As global health institutions and aid donors expanded HIV treatment throughout Africa, they rapidly ""scaled up"" programs, projects, and organizations meant to address HIV and AIDS. Yet these efforts did not simply have biological effects: in addition to extending lives and preventing further infections, treatment scale-up initiated remarkable political and social shifts. In Lesotho, which has the world's second highest HIV prevalence, HIV treatment has had unintentional but pervasive political costs, distancing citizens from the government, fostering distrust of health programs, and disrupting the social contract. Based on ethnographic observation between 2008 and 2014, this book chillingly anticipates the political violence and instability that swept through Lesotho in 2014. This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.

Telling the story of a clinical trial testing an innovative gel designed to prevent women from contracting HIV, Negotiating Pharmaceutical Uncertainty provides new insight into the complex and contradictory relationship between medical researchers and their subjects. Although clinical trials attempt to control and monitor participants' bodies, Saethre and Stadler argue that the inherent uncertainty of medical testing can create unanticipated opportunities for women to exercise control over their health, sexuality, and social relationships. Combining a critical analysis of the social production of biomedical knowledge and technologies with a detailed ethnography of the lives of female South African trial participants, this book brings to light issues of economic insecurity, racial disparities, and spiritual insecurities of Johannesburg's townships. Built on a series of tales ranging from strategy sessions at the National Institutes of Health to witchcraft accusations against the trial, Negotiating Pharmaceutical Uncertainty illuminates the everyday social lives of clinical trials. As embedded anthropologists, Saethre and Stadler provide a unique and nuanced perspective of the reality of a clinical trial that is often hidden from view.

This first-person account by one of the pioneers of HIV/AIDS research chronicles the interaction among the pediatric HIV/AIDS community, regulatory bodies, governments, and activists over more than three decades. After the discovery of AIDS in a handful of infants in 1981, the next fifteen years showed remarkable scientific progress in prevention and treatment, although blood banks, drug companies, and bureaucrats were often slow to act. 1996 was a watershed year when scientific and clinical HIV experts called for treating all HIV-infected individuals with potent triple combinations of antiretroviral drugs that had been proven effective. Aggressive implementation of prevention and treatment in the United States led to marked declines in the number of HIV-related deaths, fewer new infections and hospital visits, and fewer than one hundred infants born infected each year. Inexplicably, the World Health Organization recommended withholding treatment for the majority of HIV-infected individuals in poor countries, and clinical researchers embarked on studies to evaluate inferior treatment approaches even while the pandemic continued to claim the lives of millions of women and children. Why did it take an additional twenty years for international health organizations to recommend the treatment and prevention measures that had had such a profound impact on the pandemic in wealthy countries? The surprising answers are likely to be debated by medical historians and ethicists. At last, in 2015, came a universal call for treating all HIV-infected individuals with triple-combination antiretroviral drugs. But this can only be accomplished if the mistakes of the past are rectified. The book ends with recommendations on how the pediatric HIV/AIDS epidemic can finally be brought to an end.

The fifth edition of HIV and Aids: Education, care and counselling covers recent changes and advances in the field of HIV and AIDS treatment and care. These include a new emphasis on education, the latest statistics and the interpretation thereof; new updated biomedical information on vaccine research and testing, drug resistance (HIV and TB) and antiretroviral therapy; the standardised guidelines for antiretroviral treatment as recommended by the South African Department of Health, as well as strategies for adherence counselling. Section on children's law and it implication, and theories of behaviour change are new. The fifth edition contains many practical examples, exercises, activities, case studies and tips to assure full integration of theory and practical. It also comes with a support CD for readers.

The Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB), Division of Service Systems (DSS), is pleased to offer this manual to Ryan White CARE Act Title II grantees and planning bodies. This publication replaces the Ryan White CARE Act Title II Manual that was distributed after the CARE Act was first reauthorized in 1996. On October 20, 2000 Public Law 106-345, reauthorized the Ryan White CARE Act for a second time, with provisions that affect all CARE Act programs. This manual has incorporated all new provisions affecting the Title II program. This manual is intended for the use of grantees, planning bodies and people living with HIV disease. However, we encourage you to share it with colleagues and peers involved in all aspects of the Ryan White Title I program in your area. The manual is designed to encourage local photocopying and distribution: each section has its own cover and chapters that deal with specific topics in depth. Each section, and chapters within them, can be copied and circulated as standalone documents. This manual contains nine sections. Section One, General Information, contains information that is useful to all readers, such as an overview of the CARE Act, CARE Act 2000 legislation, summary of changes to the Title II program, a description of DSS, and an overview of technical assistance for grantees and planning bodies. Section Two, Grants Administration, includes updated information on local administration of the CARE Act as well as guidance on Maintenance of Effort. Section Three, Reporting Requirements, is new for this manual and provides in-depth history and instructions on reports that HAB/DSS requires of grantees, including allocations reports; budgeting, contracting, and fiscal reports; Minority AIDS Initiative (MAI) reports; and the new CARE Act Data Report (CADR). Sample repot forms are included. Section Four, Policies, is a complete list of Program Policy Guidance and Policy Notes that have been issued by HAB and DSS since the inception of the CARE Act. Section Five, Title II Program Categories, outlines program areas under Title II, which are designed to give States flexibility in meeting their needs. Section Six, Planning Bodies, provides materials to help Title II planning entities function more effectively. Section Seven, Coordination, reviews the various ways that Title II can coordinate in planning, funding of services, and service delivery. Section Eight, Program Guidance, presents updated legislation, DSS expectations and implementation suggestions on issues such as: needs assessment, comprehensive planning, quality management, early intervention services, and priority setting and resource allocation. Section Nine, Chief Elected Official Guide, is new for this manual and gives the reader a better understanding of the relationship of the CEO to the grantee and planning bodies. It covers both Title I and Title II CEO duties. Section Ten contains definitions and acronyms and a listing of approved service category definitions. Section Eleven is a listing of HRSA/HAB offices and Title II grantees. Points to Remember: This manual provides a practical, "how to" guide for many aspects of the Title II program. While the hope is that the manual will be a stand alone document, there are other manuals and resources such as the: Title I Manual, CARE Act Needs Assessment Guide, Training Guide: Preparing Planning Body Members, and Self Assessment Modules, as well as other HRSA publications that will supplement the information presented here; A reference list is included at the end of each chapter in the manual. Another excellent source of information and guidance for grantees and planning councils is the HAB website that is continually updated (see http: //hab.hrsa.gov); There will be continual updates and inserts sent to the Title II CARE Act community to keep your manuals as up to date as possible.

State ADAPs function as important components of Title II service systems, yet most State ADAPs are also large and complex enough to merit their own staff resources. As of January 2002, 78 percent of the States have separate individuals (or groups of individuals) administering the Title II program and the State ADAP. Given the unique role of ADAPs in the Ryan White service delivery system, HRSA prepared the ADAP Manual to assist ADAPs with their distinct issues and requirements. The ADAP Manual is meant to complement the information provided in the Ryan White CARE Act Title II Manual. ADAP-specific information from the Title II Manual has been reproduced and, in most cases, has been expanded upon and enhanced. Other areas, such as the Section 340B Drug Discount Program, are unique to the ADAP Manual. All of the information contained in this manual is designed to assist State ADAP coordinators, Title II directors, and others involved with improving access to HIV medications for low-income individuals. Some chapters of the ADAP Manual are taken directly from the Title II Manual. For a comprehensive understanding of the Title II program, however, the two manuals should be used together. Each chapter begins with a chapter summary for quick reference. In addition, each chapter includes a list of sources used and a reference list for further information.

In this collection of essays, Lawrence O. Gostin, an internationally recognized scholar of AIDS law and policy, confronts the most pressing and controversial issues surrounding AIDS in America and around the world. He shows how HIV/AIDS affects the entire population - infected and uninfected - by influencing our social norms, our economy, and our country's role as a world leader. Now in the third decade of this pandemic, the nation and the world still fail to respond to the needs of persons living with HIV/AIDS and continue to tolerate injustice in their treatment, Gostin argues. AIDS, both in the United States and globally, deeply affects poor and marginalized populations, and many U.S. policies are based on conservative moral values rather than public health and social justice concerns. Gostin tackles the hard social, legal, political, and ethical issues of the HIV/AIDS pandemic: privacy and discrimination, travel and immigration, clinical trials and drug pricing, exclusion of HIV-infected health care workers, testing and treatment of pregnant women and infants, and needle-exchange programs. This book provides an inside account of AIDS policy debates together with incisive commentary. It is indispensable reading for advocates, scholars, health professionals, lawyers, and the concerned public.

Preaching Prevention examines the controversial U.S. President's Emergency Plan for AIDS Relief (PEPFAR) initiative to "abstain and be faithful" as a primary prevention strategy in Africa. This ethnography of the born-again Christians who led the new anti-AIDS push in Uganda provides insight into both what it means for foreign governments to "export" approaches to care and treatment and the ways communities respond to and repurpose such projects. By examining born-again Christians' support of Uganda's controversial 2009 Anti-Homosexuality Bill, the book's final chapter explores the enduring tensions surrounding the message of personal accountability heralded by U.S. policy makers. Preaching Prevention is the first to examine the cultural reception of PEPFAR in Africa. Lydia Boyd asks, What are the consequences when individual responsibility and autonomy are valorized in public health initiatives and those values are at odds with the existing cultural context? Her book investigates the cultures of the U.S. and Ugandan evangelical communities and how the flow of U.S.-directed monies influenced Ugandan discourses about sexuality and personal agency. It is a pioneering examination of a global health policy whose legacies are still unfolding.

Caregiving is a long standing tradition in the African American community. This book provides historical and contemporary insight into caregiving. The authors intertwine the African American struggle for dignity and social justice with their discussion of various aspects of caregiving. An overarching theme of the book is the resilience of African Americans in carrying out their caregiving responsibilities. Although disparities are a part of the caregiving landscape, the authors individually and collectively present a rhythm of caregiving that engages the reader in caregiving across the life span. This in depth look at the African American caregiving experience exposes readers to a broader lens, thus avoiding the often overly simplistic view or culturally limited view of their caregiving experience. Caregiving is not limited to any particular groupthe old and the young are a part of the caregiving experience that is discussed in this book. The book is a collaboration between social work programs at Historically Black Colleges and Universities---Howard University (Washington, DC) and Alabama A&M University (Normal, Alabama). The book includes a wide range of content, from caring for older persons with dementia to younger disabled children. The authors/contributors also range in age and experience as caregivers. All of the authors have extensive experience working with African Americans. These are authentic accounts of the caregiving experience within the African American community.