Autoimmunity refers to the phenomenon whereby an organism or body mounts an immune response against its own tissues. As a medical term, autoimmunity is today used to account for any instance in which the body fails to recognise its own constituents as 'self', an error that results in the paradoxical situation in which self-defense (immunity, protection) manifests as self-harm (pathology). As a result, the very possibility of autoimmunity poses a problem for the notion of immunity and the concept of identity that underpins it: if self-protection can just as readily take the form of self-destruction, then it seems that the very identity of the self, and thus the boundary between self and other, is in question. Conceptually, autoimmunity thus challenges us to think critically about the nature of any sovereign entity or identity, be they human or nonhuman, cells, nations, or other forms of community. This volume reflects and engages with different disciplinary approaches to autoimmunity in the theoretical, medical or posthumanities, social and political theory, and critical science studies. It aims to provide a topical intervention within the current discussion on biopolitical thought and critical posthumanist futures. This book was originally published as a special issue of Parallax.

In Zambia, due to the rise of tuberculosis and the closely connected HIV epidemic, a large number of children have experienced the illness or death of at least one parent. Children as Caregivers examines how well intentioned practitioners fail to realize that children take on active caregiving roles when their guardians become seriously ill and demonstrates why understanding children's care is crucial for global health policy. Using ethnographic methods, and listening to the voices of the young as well as adults, Jean Hunleth makes the caregiving work of children visible. She shows how children actively seek to "get closer" to ill guardians by providing good care. Both children and ill adults define good care as attentiveness of the young to adults' physical needs, the ability to carry out treatment and medication programs in the home, and above all, the need to maintain physical closeness and proximity. Children understand that losing their guardians will not only be emotionally devastating, but that such loss is likely to set them adrift in Zambian society, where education and advancement depend on maintaining familial, reciprocal relationships.

How do modern women in developing countries experience sexuality and love? Drawing on a rich variety of interview, ethnographic and survey data from her native country of Kenya, Sanyu Mojola examines how young African women, who suffer disproportionate rates of HIV infection compared to young African men, navigate their relationships, schooling, employment and financial access in the context of a devastating HIV epidemic and economic inequality. Writing from a unique outsider-insider perspective, Mojola argues that the entanglement of love, money, and the production and transformation of girls into "consuming women" lies at the heart of women's health and coming-of-age crises. Engaging in themes of gender, consumption, and the transition to adulthood, this text is an incisive analysis of gender, sexuality, and health in Africa.

Across Africa, HIV/AIDS is slowly killing millions of people in the prime of their lives, weakening state structures, deepening poverty and reversing the gains in life expectancy achieved over the past century. Although many who study the dynamics of Africa??AA's AIDS crisis accept that, to some degree, its entrenchment is a socially produced phenomenon, few have examined how the course and intensity of the epidemic have been affected by the continents ubiquitous poverty, the impact of the pervasive structural adjustment programmes or Africa??AA's marginalization in the process of globalization until now.This book explores the socio-economic context of Africa??AA's vulnerability to HIV/AIDS as well as assessing the politics of domestic and global response. Using primary and secondary data, it charts the power relations driving Africa??AA's HIV/AIDS epidemic, frustrating the possibility of alleviation and recovery as well as working to relegate the continent to a bleak and vulnerable future. In this sense, the book marks a radical departure by providing a comprehensive analysis of Africa??A A's vulnerability to AIDS and the challenges confronting policy makers as they seek to reverse its escalating prevalence on the continent. ??AAAIDS in Africa??AA is an immensely valuable introduction to the greatest pandemic facing the world today.

The founder of "POZ" magazine shares "a captivating...eyewitness account from inside the AIDS epidemic" ("Next") and "a moving, multi-decade memoir of one gay man's life" ("San Francisco Chronicle").
As a politics-obsessed Georgetown freshman, Sean Strub arrived in Washington, DC, from Iowa in 1976, with a plum part-time job running a Senate elevator in the US Capitol. He also harbored a terrifying secret: his attraction to men. As Strub explored the capital's political and social circles, he discovered a parallel world where powerful men lived double lives shrouded in shame.
When the AIDS epidemic hit in the early 1980s, Strub was living in New York and soon found himself attending "more funerals than birthday parties." Scared and angry, he turned to radical activism to combat discrimination and demand research. Strub takes you through his own diagnosis and inside ACT UP, the organization that transformed a stigmatized cause into one of the defining political movements of our time.
From the New York of Studio 54 and Andy Warhol's Factory to the intersection of politics and burgeoning LGBT and AIDS movements, Strub's story crackles with history. He recounts his role in shocking AIDS demonstrations at St. Patrick's Cathedral as well as at the home of US Sen-ator Jesse Helms. With an astonishing cast of characters, including Tennessee Williams, Gore Vidal, Keith Haring, Bill Clinton, and Yoko Ono, is a vivid portrait of a tumultuous era: "A page-turner... with] the suspense and horror of Paul Monette's memoir "Borrowed Time" and the drama of Larry Kramer's play "The Normal Heart."...What a lot of action--and life--there is in this gripping book" ("The Washington Post").

HIV and AIDS have long been problematized in the People's Republic of China as objects of governance in political frameworks and institutions. The state's attitudes towards health programs have, nevertheless, changed significantly during the 21st century. Pilot programs at the beginning of the century, which focused on underground sex workers, have now developed into the roll-out of a nationwide program, with supportive legislation and broadcast media publicity. This book therefore examines China's evolving AIDS response, providing an up to date investigation into the positions and practices of the state. It explains the origins, rationales and implementation of initiatives focused on female sex workers and explores the extension of such initiatives to include other populations identified as key to ending the AIDS epidemic, especially homosexual men and rural-to-urban migrant labourers. Ultimately, through an analysis of the different approaches to the governance of commercial sex and sexual health, Governing HIV in China concludes by considering the challenges raised by China's commitment to the United Nations' vision of ending AIDS as a global health threat by 2030. This book will be useful for students and scholars of Social Policy, Public Health Policy and Chinese Studies.

Finalist for the 2017 Lambda Literary "Lammy" Award in LGBTQ Studies The first book to examine the correlation between mixed-race identity and HIV/AIDS among Native American gay men and transgendered people, Indian Blood provides an analysis of the emerging and often contested LGBTQ "two-spirit" identification as it relates to public health and mixed-race identity. Prior to contact with European settlers, most Native American tribes held their two-spirit members in high esteem, even considering them spiritually advanced. However, after contact - and religious conversion - attitudes changed and social and cultural support networks were ruptured. This discrimination led to a breakdown in traditional values, beliefs, and practices, which in turn pushed many two-spirit members to participate in high-risk behaviors. The result is a disproportionate number of two-spirit members who currently test positive for HIV. Using surveys, focus groups, and community discussions to examine the experiences of HIV-positive members of San Francisco's two-spirit community, Indian Blood provides an innovative approach to understanding how colonization continues to affect American Indian communities and opens a series of crucial dialogues in the fields of Native American studies, public health, queer studies, and critical mixed-race studies.

Biomedical revolutions seem to have radically altered the environment for HIV transmission: anti-retrovirals (ARVs) and drugs to reduce mother-to-child transmission promise to cut HIV transmission rates, as does male medical circumcision. However, the hopeful messages of UNAIDS are tempered with warning about expenditure shortfalls and calls for funding. Contributions to this book remind us that, along with the external financial constraints, there have been new fractures in state power and in the organisation of health systems. More than this, the book fundamentally calls into question whether biomedical interventions can change the social roots of this disease. As well as considering new policy approaches, the book reasserts a long-standing political economy approach to HIV and to adapt it to reflect new competing theoretical approaches. The chapters attempt to connect the debates about HIV/AIDS to larger discussions about globalisation, class differentiation, inequity and uneven development in African countries. This book was originally published as a special issue of Review of African Political Economy.

Since the onset of the HIV epidemic, the behaviour of men who have sex with men has been subject to intense scrutiny on the part of the behavioural and sociomedical sciences. What happens when we consider the work of these sciences to be not merely descriptive, but also constitutive of the realities it describes? The Gay Science pays attention to lived experiences of sex, drugs and the scientific practices that make these experiences intelligible. Through a series of empirically and historically detailed case studies, the book examines how new technologies and scientific artifacts - such as antiretroviral therapy, digital hookup apps and research methods - mediate sexual encounters and shape the worlds and self-practices of men who have sex with men. Rather than debunking scientific practices or minimizing their significance, The Gay Science approaches these practices as ways in which we 'learn to be affected' by HIV. It explores what knowledge practices best engage us, move us and increase our powers and capacities for action. The book includes an historical analysis of drug use as a significant element in the formation of urban gay cultures; constructivist accounts of the emergence of barebacking and chemsex; a performative response to Pre-Exposure Prophylaxis and its uptake; and, a speculative analysis of ways of thinking and doing sexual community in the digital context. Combining insights from queer theory, process philosophy and science and technology studies to develop an original approach to the analysis of sexuality, drug use, public health and digital practices, this book demonstrates the ontological consequences of different modes of attending to risk and pleasure. It is suitable for those interested in cultural studies, sociology, gender and sexuality studies, digital culture, public health and drug and alcohol studies.

A comprehensive health care system consists of services that are coordinated and integrated along the full continuum of care. For HIV patients, this includes physical health care, infectious disease management, crisis care, mental health care, substance abuse counseling, and social support services including housing, transportation, subsistence, and supports for dealing with multiple sources of stigma. This book highlights the dilemmas faced in providing comprehensive, integrated care to individuals living with HIV, providing both an understanding of existing efforts to integrate diverse systems of care, as well as insight into ways in which systems of care must be challenged in order to meet the needs of people living with HIV. Comprehensive Care for HIV/AIDS is the result of collaborative work with the county Health Department, numerous community-based organizations, and several planning boards in a metropolitan area, which have sought to provide integrated care to people living with HIV. It will be a valuable resource to the diverse community of HIV researchers, advocates and providers.

One in six adults in sub-Saharan Africa will die in their prime of AIDS. It is a stunning cataclysm, plunging life expectancy to pre-modern levels and orphaning millions of children. Yet political trauma does not grip Africa. People living with AIDS are not rioting in the streets or overthrowing governments. In fact, democratic governance is spreading. Contrary to fearful predictions, the social fabric is not being ripped apart by bands of unsocialized orphan children. AIDS and Power explains why social and political life in Africa goes on in a remarkably normal way, and how political leaders have successfully managed the AIDS epidemic so as to overcome any threats to their power. Partly because of pervasive denial, AIDS is not a political priority for electorates, and therefore not for democratic leaders either. AIDS activists have not directly challenged the political order, instead using international networks to promote a rights-based approach to tackling the epidemic. African political systems have proven resilient in the face of AIDS's stresses, and rulers have learned to co-opt international AIDS efforts to their own political ends. In contrast with these successes, African governments and international agencies have a sorry record of tackling the epidemic itself. AIDS and Power concludes without political incentives for HIV prevention, this failure will persist.

Based on interviews with women who are HIV positive, this sobering pandemic brings to light the deeply rooted and complex problems of living with HIV. Already pushed to the edges of society by poverty, racial politics, and gender injustice, women with HIV in South Africa have found ways to cope with work and men, disclosure of their HIV status, and care for families and children to create a sense of normalcy in their lives. As women take control of their treatment, they help to determine effective routes to ending the spread of the disease.

HIV/AIDS is much too complex a phenomenon to be understood only by reference to common sense and ethical codes. This book presents the cost?benefit analysis (CBA) framework in a well-researched and accessible manner to ensure that the most important considerations are recognized and incorporated. This book argues that HIV/AIDS policies need to be evidence based and that CBA is the best way to assemble and summarize the evidence. The work explains why CBA is needed and highlights a number of myths, misinformation and counterintuitive results in the field, and critiques the Millennium Development Goals approach. It also presents HIV/AIDS as a hunger issue in sub-Saharan Africa and as a sexual transmission problem in the US. The roles of nutrition, income, education, religion, agricultural policy, concurrency and sexual networks are all examined. Robert Brent explains the main cost?benefit methods and applications, including threshold analysis, willingness to pay, cost minimization, cost-effectiveness, human capital theory and the value of a statistical life. Applications cover female education, possible vaccines, condoms, and various forms of treatment. He concludes by explaining how CBA incorporates social considerations such as equity.With timely and controversial discussions, this book will be read with interest by AIDS activists, NGO members, policy-makers and public officials, as well as being accessible to non-economists interested in the subject of HIV/AIDS.

The disproportional loss of individuals to HIV/AIDS in their most productive years raises concerns over the welfare of surviving members of affected families and communities. One consequence of the rapid increase in adult mortality is the rise in the proportion of children who are orphaned. Sub-Saharan Africa, accounts for about 90 percent of these. Mainly due to the staggering toll of HIV/AIDS, research effort has focused on treatment and prevention. Children have received attention primarily in relation to 'mother to child transmission' and paediatric AIDS. These issues are important and compelling but fail to capture the whole story - the unprecedented surge in the number of children made vulnerable by HIV/AIDS. In this book we reflect on the plight of children classified as vulnerable, review interventions implemented to improve their welfare and grapple with the concept of vulnerability as it relates to human rights and the African child.

This Brief presents preliminary findings from research in three prisons in Maharashtra, India on experiences of prison inmates there living with HIV. The study explores health care services in these prisons, and problems experienced by inmates in India living with HIV, as well as their staff and caregivers. Through this preliminary study, the researchers shed light on the experiences of inmates in Indian prisons, with an aim of presenting questions for future research. The author provides an overview of the global conditions of prison inmates living with HIV, as an international comparative context for examining the cases in India. Major problems highlighted in the cases include: living conditions, high risk behavior during incarceration, delivery of medical services and adherence to ethical guidelines. Results of the study reveal that overcrowding and inadequate nutrition were major concerns for inmates living with HIV; there were no support systems available inside the prisons to address the stress related issues of the inmates; and, the prison hospital did not have provisions to cater to the treatment needs of inmates living with AIDS. The study also found that confidentiality regarding the HIV positive status could not be maintained inside the prison. This Brief presents a window into the experience of inmates in India, and presents questions for future research to understand and improve living conditions and medical service delivery within the prison system. This work will be of interest to researchers in criminology and criminal justice, particularly interested in incarceration or health issues, public health and related areas such as public policy, international studies, and demography studies in India.

Much has happened since the first appearance of AIDS in 1981: it has been identified, studied, and occasionally denied. The virus has shifted host populations and spread globally. Medicine, the social sciences, and world governments have joined forces to combat and prevent the disease. And South Africa has emerged as ground zero for the pandemic. The editors of HIV/AIDS in South Africa 25 Years On present the South African crisis as a template for addressing the myriad issues surrounding the epidemic worldwide, as the book brings together a widely scattered body of literature, analyzes psychosocial and sexual aspects contributing to HIV transmission and prevention, and delves into complex intersections of race, gender, class, and politics. Including largely overlooked populations and issues (e.g., prisoners, persons with disabilities, stigma), as well as challenges shaping future research and policy, the contributors approach their topics with rare depth, meticulous research, carefully drawn conclusions, and profound compassion. Among the topics covered: The relationship between HIV and poverty, starting from the question, "Which is the determinant and which is the consequence?" Epidemiology of HIV among women and men: concepts of femininity and masculinity, and gender inequities as they affect HIV risk; gender-specific prevention and intervention strategies. The impact of AIDS on infants and young children: risk and protective factors; care of children by HIV-positive mothers; HIV-infected children. Current prevention and treatment projects, including local-level responses, community-based work, and VCT (voluntary counseling and testing) programs. New directions: promoting circumcision, vaccine trials, "positive prevention." South Africa's history of AIDS denialism. The urgent lessons in this book apply both globally and locally, making HIV/AIDS in South Africa 25 Years On uniquely instructive and useful for professionals working in HIV/AIDS and global public health.

This book examines the gender context of HIV and critiques the global policy response. Anderson contributes to the feminist task of de-invisibilising gender as structural violence and identifies how gendered power structures are responded to at the local level in Malawi.

The issue of universal and free access to treatment is now a fundamental goal of the international community. Based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa under the aegis of ANRS (the French nationalagency for research on Aids and viral hepatitis, this timely and significant book both assesses the progress made in achieving this objective and presents a rigorous diagnosis of the obstacles that remain. Placing particular emphasis on the constraints imposed by TRIPS as well as the poor state of most public health systems in Southern countries, the contributing authors provide a comprehensive analysis of the huge barriers that have yet to be overcome in order to attain free access to care and offer innovative suggestions of how they might be confronted. In doing this, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where the disease continues to spread with devastating social and economic consequences. This volume will be a valuable addition to the current literature on HIV/AIDS in developing countries and will find widespread appeal amongst students and academics studying economics, sociology and public health. It will also be of interest to international organizations and professional associations involved in the fight against pandemics.

Heterosexual Africa? The History of an idea from the age of exploration to the age of AIDS explores the historical processes by which a singular, heterosexual identity for Africa was constructed. Epprecht argues that Africans, just like people all over the world, have always had a range of sexualities and sexual identities. Heterosexual Africa? aims to understand an enduring stereotype about Africa and Africans. It asks how Africa came to be defined as a "homosexual-free zone" during the colonial era, and how this idea not only survived the transition to independence but flourished under conditions of globalisation and early panicky responses to HIV/AIDS. In this timely volume, Epprecht examines a number of issues concerning sexuality and the construction of sexual identities that have largely been overlooked by studies of African ethnology in the past.

As the HIV/AIDS epidemic has grown to become the fourth biggest killer in the world and the leading cause of death in sub-Saharan Africa so the pressure on those working in the field to expand the scale of their activities has increased. Non-governmental organizations (NGOs) have been especially influential in the response to HIV in developing countries and the pressure to increase the scope and impact of this work is particularly strong. "Making an Impact in HIV and AIDS" recognizes that scaling up NGO programmes requires more than just additional resources or the straightforward replication or expansion of interventions. The book analyzes when expansion is appropriate, how to make it effective, how to measure the costs, and what the implications for organizations may be. It examines these issues through the experience of NGOs working in different contexts and in all aspects of HIV/AIDS including prevention, care and support, and mitigating the impact of the epidemic. The author draws on case studies from a range of countries in Africa, Asia and Latin America. She integrates the insights from these experiences with existing thinking and proposes a new typology of approaches to scaling up. Key elements of scaling up are discussed, as are issues such as the risks entailed in growth, motivations for scaling up and the special challenges related to scaling up work on HIV and AIDS. This book is aimed at those active in the HIV/AIDS field who are interested in NGO programmes, and those in the wider development field who are concerned about the impact of HIV/AIDS and what NGOs can do about it. It makes an important contribution to thinking about scaling up NGO activities in general and is particularly relevant as the pressures of the epidemic concern not only the organizations directly involved but also those working on all aspects of development.

Drawing on the case of HIV/AIDS in Thailand, this book examines how anthropological and other interpretative social science research has been utilized in modeling the AIDS epidemic, and in the design and implementation of interventions. It argues that much social science research has been complicit with the forces that generated the epidemic and with the social control agendas of the state, and that as such it has increased the weight of structural violence bearing upon the afflicted. The book also questions claims of Thai AIDS control success, arguing that these can only be made at the cost of excluding categories such as intravenous drug users, the incarcerated, and homosexuals, who continue to experience extraordinarily high levels of levels of HIV infection. Considered deviant and undeserving, these persons have deliberately been excluded from harm reduction programs. Overall, this work argues for the untapped potential of anthropological research in the health field, a confident anthropology rooted in ethnography and a critical reflexivity. Crucially, it argues that in context of interdisciplinary collaborations, anthropological research must refuse relegation to the status of an adjunct discipline, and must be free epistemologically and methodologically from the universalizing assumptions and practices of biomedicine.

A comprehensive health care system consists of services that are coordinated and integrated along the full continuum of care. For HIV patients, this includes physical health care, infectious disease management, crisis care, mental health care, substance abuse counseling, and social support services including housing, transportation, subsistence, and supports for dealing with multiple sources of stigma. This book highlights the dilemmas faced in providing comprehensive, integrated care to individuals living with HIV, providing both an understanding of existing efforts to integrate diverse systems of care, as well as insight into ways in which systems of care must be challenged in order to meet the needs of people living with HIV. Comprehensive Care for HIV/AIDS is the result of collaborative work with the county Health Department, numerous community-based organizations, and several planning boards in a metropolitan area, which have sought to provide integrated care to people living with HIV. It will be a valuable resource to the diverse community of HIV researchers, advocates and providers.

Drawing on such process thinkers as Whitehead, Deleuze and Stengers, Innovation and Biomedicine develops a powerful framework for the analysis of Biomedical Innovation. With its sustained focus on the Pre-Exposure Prophylactic pill (PrEP) for the prevention of HIV infection, the volume explores the ethical, medical and political elements entailed in the pill's testing through offshore randomized control trials (RCTs). To this end, the key concept of 'eventuation' is elaborated and deployed in the scrutiny of the 'gold standard' status of RCTs, the role of ethics in RCTs, and the enactment of the PrEP pill as a singular entity. Further, the authors engage with affective, topological and virtual dimensions to show how PrEP's eventuation also allows for new scientific and ethical questions to be crafted. Innovation and Biomedicine is a major contribution to science and technology studies, medical sociology, and the multi-disciplinary study of HIV.

"Birth in the Age of AIDS" is a vivid and poignant portrayal of the experiences of HIV-positive women in India during pregnancy, birth, and motherhood at the beginning of the 21st century. The government of India, together with global health organizations, established an important public health initiative to prevent HIV transmission from mother to child. While this program, which targets poor women attending public maternity hospitals, has improved health outcomes for infants, it has resulted in sometimes devastatingly negative consequences for poor, young mothers because these women are being tested for HIV in far greater numbers than their male spouses and are often blamed for bringing this highly stigmatized disease into the family.
Based on research conducted by the author in India, this book chronicles the experiences of women from the point of their decisions about whether to accept HIV testing, through their decisions about whether or not to continue with the birth if they test HIV-positive, their birthing experiences in hospitals, decisions and practices surrounding breast-feeding vs. bottle-feeding, and their hopes and fears for the future of their children.

"Birth in the Age of AIDS" is a vivid and poignant portrayal of the experiences of HIV-positive women in India during pregnancy, birth, and motherhood at the beginning of the 21st century. The government of India, together with global health organizations, established an important public health initiative to prevent HIV transmission from mother to child. While this program, which targets poor women attending public maternity hospitals, has improved health outcomes for infants, it has resulted in sometimes devastatingly negative consequences for poor, young mothers because these women are being tested for HIV in far greater numbers than their male spouses and are often blamed for bringing this highly stigmatized disease into the family.
Based on research conducted by the author in India, this book chronicles the experiences of women from the point of their decisions about whether to accept HIV testing, through their decisions about whether or not to continue with the birth if they test HIV-positive, their birthing experiences in hospitals, decisions and practices surrounding breast-feeding vs. bottle-feeding, and their hopes and fears for the future of their children.