In April 2010, Southern Africa HIV/AIDS Information Dissemination Service (SAfAIDS) organised a forum to share experiences on implementing interventions to address HIV and AIDS, sexuality, gender and education. The conference sought to provide a platform for sharing good practices and examining the role of culture in HIV and AIDS prevention and mitigation among participants working in training, home-based care, education, advocacy, lobbying and information production and dissemination, among others. The book is one of the avenues through which key conference outcomes are being shared. It targets professionals involved in an array of projects or programmes in the areas of HIV and AIDS, sexual and reproductive health, gender and education mainly working with NGOs, faith-based organisations (FBOs) and community-based organisations (CBOs). It is also aimed at policy makers and programme managers in governmental institutions, international NGOs (INGOs), UN agencies, media personnel, researchers and teachers. The objective of the book is to empower these target readers with skills to improve the way they implement their programmes.

This book presents models describing HIV transmission rates at population level, discussing the main statistical methods and analytical interventions. It also assesses the practical applicability of the various modelling techniques, offering readers insights into what methods are available and, more importantly, when they should be used to address HIV transmission at global level. The book includes realistic simulation models fitted to clarify the rate of HIV mother-to-child transmission (HIV MTCT), and substantiates the conclusions that can be drawn as well as the appropriate time for making global-level clinical decisions concerning people living with HIV/AIDS (PLHIVs). Intended for students, academics and researchers, the book offers more than just an introduction to the topic - it also features in-depth, yet easy-to-understand, descriptions of a new mathematical/statistical HIV mother-to-child transmission model, making it a useful resource for clinicians, public health workers and policymakers involved in implementing HIV-prevention programmes at national /global level.

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.

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.

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.

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.

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.

This ambitious book provides a comprehensive history of the World Health Organization (WHO) Global Programme on AIDS (GPA), using it as a unique lens to trace the global response to the AIDS pandemic. The authors describe how WHO came initially to assume leadership of the global response, relate the strategies and approaches WHO employed over the years, and expound on the factors that led to the Programme's demise and subsequent formation of the Joint United Nations Programme on HIV/AIDS(UNAIDS). The authors examine the global impact of this momentous transition, portray the current status of the global response to AIDS, and explore the precarious situation that WHO finds itself in today as a lead United Nations agency in global health. Several aspects of the global response - the strategies adopted, the roads taken and not taken, and the lessons learned - can provide helpful guidance to the global health community as it continues tackling the AIDS pandemic and confronts future global pandemics. Included in the coverage: The response before the global response Building and coordinating a multi-sectoral response Containing the global spread of HIV Addressing stigma, discrimination, and human rights Rethinking global AIDS governance UNAIDS and its place in the global response The AIDS Pandemic: Searching for a Global Response recounts the global response to the AIDS pandemic from its inception to today. Policymakers, students, faculty, journalists, researchers, and health professionals interested in HIV/AIDS, global health, global pandemics, and the history of medicine will find it highly compelling and consequential. It will also interest those involved in global affairs, global governance, international relations, and international development.

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.

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.

Drawing on a rich set of interviews and surveys, this book shows how the global AIDS treatment advocacy movement helped millions in the developing world gain access to life-saving medication. The movement achieved this by transforming the market for AIDS drugs from one which was 'low volume, high price' to one based on access for all. The authors suggest that a movement's ability to transform markets depends upon whether: (1) markets are contestable; (2) they have framed their arguments to resonate across their target audiences; (3) the movement itself has a coherent goal; (4) the costs are low, or the benefit-to-cost ratio is favourable; and, finally, (5) institutions are present to reward continued achievement of the new market principle. These insights are applied to a range of other cases including malaria, maternal mortality, water/diarrheal disease, non-communicable diseases, education, climate change, the ivory trade, sex trafficking and the Atlantic slave trade.

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 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.

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.

The advent of AIDS has led to a revival of interest in the historical relationship of disease to society. There now exists a new consciousness of AIDS and history, and of AIDS itself as an historic event. This provides the starting-point of this collection of essays. Its twin themes are the ‘pre-history’ of the impact of AIDS, and its subsequent history. Essays in the section on the ‘pre-history’ of AIDS analyse the contexts against which AIDS should be measured. The section on AIDS as history presents chapters by historians and policy scientists on such topics as British and US drugs policy, the later years of AIDS policies in the UK and the emergence of AIDS as a political issue in France. A final chapter looks at the archival potential in the AIDS area. As a whole the volume demonstrates the contribution that historians can make in the analysis of near-contemporary events.