Written by researchers at a federally funded outreach program to combat the spread of AIDS, this book analyzes the efforts of the Miami Community Outreach Project to intervene in AIDS-related risk behavior among intravenous drug users and their sexual partners. The work provides background information on the history of AIDS, the risk behaviors of drug abusers, and federal intervention programs. It discusses the prevalence of the HIV virus in the Miami area and gives a detailed description of the project, discussing the theoretical basis for the project, the intervention strategies used, the rationale behind those strategies, and the results achieved. Appendixes provide information on the health of the subjects, the material used, and the Belle Glade Community Outreach Project modeled after the Miami project. The book begins with background information on the history of AIDS, the risk behaviors of drug abusers and their sexual partners, and federal attempts to combat the spread of AIDS. It then discusses the prevalence of the HIV virus in the Miami area, drug abusers in the community, and the Miami Community Project. Providing a detailed description, the authors discuss the theoretical basis for the Project, the intervention strategies used, the rational behind those strategies, and the results achieved. Appendixes provide information on the health of the subjects, the research manual and educational materials used, and the Belle Glade Community Outreach Project modeled after the Miami project. The book will be of interest to drug abuse and AIDS researchers as well as to clinicians and counselors.

"I'm like a whirling leaf in the wind," said one of Dr. Lena Nilsson SchOnnesson' s patients, and another "I'm in the claws of HIV." Their voices and those of other HIV-positive patients frame the humanistic and scholarly discussion in this impor tant book. Dr. SchOnnesson, a Fulbright scholar at the HIV Center for Clinical and Behavioral Studies, Columbia University in 1995, has unusually extensive clinical experience in counseling HIV-positive gay men. Her work with 38 such patients treated between 1986 and 1995 is discussed in the pages that follow. Dr. SchOnnesson's longitudinal approach to clinical data is extremely unusual in the psychotherapy literature generally, and in the literature on counseling HIV positive men in particular. Building upon the experience of such recent scholar clinicians as Klitzman, Isay, Schaffner, and others, Dr. SchOnnesson adds some thing unique by analyzing her ongoing detailed notes of the psychotherapeutic process in a systematic quantitative as well as qualitative manner. The analysis of her data is further informed by her coauthor, Dr. Michael Ross, a therapist and investigator whose contribution to the clinical and research literature on the psychotherapeutic treatment of gay men has already been substantial."

Drawing on never before used archival materials, Replacing the Dead exposes the history of Soviet and Russian abortion policy. It is not unusual for nations recovering from wars to incentivize their populations to raise their birthrates. The post-World War II Soviet pronatalism campaign attempted this on an unprecedented scale, aiming to replace a lost population of 27 million. Why, then, did the USSR re-legalize abortion in 1955? Mie Nakachi uses previously hidden archival data to reveal that decisions made by Stalin and Khruschev under the rubric of 'family law' created a society of broken marriages, "fatherless" children, and abortions, each totaling in the tens of millions. The government reversed laws regarding paternal responsibility, thereby encouraging men to impregnate unmarried women and widows, and blocked available contraception, overriding the advice of the medical establishment. Some 8.7 million out-of-wedlock children were born between 1945 and 1955 alone. In the absence of serious commitment to supporting Soviet women who worked full-time, the policy did extensive damage to gender relations and the welfare of women and children. Women, famous cultural figures, and Soviet professionals initiated a movement to improve women's reproductive health and make all children equal. Because Soviet leaders did not allow any major reform, an abortion culture grew among Soviet women and spread throughout the Soviet sphere, including Eastern Europe and China. Based on groundbreaking research, Replacing the Dead traces how the idea of women's right to an abortion emerged from an authoritarian society decades before it did in the West and why it remains the dominant method of birth control in present-day Russia.

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.

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.

This innovative collection offers a wide-ranging palette of psychological, public health, and sociopolitical approaches toward addressing the multi-level prevention needs of gay men living with HIV and AIDS. This book advances our understanding of comprehensive health care, risk and preventive behaviors, sources of mental distress and resilience, treatment adherence, and the experiences of gay men's communities such as communities of color, youth, faith communities, and the house ball community. Interventions span biomedical, behavioral, structural, and technological approaches toward critical goals, including bolstering the immune system, promoting safer sexual practices, reducing HIV-related stigma and discrimination, and eliminating barriers to care. The emphasis throughout these diverse chapters is on evidence-based, client-centered practice, coordination of care, and inclusive, culturally responsive services. Included in the coverage: Comprehensive primary health care for HIV positive gay men From pathology to resiliency: understanding the mental health of HIV positive gay men Emerging and innovative prevention strategies for HIV positive gay men Understanding the developmental and psychosocial needs of HIV positive gay adolescent males Social networks of HIV positive gay men: their role and importance in HIV prevention HIV positive gay men, health care, legal rights, and policy issues Understanding Prevention for HIV Positive Gay Men will interest academics, researchers, prevention experts, practitioners, and policymakers in public health. It will also be important to research organizations, nonprofit organizations, and clinical agencies, as well as graduate programs related to public health, consultation, and advocacy.

This book addresses the ongoing problem of HIV in black South African women as a health inequity. Importantly, it argues that this urgent problem of justice is changeable. Sprague uses the capabilities approach to bring a theory of health justice, together with multiple sources of evidence, to investigate the complex problem of HIV and accompanying poor health outcomes in black South African women. Motivated by a concern for application of knowledge, this work discusses how to better conceptualise what health justice demands of state and society, and how to mobilise available evidence on health inequities in ways that compel greater state action to address problems of gender and health. HIV in women, and possible responses, are investigated on four distinct levels: conceptual, social structure, health systems, and law. The analysis demonstrates that this problem is indeed modifiable with long-term interventions and an enhanced state response targeted at multiple levels. This book will be of interest to academics and students in the social health sciences, gender and development studies, and global health, as well as HIV/health activists, government officials, policy makers, HIV clinicians and health providers interested in HIV.

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.

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, written decades into the HIV epidemic, reflects critically on the idea that the socially excluded populations often focused on in HIV research are in fact difficult to access and reach. The author broadly applies the concept 'hard to reach' to characterize populations that researchers find difficult to engage with. Social factors that produce marginalization and ultimately result in people choosing not to engage in research are not captured by the concept of 'hard to reach'. Limited attention has focused on how researchers can address the social factors that result in decisions to not engage in research. Disrupting the ways in which people are conceptualized as 'hard to reach' so as to refocus on transforming social systems and personal values, beliefs and approaches is understudied. This book uses case examples based on HIV research with Indigenous youth, internally displaced women, LGBTQ communities in the Global North and Global South, and persons at the intersection of these identities, to identify successful approaches to working with marginalized and often vulnerable communities and groups. The chapters signal the need for attention to five key social factors when developing successful approaches: context and storytelling; cultural humility; critical hope; imagination and possibility; and love, intimate inquiry, and the beloved community, if nations, individuals and communities are to address the epidemic in a sustainable and impactful way.

HIV continues to be a profound challenge facing communities nationally and internationally. Until a vaccine or a cure is found, prevention remains a most crucial line of defense. However, the successes made to reduce exposure and transmission have not benefited all communities equally. HIV continues to affect vulnerable communities, and HIV-related health disparities are growing. The work documented in Innovations in HIV Prevention Research and Practice through Community Engagement spotlights the effectiveness of community involvement to reduce HIV infections in the United States. This timely resource introduces the concepts of community engagement, partnership, and community-based participatory research (CBPR). Contributors provide detailed examples of these concepts in which diverse research partners blend their unique insights and skills to arrive at an authentic understanding of phenomena and inform the translation of best practices and processes to enhance equity in HIV prevention and treatment. Equitable interactive collaboration is central to these efforts, in which community members and representatives from organizations, the scientific and medical sectors, and other relevant agencies nurture long-term health improvement through sustained teamwork. Challenges and barriers to effective engagement are identified, as are characteristics of successful partnerships. Included in the book: Details of a multigenerational HIV prevention intervention in a rural southeastern community. The challenges and successes of developing, implementing, and evaluating an intervention for higher-risk predominately heterosexual black men in college. The history of gay community involvement in HIV prevention and its contributions to the theory and current practice of engagement. Next steps in the integration of HIV-related policy change and research. Community engagement within American Indian communities. Keys to sustaining a CBPR partnership to prevent HIV within ethnic, sexual, and gender minority communities. Innovations in HIV Prevention Research and Practice through Community Engagement offers researchers and practitioners in public health, community health, and medicine guidance on community engagement that is both inspiring and realistic. "Community engagement and knowledge continue to be essential to prevent HIV infections. This book is a compilation of the state-of-the-science of engagement and delves deeper into the meaning and utilization of community-based participatory research, with implications that reach beyond the HIV epidemic to public health and medicine in general." - Laura C. Leviton, PhD, Senior Advisor for Evaluation, Robert Wood Johnson Foundation, Princeton, NJ

This book offers an original anthropological approach to the AIDS epidemic in South Africa. Based on a more than fifteen years association with the region, it demonstrates why AIDS interventions in the former homeland of Venda have failed and possibly even been counterproductive. It does so through a series of ethnographic encounters, from kings to condoms, which expose the ways in which biomedical understanding of the virus have been rejected by and incorporated into local understandings of health, illness, sex, and death. Through the songs of female initiation, AIDS education, and wandering minstrels, the book argues that music is central to understanding how AIDS interventions operate. This book elucidates a hidden world of meaning in which people sing about what they cannot talk about, where educators are blamed for spreading the virus, and in which condoms are often thought to cause AIDS. The policy implications are clear: African worldviews must be taken seriously if AIDS interventions in Africa are to become successful.

Grunge. Flannel. Generation X. In 1993, Seattle was the capital of the world, Nirvana was king, and slackers were everywhere. When the Red Hot organization, a group of activists dedicated to raising money and awareness of AIDS, released their third compilation CD featuring the biggest bands of the era--Soundgarden, Smashing Pumpkins, Beastie Boys, The Breeders, Nirvana and more it quickly became the touchstone of a generation.  Rolling Stone called No Alternative a "jaw-dropping compilation of musical gems." This book takes a look back at what happened to the bands involved with the No Alternative. In includes new interviews with the musicians and others behind the record, and chronicles the downfall of an industry, the taming of a devastating illness, and the arrival of another global pandemic. It's about growing up, saying goodbye, and proving once more that you can't go home again (even if that's where you left all of your CDs).

After reviewing related theories on stigmatisation of people living with HIV/AIDS (PLWHA), this book applies social exclusion theory, actor theory and stigma theory to the study of social mechanisms of stigmatisation of PLWHA in China to show the influence and mechanism of stigmatisation on them, and tries to construct the policy framework to tackle stigmatisation from the perspective of welfare pluralism. Qualitative analysis was used and data was obtained during the field interview. Thirty PLWHA and seventeen healthy people (non-infected people and staff of ASO Service Organizations) were selected by using random sampling and snowball sampling for semi-structured depth interviews. The research examines the treatments and living conditions of those PLWHA, aiming to explore the influence of HIV on them in education, employment, medical care, economy, welfare and social relations. The book is intended for graduate students, researchers interested in this field and relevant policymakers.

This book examines the responses of African Initiated Churches to HIV in Zimbabwe. It describes the changing attitudes of African Initiated Churches to the pandemic, exploring the adjustments that have been undertaken to both doctrine and practice within the movement. The contributors show how the rigidity that often characterizes African Initiated Churches (such as opposing the use of condoms, insisting on polygamy and insisting exclusively on faith healing) have gradually given way to more constructive approaches to HIV and AIDS .

HIV & AIDS together constitute one of the most serious challenges to human life in our time. The consequences are often grave for individuals, families, whole communities and nations. How can Christians respond to this worldwide problem? This book is designed to equip church leaders and their communities with the means to save, protect and prolong lives, and, above all, enable people to live positively in the face of the HIV & AIDS epidemic. The authors forcefully argue this involvement to be seen, not as an additional activity to ministry, but as a calling that enriches ministry's essential meaning and value. Byamugisha's straightforward explanation of HIV & AIDS and suggestions for Christian responses are complemented by case studies from around the globe.

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.

Almost four decades since AIDS was first reported in Africa, the epidemic has reached a watershed moment where progress in prevention, care and support programs confronts intransigent socioeconomic and gender rights barriers and emerging funding uncertainties. While there are grounds for cautious optimism that the incidence of HIV infections and AIDS-related mortality can be further reduced, they cannot, by themselves, end the epidemic. This will require overcoming gendered inequalities, HIV stigma and neglect of high-risk youth and socially peripheralized groups.

This groundbreaking book presents compelling data and research which reveals the shocking social and economic impact of HIV/AIDS on a global scale. Barnett and Whiteside—experts in the field for over 15 years—argue that it is vital to not only look at the disease in terms of prevention and treatment, but to also consider consequences which affect households, communities, companies, governments, and countries. This is a major contribution toward understanding the global public health crisis, as well as the relationship between poverty, inequality, and infectious diseases.

Womanist AIDS Activism in the United States: "It's Who We Are" is an in-depth exploration of AIDS advocacy work among Black women. HIV/AIDS has had a disproportionate impact on Black women. In addition to high infection and mortality rates, they are likely to be responsible for the caretaking of family, friends, and community members with HIV. Angelique Harris and Omar Mushtaq conducted interviews with 36 activists from across the nation to examine the ways in which race, gender, and identity influence the motivations and approaches behind their work. The authors use womanism - an epistemological framework that centers the world views of women of color - to better situate this activism within a larger sociocultural and historical context. They also argue that womanism better encapsulates the experiences of Black women than feminism or Black feminism. The authors provide an in-depth analysis of womanism and propose how it can be applied more broadly in examinations of community engagement among women of color, specifically Black women.

This book provides a unique comparative approach to the politics of HIV/AIDS throughout the world.It features a stellar line-up of scholars including Nana Poku, Tony Barnett, Dennis Altman, Suzanne Leclerc-Madlala, Steven Robins, May Chazan, Beril Egero and Mikael Hammarskjold. It is an excellent accompaniment to Barnett and Whiteside's AIDS in the Twenty-First Century - going deeper into issues explored there. It places African case studies in comparative perspective with Asia, Australasia, Latin America and Europe.HIV/AIDS is the major political challenge of our time. Based on empirical observations from all over the world, this book examines how HIV/AIDS has become increasingly transnational, as nation states have extended their programmes across borders, and transnational networks have increased their activities.

Syringe exchange programs and safe injection services are outside-the-box interventions increasingly being used by governments, nonprofits and citizens to address dire issues percolating in tandem with America's burgeoning opioid epidemic. People who inject drugs (PWID)-almost a million Americans annually-commonly use painkillers such as heroin and fentanyl, as well as methamphetamine, benzodiazepines, barbiturates and cocaine. Yet the users themselves are often obscured or marginalized by the bigger picture. This collection of essays covers policies and practices aimed at preventing both opioid-related deaths and related infections of hepatitis and HIV.

This book considers the change in rhetoric surrounding the treatment of AIDS from one of crisis to that of 'ending AIDS'. Exploring what it means to 'end AIDS' and how responsibility is framed in this new discourse, the author considers the tensions generated between the individual and the state in terms of notions such as risk, responsibility and prevention. Based on analyses public health promotions in the UK and the US, HIV prevention science and engaging with the work of Foucault, this volume argues that the discourse of 'ending AIDS' implies a tension-filled space in which global principles and values may clash with localised needs, values and concerns; in which evidence-based policies strive for hegemony over local, tacit and communal regimes of knowledge; and in which desires compete with national and international ideas about what is best for the individual in the name of 'ending AIDS' writ large. As such, it will appeal to scholars of sociology and media studies with interests in the sociology of medicine and health, medical communication and health policy.

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's AIDS crisis accept that, to some degree, its entrenchment is a socially produced phenomenon, few have examined the contributions of the continent's ubiquitous poverty, the impact of the pervasive Structural Adjustment Programmes or Africa's marginalization in the process of globalization, on the course and intensity of the epidemic - until now. This book explores the socio-economic context of Africa's vulnerability to HIV/AIDS as well as assessing the politics of domestic and global response. Using primary and secondary data, the book charts the power relations driving Africa'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, this book marks a radical departure by providing a comprehensive analysis of Africa's vulnerability to AIDS and the challenges confronting policy makers as they seek to reverse the escalating prevalence of AIDS on the continent. The volume will be of immense value to all those interested in Africa's socio-political and economic development. It will be essential reading for students of comparative politics, international relations, and globalization.

Sub-Saharan Africa is a region devastated by HIV/AIDS. The extent of the epidemic is only now becoming clear, as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, the AIDS death toll on the continent is set to escalate rapidly. Despite progress being achieved in localized settings, the alarming statistics reflect the continuing failure of advanced countries to mount a response that matches the scale and severity of the African HIV/AIDS crisis. Over and above the colossal personal suffering, the dire social and economic consequences for fragile nation-states are already being felt, not only in health but in education, industry, agriculture, transport, human resources and economies in general. Countries already crippled by drought, poverty, debt, forced migration and civil war must now contend with massive deterioration in child survival rates and life expectancy, the erosion of the economic family base, massive and insupportable demands on health and public services, chronic labour shortages and volatile national security. Through a critical and detailed exploration of specific case studies, this invaluable volume brings together an unparalleled array of international contributors to redefine the political and economic contours of this calamitous epidemic. It examines the impact of the shortfalls in the 'Global Fund' allocation, the slow pace of administrative processing of aid and the weaknesses of institutional responses to the crisis from African countries and their partners in the global health community. It is essential reading for all concerned with public health, epidemiology, HIV/AIDS research, globalization, development, Africa and indeed our shared future. Features include: " Unique assessments of HIV/AIDS and its impact on democracy and governance in African states " Wide-ranging regional and country studies by the foremost thinkers in their fields " Multi-disciplinary contributions from areas including: Politics, Sociology, Public Health and Development Studies " Compelling and convincing evidence, thematic in approach " Innovative and culturally specific insights for long-term planning, care and support