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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.

2024 Best Book of the Year Award by the GLBTQ Division of the National Communication Association Finalist for Lambda Literary Award for Best LGBTQ+ Anthology For a generation of gay men who came of age in the 1980s and 1990s, becoming sexually active meant confronting the dangers of catching and transmitting HIV. In the 21st century, however, the development of viral suppression treatments and preventative pills such as PrEP and nPEP has massively reduced the risk of acquiring HIV. Yet some of the stigma around gay male promiscuity and bareback sex has remained, inhibiting open dialogues about sexual desire, risk, and pleasure. A Pill for Promiscuity brings together academics, artists, and activists—from different generations, countries, ethnic backgrounds, and HIV statuses—to reflect on how gay sex has changed in a post-PrEP era. Some offer personal perspectives on the value of promiscuity and the sexual communities it fosters, while others critique unequal access to PrEP and the increased role Big Pharma now plays in gay life. With a diverse group of contributors that includes novelist Andrew Holleran, trans scholar Lore/tta LeMaster, cartoonist Steve MacIsaac, and pornographic film director Mister Pam, this book asks provocative questions about how we might reimagine queer sex and sexuality in the 21st century.

In this book, France's leading medical anthropologist takes on one of the most tragic stories of the global AIDS crisis—the failure of the ANC government to stem the tide of the AIDS epidemic in South Africa. Didier Fassin traces the deep roots of the AIDS crisis to apartheid and, before that, to the colonial period.

This second edition of the book provides up-to-date information on new drugs, new proven HIV prevention interventions, a new chapter on positive prevention, and current HIV epidemiology. This definitive text covers all aspects of HIV/AIDS in South Africa, from basic science to medicine, sociology, economics and politics. It has been written by a highly respected team of South African HIV/AIDS experts and provides a thoroughly researched account of the epidemic in the region.

Why have governments responded to the HIV/AIDS pandemic in such different ways? During the past quarter century, international agencies and donors have disseminated vast resources and a set of best practice recommendations to policymakers around the globe. Yet the governments of developing countries in sub-Saharan Africa, Asia, Latin America, and the Caribbean continue to implement widely varying policies.Boundaries of Contagionis the first systematic, comparative analysis of the politics of HIV/AIDS. The book explores the political challenges of responding to a stigmatized condition, and identifies ethnic boundaries--the formal and informal institutions that divide societies--as a central influence on politics and policymaking. Evan Lieberman examines the ways in which risk and social competition get mapped onto well-institutionalized patterns of ethnic politics. Where strong ethnic boundaries fragment societies into groups, the politics of AIDS are more likely to involve blame and shame-avoidance tactics against segments of the population. In turn, government leaders of such countries respond far less aggressively to the epidemic. Lieberman's case studies of Brazil, South Africa, and India--three developing countries that face significant AIDS epidemics--are complemented by statistical analyses of the policy responses of Indian states and over seventy developing countries. The studies conclude that varied patterns of ethnic competition shape how governments respond to this devastating problem. The author considers the implications for governments and donors, and the increasing tendency to identify social problems in ethnic terms.

This groundbreaking work, with its unique anthropological approach, sheds new light on a central conundrum surrounding AIDS in Africa. Robert J. Thornton explores why HIV prevalence fell during the 1990s in Uganda despite that country's having one of Africa's highest fertility rates, while during the same period HIV prevalence rose in South Africa, the country with Africa's lowest fertility rate. Thornton finds that culturally and socially determined differences in the structure of sexual networks—rather than changes in individual behavior—were responsible for these radical differences in HIV prevalence. Incorporating such factors as property, mobility, social status, and political authority into our understanding of AIDS transmission, Thornton's analysis also suggests new avenues for fighting the disease worldwide.

After Haiti's 2010 earthquake, over half of U.S. households donated to thousands of nongovernmental organizations (NGOs) in that country. Yet we continue to hear stories of misery from Haiti. Why have NGOs failed at their mission?Set in Haiti during the 2004 coup and aftermath and enhanced by research conducted after the 2010 earthquake,Killing with Kindnessanalyzes the impact of official development aid on recipient NGOs and their relationships with local communities. Written like a detective story, the book offers rich enthnographic comparisons of two Haitian women's NGOs working in HIV/AIDS prevention, one with public funding (including USAID), the other with private European NGO partners. Mark Schuller looks at participation and autonomy, analyzing donor policies that inhibit these goals. He focuses on NGOs' roles as intermediaries in \"gluing\" the contemporary world system together and shows how power works within the aid system as these intermediaries impose interpretations of unclear mandates down the chain-a process Schuller calls \"trickle-down imperialism.\"

Fungi are major contributors to the opportunistic infections that affect patients with HIV/AIDS. Systemic infections are mainly with Pneumocystis jirovecii (pneumocystosis), Cryptococcus neoformans (cryptococcosis), Histoplasma capsulatum (histoplasmosis), and Talaromyces (Penicillium) marneffei (talaromycosis). The incidence of systemic fungal infections has decreased in people with HIV in high-income countries because of the widespread availability of antiretroviral drugs and early testing for HIV. However, in many areas with high HIV prevalence, patients present to care with advanced HIV infection and with a low CD4 cell count or re-present with persistent low CD4 cell counts because of poor adherence, resistance to antiretroviral drugs, or both. Affordable, rapid point-of-care diagnostic tests (as have been developed for cryptococcosis) are urgently needed for pneumocystosis, talaromycosis, and histoplasmosis. Additionally, antifungal drugs, including amphotericin B, liposomal amphotericin B, and flucytosine, need to be much more widely available. Such measures, together with continued international efforts in education and training in the management of fungal disease, have the potential to improve patient outcomes substantially.

In 2003, Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which established a 5-year, $15 billion initiative to help countries around the world respond to their AIDS epidemics. The initiative is generally referred to by the title of the 5-year strategy required by the act-PEPFAR, or the President's Emergency Plan for AIDS Relief. PEPFAR Implementation evaluates this initiative's progress and concludes that although PEPFAR has made a promising start, U.S. leadership is still needed in the effort to respond to the HIV/AIDS pandemic. The book recommends that the program transition from its focus on emergency relief to an emphasis on the long-term strategic planning and capacity building necessary for a sustainable response. PEPFAR Implementation will be of interest to policy makers, health care professionals, special interest groups, and others interested in global AIDS relief.

BACKGROUNDThe neonatal immune system is uniquely poised to generate broadly neutralizing antibodies (bnAbs), and thus infants are ideal for evaluating HIV vaccine candidates. We present the design and safety of a new-in-infants glucopyranosyl lipid A-stable emulsion (GLA-SE) adjuvant admixed with a first-in-infant CH505 transmitter-founder (CH505TF) gp120 immunogen designed to induce precursors for bnAbs against HIV.METHODSHIV Vaccine Trials Network 135 is a phase I randomized, placebo-controlled trial of CH505TF plus GLA-SE or placebo. Healthy infants aged ≤5 days, born to mothers living with HIV but HIV nucleic acid-negative at birth, were randomized to 5 doses of CH505TF plus GLA-SE or placebo at birth and 8, 16, 32, and 54 weeks.RESULTSThirty-eight infants (median age 4 days; interquartile range 4-4.75 days) were enrolled November 2020 to January 2022. Among 28 infants assigned to receive CH505TF plus GLA-SE and 10 assigned to receive placebo, most completed the 5-dose immunization series (32/38) and follow-up (35/38). Solicited local and systemic reactions were more frequent in vaccine (8, 28.6% local; 16, 57.1% systemic) versus placebo recipients (1, 10% local, P = 0.25; 4, 40.0% systemic, P = 0.38). All events were grade 1 except 2 grade 2 events (pain, lethargy). Serious vaccine-related adverse events were not recorded.CONCLUSIONThis study illustrates the feasibility of conducting trials of new-in-infants adjuvanted HIV vaccines in HIV-exposed infants receiving standard infant vaccinations. The safety profile of the CH505TF plus GLA-SE vaccine was reassuring.TRIAL REGISTRATIONClinicalTrials.gov NCT04607408.FUNDINGNational Institute of Allergy and Infectious Diseases of the NIH under grants UM1AI068614, UM1AI068635, and UM1AI068618.