Series Information:
Social Aspects of AIDS

This collection of essays, authored by experts across a wide range of disciplines, provides a gendered analysis of the economic choices and structures that contribute to the HIV/AIDS epidemic, and the impact of the epidemic on economic and social outcomes. Topics covered include:

• gender norms, perceptions of risk, and risk-taking behavior among specific populations of women, including sex workers in Nicaragua, African immigrants in France, and university students and urban migrant workers in China
• malnutrition and poverty as precursors to HIV infection
• gendered institutions and access to treatment
• the invisible cost of caregiving.

An introductory essay briefly surveys the social science literature on the gendered nature of the epidemic and identifies key constructs of feminist economic theory that might be productively applied to understanding HIV/AIDS.

This book was originally published as a special issue of Feminist Economics.

This collection of essays, authored by experts across a wide range of disciplines, provides a gendered analysis of the economic choices and structures that contribute to the HIV/AIDS epidemic, and the impact of the epidemic on economic and social outcomes. Topics covered include:

• gender norms, perceptions of risk, and risk-taking behavior among specific populations of women, including sex workers in Nicaragua, African immigrants in France, and university students and urban migrant workers in China
• malnutrition and poverty as precursors to HIV infection
• gendered institutions and access to treatment
• the invisible cost of caregiving.

An introductory essay briefly surveys the social science literature on the gendered nature of the epidemic and identifies key constructs of feminist economic theory that might be productively applied to understanding HIV/AIDS.

This book was originally published as a special issue of Feminist Economics.

Approximately 90% of urban HIV/AIDS education in China occurs indirectly through non-specialist media reports. Many of these reports use images of extreme suffering and poverty to communicate an understanding of who gets HIV, why and how. This book explores an important aspect of how HIV/AIDS is communicated in China's print media, posters, websites and television, suggesting that its association with Africa and Africans -- portrayed as a distant and backward land and people -- has impacted understandings of HIV/AIDS. It demonstrates how, in China's media, Africans are frequently used to embody the most extreme possibilities of poverty and disease, in contrast with the progressive, scientifically sophisticated Han Chinese, which has encouraged the urban public to develop 'imagined immunity' to HIV. By illustrating how HIV/AIDS is portrayed as a non-Han and racialized disease affecting specific bodies, races and places, the author argues that this discourse has had the effect of distancing many Chinese from the perceived possibility of infection, thus compromising the effectiveness of public health campaigns on HIV/AIDS. The book suggests that the key to combating the spread of HIV/AIDS lies in challenging the ways in which the disease is portrayed in China's media, rather than simply by continuing with the current strategy to educate more people.

This book examines the formation of scientific knowledge about the AIDS epidemic in the 1980s and shows the broader cultural assumptions which grounded these knowledge. Alex Preda highlights the metaphors, narratives, and classifications which framed scientific hypotheses about the nature of the infectious agent and its transmission ways and compares these arguments with those used in the scientific knowledge about SARS. Through detailed rhetorical analysis of biomedical publications, the author shows how scientific knowledge about epidemics is shaped by cultural narratives and categories of social thought. Preda situates his analysis in the broader frame of the world risk society, where scientific knowledge is called upon to support and shape public policies about prevention and health maintenance, among others. But can these policies avoid the influence of cultural narratives and of social classifications? The book shows how culture matters for prevention and health policies, as well as with respect to how scientific research is organized and funded.

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.

Nearly thirty years since HIV/AIDS was first identified, confusion over effective mechanisms of controlling and eradicating the illness remain prevalent. This book highlights the need for comprehensive approaches to governance, as responses to HIV/AIDS become increasingly focused upon the health aspect of the epidemic, and financial commitments become subject to aid fatigue.

This book examines the roles and influence of multiple actors and initiatives that have come to constitute the global response to the epidemic. It considers how these actors and structures of governance enhance, or limit, participation and accountability; and the impact this is having upon effective HIV/AIDS responses across the world. The book addresses participation and accountability as key elements of governance in four thematic areas: the role of the state and democratic governance; non-state actors and mechanisms of political governance; public-private partnerships and economic governance; and multilateral institutions and global governance. Drawing on the insights of public health specialists; political scientists; economists; lawyers; those working with community groups, and within international organisations, it offers valuable perspectives on the governance of HIV/AIDS.

Aimed at both academics and practitioners throughout the world, this book contributes to the academic debate surrounding global governance, health and development economics, and the work of multiple international organisations and civil society organisations.

Originally published in the "International Quarterly of Community Health Education", this work presents twenty-one chapters about the state of HIV/AIDS prevention programs in a global context.

First published in 2002, "AIDS in the Twenty-First Century" met with widespread praise from researchers and policy makers. This edition is fully revised to take account of the latest facts and developments in the field. All statistics and evidence have been updated and their meanings reconsidered. Latest developments in vaccines, anti-retroviral treatments and microbicides are discussed along with information about the President's Emergency Plan for AIDS Relief and The Global Fund to Fight AIDS, Tuberculosis and Malaria.

This book examines the global governance of the HIV/AIDS epidemic, interrogating the role of this international system and global discourse on HIV/AIDS interventions. The geographical focus is Sub-Saharan Africa since the region has been at the forefront of these interventions. There is a need to understand the relationship between the international political environment and the impact of resulting policies on HIV/AIDS in the context of people's lives. Hakan Seckinelgin points out a certain disjuncture between this governance structures and the way people experience the disease in their everyday lives. Although the structure allows people to emerge as policy relevant target groups and beneficiaries, the articulation of needs and design of policy interventions tends to reflect international priorities rather than people's thinking on the problem. In other words, he argues that while the international interventions highlight the importance attributed to the HIV/AIDS problem, the nature of the system does not allow interventions to be far reaching and sustainable. Offering a critical contribution to the understanding of the problems in HIV/AIDS in Sub-Saharan Africa, International Politics of HIV/AIDS will be invaluable to students and researchers of health, international politics and development.

Prisons and AIDS is the first book to offer critical information on the proliferation of HIV and AIDS among prison populations and to provide a much needed resource for the design and implementation of education and prevention programs within correctional facilities. Written by experts in the field - including lead author Ronald L. Braithwaite, one of the foremost authorities on public health in the United States - this comprehensive resource is grounded in solid research, including survey information funded by the National Institute of Justice and the Centers for Disease Control. The book details numerous case studies from a variety of correctional facilities that reveal compelling information on frequency of sexual contact, drug use, needle sharing, tattooing, and the lack of access to condoms among inmates. In response to the disproportionately high incarceration rate of ethnic minorities, the authors provide strategies for developing culturally sensitive HIV/AIDS prevention programs in correctional settings. The book also documents differences in the patterns of HIV/AIDS cases among adult and juvenile and male and female inmates and explores policies and programs relevant to these populations, including education and prevention, testing and disclosure, partner notification, and housing. Written for policymakers, researchers, educators, health and human service providers, managers, and administrators of correctional institutions and community-based organizations, Prisons and AIDS provides the essential information for making informed decisions concerning this growing public health crisis.

The HIV/AIDS pandemic striking South Africa is of historic proportions. More people are living with AIDS in South Africa than in any other country in the world. Just in the past decade, the life expectancy in South Africa has dropped from 67 to 43 years. The social and economic impact of this disease is hard to overstate. However, what is striking is the paucity of thoughtful, reflective scholarship and writing on the subject." AIDS and South Africa: The Social Expression of a Pandemic" addresses the economic, social and cultural impact of HIV/AIDS as it relates to South African society.

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.

HIV/AIDS has profoundly affected life in sub-Saharan Africa. It has been reported as one of the most destructive diseases in recent memory - tearing apart communities and ostracising the afflicted. But the emphasis on death, despair and destruction hardly captures the many and varied impacts of the HIV/AIDS epidemic. Award-winning novelist and doctor Uzodinma Iweala embarks on a remarkable journey in Nigeria meeting individuals and communities that are struggling daily to understand both the impact and meaning of the disease. He speaks with people from all walks of life, those living with HIV/AIDS and those who aren't, doctors, nurses, truck drivers, sex workers, shopkeepers, students, parents and children who are all trying to make sense of life, love, and our connections to each other as people in the face of an unprecedented epidemic. Beautifully written and heart-breakingly honest, Our Kind of People goes behind the headlines of this epidemic to show the real lives affected by it, illuminating the scope of the crisis and a continent's valiant struggle.

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.

The impact of AIDS cannot be adequately measured by epidemiology alone. As the editors of this volume argue, AIDS must be understood as a 'disease of society', which is challenging and changing society profoundly. Numerous books on AIDS have looked at the ways in which our social institutions, norms and values have determined how the disease has been dealt with, but this book, first published in 1991, examines the ways in which AIDS is, in turn, changing our social institutions, norms and values. It explores the impact of AIDS on the arts and popular entertainment, on our concept of family, on government and legal institutions and on the health services, and the ways in which AIDS is forcing society to come to terms with longstanding tensions between community values and individual rights.

In the mid-1980s public health officials in North America, Europe, Japan, and Australia discovered that almost half of the haemophiliac population, as well as tens of thousands of blood transfusion recipients, had been infected with HIV-tainted blood. This book provides a comparative perspective on the political, legal, and social struggles that emerged in response to the HIV contamination of the blood supply of the industrialized world. It describes how eight nations responded to the first signs that AIDS might be transmitted through blood, how early efforts to secure the blood supply faltered, and what measures were ultimately implemented to resolve the contamination. The authors detail the remarkable mobilization of haemophiliacs who challenged the state, the medical establishment, and their own caregivers to seek recompense and justice. In the end, the blood establishments in almost all the advanced industrial nations were shaken. In Canada, the Red Cross was forced to withdraw from blood collection and distribution. In Japan, pharmaceutical firms that manufactured clotting factor agreed to massive compensation -- $500,000 per haemophiliac infected. In France, blood officials went to prison. Even in Denmark, where the number of infected haemophiliacs was relatively small, the struggle and litigation surrounding blood has resulted in the most protracted legal and administrative conflict in modern Danish history. Blood Feuds brings together chapters on the experiences of the United States, Japan, France, Canada, Germany, Denmark, Italy, and Australia with four comparative essays that shed light on the cultural, institutional, and economic dimensions of the HIV/blood disaster.

At the beginning of the twenty-first century, Brazil ranked second only to the United States in the number of reported cases of AIDS. Because Brazil's extensive poverty and inequality, its fragile economic situation, and its limited network of health services, the scarce prevention/intervention resources targeted only the most visible at risk populations -- gay men, sailors, prostitutes, and street children. Virtually forgotten were Brazil's hidden drug users, as well as the tens of millions of individuals living in the country's thousands of favelas, or shantytowns, which are a characteristic part of almost every Brazilian city. In Sex, Drugs, and HIV/AIDS in Brazil the authors examine the emergence of AIDS in Brazil, its linkages to drug use and the sexual culture, and its epidemiology in such populations as cocaine users, "street children," and male transvestite prostitutes. Special attention is focused on an HIV/AIDS community outreach program established in Rio de Janeiro, which represented the first such prevention/intervention program in all of Brazil targeting indigent cocaine users. This 6-year initiative was funded by the U.S. National Institute on Drug Abuse, and carried out by the authors of this book. The research combines anthropological, sociological, and biological perspectives; all data were gathered through empirical and ethnographic techniques.

Facing up to AIDS is a novel and incisive study of a global plague which continues to threaten to engulf South Africa at this crucial moment in its history. Economists, demographers and health planners present a range of new methods of understanding the likely course of the disease, drawn from the most recent research and thinking by social scientists on the relationship between epidemic disease, economic growth and human resources. South Africa presents a unique opportunity for understanding AIDS, combining as it does Third World problems with a sophisticated infrastructure: the models of demographic projection and economic linkages which are explored here will be of major relevance for examining the socio-economic impact of AIDS in a range of countries in Asia and Latin America. Until medical science comes up with a miracle vaccine, the modification of behaviour is the only defence, and the essays in this volume make a powerful case for putting further resources into the research needed to bring this about.

"It has long been a belief of the feminist academic community that personal voices and experiences must be validated and heard. This volume succeeds admirably in being true to that tradition."--"Canadia HIV/AIDS Policy and Law Newsletter"

Women now account for the majority of all new HIV/AIDS cases diagnosed in the United States. Yet, the resources allotted to women for research, health services, education, and outreach remain woefully inadequate. The Gender Politics of HIV/AIDS in Women fills crucial gaps in understanding the specific effects of HIV and AIDS on and in women's lives. It takes as its starting point the premise that it is vitally important for researchers, teachers, health service providers, public policy makers, and community-based organizers to begin taking gender-- especially as it intersects with race, class, and sexuality-- into consideration as they work with HIV-infected women.

The first comprehensive, interdisciplinary volume on this topic, The Gender Politics of HIV/AIDS in Women goes beyond tokenism, with a contributor's list made up of approximately 45% people of color, including African Americans, Latinos/as, Asian Americans and Pacific Islanders, and Native Americans. The volume emphasizes marginalized populations such as the homeless, sexworkers, youth, the elderly, intravenous drug users, transgendered people, lesbians, bisexuals, incarcerated women, and victims of sexual abuse and domestic violence.

The contributors, including Evelyn Hammonds, Risa Denenberg, Michelle Murrain, and Paul Farmer, are recognized experts in their diverse fields. From their posts at the center of the pandemic--in the laboratory, the academy, clinics, and communitybased organizations--they criticize blind spots in the recognition and treatment of HIV in women and articulate accessible and practical solutions to specific areas of difficulty.

As we approach the 21st century, we also approach the third decade of the AIDS epidemic. Mental health care providers must face the crucial fact that the human immunodeficiency virus (HIV) and the condition it causes, Acquired Immune Deficiency Syndrome (AIDS) is the leading cause of death among Americans aged 25-44 years.

HIV Mental Health for the 21st Century provides a roadmap for mental health professionals who seek to develop new strategies aimed at increasing the longevity and quality of life for people living with HIV/AIDS, as well as at controlling the future spread of the disease. Divided into five sections, this volume covers basic concepts in HIV/AIDS mental health; specialized aspects of HIV/AIDS clinical care; models of clinical care; program evaluation; and HIV mental health policy and programs. Chapters treat issues such as feelings of caregivers, the role of spirituality in mental health care, rural practice, mental health home care, and working with children.

For gay men, the demands of the AIDS epidemic are enormous and unrelenting. Regardless of HIV status, all are called on to maintain vigilant safety with sex, to face down a cultural stigma greater even than homophobia, and to somehow find a way to go forward in a world heavy with loss. As exhaustion and grief threaten to overwhelm the activism and optimism of earlier years, and with new infections on the rise among young gay men, the challenge of finding meaning in a world turned upside down is more than an idle philosophical exercise. It is a matter of psychological and perhaps even physical survival.
In this poignant and uncompromising new book, Dr. Steven Schwartzberg offers a ground-breaking perspective on how gay men (and particularly HIV-positive gay men) find ways to rebuild a world of meaning amid the trauma and uncertainty of the AIDS crisis. Eschewing both glib prescriptions for turning tragedy into triumph, and theoretical abstractions, Schwartzberg grounds his insights in his own experiences as a gay man and as a practicing psychotherapist, and in in-depth interviews with nineteen men living with HIV. Ranging in age from twenty-seven to fifty, the men include a construction foreman, a physician, an art historian, a waiter, a librarian, and a licensed massage therapist. With candor, insight, eagerness, and a remarkable ability to share of themselves, they speak eloquently about how HIV has affected their views of the world, their senses of themselves, and how they live their lives. Interweaving the men's stories with observations from his research and clinical practice, Schwartzberg bears witness to the remarkable transformations some men have accomplished, and the anguish of meaninglessness that weighs others down. He strives to uncover why some view HIV as a catalyst for change or growth, while others see it only as punishment. And though he passes no judgment on the coping strategies he describes, Schwartzberg does insist on the vital necessity of balancing somber reality with healing, life-sustaining hope. He argues that men who opt for too much illusion and too little reality risk shoddy self-care and inadequate preparation for the future, while those who find no escape from reality may teeter into rage or suicidal despair.
Beautifully written, with piercing awareness of the enormity of the challenges confronting individuals with HIV, this book celebrates the resilience of the human spirit. It is both a keen psychological guide and an elegiac chronicle of what life for many has become. Gently pointing the way to an oasis of growth, strength, and love that exists amid the epidemic's bleak terrain of loss, it is essential reading for people living with HIV, for their friends, families, and the mental health professionals who care for them, and for all gay men grappling with the enormous changes AIDS has brought to a community under siege.

AIDS and drug addiction is a topic of great and growing concern. AIDS first appeared among intravenous drug users in Europe in 1984, three years after the first cases were seen among homosexuals. This epidemic has spread more rapidly among intravenous drug users than in any other risk group. The high rates of HIV-1 seroprevalence among drug users in France, Italy, and Spain account for 85% of the total number of AIDS in intravenous drug users in Europe. It is anticipated that HIV-infected drug users will soon place a heavy burden on both drug treatment facilities and specialized health care units. The HIV-1 epidemic will also cross the former iron curtain. This contribution covers the wide and complex scene of drug problems and addiction as a whole. It gives researchers an opportunity to obtain background information on the spread of HIV and AIDS among intravenous drug users as well as on the clinical and psychological effects of HIV-1 infection and AIDS in Europe. The topics reviewed include surveys of intravenous drug use, HIV prevalence, detoxification, risk reduction, changing health behaviors, evaluating AIDS interventions and the impact of methadone maintenance treatment. This monograph will be of value to all clinicians, researchers, and policy makers who are concerned with the connection between intravenous drug use and AIDS.

A tidal wave of panic surrounded homosexuality and AIDS in the 1980s and early 1990s, the period commonly called 'The AIDS Crisis'. With the advent of antiretroviral drugs in the mid '90s, however, the meaning of an HIV diagnosis radically changed. These game-changing drugs now enable many people living with HIV to lead a healthy, regular life, but how has this dramatic shift impacted the representation of gay men and HIV in popular culture? Positive Images is the first detailed examination of how the relationship between gay men and HIV has transformed in the past two decades. From Queer as Folk to Chemsex, The Line of Beauty to The Normal Heart, Dion Kagan examines literature, film, TV, documentaries and news coverage from across the English-speaking world to unearth the socio-cultural foundations underpinning this 'post-crisis' period. His analyses provide acute insights into the fraught legacies of the AIDS Crisis and its continued presence in the modern queer consciousness.