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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.
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