With the development of effective antiretroviral therapies (ART) in the mid-1990s, HIV became a treatable although serious condition, and people who are adherent to HIV medications can attain normal or near-normal life expectancies. Because of the success of ART, people 50 and older now make up a majority of people with HIV in high-income countries and other places where ART is accessible. The aging of the HIV epidemic is a global trend that is also being observed in low- and middle-income countries, including countries in sub-Saharan Africa, where the greatest number of older people with HIV reside (3.7 million). While globally over half of older adults with HIV are in sub-Saharan Africa, we have little information about the circumstances, needs, and resiliencies of this population, which limits our ability to craft effective policy and programmatic responses to aging with HIV in this region. At present, our understanding of HIV and aging is dominated by information from the U.S. and Western Europe, where the epidemiology of HIV and the infrastructure to provide social care are markedly different than in sub-Saharan Africa. Aging with HIV in Sub-Saharan Africa addresses this gap in our knowledge by providing current research and perspectives on a range of health and psychosocial topics concerning these older adults from across this region. This volume provides a unique and timely overview of growing older with HIV in a sub-Saharan African context, covering such topics as epidemiology, health and functioning, and social support, as well as policy and program implications to support those growing older with HIV. There are very few published volumes that address HIV and aging, and this is the first book to consider HIV and aging in sub-Saharan Africa. Most publications in this area focus on HIV and aging in Uganda and South Africa. This volume broadens the scope with contributions from authors working in West Africa, Botswana, and Kenya. The range of topics covered here will be useful to professionals in a range of disciplines including psychology, epidemiology, gerontology, sociology, health care, public health, and social work.

Lucky Lupin is a poignant yet light-hearted story of survival against the odds, based on Charlie Mortimer's life with HIV/Aids during the early years (1984-1996), when there was neither treatment nor cure. Using a combination of good luck, gallows humour, Fray Bentos pies and copious quantities of Solpadeine, Charlie survived not only the illness but the hysteria that accompanied the so-called 'gay plague'. Anyone infected became a social pariah; had the local launderette got word of his illness they wouldn't have washed his sheets but burnt them. Whilst taking full responsibility for the consequences of his behaviour - 'The fact is you don't get AIDS from watching telly' - Charlie initially took to the sofa and prepared for death, but, in time, he found the inner strength required to confront his fatal diagnosis, becoming, among other things, an antiques dealer and contemporary art collector. With blistering and often hilarious candour Charlie also recounts his childhood where he developed a passion for cars, cultivated by his adventurous mother 'Nidnod', his dizzying array of careers and somewhat curious domestic arrangements including the 'adoption' of a bank robber for twelve years. He also confronts head on his experiences of coming to terms with confused sexuality, addiction, epilepsy and clinical depression before finding lasting contentment. Praise for Dear Lupin: 'As well as being the funniest book I've read in ages, it's also extremely touching. A delight then, on every front.' The Spectator 'Very, very funny.' Sunday Times 'Wry, trenchant, often extremely funny, but also charmingly forbearing and forgiving.' Country Life

"Adelman and Frey take advantage of every opportunity to leave their audience with a splendid reading experience that will prompt one to think about community and communication in new and exciting ways. And as it should be, the reader also will not soon forget the echoes of the voices of the ordinary, but remarkable, men and women who inspired the work -- the residents who live and have lived in the fragile community at BH". -- Journal of Health Communication

This book examines the concept of "community", focusing on how communication practices help manage the tensions of creating and sustaining everyday communal life amidst the crisis of human loss. While acknowledging how the contradictory and inconsistent nature of human relationships inevitably affects community, this intimate and compelling text shows how community is created and sustained in concrete communication practices.

The authors explore these ideas at Bonaventure House, an award-winning residential facility for people with AIDS, where the web of social relationships and the demands of a life-threatening illness intersect in complex ways. Facing a life-threatening illness can defy meaningful social connections, but it can also inspire such ties, sometimes in ways that elude us in the course of daily life. By understanding how collective communication practices help residents forge a sense of community out of the fragility and chaos f living together with AIDS, we are able to better understand how communication is inexorably intertwined with the formation of community in other environments.

Based on seven years of ethnographic research including participant-observation, in-depth interviews, and questionnaires, thisbook weaves together narratives and visual images with conceptual analysis to uncover the ongoing oppositional forces of community life, and to show how both mundane and profound communication processes ameliorate these tensions, and thereby sustain this fragile community. Because the average length of stay for a resident is seven months -- in which time he or she moves from being a newcomer to a community member to someone the community remembers -- the text reflects this short, but crystallized life, starting with the day a new resident opens the door to the day he or she passes away.

The writing is very rich -- intimate, engaging, personal, compelling, and vivid. The stories told discuss such deeply personal topics as the dilemmas of romantic relationships in a context fraught with many perils; issues of power, authority, and control that enable and constrain social life; and communicative practices that help residents cope with bereavement over the loss of others as well as their own impending deaths. The text concludes by examining the lessons learned from Bonaventure House about creating and sustaining a health community, and serves as an inspiration for strengthening interpersonal relationships and communities in other environments.

As the HIV epidemic moves into its fourth decade, it is clear that the global response has failed to adequately address the needs of a wide range of vulnerable populations and groups. Chief among these are gay, bisexual and other men who have sex with men, and transgender persons, who globally face the disproportional burden of HIV infection. This volume rethinks HIV prevention and health promotion for sexual and gender minorities - in both the industrialised societies of the West, as well as in the developing nations of the Global South. The chapters it contains offer a critical analysis of past and present HIV research employing categories to designate gay and other men who have sex with men, transgender persons, and/or other persons and communities with diverse gender and sexual identities. Contributors question the politics of many of the existing classifications and categories in HIV research and argue for a more sophisticated analysis of gender and sexual diversity in order to tackle the social and political barriers that impede the design of successful HIV prevention and health promotion approaches. This book was originally published as a special issue of Global Public Health.

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.

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.

A remarkable partnership between the Indiana University School of Medicine and the Moi University School of Medicine in Kenya has built one of the most comprehensive and successful programs in the world to control HIV/AIDS. Calling upon the resources of the Americans, the ingenuity of the Kenyans, and their shared determination to care for patients who had been given up for dead, the program has been nominated for a Nobel Peace Prize and described as a miracle by the U.S. ambassador to Kenya. Doctors from Kenya and the United States employing methods once considered unfeasible, such as successfully administered antiretroviral regimes have created a model program for saving lives and empowering the sick and impoverished. Against formidable odds, these partners demonstrate how medicine and caring can overturn preconceived notions about Africa and help wipe out the world's most devastating pandemic."

Liver disease has been identified as a leading cause of death in HIV-infected patients since the introduction of highly active antiretroviral therapy (HAART) in 1996. The HIV treatment community has been caught largely unaware of this emerging dilemma. Many HIV care providers are ill-equipped to understand and interpret liver injury patterns, or to provide comprehensive care and management for viral coinfections which they are not familiar with. HIV and Liver Disease provides a comprehensive update of the field covering the epidemiology, pathogenesis, management and treatment of liver disease in patients with HIV infection. The volume will help HIV care providers understand and interpret liver injury patterns, and/or provide comprehensive care and management for viral coinfections. Gastroenterologists and hepatologists will gain an understanding of complex drug regimens that are used to treat HIV and which may impact HCV and HBV treatment. Written by expert clinicians and researchers across multiple disciplines, HIV and Liver Disease will be of great value to gastroenterologists, hepatologists, infectious disease practitioners, as well as other health care providers who provide care or participate in research in the field of HIV.

Carolyn Jones's vivid and life-affirming portraits capture people from all backgrounds -- children and grandmothers, men and women of all races -- living with HIV and AIDS.
It is estimated that over one million people in the United States would test positive for the Human Immune Virus, and many others are already suffering from Acquired Immune Deficiency Syndrome. A common-and harmful-misconception holds that AIDS is an instant death sentence but, in fact, testing positive for HIV does not mean immediate illness. Carolyn Jones has collaborated with George DeSipio, Jr., and Michael Liberatore (co-founders of the project), and the seventy-three people who volunteered to pose for these photographs in an inspiring effort to change the way we think about AIDS. Jones's compelling portraits have the power to profoundly alter perceptions about this disease, and about the way we all live and die. AIDS poses challenging questions that we must each grapple with, whether healthy or not. These captivating pictures illustrate the self-confidence and wisdom of ordinary people coping with an extraordinary fate, facing their mortality, questioning their priorities, and living life to the fullest. Their energy, courage, and dignity in the face of such adversity offer a vital lesson in how to embrace life, day by day. Their faces and their stories are proof that AIDS doesn't look like anyone -- it looks like, and ultimately is, all of us.
Design Industries Foundation for AIDS (DIFFA) is the sole recipient of the royalties from the sale of "Living Proof." For additional information regarding "Living Proof" and the Design Industries Foundation for AIDS, please call DIFFA, (212) 727-3100.

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

Table of Contents

Contents: Preface; Introduction. Section One Overview of the Issue: AIDS related vulnerabilities among children in Sub-Saharan Africa: an overview, Lyndsey McMahan, Chiedza Mufunde and Margaret Lombe. Section Two The Living Arrangement of Orphaned and Vulnerable Children in Sub-Saharan Africa: Fostered children in Botswana, Tapologo Maundeni, Naomi Seboni and Ogar Rapinyana; Experiences of children in residential care: the case of Kenya, Protus Lumiti, Alex J. Ochumbo and Nicholas Syano; The living arrangements of vulnerable children in Zambia, Margaret Lombe and Theresa Lungu. Section Three Responding to Orphaned and Vulnerable Children: An Overview of Public and Private Initiatives: Responses to orphaned and vulnerable children (OVC) in Botswana, Naomi Seboni, Tapoplogo Maundeni, Ogar Rapinyana and Mosidi Tseleng Cynthia Mokotedi; Responding to orphaned and vulnerable children in Kenya, Alex Ochumbo, Protus Lumiti, and Nicholas Syano; Responding to orphaned and vulnerable children in Zambia, Theresa Lungu, Chrisann Newransky and Aakanksha Sinha. Section Four Children Speak Out: Children speak out: is anyone listening?, Margaret Lombe and Alex Ochumbo. Section Five Making Children Matter: Vulnerability among children and the Convention on the Rights of the Child, Margaret Lombe and Harriet Mabikke; Conclusion: closing thoughts, Margaret Lombe, Harriet Mabikke and Alex Ochumbo. Index.

Witchcraft and a Life in the New South Africa reconstructs the biography of an ordinary South African, Jimmy Mohale. Born in 1964, Jimmy came of age in rural South Africa during apartheid, then studied at university and worked as a teacher during the anti-apartheid struggle. In 2005, Jimmy died from an undiagnosed sickness, probably related to AIDS. Jimmy gradually came to see the unanticipated misfortune he experienced as a result of his father's witchcraft and sought remedies from diviners rather than from biomedical doctors. This study casts new light on scholarly understandings of the connections between South African politics, witchcraft and the AIDS pandemic.

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.

Written by a leading expert in the field, this book provides a clear and incisive analysis of the different perspectives of the global response to HIV/AIDS, and the role of the different global institutions involved. The text highlights HIV/AIDS as an exceptional global epidemic in terms of the severity of its impact as a humanitarian tragedy of unprecedented proportion, its multi-dimensional characteristics, and its continuous evolution over more than two decades. The careful analysis in this volume critically reviews key issues in the global response, including: HIV/AIDS as a development challenge North-South power relationships and tensions international and regional partnerships between donor governments and recipient countries governance of global institutions and impact on the capacity of developing countries to respond effectively to the epidemic prevention versus treatment as options in HIV/AIDS services how to make the money work in support of effective AIDS financing. Providing a comprehensive but easy to read and compact overview of history, trends and impacts of HIV/AIDS and the global efforts to respond effectively this book is essential reading for all students of international relations, health studies and international organizations.

Following the development of anti-retroviral therapies (ARVs), many people affected by HIV in the 1980s and 1990s have now been living with the condition for decades. Drawing on perspectives from leading scholars in Bangladesh, Canada, Hong Kong, New Zealand, Switzerland, Ukraine, the UK and the US, as well as research from India and Kenya, this book explores the experiences of sex and sexuality in individuals and groups living with HIV in later life. Contributions consider the impacts of stigma, barriers to intimacy, physiological sequelae, long-term care, undetectability, pleasure and biomedical prevention (TasP and PrEP). With the increasing global availability of ARVs and ageing populations, this book offers essential future directions, practical applications and implications for both policy and research.

Highly active antiretroviral therapy (HAART) is a therapeutic intervention developed by clinicians and researchers in order to fight the HIV pandemic. It has contributed to a significant reduction in AIDS-related mortality and allowed many previously bed-ridden patients to live healthier, more productive lives. Until the advent of HAART in 1996, a diagnosis of HIV infection was considered a death sentence. A decade later, the disease has been transformed into a serious, yet potentially manageable, medical condition for thousands of people living with HIV/AIDS in the developed world - almost overnight creating a generation of "HIV Survivors" - and forged a global movement to ensure that its Lazarus-like benefit reaches millions more in the developing world.
This book reviews the achievements of HAART over the past decade, and explores the challenges that may arise in the future. It recounts key landmarks in the development and introduction of HAART from the perspective of clinicians, researchers, economists, sociologists, and public policy experts, including the co-discoverers of HIV, Luc Montagnier and Robert Gallo. It explores the evolution of the disease, the evolution of HIV treatment, and the economic, social, and public policy impacts of both HIV and the introduction of HAART.

As we approach the 25th anniversary of the first recognition fo 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 by patients, and how the resulting activity is monitored and evaluated in order to improve the effectiveness, efficiency, equity and acceptability of the response.
The 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 seriousoutstanding issues, and chapters which analyze specific country and organizational responses. There is no perfect health system, but the evidence provided here allows the sharing of knowledge, and an opportunity to assess the impact and reactions, to an epidemic that must be considered a long term issue.

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.

As news headlines report staggering numbers of people infected with HIV or AIDS across the globe and as stereotypes of typical AIDS patients become less and less specific to particular sexual orientations and ethnic backgrounds, the AIDS pandemic shows little sign of relenting. AIDS crosses geopolitical and social barriers, and social and behavioral scientists are confronted with the new challenge of developing scientific inquiry and corresponding interventions around participatory, community-based, and community-focused methods. These interventions are increasingly targeting the contextual influences on individual behavior, such as peer groups, social networks and support systems, and community norms. Community-level interventions also draw on local resources and are respectful of sociocultural circumstances and traditions. This book articulates how the social and behavioral sciences can respond to HIV/AIDS. It is written for all who have a stake in AIDS research, stimulating discussion and debate about the natures of community research and intervention broadly across such disciplines as public health, community health education, urban planning, psychology, sociology, anthropology, and philosophy of science. The book proposes alternative perspectives on means of ascertaining knowledge about the HIV/AIDS pandemic and the inclusion of community collaboration in interventions.

Witchcraft and a Life in the New South Africa reconstructs the biography of an ordinary South African, Jimmy Mohale. Born in 1964, Jimmy came of age in rural South Africa during apartheid, then studied at university and worked as a teacher during the anti-apartheid struggle. In 2005, Jimmy died from an undiagnosed sickness, probably related to AIDS. Jimmy gradually came to see the unanticipated misfortune he experienced as a result of his father's witchcraft and sought remedies from diviners rather than from biomedical doctors. This study casts new light on scholarly understandings of the connections between South African politics, witchcraft and the AIDS pandemic.

This text provides a clinical framework for the diagnosis and management of more than seventy potential neurological complications that may occur in the HIV infected patient. The clinical framework is designed to be "user friendly" so that even the most inexperienced clinician should be able to arrive at the correct diagnosis. The neurological complications of HIV disease have considerably changed in the last decade. Not only have more opportunistic conditions been described but other complications arising from antiretroviral drugs such as lipodystrophy and accelerated atherosclerosis have become problematic. Moreover, the pattern of complications has altered. Diseases such as cerebral toxoplasmosis, AIDS dementia complex and primary central nervous system lymphoma are now becoming uncommon to rare while peripheral neuropathy is becoming increasingly common. In line with these changes, there have been very significant advances in the therapy of HIV disease in general and in neurological complications in particular. Patients with AIDS dementia complex now have a variety of antiretroviral and adjuvant drugs available to them in contrast to the situation only five years ago where therapy was confined to two antiretroviral drugs at best.

This volume aims at presenting the latest international research and discoveries in the neurocognitive aspects and complications in HIV/AIDS, and how this understanding can shape and inform how we think about clinical practice and patient care in HIV/AIDS as well as lead to a better understanding of the underlying neuropathogenesis. The chapter, "Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders", of this book is available open access under a CC BY 4.0 license at link.springer.com

Living with HIV: A Patient's Guide, Second Edition builds on the success of the first edition by updating and adding critical information that will help the newly diagnosed adjust to their illness and the long-term survivor improve their life and supplement their foundation of HIV knowledge. In addition, new and useful topics have been added including the most complete medication information for even the latest medications to hit the market. The book discusses the growing practice of using HIV medication as a prevention method; PrEP as it is commonly called. Finally, there is essential information needed by those people living with HIV that use the wealth of information on the Internet to help them live a longer, healthier life. The second edition is written in an easy to understand, clear-cut style that makes it easy for anyone; from the long-term patient to the newly infected; to understand what it takes to live a healthy life with HIV.

In Close To The Knives, David Wojnarowicz gives us an important and timely document: a collection of creative essays -- a scathing, sexy, sublimely humorous and honest personal testimony to the "Fear of Diversity in America."

From the author's violent childhood in suburbia to eventual homelessness on the streets and piers of New York City, to recognition as one of the most provocative artists of his generation -- Close To The Knives is his powerful and iconoclastic memoir.

Street life, drugs, art and nature, family, AIDS, politics, friendship and acceptance: Wojnarowicz challenges us to examine our lives -- politically, socially, emotionally, and aesthetically.

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.