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This book is about life in the time of the HIV epidemic in Eastern Africa. By tracing the shadow of the epidemic over the last 30 years in Uganda and more broadly in the region, the author explores the impact of the epidemic on people's lives and livelihoods, placing the epidemic within the context of the social, political and economic changes that have occurred over the last three decades. While the story inevitably touches on loss and suffering, the message is also about managing the impact of an epidemic which, at one time, was expected to wipe out communities. When one looks for traces of the in southern Uganda, once thought to be the epi-centre of the epidemic, it is hard to see any lasting impact at a community wide level. Delve deeper and there are scars to be found among some families and some patterns of change that are a direct result of the epidemic. However, that is not the whole story. The book goes on to explore the effect of improved treatment and care on perceptions of the epidemic and the fragile hope that now exists as governments and donors struggle to scale-up anti-retroviral therapy. The threats to this hope are examined not only from drug shortages but also from the signs of rising rates of new infections among some communities in the region. The book concludes by putting HIV into the context of other epidemics, and reflecting on what we can learn from Spanish flu and the Black Death about the lasting impact, or not, of HIV.
By tracing the shadow of the epidemic over the last 30 years in Uganda and more broadly in the region, HIV and East Africa investigates the impact of the epidemic on people's lives and livelihoods, placing the epidemic within the context of the social, political and economic changes that have occurred over the last three decades. Whilst it inevitably touches on loss and suffering, the message is also about managing the impact of an epidemic which has had a profound impact on many lives. When one looks for traces in southern Uganda, once thought to be the epicentre of the epidemic, it is hard to see any lasting impact at a community wide level. Delve deeper and there are scars to be found among families and patterns of change which are a direct result of the epidemic The book goes on to explore the effect of improved treatment and care on perceptions of the epidemic and concludes by putting HIV into the context of other disease outbreaks, reflecting on what we can learn from the history of other epidemics as well as the last 30 years of the HIV epidemic.
 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.
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.
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