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This chapter discusses an interdisciplinary research program: The Center for AIDS Prevention Studies (CAPS) in San Francisco. CAPS was founded in 1986 with a principal emphasis on primary prevention. One of the first findings reported by researchers was that after a diagnosis of HIV seropositive, men either in nonmonogamous relationships or not in a relationship reported substantial reductions in high-risk but not low-risk sexual behaviors. Another early finding was that the use of recreational drugs during sex, the number of drugs used, and the frequency of combining sex and drugs were all positively associated with risky sexual activity.

This chapter examines the AIDS epidemic and the concomitant political and financial crises in the Republic of Congo. It describes the postcolonial, postsocialist Republic of Congo prior to the 1997 civil war, where borderland was as much metaphoric and situational as geographic and postcolonial, and where the treatment of AIDS patients was virtually impossible. The chapter discusses local ways of managing and curtailing speech about and knowledge of AIDS, and the politics of international health interventions.

Significant attention has been devoted, locally and internationally, to issues raised by South Africa over HIV and AIDS. Politics has taken center stage in the South African response to the AIDS epidemic with the publication of the open letter from President Mbeki. The letter states that whatever lessons may be drawn from the West about the issue of HIV/AIDS, a simple superimposition of the Western experience on African reality is absurd and illogical. An ambitious program to fight AIDS combining information programs, distribution of condoms, treatment of venereal diseases, and campaigns to stop discrimination against patients was launched. The budget initially allocated to AIDS programs amounted to only 20 million rands, but it was announced that it would soon be multiplied by five to include the international aid from the European Union and USAID. It was declared on World AIDS Day, December 1, 1997, Odi stadium, Mabopane, that dying patients willing to take responsibility for their actions should not be prevented from using the still-unapproved Virodene drug.

This chapter deals with the epidemic takeoff of HIV infection in the Black population in the 1990s, a period marked by the transition from Apartheid to a new democratic South Africa and the presidency of Nelson Mandela. Doctors and nurses recall their first cases, the suffering they witnessed, and the deaths they attended. The chapter details the response of medical institutions to the mounting tide of AIDS. As black, white, and Indian doctors and nurses became increasingly alarmed by, but committed to, the care of desperately sick people with HIV, they encountered indifference, if not outright resistance, from colleagues and administrators. Many with clinical responsibilities rejected AIDS patients, being both fearful of infection and wrongly believing that therapeutic measures were useless.

The studies carried out on AIDS in South Africa generally testify to a remarkable presentism. The controversies surrounding AIDS create a privileged framework for the expression and recognition of the violence and injustice. The AIDS epidemic, through its powerfully elusive epidemiological reality and through the verbal inflation surrounding it, represents the overflow that the Truth and Reconciliation Commission was unable to channel. Contagious diseases in many African cities have led to attempts to set up policies of spatial segregation to protect the European population. The history of epidemics is an integral part of the history of racial segregation in South Africa. The risk of contagion has often been the most effective argument to justify the implementation of legal and physical measures initiating or reinforcing the separation of groups that it would have been more difficult politically to justify by strictly biological criteria. Segregationist policies in public health offer the advantage of being a neutral and technical excuse that can even be presented as beneficial for everybody.

This chapter traces the emergence of AIDS in white gay men in Cape Town and Johannesburg in the early and mid-1980s, at a time when therapeutic impotence characterized the clinical response to HIV in Europe and America. After establishing the social and legal status of homosexuality in South Africa, it introduces a number of physicians, many of whom were themselves gay, who watched with astonishment as their young male patients began to die. Despite the denial of the AIDS epidemic by members of the gay community, the discriminatory restrictions on AIDS treatment put in place by hospitals, the homophobia of the medical profession and the indifference of the state, these few gay doctors struggled to treat their patients and to let them die with dignity. As AIDS appeared in the South African Black population, recollections of this earlier epidemic dimmed and disappeared.

This chapter begins with a discussion of the emergence and rapid global spread of AIDS. In 2013, 1.5 million people died of AIDS despite the existence of antiretrovirals. The majority of these deaths occurred in sub-Saharan Africa, where AIDS is the leading cause of death in about half the countries. In Europe and the United States twenty-seven thousand people died from AIDS in 2013, most of whom could have been saved if they had had access to early diagnosis and appropriate treatment. The remainder of the chapter covers how the number of people infected with HIV is estimated; generalized and concentrated epidemics; the diversification of epidemics; the factors that determine the spread HIV; and the achievements made in the global response to AIDS.

This chapter first details the emergence of the AIDS epidemic in the 1980s and the events that galvanized AIDs activism and led to important victories on both the legislative and the scientific fronts. It then describes the emergence of the modern breast cancer activist movement during the period from 1987 through 1992. Though it began slowly, it quickly gained steam and became a formidable social and political force in a very short space of time. Taking note of the successes of militant AIDS activism, breast cancer survivors started forming their own organizations and adopted the direct political action model of AIDS activists. It wasn't long, however, before tensions arose between the two activist communities. In 1990, U.S. government research expenditures were $1.1 billion for AIDS and $77 million for breast cancer. Breast cancer activists condemned this funding discrepancy, given that breast cancer had claimed six times as many lives in the past decade as had AIDS.

In this essay, Berube writes of the need to grieve and mourn as well as to acknowledge the horrific human cost of the AIDS epidemic. At the same time, he takes strong issue with those who try to impose meaning on the tragedy. Some of the responses to AIDS, Berube argues, continued a long historical tradition of scapegoating gay men for their sexual desires. Instead, Berube sees AIDS as “a profound tragedy” and mourns the loss of “our old shelters,” where, through sexual expression, gay men had found warmth, companionship, pleasure, and community. “Caught in the Storm” is the first of several long essays that Berube composed in which he mined his personal experience for broader insights into both the past and the present. Berube published it in Out/Look, a Bay Area publication with a national reach that was founded in 1988, just as the AIDS epidemic was leading to a revival of radical critiques of American society and more militant gay activism.

This introductory chapter argues that HIV/AIDS is not simply a biomedical phenomenon but a complex biosocial occurrence. Much as other incoming trends, beliefs, and practices are reshaped within different cultures, diseases are also changed when they appear in different cultures. As such, it is important to analyze how AIDS is understood, accounted for, acted upon, and experienced in localized contexts. Since the AIDS epidemic is in relatively early stages in Melanesia, most of the accounts in this book are of cultural understandings built on incoming information of various kinds, from official to rumor, rather than on direct experience. Although the presence of AIDS has been felt in the Pacific since 1982, it is only now, when the epidemics there are starting to get out of control, that the issue is being taken seriously and research has begun to increase.

This chapter examines how the AIDS epidemic is being experienced, interpreted, understood, and confronted in Lake Kopiago in the far northwestern corner of Southern Highlands Province. There, AIDS deaths are being attributed to the agency of witches, giving rise to heightened concerns about witchcraft more generally, and are being viewed and talked about as symptomatic of the world's end. Indeed, for the Duna speakers of Lake Kopiago, the AIDS epidemic is unfolding within a cosmology that gives priority to notions of entropic decline by paying particular attention to instances of social, moral, and environmental degradation. The chapter also assesses some assumptions being made about HIV/AIDS.

This chapter focuses on the analysis of the role of grandparents in ageing Sub-Saharan Africa. It observes that Africa is beginning to re-discover and apply what had worked in the past in terms of building tacit intergenerational relationships in an era of globalisation. It focuses on emerging patterns of distorted family relations and their coping strategies with the ‘missing generation’ in the middle as a result of the HIV/AIDS epidemic. It focuses mainly on introducing new trends in grandparenting, while the pandemic is decimating the region's human capital.

This chapter begins with a discussion of the severe AIDS epidemic in Southern Africa. The region accounts for over one third of all people living with HIV in the world, and the nine countries with the highest prevalence in the world are in Southern Africa. Given these sobering statistics, as well as a continued high spread of HIV, the situation can be characterized as “hyperendemic.” The remainder of the chapter covers the vulnerability of women to HIV in Southern Africa; the drivers of hyperendemic HIV; the impact of apartheid and its ramifications on current sexual behavior, and hence the spread of HIV; the role of government policy in curbing HIV infection and death; and progress in the AIDS response in Southern Africa.

This chapter discusses how new forms of Christianity have become a major influence on how the Lelet of central New Ireland comprehends HIV/AIDS. The cultural resources drawn on by the Lelet in making sense of the AIDS epidemic come from their own indigenous culture and also from their long history of contact with Western social forms, ideas, and practices, dating from early in the twentieth century. Thus, they have a long acquaintance with the beliefs and practices of biomedicine, which was introduced in the early days by missionaries. However, having been caught up in the recent wave of charismatic and Pentecostal evangelism, many Lelet now believe that God has the power to heal all afflictions, regardless of their cause.

This introductory chapter discusses the importance of studying the role of Latino GBT activists in the AIDS movement in the United States. Scholars and the general media have overlooked the work and the voices of Latino GBTs in the AIDS movement, creating a void in the history of the AIDS movement, the social sciences, and public health in the United States. This is troubling because ethnic and sexual minorities are currently more affected by the epidemic than their white counterparts, and because the larger Latino population in the United States is less supportive of civil liberties for homosexuals than for whites and African Americans. Indeed, the absence of Latino GBTs' voices hinders one's understanding of how a group already marginalized because of their ethnicity and skin color confronts adversity, such as the AIDS epidemic.

Shilts begins work on And the Band Played On for St. Martin’s Press – despite an initial struggle to find a publisher for the work. Shilts tackles the complexity of writing about an ongoing infectious disease pandemic with an unknown ending. Shilts unveils his thesis that AIDS succeeded because of government neglect, gay leaders public relations concerns, and news media reluctance to cover gay-related issues. Shilts employs “new journalism” techniques to tell the story of AIDS including reconstructed dialogue and internal thoughts. Shilts learns of the existence of a gay man infected with HIV still sexually active. Shilts uncovers and misinterprets the first “cluster study” on KS victims in southern California. Initial criticism of Shilts for “Patient Zero” concept raised.

This chapter addresses failures in healthcare (AIDS and Opioids Epidemics), the economy (Great Depression and Recession), and the environment (Population and Climate). Multi-level analyses are used to provide comparisons across case studies. How these types of domains anticipate and manage failures are briefly reviewed. Surveilling versus controlling failures are contrasted. These insights are used to foreshadow later discussions of failure management.