As we enter the last decade of the twentieth century, the AIDS epidemic looms ever larger and threatening. The specter of upwards of a million deaths in the United States and perhaps many millions worldwide from a sexually transmitted virus shakes our belief in modem medical science, while challenging the foundations of democratic society. Almost ten years into the epidemic, and with an enormous body of basic science research on the Human Immunodeficiency Virus (HIV), we still do not know why AIDS emerged when it did or how to stop its spread. A very humbling experience for scientists, clinicians, public health experts, politicians, and the general public. Yet there are signs that a well coordinated multidisciplinary research program can conquer the epidemic and, perhaps, provide the basis for preventing future epidemics. The HIV family of viruses is now better understood, both in terms of structure and function, than any other virus. Genetically engineered peptides and nucleic acids are being tested as specific treatments or vaccines against HIV infection/disease. Most prom ising are the strides which have been made in understanding those aspects of human behavior which have contributed to the spread of HIV infection and which must be substantially modified if AIDS is to be controlled and eventually eradicated. The basis of that understanding has roots in a diverse set of disciplines which have converged in the work presented in this book."

Methodological problems have hampered researchers' efforts to understand and control AIDS since the beginning of the epidemic. This practical book addresses these problems by using actual health research case studies to develop strategies regarding design and sampling, measurement, and analysis and modeling issues. Researchers working on both biological and behavioral aspects of the disease will find this work a singularly effective tool to improve their study designs.

This book is intended to educate the primary health care provider about sexually transmitted and related diseases as they present in homosexually active men. But why a book discussing sexually transmitted diseases (STDs) in this population only? Surely STDs are not limited to homosexual males. The relatively high rates of incidence of many of these diseases among homosexually active men, however, and the large number of associated diagnostic and treatment problems have necessitated the collection into one volume of the information that is par ticularly relevant to the primary health care of this population. A book dealing with current trends in the diagnosis and treatment of sexual diseases can, by nature of the task, be neither encyclopedic nor all-encompassing. In this volume, the choice of disease entities and the amount of material included on each are based on consideration of the amount of current information and the relative degree of uniqueness of a given problem in homosexual men, rather than the absolute frequency of the disease. There is, therefore, a considerable amount of material on hepatitis B and gonococcal infections, reflecting the recent explosion of research and clinical investigation in these two areas. In contrast, little is said about nonspecific urethritis, chancroid, and lymphogranuloma ve nereum. In the case of nonspecific urethritis, although it is extremely common in homosexual men, little progress has been made in diagnosis or therapy."

"AIDS is kind of like life, just speeded up. " JavonP., heroinaddictwithAIDS, Bronx, NewYork, 1988 "Now I'm not so much scared of dying as scared of living. " Mike D., heroin addict with AIDS, New Haven, Connecticut, 1998 Within little more than a decade, AIDS has been tranformed from an untreatable, rapidly fatal illness, into a manageable, chronic disease. Most of this tranformation has occurred in the past five years, accelerated by the advent of protease inhibitors and the proven benefits of combination antiretroviral therapy and prophylaxis against opportunistic infections. For people living with HIV/AIDS, these developments have offered unprecedented hope, and also new challenges. As reflected in the quotes above, some of the anxieties and anticipation of premature dying have been replaced by the uncertainties involved in living with a long-term, unpredictable illness. The role of caregivers for people with HIV/AIDS has also changed radically over this time. Earlier in the epidemic, we learned to accompany patients through illness, to bear witness, to advocate, to address issues of death, dying, and - reavement. The arrival of more effective therapy has brought with it new capabi- ties, but also new complexities, raising difficult problems concerning access to care, adherence, and toxicity.

Methodological problems have hampered researchers' efforts to understand and control AIDS since the beginning of the epidemic. This practical book addresses these problems by using actual health research case studies to develop strategies regarding design and sampling, measurement, and analysis and modeling issues. Researchers working on both biological and behavioral aspects of the disease will find this work a singularly effective tool to improve their study designs.

As we enter the last decade of the twentieth century, the AIDS epidemic looms ever larger and threatening. The specter of upwards of a million deaths in the United States and perhaps many millions worldwide from a sexually transmitted virus shakes our belief in modem medical science, while challenging the foundations of democratic society. Almost ten years into the epidemic, and with an enormous body of basic science research on the Human Immunodeficiency Virus (HIV), we still do not know why AIDS emerged when it did or how to stop its spread. A very humbling experience for scientists, clinicians, public health experts, politicians, and the general public. Yet there are signs that a well coordinated multidisciplinary research program can conquer the epidemic and, perhaps, provide the basis for preventing future epidemics. The HIV family of viruses is now better understood, both in terms of structure and function, than any other virus. Genetically engineered peptides and nucleic acids are being tested as specific treatments or vaccines against HIV infection/disease. Most prom ising are the strides which have been made in understanding those aspects of human behavior which have contributed to the spread of HIV infection and which must be substantially modified if AIDS is to be controlled and eventually eradicated. The basis of that understanding has roots in a diverse set of disciplines which have converged in the work presented in this book."

"AIDS is kind of like life, just speeded up. " JavonP. ,heroinaddictwithAIDS, Bronx,NewYork, 1988 "Now I'm not so much scared of dying as scared of living. " Mike D. , heroin addict with AIDS, New Haven, Connecticut, 1998 Within little more than a decade, AIDS has been tranformed from an untreatable, rapidly fatal illness, into a manageable, chronic disease. Most of this tranformation has occurred in the past five years, accelerated by the advent of protease inhibitors and the proven benefits of combination antiretroviral therapy and prophylaxis against opportunistic infections. For people living with HIV/AIDS, these developments have offered unprecedented hope, and also new challenges. As reflected in the quotes above, some of the anxieties and anticipation of premature dying have been replaced by the uncertainties involved in living with a long-term, unpredictable illness. The role of caregivers for people with HIV/AIDS has also changed radically over this time. Earlier in the epidemic, we learned to accompany patients through illness, to bear witness, to advocate, to address issues of death, dying, and - reavement. The arrival of more effective therapy has brought with it new capabi- ties, but also new complexities, raising difficult problems concerning access to care, adherence, and toxicity.