HIV/AIDS: Global Frontiers in Prevention/Intervention

Foreword: Peter Aggleton and Richard Parker, "Globalization, Vulnerability, and the response to HIV and AIDS."

Examination of the ways in which a number of key processes associated with globalization in the late 20^th and early 21^st centuries have shaped the HIV epidemic.

Introduction to the Book

1. Cynthia Pope, Renée T. White, and Robert Malow, "Global Convergences: Emerging Issues in HIV Risk, Prevention, and Treatment"

Presents the importance of using an interdisciplinary global approach to conceptualize the complex dynamics that encourage or mitigate HIV prevention, transmission, and treatment and highlighst a structural approach to understanding the spread of HIV worldwide.

Section 1: Evolving Theories of Harm Reduction and HIV risk

1. Framing Essay: Scott Burris, "Addressing the "Risk Environment" for Injection Drug Users: The Mysterious Case of the Missing Cop."
   Using an ecological model, this paper reviews international evidence that laws and law enforcement practices influence risk for Injection Drug Users.
2. Megan Comfort, "HIV/AIDS and the United States’s Correctional Institutions: A Looming Public-Health Disaster."
   Discusses the particular hazards of carceral environments regarding HIV transmission and treatment and how the prevalence of HIV/AIDS in jails and prisons affects public health on a scale far exceeding the millions of individuals residing behind bars.

4) Michael Duke, JiangHong Li, and Merrill Singer. "Drug use, Syringe Sharing and HIV Risk in the People’s Republic of China"
Presents the results of a pilot study of syringe sharing in Guangdong province in the south of China, highlighting how the unique changing economy and social circumstances in China will lead to increasing HIV rates there.

1. Scott Clair, Merrill Singer, Francisco I. Bastos, Monica Malta, Claudia Santelices, and N. Ebertoni. "The Role of Drug Users in the Brazilian HIV/AIDS Epidemic: Patterns, Perceptions and Prevention."

Discusses the role of stereotypes in determining Rio cocaine users’ perceptions of HIV transmission and oral HIV testing.

Section 2: Gender, Sexuality and HIV Risk

2. Framing Essay: Geeta Rao Gupta and Ellen Weiss, "Gender and HIV: Reflecting Back, Moving Forward"
   Reviews the ways in which gender inequalities contribute to women and men’s vulnerability to HIV and discusses key principals for fostering HIV prevention among women and men, and lays out a framework for addressing gender inequalities within the context of HIV prevention programming.
3. Rhonda Rosenberg and Robert Malow, "The Hard Science of Hard Risks in Women’s HIV Prevention: Making Biology Part of the Context."
   Discusses the oft- neglected role of women’s biology, its role in HIV behavioral interventions and the challenges to researchers that are posed by the genomic era.
4. Treena Orchard, John O’Neil, James Blanchard, and Stephen Moses, "HIV/AIDS Prevention programming with ‘traditional’ sex workers in rural India: challenges for the empowerment approach in community-sanctioned sex work communities."
   Describes the cultural systems that produce sex work in Karnataka and Rajasthan, India as a community sanctioned occupation and provides a critical review of prevention programs designed to prevent HIV/AIDS and Sexually Transmitted Infections in these communities.
5. Olena Hankivsky, "The Challenge of HIV/AIDS in Ukraine"
   Provides a brief overview of the history and current HIV/AIDS situation in Ukraine, and analyzes key challenges for moving forward in the fight against HIV/AIDS, especially the need for developing gender sensitive approaches that respond to the unique and growing needs of HIV positive women in the region..
6. Laëtitia Atlani-Duault, "Homosexual Repression and AIDS in Post-soviet Central Asia"

Provides a chronological analysis of key events in the history of male Central Asian homosexuals covering four critical periods. Shows how the HIV/AIDS epidemic aggravated prejudice and discrimination. Yet, the pandemic provided individuals with an extraordinary opportunity to fight for the rights of homosexuals.

7. Hansjörg Dilger, "African Sexualities Revisited: Gender, Social Relations and Culture in the Context of Globalization and AIDS in Tanzania."
   Analyzes how sexuality in Africa is imagined by internationally driven AIDS campaigns and how this fits with the cultural, political, economic, and moral processes that shape the construction of sexualities in specific regions of sub-Saharan Africa.
8. Taigy Thomas, Lianne Urada, Donald Morisky, and Robert Malow,  "Best Practice Example of the Philippines: A Low-Level Prevalence Country and the Male "Bridge" Population"
   In order for the chain of HIV/AIDS transmission to be interrupted in seemingly low risk female populations, prevention strategies to reduce male risk behavior are critical. The Philippines is an example of this successful strategy.

Section 3: Critical Intersections between Biomedicine, Behavior, and HIV

9. Framing Essay:  Sande Gracia Jones, "Looking Inside the Pill Bottle: The Evolution of HIV Antiretroviral Combination Drug Therapy."
   The author describes the evolution of HIV drug therapy from AZT to HAART, from the perspective of both researchers and persons living with HIV; explores past and current issues related to ARV drug resistance and medication adherence; and concludes with a brief discussion of HIV drug therapy in the 21^st century.
10. Laurie Sylla and Clair Kaplan, "Microbicides: Revolutionizing HIV Prevention?"
    Microbicide research investment needs to increase dramatically since the face of the AIDS epidemic is increasingly female. HIV prevention methods should be responsive to women’s unique biological, social, cultural, structural and interpersonal needs.
11. Durvasula, Ramani, Lisa R. Norman, and Robert Malow. "Current Perspectives on the Neuropsychology of HIV"
    Examines the neuropsychology of HIV. Controversial and contemporary issues are highlighted including the impact of HAART on neuropsychology performance in people living with HIV, methodological issues, co-infection with Hepatitis C, and the neuropsychology of HIV in the developing world.
12. Jane Simoni, K. Rivet Amico, Cynthia Pearson, and Robert Malow, "Overview of Adherence to Antiretroviral Therapies"
    Describes the barriers to achieving optimal levels of ARV adherence, theoretical conceptualizations of these barriers, factors facilitating ART adherence, and research on the behavioral strategies evaluated to promote adherence. Jane
13. Jannette Berkley-Patton, "Adherence Masters: Reaching for Perfection in ART Adherence"
    The chapter documents that adherence mastery of an ART treatment plan involves a complex set of behaviors, including maintenance of near-perfect compliance.

 

Section 4: Explorations in New Forms of Intervention and Prevention

14. Framing Essay: Ralph J. DiClemente, Colleen P. Crittenden, Eve S. Rose, and Jessica M. Sales, "Optimizing Prevention and Control of STI/HIV among Adolescents: A Social Contextual Perspective" 
    The threat of acquiring a sexually transmitted infection (STI) is one of the most significant public health risks facing adolescents today. From an economic and social perspective, these infections continue to exact a significant toll on adolescents and society, in general, worldwide.
15. H. Virginia McCoy, Robert Malow, Ruth W. Edwards, Anne Thurland, Rhonda Rosenberg, "Evidence-Based Community Interventions: The Community Readiness Model"
    This chapter discusses the history, methods, and significance of a Community Readiness Model of behavioral risk prevention and presents an application of its use in the U.S. Virgin Islands.
16. Jessy G. Dévieux, Marie-Marcelle Deschamps, Deanne M. Samuels, Michèle M. Jean-Gilles, Gilbert Saint Jean, Lisa Metsch, and Robert Malow, "Barriers to Care among HIV-positive Haitians:  An examination of sociocultural factor."
    This chapter discusses issues surrounding barriers to HIV medical treatment in Haiti by drawing on historical and socio-cultural research.
17. Peter Ibembe, "The Evolution of the ABC Strategy of HIV Prevention in Uganda: state and international impact on public health"  
    This essay presents a health policymakers’ insider view of the much-lauded ABC prevention strategy, and how international donors have influenced the propagation of this model.

Kathy Goggin, Megan Pinkston, Nceba Gqaleni, Thandi Puoane, Douglas Wilson, Jannette Berkley-Patton, and David A. Martinez

18. Kathy Goggin, Megan Pinkston, Nceba Gqaleni, Thandi Puoane, Douglas Wilson, Jannette Berkley-Patton, and David A. Martinez, "The Role of South African Traditional Health Practitioners in HIV/AIDS Prevention and Treatment."
    This chapter provides the first published data demonstrating that South African Traditional Health Providers provide effective prevention and treatment services to HIV-positive and at-risk individuals, THPs are using hematology reports in their practices, and that they are willing to make referrals to allopathic health care.

Section 5: Policies of (In)Justice: Structural Responses to HIV

19. Framing Essay: Renee White, Cynthia Pope, and Robert Malow, "HIV, Public Health, and Social Justice: Reflections on the Ethics and Politics of Health Care"

This essay examines how structural violence has influenced HIV vulnerability and access to heath care and life-saving drugs.

20. Susan Craddock, "AIDS and the Politics of Violence."
    This chapter posits whether calling the AIDS epidemic in Sub-Saharan Africa a genocide is viable. The author posits that it holds the possibility for generating greater visibility to a situation that exists in part because of government response; for holding scientists in the public and private sectors accountable to the downstream implications of their research; and for raising questions about the humanitarian contradictions of intellectual property regulation.
21. Tim Frasca, "Lessons from the Latin American AIDS Epidemic"
    Reviews the successes and failures in the fight against HIV/AIDS in Latin America: particularly governmental response to secondary problems people living with HIV/AIDS face and the need for sexuality education.
22. Ronald Bayer and Gerald Oppenheimer. "Roll-out and Rationing: Providing Anti-retroviral Therapy in South Africa"  
    Presents the ethical and clinical experience of public sector physicians during the post-Apartheid period in South Africa, who were faced with poverty, medical scarcity and government resistance in treating people with HIV. This chapter shows that the onset of the government’s "roll-out" of anti-retroviral therapy (ART) in 2003, providing drugs to public sector patients, has not put an end to the rationing of care that characterized the pre-ART period.
23. Tasleem Padamsee, "Understanding the Making of National HIV/AIDS Policies: The Critical Role of Health Care Institutions in the U.S. and the U.K."
    The formative influence of national healthcare institutions on HIV/AIDS policies is explored here through a comparison of the treatment-related policy choices made by the United States and the United Kingdom since the start of the epidemic.
24. Antonio Estrada and Barbara Estrada, "Barriers to HIV/AIDS Medical Care among HIV Infected Latinos Residing along the U.S.-Mexico Border"
    A lack of health care services and lack of HIV/AIDS trained physicians contribute to the medically underserved nature of the border region. Solutions that involve bi-national cooperation between Mexico and the United States can be successful, but the current dynamics along the US-Mexico border preempt cooperation and the provision of medical care in the area.

 

Section 6: Media and HIV/AIDS

25. Framing Essay: Seth Noar, "The Utility of 'Old' and 'New' Media as Tools for HIV Prevention"
    The chapter discusses the roles that both ‘old’ and ‘new’ media have played in HIV/AIDS prevention, examining the broad literature on HIV/AIDS mass communication campaigns (old media) as well as emerging literature on computer-based interventions, many of which are Internet-based (new media).
26. Kylie Thomas, "HIV/AIDS: Towards a Living History in Post-Apartheid South Africa"
    Exploration of the impact of photojournalist Gideon Mendel’s photographs on the representation and self-presentation of people living with HIV/AIDS in South Africa. Argues that his photographs contested how HIV/AIDS was constructed by state discourse
27. Kriss Barker, "Sex, Soap, and Social Change: The Sabido Methodology."
    Explores the Sabido methodology of disseminating HIV prevention messages and the reasons why this theory-based approach to behavior change communication has been so successful. Why do audiences from the Philippines, to India, from Tanzania to Ethiopia, and from Mexico to Bolivia find these HIV-related dramas irresistible – and much more than merely educating in an entertaining way?
28. Siv Cheng, "A Cambodian Story of a Global Epidemic."

An autobiographical account of a woman living with AIDS since 2000. Currently based in the Capitol Phnom Penh as a Technical Advisor for the Internews Europe Mekong Project, her responsibility is to improve media coverage of the epidemic, particularly to enhance the positive voices in the media.

Section 7: Vulnerable Populations: Conflict, Natural Disaster, and Migration

29. Framing Essay: Paul B. Spiegel and Anne Bennedsen, "The Epidemiology of HIV among Conflict-Affected and Displaced Populations: Current Concepts"
    A call to refashion state response to the needs of displaced persons with HIV/AIDS. Failure to provide comprehensive HIV prevention, care and treatment to these individuals and groups will affect both host populations and the host country.
30. Karla Wagner, Deborah Brief, Melanie J. Vielhauer, Steve Sussman, Terence M. Keane, and Robert Malow, "The Potential for PTSD, Substance Use and HIV Risk Behavior among Adolescents Exposed to Hurricane Katrina"
    A description of the current state of knowledge about the effects of hurricanes, such as Katrina (2006), and similar natural disasters on adolescent psychological well-being, with a particular focus on psychological morbidity and negative health behaviors in the form of Post-Traumatic Stress Disorder, substance use, and HIV-risk behavior.
31. Ezekiel Kalipeni, Joseph Oppong, and Jayati Ghosh, "Africa’s Globalization: The Colonial Labor Economy, Migration and HIV/AIDS"
    The chapter analyzes some of the impacts of globalization on HIV/AIDS in Africa, including internal and international migrant labor flows and the consequences for HIV proliferation, the role of globalization in fostering inequality and poverty in weaker economies, and increasing vulnerability for women and girls.
32. Roger McLean, "Mobile Populations, Vulnerability and HIV/AIDS in a Globalized world – the case of the English speaking Caribbean"
    Addresses HIV/AIDS and migration in the region, with specific reference to those mobile groups classified as high-risk based on their vulnerability to contracting and possibly spreading the virus. This includes commercial sex workers, men who have sex with men, and street children.
33. Heather Culbert, David Tu, Daniel P. O’Brien, Tom Ellman, Clair Mills, Nathan Ford, Tina Amisi, Keith Chan, Sarah Venis, Medecins San Frontieres, "HIV Treatment in a Conflict Setting: Outcomes and Experiences from Bukavu, Democratic Republic of the Congo."
    This article presents outcomes from study in the DRC, looking at HIV in an area of violent political conflict. The authors stress that it is important that HIV prevention and treatment programs not wait until a conflict is over until they mount campaigns.
34. Michael J. Westerhaus, Amy C. Finnegan, Yoti Zabulon, and Joia S. Mukherjee. "Framing HIV Prevention Discourse to Encompass the Complexities of War in Northern Uganda."

The authors propose a human rights approach as a viable model for HIV prevention in northern Uganda. This essay emphasizes that individual behavior modification of HIV prevention must be understood in terms of structural constraints, such as war.

Section 8: Living and Caring for Individuals with HIV/AIDS

35. Framing Essay: Todd Faubion, "Multiplicity of Meaning: Living with HIV/AIDS"
    Captures current writing pertaining to the myriad implications of living with HIV/AIDS and thematic similarities among disparate groups in disparate places around the world. The risk of contracting and suffering from HIV/AIDS relates more to social stressors, such as poverty, gender power imbalances, migration status, low educational attainment, and stigma than to inherent biological risk.
36. Mary Fisher, "A Word to Policymakers and Pilgrims."
    Proposes strategies that utilize coalitions of policymakers and AIDS advocates in the United States in order to devise innovative responses to the AIDS pandemic.
37. Helen Ruth Aspaas. "Mending the Safety Net: Women Community Activists in AIDS-Affected Regions of East Africa."
    Describes how female caregivers in rural East African communities draw on their experiences to function as community organizers and advocates.
38. Jonathan Mayer, "Back to Nima"
    A personal narrative uncovers the daily challenges and rewards of service provision in Nima, Ghana. Work in the field shifts from relationship building to health care to the emotional maintenance needed to be effective to patients.
39. Ami Moore, "Resilience and meaning ascribed to the experiences of care giving to children living with HIV/AIDS in Togo"
    Examines the experiences of caregiving to children with HIV/AIDS in the low income country of Togo, West Africa. The paper examines resilience and the ascribed meanings seropositive parents and seronegative caregivers gave to their experiences as ways of effectively coping with the challenges of caregiving.

Section 9: Globalizing theory on HIV/AIDS: Frameworks for the future

40. Framing Essay: Sam Friedman, "Globalization and Interacting Large-scale Processes and How They May Affect the HIV/AIDS Epidemic"
    Focuses on globalization and other large-scale social and economic processes (such as wars, falling profit rates, sociopolitical transitions, global warming, migration, slummification, and social movements). Illustrates how some of the pathways come to affect different groups of human beings differently and what this tells us about what should be done.
41. Jason Meyers and Robin Kearns, "Feelings, Bodies, Places: New directions for geographies of HIV/AIDS"

Draws on human geography to explore how the diseased body represents a site of struggle and contestation. HIV/AIDS is incorporated into the world of everyday life in which literal place and place in the world (status and identity) are linked to appearance, demeanor, and feelings.

42. Cindy Patton, "‘Scaling Up:’ Managing the Global and the Local in the HIV Pandemic"
    Debates have arisen concerning the efficacy of the World Health Organization’s 3X5 Program to deliver HIV antiretrovirals to three million people by 2005. By focusing on the dissemination of HIV-ARVs and risk reduction education as the two distinct strategies adopted by proponents of the 3X5 Program, the chapter illustrates the challenges inherent in reconciling different frameworks used to translate science into public health policy.
43. Sandra Sufian, "Towards an Interdisciplinary Agenda for Research on HIV/AIDS in the Middle East and North Africa: New Directions for the Age of Globalization"
    The Middle East and North Africa (MENA) is a region where little research has been done and where there is a dire need for more. This chapter calls for strengthening and amplifying interdisciplinary research on HIV/AIDS issues in the Middle East.
44. Vinh-Kim Nguyen. "Viropolitics: How HIV is Producing Globalization"
    The paper anchors the book as it shows how HIV epidemic produces globalization in new ways. Processes of internationalization have shaped how individuals interact as a global community.

Biography

Cynthia Pope is Associate Professor of Geography at Central Connecticut State University and Lecturer in Global Health at Yale University. Her work deals with the intersections of geopolitics, gender, and HIV risk in the developing world, particularly Latin America and the Caribbean.

Renee T. White is Professor of Sociology and co-director of Black Studies at Fairfield University. She is co-editor of the Journal of HIV/AIDS Prevention in Children and Youth. Her research focuses on health disparities, reproductive and AIDS-related social policy, urban inequalities and social justice.

Robert Malow is a Professor of Public Health at Florida International University and is associated editor of AIDS Education and Prevention. He has authored over 150 scientific publications and has led over a dozen National Institutes of Health-funded projects in the area of HIV and substance abuse.

"Cynthia Pope, Renee T. White, and Robert Malow, in collaboration with an interprofessional team of 108 colleagues, offer a compendium of essays and articles that advance our understanding of the complex challenges that HIV/AIDS poses for public health practitioners and public health infrastructure globally. The book includes contributions from professionals, advocates and HIV activists who have made HIV and AIDS their life's work. Contributors include internationally respected experts in their respective fields as well as emerging voices that will carry the dialogue of HIV and its influence on human populations and environments into the future. This book covers emerging issues in HIV risk, prevention, and treatment. It includes sections on (a) evolving theories of harm reduction and HIV risk, (b) gender, sexuality, and HIV risk, (c) critical intersections between biomedicine, behaviour, and HIV, (d) exploration of new forms of intervention and prevention, (e) social structural policy responses to HIV, (f) the role of the media in HIV/AIDS, (g) HIV vulnerabilities and vulnerable populations, (h) living and caring for persons with HIV/AIDS, and a concluding section dedicated to (i) globalizing theory on HIV/AIDS for the future. Each section opens with a framing essay to provide students of public health, related professions, and the lay reader with context for the discussion that unfolds. The editors have skillfully selected exemplars from the broad geographies and perspectives that influence persons affected by HIV disease. Not only does the book discuss the geographical and geopolitical environments around the globe that provide the contexts in which HIV exists and sometimes flourishes, but it also covers the internal geographies of persons living with HIV disease. This internal or human geography highlights the complexities of the interrelationships between host and disease vector and how these factors become more complex when viewed from the spatial and temporal elements of the broader global environments."

-- Craig Phillips, University of British Columbia, Nurse Education Today, January 2009

"In this original edition of HIV/AIDS: Global Frontiers in Prevention/Intervention, Cynthia Pope, Renee T. White, and Robert Malow provide an impressive examination of HIV/AIDS from a historical, social, political, and biomedical perspective while transcending issues of culture, gender, and global impact. By making minimal assumptions about the reader’s knowledge and with an outstanding range of insightful articles, the editors make accessible a comprehensive and highly readable introduction to HIV and AIDS on a global scale…The editors begin with an overview that addresses global convergences and emerging issues in HIV risk, prevention, and treatment. This overview, with its discussion of the importance of using an interdisciplinary and structural approach to the conceptualization of the complex dynamics that encourage or mitigate HIV prevention, transmission, and treatment worldwide, provides the foundation for the remainder of the book. As the title clearly implies, Pope, White, and Malow methodically explore the omnipresent concept of HIV/AIDS from a global viewpoint in terms of evolving theories of harm and risk reduction, gender and sexuality, the interrelationship of biomedicine and behavior, exploration of new forms of intervention and prevention, policies of justice, media and HIV, vulnerable populations, caring for individuals with HIV/ AIDS, and globalizing theory on HIV/AIDS. To achieve this noteworthy and comprehensive goal, the book is divided into nine sections and has a total of 37 chapters. Each section begins with a framing essay that sets the stage for the chapters within the section…The editors conclude this comprehensive overview of the global HIV/AIDS epidemic with a section addressing the concept of a globalizing theory on HIV/ AIDS and frameworks for future prevention and intervention. The last of the nine framing essays focuses on the global impact of the HIV/AIDS epidemic in terms of other large-scale social and economic processes, many of which have been addressed throughout this voluminous text... In this textbook and reference, Pope, White, and Malow have meticulously assembled a resource that offers myriad cutting-edge issues in HIV/AIDS research, policy making, and advocacy from a global perspective… Without question, this book provides a wealth of information and presents a unitary geographical, sociological, and public health frame of reference for the analysis of HIV/AIDS prevention and intervention on a global scale."

-- Eric Fenkl, Visiting Clinical Assistant Professor, Florida International University, Miami, JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. 20, No. 3, May/June 2009

"I would use this book for a general introductory HIV/AIDS course, a more specific HIV/AIDS preventioncourse, or I would use individual sections and chapters for an introductory development or public health course. The section essays will remain temporally relevant even as new developments (such as a possible vaccine and changes in the ebb and flow of international funding) rapidly evolve. Overall, this book offers a solid and provocative foundation for complex problems that biomedical research, social science, and active organizations address. The editors’ determination to encourage interdisciplinary conversations that are practical and timely is evident in each section and each chapter."–Stephanie Brooker, University of Colorado (2010)