In the decade since AIDS was first recognised the enormous and worldwide social and medical implications of this disease have been increasingly recognised. The exponential increase in the number of people infected with HIV has been paralleled by the written literature on the subject. When this book was initially conceived the question was why another book? It seemed to me at that time and since, that as HIV presented ever more complex problems, they were best solved when considered within a wider context, using basic principles of individual medical specialties and applying them. For this reason, all the chapter authors were experienced in a particular field and applied that knowledge to HIV. All the authors were working at the Middlesex Hospital in London when the AIDS services there were expanding to fill a need, from 2 beds in 1986 to two wards today. The authors were frontline staff looking after all aspects of HIV infection within a wider general medical context. Many are now consultants or senior lecturers. It is the aim of the book to provide an insight into HIV and AIDS as a overview for someone starting to work in this field or who sees such patients occasionally and requires some basic guidelines. For this reason the chapters are based predominantly on organ systems and are divided into sections covering the presenta tion, methods of investigation and treatment or action required of relevant conditions."

In most countries, primary prevention programmes against the HIV / AIDS epidemic have been implemented. Broadly speaking, three levels of intervention can be identified: - national campaigns directed to the general population; most of them are multi phase campaigns aimed at providing information about HIV transmission and protective behaviour; they use the various mass media channels and are mainly directed to sexual behaviour modifi cation; - community-based interventions, addressed to specific target popula tions; these populations have been typically selected according to both the high risk of infection (gay men and prostitutes) and the difficulty to reach the members of these communities (intravenous drug users); - individual testing and counselling, often supported by public funds or large non-governmental organizations. Major efforts have been devoted to the development and the implemen tation of these preventive programmes, both in terms of human re sources and financial support. On the other hand, in most countries, far less energy has been put into the evaluation of these campaigns. This gap is not explained by the fact that evaluation of AIDS/HIV cam paigns is a totally new challenge in terms of methodology: there are classical methods, developed over twenty years and used in other fields of prevention."

This guide to the legal aspects of AIDS has been thoroughly revised. Written by experienced legal professionals under the auspices of Britain's major AIDS charity, it addresses areas of the law affected by AIDS, including: insurance, housing, employment, children and young people, and immigration. It examines all the legal needs of people with AIDS and HIV infection. The book includes a section on the medico-legal aspects of AIDS (such as antibody testing and the subject of informed consent) and a chapter on the legal and practical steps towards setting up a voluntary or charitable organization. Concise and accessible, this guide should be useful to counsellors, health and social workers, lawyers, welfare agency advisors and anyone who needs a legal rights guide to AIDS.

Series Information:
Social Aspects of AIDS

The care paradigm for people with HIV has shifted from managing progressive illness with a poor prognosis to managing a chronic condition. Despite this improvement, people living with HIV continue to experience considerable stresses, so promoting their holistic wellbeing is a key aspect of long-term care. This book provides an accessible introduction for healthcare professionals who work with people living with HIV. It is designed to help readers understand how care in practice can be more person-centred and psychologically focused, whilst promoting compassion, health and wellbeing. Topics covered include self-awareness, attachment theories and communication as well as key aspects of providing care for people living with HIV, such as stigma in young adults, neurocognitive issues, the sexualized use of drugs, managing neuropathic pain, and the needs of older adults living with HIV. Invaluable reading for health professionals working within multidisciplinary teams that provide care for people living with HIV, this book is also a core text for those studying in the area.

Forty years ago, the age-old battle against infectious diseases as a major threat to human health was believed close to being won. However, by the late twentieth century, the increase of emerging and reemerging infectious diseases was evident in both low and high income countries. About 30 new infectious diseases have been identified in the last 20 years. Among the "new" diseases, and most importantly, the Human Immunodeficiency Virus (HIV) epidemic, with 40 million persons infected and 25 million deaths since its first description, presents one of the most significant health, societal and security challenges facing the global community. The interaction of HIV/AIDS with tuberculosis, malaria and bacterial infections have increased HIV-related morbidity and mortality, and in turn, the HIV pandemic has brought about devastating increases in tuberculosis.

Understanding the population impact and the dynamics of infection diseases in the most affected region is critical to efforts to reduce the morbidity and mortality of such infections, and for decisions on where to use limited resources in the fight against infections.

This book aims to contribute to these efforts by offering a demographic and epidemiological perspective on emerging and reemerging infections in sub-Saharan Africa.

Living with HIV can be stressful, which can affect both your emotional and physical well-being. You may feel a loss of control over your life, socially isolated, or anxious and depressed. Studies have shown that prolonged stress can negatively impact the immune system, making it less effective in fighting illness. If you are concerned about the impact stress has on your life and on your health, this book can help you learn to relax and manage stress more effectively.
This book presents a group treatment program that has been scientifically proven to reduce stress in individuals living with HIV. Written by the developers of this groundbreaking program, this workbook is based on the principles of Cognitive-Behavioral Stress Management (CBSM). You will learn a variety of relaxation techniques, all designed to help you reduce tension and stress. As you become more aware of stress and its effects, stress management skills will increase your ability to cope.
This workbook comes complete with user-friendly monitoring forms and homework exercises designed to help reinforce the skills learned in group. It also includes instructions for relaxation practice that will remain useful long after you've completed the program. Used in conjunction with the group program described in the corresponding facilitator guide, this workbook will help you successfully manage stress and lead a more healthy life.

For individuals living with HIV, stress can have a critical impact on emotional and physical well-being. Many HIV-infected individuals feel a loss of control over their lives, experience social isolation, and may suffer from anxiety and depression. Stress has been shown to decrease immune functioning, which is a significant concern for HIV-infected individuals.
Written by the developer of the treatment, this manual presents an empirically supported, group treatment program that teaches HIV-infected individuals how to manage their stress. This comprehensive Cognitive-Behavioral Stress Management (CBSM) program combines stress management with relaxation training. Each group meeting introduces a new relaxation method, such as progressive muscle relaxation, imagery, and meditation. Stress management skills build on one another and include cognitive restructuring, coping strategies, and establishing a strong social network. By the end of the program, participants are equipped with a variety of inter-related techniques that they can use to reduce stress and improve their quality of life.
The guide is designed to be used in conjunction with the corresponding workbook, which provides exercises to be completed in session, monitoring forms, and homework assignments. Together they include all the material and information needed to effectively implement this program.

In what circumstances and on what basis, should those who transmit serious diseases to their sexual partners be criminalised? In this new book Matthew Weait uses English case law as the basis of a more general and critical analysis of the response of the criminal courts to those who have been convicted of transmitting HIV during sex. Examining cases and engaging with the socio-cultural dimensions of HIV/AIDS and sexuality, he provides readers with an important insight into the way in which the criminal courts construct the concepts of harm, risk, causation, blame and responsibility. Taking into account the socio-cultural issues surrounding HIV/AIDS and their interaction with the law, Weait has written an excellent book for postgraduate and undergraduate law and criminology students studying criminal law theory, the trial process, offences against the person, and the politics of criminalisation. The book will also be of interest to health professionals working in the field of HIV/AIDS genito-urinary medicine who want to understand the issues that may face their clients and patients.

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.

Neurological complications of progressive HIV-1 infection remain a common cause of morbidity even during widespread use of antiretroviral therapy (ART). Long-term resistance to ART, drug compliance, untoward drug side effects, a myriad of opportunistic infection, depression and other psychiatric disease manifestations, concomitant drug abuse, neuropathies, and an inability to clear viral reservoirs, explain, in large measure, disease progression and immune deterioration. These are associated with a number of psychiatric, muscle, nerve, infectious, as well as cognitive, behavioral, and motor disturbances seen in infected people. Fully updated from the previous two editions and replete with color images, The Neurology of AIDS, Third Edition covers each of these neurological complications and more with a focus on molecular and viral disease processes, cellular factors influencing viral replication therapeutic challenges, and the changing epidemiological patterns of disease. From basic science to clinical care, to epidemiological disease patters, The Neurology of AIDS is the only complete textbook available on AIDS neurology and the only one comprehensive enough to stand alone in each segment of study in brain disorders affected by the human immunodeficiency virus. It is an indispensable resource for students, resident physicians, practicing physicians, and for researchers and experts in the HIV/AIDS field.

Here are stories and encouragements for people with AIDS / HIV. This powerful and inspiring book goes beyond the usual stereotypes of AIDS sufferers to impart the realities of ordinary people who have acquired the syndrome and of those who love and care for them. Selected as one of The 1993 Books for the Teen Age by The New York Public Library.

It is now forty years since the discovery of AIDS, but its origins continue to puzzle doctors, scientists and patients. Inspired by his own experiences working as a physician in a bush hospital in Zaire, Jacques Pepin looks back to the early twentieth-century events in central Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how military campaigns, urbanisation, prostitution and large-scale colonial medical interventions intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Leopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential perspective on HIV/AIDS and on the lessons that must be learned as the world faces another pandemic.

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.

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.

Despite enormous efforts, over 100,000 papers and over $22 billion spent by the US taxpayer alone, the HIV-AIDS hypothesis has failed to produce any public health benefits, no vaccine, no effective drug, no prevention, no cure, not a single life saved. Is the science system to be blamed? Has science failed to reveal the truth about AIDS? In AIDS: Virus or Drug Induced?, two dozen scientists, scholars and journalists have investigated the status quo of AIDS research. Most of them have questioned the HIV-AIDS hypothesis before, but have since been censored, and sociologically excluded from AIDS research, politics and journalism. Here they are united for the first time to put on trial the HIV-AIDS hypothesis. There are those who acquit HIV entirely. Others who make a case for HIV as a necessary, but not a sufficient cause of AIDS. And one medical scientist who, together with the huge AIDS literature, defends the hypothesis that HIV is sufficient to cause AIDS. The book convincingly reveals that the scientific method could very well find a solution to AIDS, but only if ideas can be exchanged freely and if the HIV monopoly can be broken. AIDS: Virus or Drug Induced? illustrates that the solution to AIDS could be as close as one of several, very testable and very affordable alternatives to the unproductive HIV-AIDS hypothesis.

What does it mean to oppose AIDS, to be at odds with AIDS? What kind of rupture with history does AIDS represent? How does AIDS and what is said about AIDS relate to gay identity? How does AIDS relate to thinking and acting, particularly deconstructive thinking? The author confronts these questions from a broad philosophical background that ranges from Kant, Nietzsche, Kierkegaard, and Heidegger to contemporary thought concerning gay activism and AIDS research, all brought together in an effort to find a philosophical language capable of doing justice to the singularity of lived experience in the shadow of AIDS.
In examining what AIDS reveals about the conditions of existence, Garcia Duttmann develops the idea of the "dis-unity" or "at-odds-ness" of existence, of the "non-belonging" that characterizes the marginalized, outcast, or abandoned, and exposes human existence itself. He analyzes what AIDS reveals about the character of history through two intertwined issues. First, he examines arguments bearing on the epochal significance of AIDS, the idea that AIDS reveals something uniquely characteristic of our time, hence that the epidemic marks a historical caesura. Second, he develops a theory of historical witnessing suggesting that the phenomena of historical event and bearing witness are not at all separate, but instead are co-originary, inhering in the same complex.

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.

As HIV/AIDS continue to plague societies around the world, more and more social workers encounter HIV-infected individuals and their families and friends who are searching for help and support. In HIV and Social Work: A Practitioner's Guide, experienced social workers share their practice wisdom, knowledge, and skills on a broad range of issues. Their words of wisdom will give you the willingness to follow problems through and the flexibility and creativity that are required when dealing with issues concerning HIV/AIDS. At the same time, you will achieve a sense of empowerment and optimism as you realize that there are things you can do--very specific kinds of help you can offer--that can make an enormous difference in the lives of people with HIV/AIDS and those who love and care for them.

HIV and Social Work is a practical, user-friendly resource for social workers who practice in a variety of settings and fields. You'll find it a rich and useful book if you're moving into HIV/AIDS work and want guidance, or if you're experienced and want to sharpen your skills, or if you just want to be prepared for when you find people with HIV or their family members in your office in need of help. Specifically, you'll gain valuable insight about:

basic psychosocial interventions for people with HIV/AIDS

in-depth practical suggestions for specific problem areas and specific groups of people with HIV/AIDS

better listening skills

how to know your own limitations and live your own life more fully in the face of sadness

the importance and challenge of returning to fundamental social work skills

You'll refer to HIV and Social Work time and time again as you confront new HIV-related situations in your practice for which you need easy-to-understand descriptions of what to do and how to do it. Acknowledging your busy schedule, the book is organized so that you may use it on a “knowledge as needed” basis or read it straight through. Written specifically by and for social workers, HIV and Social Work is highly recommended as required reading in social work programs at the Bachelor's and/or Master's levels.

Table of Contents

Contents

About the Editors Contributors

Foreword

Preface

Acknowledgments

Section I: Introduction

Essential Facts Every Social Worker Needs to Know

Getting Started: Basic Skills for Effective Social Work with People with HIV

Multicultural Competence

Back to the Future: Survival, Uncertainty, and Hope

Section II: Practice Settings

Case Management in AIDS Service Settings

Part A: Services in Health Settings

Discharge Planning in Acute Care

Involving Family and Significant Others in Acute Care

Bereavement Work in the Acute Care Setting

Involving Families in Hospice and Home Care

Bereavement Work in Hospice and Home Care

Helping a Person with HIV/AIDS Get into Clinical Trials

Helping a Person with HIV/AIDS Prepare a Power of Attorney and a Living Will

Part B: Services in Mental Health Settings

Individual Clinical Issues

Disrupted Dialogues: Working with Couples

Clinical Issues in Groups for HIV-Infected Individuals

Clinical Issues for Families

HIV Risk Assessment in Mental Health Settings

Ethical Issues in Clinical Practice

HIV in Private Practice

Identifying and Treating HIV-Associated Dementia

Organizing Support Groups for People Affected by HIV

Section III: People in Special Circumstances

Addressing HIV Risks with Clients Who Use Drugs

Part A: Services for Children and Families

Counseling Parents and Children with HIV

Helping a Parent with HIV Tell His or Her Children

Talking with Parents About Creating a Legacy for Their Children

Talking with Parents About Permanency Planning

Working with Children with HIV in Day Care, Elementary, and Secondary Schools

Talking to Women with HIV About Childbearing Issues

Part B: Services for Special Populations

Services to Adolescents

Services to People with HIV in the Workplace

Providing Service to Gay Men

Providing Services to HIV-Positive Women

Providing Services to Elderly People with HIV

Social Work Practice with HIV-Positive People in Rural Settings

Providing Services to People with Preexisting Mental Illness

HIV Services in Correctional Facilities: Negotiating a Complex Environment

Section IV: Economic Supports and Housing

Economic Supports and Advocacy

Housing for People with HIV

Section V: Caring for the Professional Caregiver

Caring for Ourselves: Understanding and Minimizing the Stresses of HIV Caregiving

Meeting the Emotional Needs of Health Care Providers

Changing the System: Don't Mourn. . . Organize!

Index

Reference Notes Included

What does it mean to oppose AIDS, to be at odds with AIDS? What kind of rupture with history does AIDS represent? How does AIDS and what is said about AIDS relate to gay identity? How does AIDS relate to thinking and acting, particularly deconstructive thinking? The author confronts these questions from a broad philosophical background that ranges from Kant, Nietzsche, Kierkegaard, and Heidegger to contemporary thought concerning gay activism and AIDS research, all brought together in an effort to find a philosophical language capable of doing justice to the singularity of lived experience in the shadow of AIDS.
In examining what AIDS reveals about the conditions of existence, Garcia Duttmann develops the idea of the "dis-unity" or "at-odds-ness" of existence, of the "non-belonging" that characterizes the marginalized, outcast, or abandoned, and exposes human existence itself. He analyzes what AIDS reveals about the character of history through two intertwined issues. First, he examines arguments bearing on the epochal significance of AIDS, the idea that AIDS reveals something uniquely characteristic of our time, hence that the epidemic marks a historical caesura. Second, he develops a theory of historical witnessing suggesting that the phenomena of historical event and bearing witness are not at all separate, but instead are co-originary, inhering in the same complex.

This book offers detailed ethnographic studies from African and the Caribbean to explain AIDS in a global and comparative third-world context. The essays move beyond medical or epidemiological models, explaining the epidemic in its economic, social, political, and historical contexts.

Many of the questions related to the treatment of drug addiction originate from the confusion that still characterizes this issue, even though biology is irreversibly changing our outlook on the physiology and psychopathology of the mind. In fact, prejudices stemming from the archaic concept of mind-body dualism are so difficult to eradicate that even a skilled psychiatrist may find it hard to distinguish a psychiatric symptom from a socially transgressive behavior. The dilemma becomes even more salient for drug addiction, since many of the substances which induce abuse and dependence are illegal, and their production, trade and use are forbidden by law. If the use of heroin is connoted as a crime, it may become controversial to recognize its chronic sequelae as a disease. Hence, withdrawal symptoms may alternatively be attributed to drug effects, or labelled as immoral attitudes arising from a vicious personality. However, the physician's judgement, which has to be merely instrumental at improving the patient's quality of life, should never be influenced by such complex setting. In fact, the only concern of the physician must be that of ascertaining the causes of symptoms and of removing them: if symptoms are induced by the toxic effect of a drug, he has to use the most effective antidote, and then proceed towards a detoxification; if they are due to withdrawal, a substitutive substance should be given initially. In the case of narcotics, substitutive therapy on a maintenance basis may become mandatory.

In 1989, the First International Symposium on Cytokines in Hemopoiesis, Oncology, and AIDS was held in Hanover, FRG. Since then there has been an explosion of knowledge in this field. New cytokines have been discovered, on which data are presented in this book, and receptors have already been cloned for many cytokines. In clinical application, some cytokines such as TNF have almost completely left the stage, but this may not be for ever. Enormous progress has been made in the field of hemopoietic growth factors, for which clinical studies from phase I to phase III have been conducted, and some of which have even been registered for routine use. In spite of this rapid development our knowledge of how to clinically exploit the effects of cytokines is very limited and lies far behind the advances made in basic research. Even for the hemopoietic growth factors, questions regarding the effect of adjuvant therapy on survival and or on general outcome in chemother apy have still not been answered. Discussion and exchange between those involved in basic science and clinical research is still urgently needed. We hope to successfully contribute to this process by continuing the series proceedings of the International Symposia on Cytokines in Hemopoiesis, Oncology, and AIDS. Hannover, in July 1992 Mathias Freund Hartmut Link Reinhold E. Schmidt Karl Welte List of Contributors Abbadessa, V. Istituto die Clinica Medica III, Centro Interdipartimenta de Ii Ricerche in Oncologia Clinica, 90100 Palermo, Italy Abecassis, M."

The disease that came to be called acquired immunodeficiency syndrome (AIDS) was first identified in the summer of 1981. By that time, nearly 100,000 persons in the United States may have been infected with human immunodeficiency virus (HIV). By the time the routes of transmission were clearly identified and HIV was established as the cause of AIDS in 1983, over 300,000 people may have been infected. That number has continued to increase, with approximately 1,000,000 Americans believed to be infected in 1991. The epidemic is of great public health concern because HlV is infectious, causes severe morbidity and death in most if not all of those infected, and often occurs in relatively young persons. In addition, the cost of medical care for a person with HIV disease is high, and the medical care needs of HIV-infected persons place a severe burden on the medical care systems in many areas. Understanding and controlling the HIV epidemic is a particularly difficult challenge. The long and variable period between HIV infection and clinical disease makes it difficult both to forecast the future magnitude of the epidemic, which is important for health care planning, and to estimate the number infected in the last several years, which is important for monitoring the current status of the epidemic.