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Books > Medicine > Clinical & internal medicine > Diseases & disorders > Infectious & contagious diseases > HIV / AIDS
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.
In the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history. Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles." Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH--sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties. Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists.
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.
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.
If, out of the blue, you were given just two weeks to live, how would you feel? What would you do? How would you prepare for the end? Who would you tell - and how? This was the terrible position Roland Chesters found himself in in the late summer of 2006. He knew he was seriously ill - but had no idea he had both HIV and AIDS. Luckily, Roland did not die. Expert medical help and his own determination not to give in saw him through. His life, though, had changed forever... 'Ripples From the Edge of Life' is Roland's account of a life-changing diagnosis and its impact on him and those closest to him. More than a memoir, Roland's story is not unique; ripples spread outwards, and this empowering collection gives voice to fourteen others who have survived similar traumatic diagnoses. This book contains wisdom, hope, humour and inspiration in equal measure. It is an essential read for anyone living with a life-changing condition, and for those who support them.
HIV/AIDS affects women worldwide. Elderly women bear a disproportionate burden of caring for those who are afflicted with the disease, while young women increasingly comprise the majority of new HIV cases. Intervention programs often fail to take into account the particular situations and behaviors that make women more vulnerable than men. Though policy debates increasingly include women and gender considerations, funds and resources for women, especially those already suffering with HIV/AIDS, remain inadequate. "Women's Experiences with HIV/AIDS" gives voice to the experience of individual women whose personal stories reveal the daily struggles and concerns that fill their lives, but are ignored in the larger dialogues about HIV/AIDS. Women and men from diverse backgrounds discuss the differences between women within and across cultures and how particular traditions and attitudes can affect the prevention of, or vulnerability to, HIV/AIDS. The authors address not only women's empirical experiences, but also their personal feelings, beliefs, and expectations as reflected in their narratives. Approaching the issue from several disciplines, "Women's Experiences with HIV/AIDS" paves the way for the empowerment of women by bringing them directly into the debates concerned with their protection against HIV/AIDS. This collection, edited by two well-known scholars in this field, provides a much-needed critical examination of the interventions and policies that do not yet fully address the needs and limitations of women and girls suffering with, or confronting the possibility of, infection.
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.
Like other dangerous but pleasurable activities, such as downhill skiing and mountain climbing, engaging in unprotected sex implicitly involves the weighing of costs and benefits. Recognizing that the transmission of the AIDS virus is a consequence of personal choices - often rational and informed - to engage in risky conduct, the authors employ the tools of economic analysis to reassess the orthodox approach to AIDS by public health specialists. Standard predictions of the spread of AIDS, the authors argue, are questionable because they ignore rational behavioral responses to the risk of infection. For the same reason, customary recommended public health measures, such as extensive testing for the AIDS virus, not only may be ineffective in controlling the spread of the disease but may actually cause it to spread more rapidly. The authors examine regulatory measures and proposals such as mandatory testing, criminal punishments, and immigration controls, as well as the subsidization of AIDS education and medical research, the social and fiscal costs of AIDS, the political economy of the government's response, and the interrelation of AIDS and fertility risk. Neither liberal nor conservative, yet on the whole skeptical about governmental involvement in the epidemic, this book is certain to be controversial, but its injection of hard-headed economic thinking into the AIDS debate is long overdue. Although Private Choices and Public Health is accessible to the interested general reader, it will also capture the attention of economists - especially those involved in health issues - epidemiologists, public health officials, and specialists in sexual behavior and drug addiction.
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.
"Will to Live" tells how Brazil, against all odds, became the first developing country to universalize access to life-saving AIDS therapies--a breakthrough made possible by an unexpected alliance of activists, government reformers, development agencies, and the pharmaceutical industry. But anthropologist Joao Biehl also tells why this policy, hailed as a model worldwide, has been so difficult to implement among poor Brazilians with HIV/AIDS, who are often stigmatized as noncompliant or untreatable, becoming invisible to the public. More broadly, Biehl examines the political economy of pharmaceuticals that lies behind large-scale treatment rollouts, revealing the possibilities and inequalities that come with a magic bullet approach to health care. By moving back and forth between the institutions shaping the Brazilian response to AIDS and the people affected by the disease, Biehl has created a book of unusual vividness, scope, and detail. At the core of "Will to Live" is a group of AIDS patients--unemployed, homeless, involved with prostitution and drugs--that established a makeshift health service. Biehl chronicled the personal lives of these people for over ten years and Torben Eskerod represents them here in more than one hundred stark photographs. Ethnography, social medicine, and art merge in this unique book, illuminating the care and agency needed to extend life amid perennial violence. Full of lessons for the future, "Will to Live" promises to have a lasting influence in the social sciences and in the theory and practice of global 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.
Dawning Answers charts the legacy of the global HIV/AIDS epidemic to the theory and practice of public health. Richly detailed chapters describe how advances in techniques and startegies to monitor health events, develop public policy, set funding priorities, mobilize communities, support the adoption of safer behaviors, ensure access to needed prevention and treatment services, and involve affected populations in public health research, intervention, and evaluation, all owe a substantial debt to those who have adapted, redefined, and extended these techniques and startegies in response to HIV/AIDS. The book offers thoughtful analyses from experts in various fields and disciplines. Although most of the examples reflect the U.S. experience, relevant examples from other countries are cited, and an entire chapter is devoted to the evolving impact of HIV/AIDS on global health and development. Devastating as the losses from AIDS have been, the many public health lessons learned as a result of the epidemic have positively influenced other domains of public health and will continue to exert an influence on new approaches to health assessment, policy development, and assurance.
This groundbreaking book describes the emerging field of theoretical immunology, in particular the use of mathematical models to describe the spread of infectious diseases within patients. It reveals fascinating insights into the dynamics of viral and other infections, and the interactions between infectious agents and immune responses. Structured around the examples of HIV/AIDS and hepatitis B, Nowak and May show how mathematical models can help researchers to understand the detailed dynamics of infection and the effects of antiviral therapy. Models are developed to describe the dynamics of drug resistance, immune responses, viral evolution and mutation, and to optimise the design of therapy and vaccines.
In the 15 years of the acquired immunodeficiency syndrome (AIDS) pandemic much has been learnt about its natural history and complications. It is clear that the lung is a major target organ both for the human immunodeficiency virus (HIV), and a wide array of infectious and non-infectious pulmonary complications. A great deal of information on the epidemiology, microbiology, immunology, clinical features, diagnosis and management of these pulmonary complications has accumulated during the past 15 years. Given the enormous explosion in information, it is now timely to bring together this knowledge in this 25-chapter volume on AIDS and respiratory medicine. The contributors to this volume are prominent epidemiologists, doctors, microbiologists and scientists from Europe, USA and Africa. Professors Chretien and Enarson give a masterful account of the epidemiology of lung complications of HIV. Drs Zumla, Rowland Jones and Professor McMichael give a detailed summary of the lung immune responses to HIV. They outline normal lung defenses and discuss the consequences of HIV infection on them. The pulmonary radiological features of HIV and its complications as seen in the USA and Europe are illustrated by Professors Armstrong and Dee and this is compared and contrasted by Professor Tshibwabwa-Tumba who brings together his vast experience of chest X-rays in AIDS patients from Central Africa. Drs O'Doherty and Miller deal with the uses, and potential applications, of nuclear medicine in imaging of the chest in AIDS patients."
In Viral Sex, leading AIDS researcher Jaap Goudsmit illuminates the origins and nature of the world's most lethal epidemic. This fascinating epidemiological whodunit, or...`howdunit' (The Lancet), takes us on a journey from the African rainforest, to ancient Egypt, to pioneering research labs in the U.S. and Europe. The concept of `viral sex', Goudsmit explains, is central to understanding the AIDS crisis. HIV not only produces offspring that are almost exact copies of the parents, but also reproduces sexually, creating a recombinant population of variants. This `viral sex' gives HIV an edge in adapting to new hosts, enabling it to survive the leap from ape to man. Goudsmit argues that the man-made phenomenon of deforestation and human encroachment on the African monkey habitat provided the opportunity for the SIV virus to jump to its new host, human beings, who then brought HIV out of the Cameroon rainforest at the turn of the century. Provocative, vividly written, and impeccably researched, Viral Sex instills readers with a new sense of the urgent need to contain HIV and other similarly lethal viruses before they spread beyond the grasp of even the most sophisticated science.
This book examines the issues surrounding the growing epidemic of women and children with HIV and AIDS. It explores such issues as discrimination in employment, housing, health care, and education, and looks at medical testing, confidentiality, reproductive freedom, income assistance, child welfare, and child custody. Focusing on the federal and state statutes that protect women and children with HIV and AIDS from discrimination, this book also examines the statutes that govern the operation of the public systems to which significant numbers of women with HIV and AIDS turn to for financial and medical needs, housing assistance, and social services. Clear and accessible, this book is vital reading for anyone interested in learning more about the policies, provisions, and legal concepts surrounding this issue.
Historically, the fields of public health and human rights have remained largely separate. The AIDS pandemic, however, made it clear that a complex relationship exists between the two fields. Women and children have proven to be extremely vulnerable to infection with HIV due to their inability to protect themselves in intimate relationships, their sexual exploitation, and their lack of economic and educational alternatives. On the other hand, coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known or suspected of having AIDS, and decrease the effectiveness of public health measures. Protecting and promoting human rights is becoming one of the key means of preserving the health of individuals and populations. A penetrating analysis of the close relationship between public health and human rights, this book makes a compelling case for synergy between the two fields. Using the AIDS pandemic as a lens, the authors demonstrate that human health cannot be maintained without respect for the dignity and rights of persons, and that human rights cannot be deemed adequate and comprehensive without ensuring the health of individuals and populations. In the course of their analysis, Gostin and Lazzarini tackle some of the most vexing issues of our time, including the universality of human rights and the counter-claims of cultural relativity. Taking a cue from environmental impact assessments, they propose a human rights impact assessment for examining health policies. Such a tool will be invaluable for evaluating real-world public health problems and is bound to become essential for teaching human rights in schools of public health, medicine, government, and law. The volume critically examines such issues as HIV testing, screening, partner notification, isolation, quarantine, and criminalization of persons with HIV/AIDS, all within the framework of international human rights law. The authors evaluate the public health effects of a wide range of AIDS policies in developed as well as developing countries. The role of women in society receives special emphasis. Finally, the book presents three case histories that are important in the HIV/AIDS pandemic: discrimination and the transmission of HIV and tuberculosis in an occupational health care setting; breast feeding in the least developed countries; and confidentiality and the right of sexual partners to know of potential exposure to HIV. The cases challenge readers with some of the complex questions facing policy-makers, scientists, and public health professionals, and exemplify a method for analysing these problems from a human rights perspective. Gostin and Lazzarini have written a book that will be a valuable addition to the libraries of public health teachers and practitioners, legal scholars, bioethicists, policy makers, and public rights activists.
William Clark's At War Within takes us on a fascinating tour through the immune system, examining the history of its discovery, the ways in which it protects us, and how it may bring its full force to bear at the wrong time or in the wrong place. Scientists have only gradually come to realize that this elegant defence system not only has the potential to help, as in the case of smallpox, but also the potential to do profound harm in health problems ranging from allergies to AIDS, and from organ transplants to cancer. Dr Clark discusses the myriad of medical problems involving the immune system, and systematically explains each one, making the complexities of this delicately balanced mechanism comprehensible to the lay reader.
This ground-breaking work is the first book to present a Darwinian perspective on infectious disease. It views disease-producing bacteria and viruses as parasites and explains the history of disease as a host-parasite relationship, one which can evolve in many different ways and with radically different effects on the host population. The author's evolutionary approach is interdisciplinary, drawing on theory and example from the fields of epidemiology, molecular genetics, biochemistry, physiology, evolutionary ecology, and the ecology of populations and communities.
The rapidly proliferating research on the human immunodeficiency
virus (HIV), now well in its second decade, continues to generate
new information at a rate heretofore unparalleled in medicine. As a
direct result, the increasing variety of methods for the
prevention, diagnosis, and treatment of HIV and AIDS has made it
difficult for physicians to keep abreast of the optimal management
approaches in the field. The HIV Manual is an immensely practical,
accessible, and up-to-date summary of the wide range of clinically
relevant information on HIV-infected adults. It deals with the key
issues and frequently encountered problems in HIV clinical care,
and includes a special section on the symptom-based approach to
diagnosis. In addition, this concise reference contains several
chapters discussing topics rarely covered in similar books on the
subject, such as HIV testing, initial evaluation, future anti-HIV
therapies, alternative therapies, and nutrition.
AIDS in the World, Vol. 1, published in 1992, was the first full analysis of mankind's global confrontation with this disease. The AIDS scene, however, spurred by the infusion of enormous monetary allocations, and the participation of thousands of health care professionals, researchers, and social workers, has been changing so rapidly that the need for a second volume was felt much earlier than expected. In AIDS in the World II, the authors extend the international comaprisons from 38 countries to the entire world, and show that the AIDS pandemic has become increasingly fragmented within the world population. They present data that takes the discussion beyond the current understanding of the vulnerability of nations and communities to the worldwide spread of HIV, engaging in a detailed exploration of the social strategies that have enabled individuals to avoid infection. Greater emphasis is placed upon the vulnerabilities of different age and sex groups, such as infants, children and women.
AIDS in the World II charts a course into the future based on a clear analysis of the global pandemic and response, the crucial lessons learned from the first decade, and the understanding of the scientific and social dimensions of the HIV challenge. The book explains how the diversity of reactions to the pandemic has contributed to a more specific understanding of the determinants of our vulnerability to HIV/AIDS, and offers a blueprint for an expanded global prevention effort. Intended to serve the information needs of all professionals involved in AIDS research and care, this volume's accessibility and clarity of writing also make it appropriate for the general reader.
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.
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