The chapters are broadly divided into two types, medical and social/emotional. Since the primary author is the director of the Infectious Diseases Division at the Johns Hopkins Hospital, it is not surprising that the medical sections read better. They cover everything from what types of tests are done to screen for HIV to when to start Highly Active Antiretroviral Therapy (HAART) to what you can expect in terms of care from the various types of health care providers (HMO, private, etc.).
Throughout the sections on the physical aspects of the disease is an underlying pride in the accomplishments of traditional medicine in combating HIV. Numerous mentions are made of past successes with other diseases such as smallpox and polio and much is said of the improved quality of life as a result of HAART. Drawbacks of HAART such as side effects, cost, and stress are given their due, but it is clear that HAART is considered the key to any long-term approach to living with HIV.
Complimentary and alternative treatments are discussed, but the author admits Western (Traditional) medicine does not teach or study them so they are viewed with skepticism and ignorance. Included in the chapter on traditional medical treatment is a useful chart on the commonly prescribed medications for people living with HIV. It gives the cost, conditions for prescription, and important information such as side effects. Given the rate of new medication development this chart is already missing the most recently approved antiretroviral, Tenofovir (Viread). Overall, a person who reads the medical sections will have a good idea of how HIV affects the body and will be able to ask intelligent questions of their doctors or anyone else who treats HIV.
The weaker sections of the book pertain to all the other issues that come with HIV infection. Major concerns like social, emotional, legal, financial, and spiritual issues are addressed and good advice on where to get help is given. My main problem is more the form, not the content. In order to give the disease a human touch, these chapters use eight fictional people who represent most of the major groups of those affected by HIV. Instead of just telling their individual stories to illustrate particular points, you get random quotes on the fear of having people know you are HIV positive, the guilt of potentially exposing a partner, the anger at workplace discrimination and the stress of the financial burden. At points, the quotes have the feel of movie testimonials you see on TV where people are just walking out of the theater and look like they are reading a cue card. Another problem was the coping strategies. After reading this book you are left with the impression that whatever you normally do to cope with stress, simply apply to HIV and it will probably work. This strikes me as simplistic and dangerous. If for no other reason, some people do not cope with everyday life stress effectively much less something as serious as HIV. I think the authors could have gone out on a limb a little more and said something more substantial than hang in there, it will work out. Nevertheless, these chapters do bring up important issues that a person newly affected might not have considered before and where to get help.
Given the overwhelming amount of information that can be discussed regarding HIV, it is inevitable that some things were not covered. The authors concede some issues like children with HIV deserve their own book and were omitted. Somewhat more disappointing was the lack of coverage of women's issues. In the chapter on opportunistic infections, gynecological issues receive a meager one and one half pages. Scary considering the infection rates of women are climbing. In the five page chapter on "What's Ahead" the first four pages reiterate how great HAART is specifically and Western medicine is in general, leaving one page to say we are stuck with HAART and all its limitations for at least the near future if not forever.
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