Winner of the Sociology of Health and Illness Book Prize 2008 Of approximately 37 million HIV positive people in the world, 24.7 million live in sub-Saharan Africa and about 5..5 million in South Africa. Despite its relatively powerful economy and infrastructure, South Africa has been dramatically affected by the HIV pandemic. Using narrative analysis of a three year interview study and textual analysis of political materials, HIV in South Africa examines the impact of HIV on people's everyday lives in the country. Examining the relationship between personal accounts of living with HIV and wider medical, political and religious discourses, the book also highlights the significance of class, race and gender on individuals' experiences. These engaging stories of everyday lives provide an accessible way to connect with HIV as a health and development issue. Fascinating, challenging and constructive, this is an important contribution in an area of great social relevance. The ebook is available free of charge to those with addresses on the United Nations Development Programme's Human Development Index of Medium and Low Rankings (see http://hdr.undp.org/hdr2006/pdfs/report/HDR_2006_Tables.pdf), who can apply to the following address: www.ebookstore.tandf.co.uk

As we approach the 25th anniversary of the first recognition of HIV/AIDS in 1981, this book reflects on the international impact of the disease. It has persistently remained a global issue, with more than 50 million people worldwide estimated to have been infected since that date. This ambitious book, written by 165 authors from 30 countries, offers a multi-country comparative study that examines how the response to the common, global threat of HIV is shaped by the history, culture, institutions and health systems of the individual countries affected. Increasingly the shift of health systems has been from prevention only as the main containment strategy, to a strategy that includes scaling up HIV treatment, and care and prevention services, including antiretroviral therapy. Thus, all parts of the health system must be involved; policy makers, healthcare professionals and users of the services have been forced to think differently about how services are financed, how resources are allocated, how systems are structured and organized, how services are delivered to patients, and how the resulting activity is monitored and evaluated in order to improve the effectiveness, efficiency, equity and acceptability of the response. This book is unique in attempting to describe and assess a range of responses across the globe by situating them within the characteristics of each country and its health system. Most chapters combine a health policy expert with an HIV specialist, allowing both a 'top down' health system approach and a 'bottom up' HIV-specific perspective. There are thematic and analytical sections, which provide an overview and some suggestions for solutions to the most serious outstanding issues, and chapters which analyse specific country and organisational responses. There is no perfect health system, but the evidence provided here allows the sharing of knowledge, and a opportunity to assess the impact and reactions, to an epidemic that must be considered a long term issue.

This book explores the experiences and emotional expression of 30 people Living with HIV/AIDS (PLWHA) using qualitative research methods such as "illness narratives," and analyzes the dilemmas of "sicknesses of the society" including "Acquired Needs Deficiency" Syndrome, "Acquired Expectation Insufficiency" Syndrome, and "Acquired Punishment" Syndrome at the micro, meso and macro levels, so as to investigate higher-intensity negative emotions.In turn, the book draws on the perspectives of conflict and game, structure and function, and system and interaction, in order to propose a dynamic mechanism of emotion and expression, and argues that these negative emotions can be transformed, strengthened and presented through defense mechanisms such as suppression and attribution, which will influence social institutions at the micro, meso and macro levels and even possibly bring about positive changes in the social structure.

Fifteen years ago the AIDS `epidemic' did not exist on the public agenda. In just over a decade the public and official response to the disease has resulted in the development of a whole network of organizations devoted to the study, containment, and practical treatment of AIDS. In this important and original analysis of AIDS policy, Virginia Berridge examines the speed and nature of the official (and unofficial) response to this new and critical historical event. The policy reaction in Britain passed through three stages. From 1981-1986 the outbreak of a new contagious disease led to public alarm and social stigmatization, with a lack of scientific certainty about the nature of the disorder. AIDS was a new and open policy area - there were no established departmental, local, or health authority mechanisms for dealing with the problem. This was a period of policy development from below, with relatively little official action and many voluntary initiatives behind the scenes. This phase was succeeded in 1986-1987 by a brief stage of quasi-wartime emergency, in which national politicians and senior civil servants intervened, and a high-level political response emerged. That response was a liberal one of `safe sex' and harm minimization rather than draconian notification or isolation of carriers. The author demonstrates that despite the `Thatcher revolution' in government in the 1980s, crisis could still stimulate a consensual response. The current period of `normalization' of the disease sees panic levels subsiding as the rate of growth slows and the fear of the unknown recedes. Official institutions have been established and formal procedures adopted and reviewed; paid professionals have replaced the earlier volunteers. The 1990s have seen change in the liberal consensus towards a harsher response and the partial repoliticization of AIDS. In this fascinating and scholarly account, Virginia Berridge analyses a remarkable period in contemporary British history, and exposes the reaction of the British British political and medical elites, and of the British public, to one of the most challenging issues of this century.

Educator Patti Lather and psychologist Chris Smithies observed and chronicled support groups for women diagnosed with HIV. Whether black, Latina, poor, or middle class, the women in these groups share the common bond of living with HIV/AIDS, and they describe how it affects their lives in terms full of practical reality and moving poignancy, as they fight the disease, accept, reflect, live and die with and in it.

In 2003-2006, Patricia Henderson lived in the South African province of KwaZulu-Natal where she recorded the experiences of people living with HIV/AIDS. In this illuminating study, she recounts the concerns of rural people and explores local repertoires through which illness was folded into everyday life. The book spans a period when antiretroviral medication was not available, and moves on to a time when the treatment became accessible. Hope gradually became manifest in the recovery of a number of people through antiretroviral therapies and 'the return' of bodies they could recognise as their own. This research implies that protracted interaction with people over time, offers insights into the unfolding textures of everyday life, in particular in its focus on suffering, social and structural inequality, illness, violence, mourning, sensibility, care and intimacy.

Throughout the debate over how - and if - AIDS education should be taught to school age children, teachers who want to bring the subject of AIDS into their classroom have had few, if any, resources to guide them. This work responds to the need for AIDS education material with a practice-based, interactive curriculum that should enable teachers to effectively educate students about the risk of AIDS and HIV infection. It begins with a discussion of how teachers can create an environment of support for an AIDS education programme. Recognizing that AIDS education must differ for students of different age groups, the text presents tailored, age-appropriate material - what and how teachers should communicate AIDS information to young children, older children and teenage students. It also addresses actual methods teachers can use to influence their students' attitudes and behaviour by helping them to recognize problem situations in which risks might arise, and presenting them with the actual skills they need to protect themselves in such situations.

In recent years, the economy of the Caribbean has become almost completely dependent on international tourism. And today one of the chief ways that foreign visitors there seek pleasure is through prostitution. While much has been written on the female sex workers who service these tourists, "Caribbean Pleasure Industry" shifts the focus onto the men. Drawing on his groundbreaking ethnographic research in the Dominican Republic, Mark Padilla discovers a complex world where the global political and economic impact of tourism has led to shifting sexual identities, growing economic pressures, and new challenges for HIV prevention. In fluid prose, Padilla analyzes men who have sex with male tourists, yet identify themselves as "normal" heterosexual men and struggle to maintain this status within their relationships with wives and girlfriends. Padilla's exceptional ability to describe the experiences of these men will interest anthropologists, but his examination of bisexuality and tourism as much-neglected factors in the HIV/AIDS epidemic makes this book essential to anyone concerned with health and sexuality in the Caribbean or beyond.

In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental, and rarely discussed questions about truth, lies, sex, and trust.

Drawing from interviews with over seventy gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social, and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, despair, and fear that shape individual dilemmas about whether to disclose to, deceive, or trust others concerning this disease. Some of those interviewed revealed their diagnosis widely; others told no one. Some struggled and ultimately told their partners; others spoke in codes or half-truths. One woman discovered her husband's diagnosis in a diary; when confronted, he denied it.

Each year in the United States, 40,000 new cases of HIV arise, yet approximately one-third of the 900,000 Americans who are infected do not know it. As treatments have improved, unsafe sexual behavior has increased and efforts at prevention have stalled. Many of those infected continue to fear and experience rejection and discrimination. Addressing broad debates about the nature of secrecy, morality, and silence, this book explores public policy questions in the light of the nuanced, private decisions that are shaping the course of an epidemic and have broader indications for all.

In this innovative study, Lukas Engelmann examines visual traditions in modern medical history through debates about the causes, impact and spread of AIDS. Utilising medical AIDS atlases produced between 1986 and 2008 for a global audience, Engelmann argues that these visual textbooks played a significant part in the establishment of AIDS as a medical phenomenon. However, the visualisations risked obscuring the social, cultural and political complexity of AIDS history. Photographs of patients were among the earliest responses to the mysterious syndrome, cropped and framed to deliver a visible characterisation of AIDS to a medical audience. Maps then offered an abstracted image of the regions invaded by the epidemic, while the icon of the virus aspired to capture the essence of AIDS. The epidemic's history is retold through clinical photographs, epidemiological maps and icons of HIV, asking how this devastating epidemic has come to be seen as a controllable chronic condition.

In some parts of South Africa, more than one in three people are HIV positive. Love in the Time of AIDS explores transformations in notions of gender and intimacy to try to understand the roots of this virulent epidemic. By living in an informal settlement and collecting love letters, cell phone text messages, oral histories, and archival materials, Mark Hunter details the everyday social inequalities that have resulted in untimely deaths. Hunter shows how first apartheid and then chronic unemployment have become entangled with ideas about femininity, masculinity, love, and sex and have created an economy of exchange that perpetuates the transmission of HIV/AIDS. This sobering ethnography challenges conventional understandings of HIV/AIDS in South Africa.

The African AIDS epidemic has sparked fierce debate over the role of religion. Some scholars and activists argue that religion is contributing to the spread of HIV and to the stigmatization of people living with AIDS. Others claim that religion reduces the spread of HIV and promotes care and support for the sick and their survivors.
Religion and AIDS in Africa offers the first comprehensive empirical account of the impact of religion on the AIDS epidemic. Jenny Trinitapoli and Alexander Weinreb draw upon extensive fieldwork in Malawi, including hundreds of interviews with religious leaders and lay people, and survey data from more than 30 other sub-Saharan African countries. Their research confirms the importance of religious narratives and institutions in everything related to AIDS in Africa. Among other key findings, Trinitapoli and Weinreb show that a combination of religious and biomedical approaches to prevention reduces risk most effectively; that a significant minority of religious leaders encourage condom use; that Christian congregations in particular play a crucial role in easing suffering among the sick and their dependents; and that religious spaces in general are vital for disseminating information and developing new strategies for HIV prevention and AIDS mitigation.
For anyone wishing to move beyond the rhetoric and ideology that plague debates about one of the most challenging crises of our time, Religion and AIDS in Africa is the authoritative account. It will change the way readers think about religious life and about AIDS in the region.

Early in the 1980s AIDS epidemic, six gay activists created one of the most iconic and lasting images that would come to symbolize a movement: a protest poster of a pink triangle with the words "Silence=Death." The graphic and the slogan still resonate widely today, the latter an anthem for AIDS activism, and are often used-and misused-to brand the entire movement, appearing in a variety of ubiquitous manifestations. Cofounder of the collective Silence=Death and member of the art collective Gran Fury, Avram Finkelstein tells the story of how his work and other protest artworks associated with the early years of the pandemic were created. In his writing about art and AIDS activism, the formation of collectives, and the political process, Finkelstein exposes us to a different side of the traditional HIV/AIDS history told twenty-five years later and offers a creative toolbox for those who want to learn how art and activism save lives.

In this innovative study, Lukas Engelmann examines visual traditions in modern medical history through debates about the causes, impact and spread of AIDS. Utilising medical AIDS atlases produced between 1986 and 2008 for a global audience, Engelmann argues that these visual textbooks played a significant part in the establishment of AIDS as a medical phenomenon. However, the visualisations risked obscuring the social, cultural and political complexity of AIDS history. Photographs of patients were among the earliest responses to the mysterious syndrome, cropped and framed to deliver a visible characterisation of AIDS to a medical audience. Maps then offered an abstracted image of the regions invaded by the epidemic, while the icon of the virus aspired to capture the essence of AIDS. The epidemic's history is retold through clinical photographs, epidemiological maps and icons of HIV, asking how this devastating epidemic has come to be seen as a controllable chronic condition.

The search for a "patient zero" popularly understood to be the first infected case in an epidemic has been key to media coverage of major infectious disease outbreaks for more than three decades. Yet the term itself did not exist before the emergence of the HIV/AIDS epidemic in the 1980s. How did this idea so swiftly come to exert such a strong grip on the scientific, media, and popular consciousness? In Patient Zero, Richard A. McKay interprets a wealth of archival sources and interviews to demonstrate how this seemingly new concept drew upon centuries-old ideas and fears about contagion and social disorder. McKay presents a carefully documented and sensitively written account of the life of Gaetan Dugas, a gay man whose skin cancer diagnosis in 1980 took on very different meanings as the HIV/AIDS epidemic developed and who received widespread posthumous infamy when he was incorrectly identified as patient zero of the North American outbreak. McKay shows how investigators from the US Centers for Disease Control inadvertently created the term amid their early research into the emerging health crisis; how an ambitious journalist dramatically amplified the idea in his determination to reframe national debates about AIDS; and how many individuals grappled with the notion of patient zero adopting, challenging and redirecting its powerful meanings as they tried to make sense of and respond to the first fifteen years of an unfolding epidemic. With important insights for our interconnected age, Patient Zero untangles the complex process by which individuals and groups create meaning and allocate blame when faced with new disease threats. What McKay gives us here is myth-smashing revisionist history at its best.

A citizen's guide to America's most debated policy-in-waiting There are few issues as consequential in the lives of Americans as health care-and few issues more politically vexing. Every single American will interact with the health care system at some point in their lives, and most people will find that interaction less than satisfactory. And yet for every dollar spent in our economy, 19 cents go to health care. What are we paying for, exactly? Health care policy is notoriously complex, but what Americans want is quite simple: good health care that's easy to use and doesn't break the bank. Polls show that as many as 70 percent of Americans want the government to provide universal health coverage to all Americans. What's less clear is how to get there. Medicare for All is the leading proposal to achieve to universal health coverage in America. But what is it exactly? How would it work? More importantly, is it practical or practicable? This book goes beyond partisan talking points to offer a serious examination of how Medicare for All would transform the way we give, receive, and pay for healthcare in America.

When addressing the factors shaping HIV prevention programs in sub-Saharan Africa, it is important to consider the role of family planning programs that preceded the epidemic. In this book, Rachel Sullivan Robinson argues that both globally and locally, those working to prevent HIV borrowed and adapted resources, discourses, and strategies used for family planning. By combining statistical analysis of all sub-Saharan African countries with comparative case studies of Malawi, Nigeria, and Senegal, Robinson also shows that the nature of countries' interactions with the international community, the strength and composition of civil society, and the existence of technocratic leaders influenced variation in responses to HIV. Specifically, historical and existing relationships with outside actors, the nature of nongovernmental organizations, and perceptions of previous interventions strongly structured later health interventions through processes of path dependence and policy feedback. This book will be of great use to scholars and practitioners interested in global health, international development, African studies and political science.

This publication is a multi-authored investigation into HIV reporting in South Africa, and combines journalism with research to present an analysis that is at once broad in its scope and focused on the important issues. What is left unsaid: Reporting the South African HIV epidemic is a collection of work produced by the fellows of the HIV/AIDS & the Media Project, started by Helen Struthers and Anton Harber in 2003. It contains a selection of the best journalism and research produced by the Media Project Fellows, which gives an important insight into the history and key issues of South African health politics and media reporting on HIV in the last decade. The texts range from in-depth quantitative and qualitative research documents to radio and television transcripts and candid interviews. The title's first section contains research and news reporting reflecting on how the media has reported HIV-related issues, while the second section consists of reporting on pertinent aspects of HIV: stigma, denial, disclosure; PMTCT; orphans and vulnerable children; abstinence and faithfulness; and traditional healers. Each half informs and elucidates the other and works to, as journalism should, shine a light on one the world's most pressing concerns, both at the grassroots and higher levels, and give a voice to those whose voices are often not heard against the din of political controversy that surrounds HIV.

To date, there is a dearth of surveillance data on the prevalence of HIV and associated risk behaviours among men who have sex with men (MSM) in South Africa. This is particularly true for data collected from several sites using the same sampling approach. This study called the Marang Men's Project was undertaken to fill this information gap. It was implemented among MSM in the three largest cities of South Africa, namely, Cape Town in the Western Cape, Durban in KwaZulu-Natal and Johannesburg in Gauteng. The high HIV prevalence estimates found in our study among MSM in each of the three study cities call for a need to implement a national HIV bio-behavioural surveillance programme for MSM. The Marang Men's Project has demonstrated that there is an urgent need for interventions, which respond not only to the heterosexual HIV epidemic but also to the HIV epidemic among MSM in South Africa. This survey therefore provides valuable information to SANAC, the national and provincial Departments of Health (DoHs), and lesbian, gay, bisexual, transgender and intersex (LGBTI) organisations to both implement and advocate for improved programmes for the health of MSM.

Currently 6.4 million people in South Africa live with HIV, this figure represents a quarter of the burden of HIV infections in sub-Saharan Africa and 18 per cent of the global burden. With this view, the South African National HIV Prevalence, Incidence and Behaviour Survey, 2012 is a crucial report for government, policy makers and other stakeholders as they work towards reducing the HIV epidemic in South Africa. This 2012 HIV survey is the fourth in the series of national population-based surveys. The survey was conducted from December 2011 to November 2012. As with previous surveys, it was designed to investigate the overall HIV prevalence, incidence and behaviour as well as social determinants that drive the epidemic. It also served to collect data to help monitor the National Strategic Plan 2007-2011 and set the baseline for the 2012-2016 NSP. This report is a must-read and essential for researchers who want to understand the HIV dynamics in South Africa.

Whenever the topic of large jails and public hospitals in urban America is raised, a single idea comes to mind. It is widely believed that because we as a society have dis-invested from public health, the sick and poor now find themselves within the purview of criminal justice institutions. In Redistributing the Poor, ethnographer and historical sociologist Armando Lara-Millan takes us into the day-to-day operations of running the largest hospital and jail system in the world and argues that such received wisdom is a drastic mischaracterization of the way that states govern urban poverty at the turn of the 21st century. Rather than focus on our underinvestment of health and overinvestment of criminal justice, his idea of "redistributing the poor" draws attention to how state agencies circulate people between different institutional spaces in such a way that generates revenue for some agencies, cuts costs for others, and projects illusions that services have been legally rendered. By centering the state's use of redistribution, Lara-Millan shows how certain forms of social suffering-the premature death of mainly poor, people of color-are not a result of the state's failure to act, but instead the necessary outcome of so-called successful policy.

A coming-of-age memoir of life on the front lines of the AIDS crisis with ACT UP New York. From the moment Ron Goldberg stumbled into his first ACT UP meeting in June 1987, the AIDS activist organization became his life. For the next eight years, he chaired committees, planned protests, led teach-ins, and facilitated their Monday night meetings. He cruised and celebrated at ACT UP parties, attended far too many AIDS memorials, and participated in more than a hundred zaps and demonstrations, becoming the group's unofficial "Chant Queen," writing and leading chants for many of their major actions. Boy with the Bullhorn is both a memoir and an immersive history of the original New York chapter of ACT UP, the AIDS Coalition to Unleash Power, from 1987 to 1995, told with great humor, heart, and insight. Using the author's own story, "the activist education of a well-intentioned, if somewhat naive nice gay Jewish theater queen," Boy with the Bullhorn intertwines Goldberg's experiences with the larger chronological history of ACT UP, the grassroots AIDS activist organization that confronted politicians, scientists, drug companies, religious leaders, the media, and an often uncaring public to successfully change the course of the AIDS epidemic. Diligently sourced and researched, Boy with the Bullhorn provides both an intimate look into how activist strategies are developed and deployed and a snapshot of life in New York City during the darkest days of the AIDS epidemic. On the occasions where Goldberg writes outside his personal experience, he relies on his extensive archive of original ACT UP documents, news articles, and other published material, as well as activist videos and oral histories, to help flesh out actions, events, and the background stories of key activists. Writing with great candor, Goldberg examines the group's triumphs and failures, as well as the pressures and bad behaviors that eventually tore ACT UP apart. A story of ordinary people doing extraordinary things, from engaging in outrageous, media-savvy demonstrations, to navigating the intricacies of drug research and the byzantine bureaucracies of the FDA, NIH, and CDC, Boy with the Bullhorn captures the passion, smarts, and evanescent spirit of ACT UP-the anger, grief, and desperation, but also the joy, camaraderie, and sexy, campy playfulness-and the exhilarating adrenaline rush of activism.

The Life and Death of ACT UP/LA explores the history of the AIDS Coalition to Unleash Power, Los Angeles, part of the militant anti-AIDS movement of the 1980s and 1990s. ACT UP/LA battled government, medical, and institutional neglect of the AIDS epidemic, engaging in multi-targeted protest in Los Angeles and nationally. The book shows how appealing the direct action anti-AIDS activism was for people across the United States; as well as arguing the need to understand how the politics of place affect organizing, and how the particular features of the Los Angeles cityscape shaped possibilities for activists. A feminist lens is used, seeing social inequalities as mutually reinforcing and interdependent, to examine the interaction of activists and the outcomes of their actions. Their struggle against AIDS and homophobia, and to have a voice in their healthcare, presaged the progressive, multi-issue, anti-corporate, confrontational organizing of the late twentieth century, and deserves to be part of that history.

The Life and Death of ACT UP/LA explores the history of the AIDS Coalition to Unleash Power, Los Angeles, part of the militant anti-AIDS movement of the 1980s and 1990s. ACT UP/LA battled government, medical, and institutional neglect of the AIDS epidemic, engaging in multi-targeted protest in Los Angeles and nationally. The book shows how appealing the direct action anti-AIDS activism was for people across the United States; as well as arguing the need to understand how the politics of place affect organizing, and how the particular features of the Los Angeles cityscape shaped possibilities for activists. A feminist lens is used, seeing social inequalities as mutually reinforcing and interdependent, to examine the interaction of activists and the outcomes of their actions. Their struggle against AIDS and homophobia, and to have a voice in their healthcare, presaged the progressive, multi-issue, anti-corporate, confrontational organizing of the late twentieth century, and deserves to be part of that history.

** With a new introduction by Russell T Davies ** A new edition of the award-winning, ground-breaking account of the early AIDS crisis in Britain. 'A remarkable journalistic achievement.' Time Out 'Powerful . . . Indispensable.' Observer 'Superb.' London Review of Books Winner of the Somerset Maugham Prize How does a country control a virus that is killing increasing numbers of people? How does a government contain an epidemic spread by sex, drug use and blood products? And how does a population react when told that everyone is at risk from infection? By 1986, when the British Government woke up to the problem of AIDS, it estimated that 30,000 people had already been infected with HIV. Why was it so slow to act? Would the situation have been different if most of those affected had not been gay men? Award-winning journalist Simon Garfield presents a story of political intrigue, of panic and hysteria, of wasted opportunities and of a medical battle conducted against seemingly impossible odds. Including interviews with key figures in the fight against the virus as well as those facing personal devastation and prejudice, The End of Innocence is an important and powerful story, compellingly told. Features a new afterword by the author.