion. (15 minutes)

   1. What is a horizon of significance?

   2. How do you write a horizon of significance?

3. Students will write sample horizon of significance together as a class (10 minutes)

4. Students will then construct the horizon of significance of their paper (free write for 15 minutes)

5. Students meet in peer-editing groups to discuss topics and outlines (30 minutes).

6. Homework:

   1. Write rough draft of final paper.

   2. Must include

      1. Hard scientific research/ data about the effect of AIDS on the immune system (and potentially the effect of AIDS treatments on the human immune response)

      2. Analysis of AIDS narratives (such as Angels in America or How to Survive a Plague) and placing it within a scientific context.

      3. Historical and social context for topic.

      4. Horizon of significance--why is this paper important? How does it contribute to our holistic and interdisciplinary understanding of AIDS? How can this type of understanding improve scientific research, treatment plans, and public health policy?

 

Class XIV -- Last Class

1. Student Presentations (1 hour)

   1. Each student will give a brief presentation to the class about the topic they are covering for their final research paper and discuss it’s horizon of significance.

2. Lecture and class discussion on cutting-edge research being done at Haverford College to treat HIV/AIDS (30 minutes).

   1. Guest student speakers working in Professor Lou Charkoudian lab can discuss their research for the lab and host a Q&A section at the end of class.

   2. Link to current research in the Charkoudian Lab:https://www.haverford.edu/chemistry/Charkoudian/research/

Week 8. Finals Week.

Final Research Paper due on Friday at 5 pm. Feel free to schedule conferences with professor, writing center, KINSC tutors, or peer-editing groups.

Rationale.

In my last Web Paper, I wrote a letter to Science Faculty at colleges like Haverford and Bryn Mawr urging them to create a more ecological curriculum. The goal of this ecological curriculum would be to place introductory science courses within the context of student lived experiences; in other words, making the material meaningful to them. So, with this Web E post, I decided to practice what I preached and create a lesson plan for a quarter-long course entitled How to Survive a Plague: Representations of HIV/AIDS.This course aims to explore human autoimmune disorders within the context of social justice and public health and it’s effect on scientific discovery. The course opens with Toni Kushner’s playAngels in America so that students can develop compassion and empathy for people with AIDS and also to recognize them as complex human beings. The play, along with several youtube clips posted under “Week 1”, will aim to put a face to the disease, and instigate a desire to learn more about the cause of AIDS, how the human immune system works (and fails), and possible treatments. The course then will dive into the complex biological processes that make up our immune system so that students can engage with material that gives insight into the scientific cause and effect of HIV/ AIDS and AIDS treatments (Weeks II-IV). In these three weeks, classes will be lecture-based but will also allow for student engagement in small-group journal discussions, where students can choose journal articles that intrigue them and discuss both their social and scientific importance with classmates.

Midway through the course, there will be a test to assess student knowledge of the underlying scientific processes of the immune system and the HIV virus. After the test, students will work in small groups to prepare a poster presentation to the rest of the class. These poster presentations really allow students to pursue their own interests within the context of the course and to engage in both teaching and learning with each other (Week 5). In the final week of class, students will be working on their own research paper to explore intersections between science research, social activism, and personal AIDS narratives. The purpose of this project is to allow students to showcase not only what they have learned in the course but to also pursue an intriguing thread that was left untied in class discussions, poster presentations, or even the mid-quarter exam. Students will be working in peer editing groups so they have a chance to improve their writing, offer advice to their classmates, and learn about their classmates’ projects.

The final class acts as the “horizon of significance” for the course. It asks, why was this course important or meaningful? Students will give brief presentations about their final projects to engage the entire class in a sample of the many directions one can pursue after this course. Maybe one student’s project will focus on the organization Act-Up and how it changed the FDA’s response system to health crises. Another student may focus on the synthesis of AZT and how it revolutionized modern medicine by bringing organic synthesis to the forefront. Yet another student may focus on HIV and prostitution in South Africa. Instead of wrapping up the course with a nice ribbon, I want to burst it open by showcasing where the course can take students in their life as activists, researchers, writers, or doctors. The last thirty minutes of the course offers students an example of what pursuing one of these threads could look. Lou Charkoudian, a professor at Haverford College, researches the biosynthesis of an organic molecule that could help treat AIDS and how to mimic that biosynthesis in the lab. Who knows? Maybe she would be looking to take on a research assistant from this class!

References.

Abbas, Abul K., and Andrew H. Lichtman. Basic Immunology: Functions and Disorders of the Immune System. Philadelphia, PA: Saunders/Elsevier, 2009. Print.

 

Ascher, M. S., and H. W. Sheppard. "AIDS as Immune System Activation: A Model for Pathogenesis." Clinical & Experimental Immunology 73 (1988): 165-67. NCBI. Web. 10 Mar. 2015.

 

Fleming, D. T., and J. N. Wasserheit. "From Epidemiological Synergy to Public Health Policy and Practice: The Contribution of Other Sexually Transmitted Diseases to Sexual Transmission of HIV Infection."Sexually Transmitted Infections 75.1 (1999): 3-17. Web.

 

How To Survive A Plague. Dir. David France. By David France and T. Woody Richman. Prod. Dan Cogan. Perf. Peter Staley, Larry Kramer, Iris Long. Sundance Selects, 2012. DVD.

 

Jay, Paul. "The T4 Gene Encodes the AIDS Virus Receptor and Is Expressed in the Immune System and the Brain Maddon." Cell 47.3 (1986): 333-48.ScienceDirect. Web. 10 Mar. 2015.

 

Kushner, Tony. Angels in America. New York: Theatre Communications Group, 1996. Print.

 

McMurry, John. Organic Chemistry 8th Edition. N.p.: Cengage Learning, 2011. Print

 

Miedema, Frank, Matthijs Tersmette, and Renéa.w Van Lier. "AIDS Pathogenesis: A Dynamic Interaction between HIV and the Immune System." Immunology Today 11 (1990): 293-97. ScienceDirect. Web. 10 Mar. 2015.

 

Royce, Rachel A., Arlene Seña, Willard Cates, and Myron S. Cohen. "Sexual Transmission of HIV." New England Journal of Medicine 336.15 (1997): 1072-078. Web. 10 Mar. 2015.

 

Zhang, Z. "Sexual Transmission and Propagation of SIV and HIV in Resting and Activated CD4 T Cells." Science 286.5443 (1999): 1353-357. Science. Web. 10 Mar. 2015.

 

Ziegler, John L., and Daniel P. Stites. "Hypothesis: AIDS Is an Autoimmune Disease Directed at the Immune System and Triggered by a Lymphotropic Retrovirus."Clinical Immunology and Immunopathology 41.3 (1986): 305-13.ScienceDirect. Web. 10 Mar. 2015.

 

Pilcher, Christopher D., Hsiao Chuan Tien, Joseph J. Eron Jr., Pietro L. Vernazza, Szu‐Yun Leu, Paul W. Stewart, Li‐Ean Goh, and Myron S. Cohen. "Brief but Efficient: Acute HIV Infection and the Sexual Transmission of HIV."The Journal of Infectious Diseases 189.10 (2004): 1785-792. Web.