In the global race to reach the end of AIDS, why is the world slipping off track? The answer has to do with stigma, money, and data. Global funding for AIDS response is declining. Tough choices must be made: some people will win and some will lose. Global aid agencies and governments use health data to make these choices. While aid agencies prioritize a shrinking list of countries, many governments deny that sex workers, men who have sex with men, drug users, and transgender people exist. Since no data is gathered about their needs, life-saving services are not funded, and the lack of data reinforces the denial. The Uncounted cracks open this and other data paradoxes through interviews with global health leaders and activists, ethnographic research, analysis of gaps in mathematical models, and the author's experience as an activist and senior official. It shows what is counted, what is not, and why empowering communities to gather their own data could be key to ending AIDS.

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

This volume summarizes recent advances in understanding the mechanisms of HIV-1 latency, in characterizing residual viral reservoirs, and in developing targeted interventions to reduce HIV-1 persistence during antiretroviral therapy. Specific chapters address the molecular mechanisms that govern and regulate HIV-1 transcription and latency; assays and technical approaches to quantify viral reservoirs in humans and animal models; the complex interchange between viral reservoirs and the host immune system; computational strategies to model viral reservoir dynamics; and the development of therapeutic approaches that target viral reservoir cells. With contributions from an interdisciplinary group of investigators that cover a broad spectrum of subjects, from molecular virology to proof-of-principle clinical trials, this book is a valuable resource for basic scientists, translational investigators, infectious-disease physicians, individuals living with HIV/AIDS and the general public.

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.

The real story of AIDS how it originated with a virus in a chimpanzee, jumped to one human, and then infected more than 60 million people is very different from what most of us think we know. Recent research has revealed dark surprises and yielded a radically new scenario of how AIDS began and spread. First recounted in Spillover, which Walter Isaacson called a frightening and fascinating masterpiece, The Chimp and the River is the true account of how an unnoticed chimpanzee infection became a human plague. With a new introduction by the author, David Quammen s hair-raising report tracks the virus from chimp populations in the jungles of southeastern Cameroon to laboratories across the globe, as he unravels the mysteries of when, where, and under what circumstances such a consequential spillover can happen. An audacious search for answers amid more than a century of data, The Chimp and the River tells the haunting tale of one of the most devastating pandemics of our time."

A witch's curse, an imperialist conspiracy, a racist plot-HIV/AIDS is a catastrophic health crisis with complex cultural dimensions. From small villages to the international system, explanations of where it comes from, who gets it, and who dies are tied to political agendas, religious beliefs, and the psychology of devastating grief. Frequently these explanations conflict with science and clash with prevention and treatment programs. In Witches, Westerners, and HIV Alexander Roedlach draws on a decade of research and work in Zimbabwe to compare beliefs about witchcraft and conspiracy theories surrounding HIV/AIDS in Africa. He shows how both types of beliefs are part of a process of blaming others for AIDS, a process that occurs around the globe but takes on local, culturally specific forms. He also demonstrates the impact of these beliefs on public health and advocacy programs, arguing that cultural misunderstandings contribute to the failure of many well-intentioned efforts. This insightful book provides a cultural perspective essential for everyone interested in AIDS and cross-cultural health issues.

The world continues to lose more than a million lives each year to the HIV epidemic, and nearly two million individuals were infected with HIV in 2017 alone. The new Sustainable Development Goals, adopted by countries of the United Nations in September 2015, include a commitment to end the AIDS epidemic by 2030. Considerable emphasis on prevention of new infections and treatment of those living with HIV will be needed to make this goal achievable. With nearly 37 million people now living with HIV, it is a communicable disease that behaves like a noncommunicable disease. Nutritional management is integral to comprehensive HIV care and treatment. Improved nutritional status and weight gain can increase recovery and strength of individuals living with HIV/AIDS, improve dietary diversity and caloric intake, and improve quality of life. This book highlights evidence-based research linking nutrition and HIV and identifies research gaps to inform the development of guidelines and policies for the United Nations' Sustainable Development Goals. A comprehensive approach that includes nutritional interventions is likely to maximize the benefit of antiretroviral therapy in preventing HIV disease progression and other adverse outcomes in HIV-infected men and women. Modification of nutritional status has been shown to enhance the quality of life of those suffering HIV/AIDS, both physically in terms of improved body mass index and immunological markers, and psychologically, by improving symptoms of depression. While the primary focus for those infected should remain on antiretroviral treatment and increasing its availability and coverage, improvement of nutritional status plays a complementary role in the management of HIV infection.

Efforts within the past decade to address the HIV/AIDS pandemic in sub-Saharan Africa have dealt with HIV/AIDS principally as a medical concern-despite the fact that doctors continue to be confronted with the complex relationship of the disease to broader social issues. When medical and governmental institutions fail, artists step in. Contemporary performances in Uganda often focus on gender and health-related issues specific to women and youths, in which song texts warn against risky sexual environments or unprotected sexual behavior. Music, dance, and drama are principal tools of local initiatives that disseminate information, mobilize resources, and raise societal consciousness regarding issues related to HIV/AIDS. Through case studies, song texts, interviews, and testimonies, Singing for Life: HIV/AIDS and Music in Uganda examines the links between the decline in Uganda's infection rate and grassroots efforts that make use of music, dance, and drama. Only when supported and encouraged by such performances drawing on localized musical traditions have medical initiatives taken root and flourished in local healthcare systems. Gregory Barz shows how music can be both a mode of promoting health and a force for personal therapy, presenting a cultural analysis of hope and healing.

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

For young gay men who came of age in the United States in the 1980s, the HIV/AIDS epidemic was a formative experience in fear, hardship, and loss. Those who were diagnosed before 1996 suffered an exceptionally high rate of mortality, and the survivors-both the infected individuals and those close to them-today constitute a "bravest generation" in American history. The AIDS Generation: Stories of Survival and Resilience examines the strategies for survival and coping employed by these HIV-positive gay men, who together constitute the first generation of long-term survivors of the disease. Through interviews conducted by the author, it narrates the stories of gay men who have survived since the early days of the epidemic; documents and delineates the strategies and behaviors enacted by men of this generation to survive it; and examines the extent to which these approaches to survival inform and are informed by the broad body of literature on resilience and health. The stories and strategies detailed here, all used to combat the profound physical, emotional, and social challenges faced by those in the crosshairs of the AIDS epidemic, provide a gateway for understanding how individuals cope with chronic and life-threatening diseases. Halkitis takes readers on a journey of first-hand data collection (the interviews themselves), the popular culture representations of these phenomena, and his own experiences as one of the men of the AIDS generation. This riveting account will be of interest to health practitioners and historians throughout the clinical and social sciences-or to anyone with an interest in this important chapter in social history.

Almost four decades after the discovery of HIV/AIDS, the world continues to grapple with this public health challenge. Thinking Differently about HIV/AIDS explores the limits of mainstream approaches to the HIV/AIDS epidemic and challenges readers to develop alternate solutions, emphasizing the value of critical social science perspectives. The contributors investigate traditions of inquiry - governmentality studies, institutional ethnography, and Indigenous knowledges, among others - to determine what these perspectives can bring to HIV/AIDS research, policy, and programming. Ultimately, this book demonstrates how and why critical social science is necessary for rethinking research and action required to address the epidemic.

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.

In Virus Hunt, renowned virologist Dorothy H. Crawford takes us inside one of the great research quests of our time--the search for the origin of AIDS. From hospital intensive care wards to research laboratories to the African rain forests, Crawford follows the trail of the virus back to its roots deep in Africa. We track wild monkeys and apes through the jungle--gathering their DNA via hair and feces samples--to discover from which primates HIV first jumped to our species, ultimately concluding that the most virulent strain, HIV-1, came from chimpanzees in Cameroon. We then time travel back to colonial Africa around the turn of the 20th century, when the virus first spread to humans. But even the rapidly mutating HIV could not survive in one person long enough to adapt to our immune system. Crawford shows that it may have been given the opportunity to adapt by being transmitted rapidly from one person to the next through unsterile syringes, ironically used during a campaign to wipe out disease by mass inoculation. The book then moves to Leopoldville (now Kinshasa), where Crawford describes the unique series of social upheavals, starting in the 1920s, that sparked epidemic levels of sexually transmitted diseases, allowed HIV-1 to begin its exponential growth. And when in the 1960s chance took the virus abroad to Haiti, from where it jumped to the United States, its pandemic spread began. Crawford tells a gripping story of brilliant scientific sleuthing, breakthrough discoveries, tragic errors, stubborn intractable mysteries, generous collaborations, and bitter disputes. And along the way, she conveys, with a light and engaging touch, a wealth of interesting observations about viruses, DNA, disease, immune systems, the very latest research methods, and of course HIV.

Since the early days of the AIDS epidemic, many bizarre and dangerous hypotheses have been advanced to explain the origins of the disease. In this compelling book, Nicoli Nattrass explores the social and political factors prolonging the erroneous belief that the American government manufactured the human immunodeficiency virus (HIV) to be used as a biological weapon, as well as the myth's consequences for behavior, especially within African American and black South African communities. Contemporary AIDS denialism, the belief that HIV is harmless and that antiretroviral drugs are the true cause of AIDS, is a more insidious AIDS conspiracy theory. Advocates of this position make a "conspiratorial move" against HIV science by implying its methods cannot be trusted and that untested, alternative therapies are safer than antiretrovirals. These claims are genuinely life-threatening, as tragically demonstrated in South Africa when the delay of antiretroviral treatment resulted in nearly 333,000 AIDS deaths and 180,000 HIV infections-a tragedy of stunning proportions. Nattrass identifies four symbolically powerful figures ensuring the lifespan of AIDS denialism: the hero scientist (dissident scientists who lend credibility to the movement); the cultropreneur (alternative therapists who exploit the conspiratorial move as a marketing mechanism); the living icon (individuals who claim to be living proof of AIDS denialism's legitimacy); and the praise-singer (journalists who broadcast movement messages to the public). Nattrass also describes how pro-science activists have fought back by deploying empirical evidence and political credibility to resist AIDS conspiracy theories, which is part of the crucial project to defend evidence-based medicine.

The study of viruses necessarily involves dissecting the intimate details of cellular pathways. Viruses have often been employed as tools in studying cellular pathways, as was done by early retrovirologists such as Peyton Rous in attempting to understand the mechanism of cellular transformation and oncogenesis. On the other side of the coin, virologists seek to de?ne those cellular elements interacting intimatelywiththeir virus ofinterestinorder to better understand viral replication itself, and in some cases to develop antiviral strategies. It is in the intersection of virology and cell biology that many of us ?nd the most rewarding aspects of our research. When a new discovery yields insights into basic cellular mechanisms and presents new targets for int- vention to ?ght a serious pathogen, the impact can be high and the excitement intense. HIV has been no exception to the rule that viruses reveal many basic aspects of cellular biology. In recent years, in part because of the importance of HIV as a major cause of human suffering, numerous cellular processes have been elucidated through work on processes or proteins of this human retrovirus. The excitement in this ?eld is especially well illustrated by the discovery of new innate means of resisting viral replication, such as the work on APOBEC3G, TRIM5a, and BST-2/ tetherin presented in this volume.

The Culture of AIDS in Africa enters into the many worlds of expression brought forth across this vast continent by the ravaging presence of HIV/AIDS. Africans and non-Africans, physicians and social scientists, journalists and documentarians share here a common and essential interest in understanding creative expression in crushing and uncertain times. They investigate and engage the social networks, power relationships, and cultural structures that enable the arts to convey messages of hope and healing, and of knowledge and good counsel to the wider community. And from Africa to the wider world, they bring intimate, inspiring portraits of the performers, artists, communities, and organizations that have shared with them their insights and the sense they have made of their lives and actions from deep within this devastating epidemic.
Covering the wide expanse of the African continent, the 30 chapters include explorations of, for example, the use of music to cope with AIDS; the relationship between music, HIV/AIDS, and social change; visual approaches to HIV literacy; radio and television as tools for "edutainment;" several individual artists' confrontations with HIV/AIDS; various performance groups' response to the epidemic; combating HIV/AIDS with local cultural performance; and more. Source material, such as song lyrics and interviews, weaves throughout the collection, and contributions by editors Gregory Baz and Judah M. Cohen bookend the whole, to bring together a vast array of perspectives and sources into a nuanced and profoundly affective portrayal of the intricate relationship between HIV/AIDS and the arts in Africa.

Winner, 2021 Joseph W. Elder Prize in the Indian Social Sciences Winner, 2021 Ruth Benedict Prize, Association for Queer Anthropology Hijras, one of India's third gendered or trans populations, have been an enduring presence in the South Asian imagination-in myth, in ritual, and in everyday life, often associated in stigmatized forms with begging and sex work. In more recent years hijras have seen a degree of political emergence as a moral presence in Indian electoral politics, and with heightened vulnerability within global health terms as a high-risk population caught within the AIDS epidemic. Hijras, Lovers, Brothers recounts two years living with a group of hijras in rural India. In this riveting ethnography, Vaibhav Saria reveals not just a group of stigmatized or marginalized others but a way of life composed of laughter, struggles, and desires that trouble how we read queerness, kinship, and the psyche. Against easy framings of hijras that render them marginalized, Saria shows how hijras makes the normative Indian family possible. The book also shows that particular practices of hijras, such as refusing to use condoms or comply with retroviral regimes, reflect not ignorance, irresponsibility, or illiteracy but rather a specific idiom of erotic asceticism arising in both Hindu and Islamic traditions. This idiom suffuses the densely intertwined registers of erotics, economics, and kinship that inform the everyday lives of hijras and offer a repertoire of self-fashioning beyond the secular horizons of public health or queer theory. Engrossingly written and full of keen insights, the book moves from the small pleasures of the everyday-laughter, flirting, teasing-to impossible longings, kinship, and economies of property and substance in order to give a fuller account of trans lives and of Indian society today.

Quantitative Methods in HIV/AIDS Research provides a comprehensive discussion of modern statistical approaches for the analysis of HIV/AIDS data. The first section focuses on statistical issues in clinical trials and epidemiology that are unique to or particularly challenging in HIV/AIDS research; the second section focuses on the analysis of laboratory data used for immune monitoring, biomarker discovery and vaccine development; the final section focuses on statistical issues in the mathematical modeling of HIV/AIDS pathogenesis, treatment and epidemiology. This book brings together a broad perspective of new quantitative methods in HIV/AIDS research, contributed by statisticians and mathematicians immersed in HIV research, many of whom are current or previous leaders of CFAR quantitative cores. It is the editors' hope that the work will inspire more statisticians, mathematicians and computer scientists to collaborate and contribute to the interdisciplinary challenges of understanding and addressing the AIDS pandemic.

Though more than 150,000 AIDS-related deaths have been reported worldwide and between 5 and 10 million people are now infected with its precursor, HIV-1, the deadly and relatively new AIDS virus is still a mystery. AIDS and the Social Sciences: Common Threads, an enlightening examination of the AIDS epidemic from the viewpoints of various social sciences, provides us with clues to that mystery. The essays' original research and firsthand accounts from social scientists offer an excellent overview of the research agendas and directions for a disease that is an increasing presence in our society. Sociologists, geographers, anthropologists, psychologists, social workers, and people in government agencies converge in this book to discuss the social, political, economic, legal, moral, and ethical issues related to AIDS. Their methods of approaching the study of AIDS range from a case study approach to survey research to participant observation. Among the topics examined in this distinctive collection are the geographic origins of AIDS, the psychosocial aspects of AIDS, the impact of AIDS on women and children, and the federal funding patterns of AIDS-related research. One chapter traces the diffusion of the pandemic in major urban areas, smaller cities, and finally rural America. Another documents the devastating impact the disease has had on central and East Africa, some areas of which have as many as one in four adults who are HIV-infected. AIDS and the Social Sciences could serve as a primary or supplemental text for college courses and is an important resource for anyone interested in social science or public health.

Today, AIDS has been indelibly etched in our consciousness. Yet it was less than twenty years ago that doctors confronted a sudden avalanche of strange, inexplicable, seemingly untreatable conditions that signaled the arrival of a devastating new disease. Bewildered, unprepared, and pushed to the limit of their diagnostic abilities, a select group of courageous physicians nevertheless persevered. This unique collective memoir tells their story.

Based on interviews with nearly eighty doctors whose lives and careers have centered on the AIDS epidemic from the early 1980s to the present, this candid, emotionally textured account details the palpable anxiety in the medical profession as it experienced a rapid succession of cases for which there was no clinical history. The physicians interviewed chronicle the roller coaster experiences of hope and despair, as they applied newly developed, often unsuccessful therapies. Yet these physicians who chose to embrace the challenge confronted more than just the sense of therapeutic helplessness in dealing with a disease they could not conquer. They also faced the tough choices inherent in treating a controversial, sexually and intravenously transmitted illness as many colleagues simply walked away. Many describe being gripped by a sense of mission: by the moral imperative to treat the disempowered and despised. Nearly all describe a common purpose, an esprit de corps that bound them together in a terrible yet exhilarating war against an invisible enemy.

This extraordinary oral history forms a landmark effort in the understanding of the AIDS crisis. Carefully collected and eloquently told, the doctors' narratives reveal the tenacity and unquenchable optimism that has paved the way for taming a 20th-century plague.