AIDS and the Distribution of Crises

Shruti Varadarajan, MD

Fam Med. 2022;54(5):402-403.

DOI: 10.22454/FamMed.2022.418837

Book Title: AIDS and the Distribution of Crises

Authors: Jih-Fei Cheng, Alexandra Juhasz, Nishant Shahani

Publication Information: Durham, NC, and London, UK, Duke University Press, 2020, 336 pp., $28.95, paperback

AIDS and the Distribution of Crises is a curated collection of perspectives and scholarly work on the past, present, and future of the global AIDS crises. The volume is presented with an introduction, 13 chapters, and an afterword. In these 13 chapters, the volume lays out the connections and history of AIDS in relation to racism, sexism, homo- and transphobia, global capitalism and colonialism. The editors of the volume are each academics and longtime AIDS activists who found common ground in their work and wanted to share broad perspectives on the past, present, and future of the AIDS pandemic in the context of the global political environment. The topics and perspectives presented are stirring, and inspire readers to explore further by watching the referenced documentaries or reading related scholarly work. This is not a book to sit down and read from cover to cover, but rather to read a chapter or section then reflect and explore the topics further before going to the next section. Each chapter is rich with resources embedded in the reading as well as footnotes and a bibliography.

This volume makes it clear that when it comes to the global AIDS crises, things are not as they seem, and things are not and have not been as they have been portrayed by the media and scholarly work. This volume sets to dispel the all-too-common notion that the development of antiretroviral therapy has made AIDS a crisis of the past. As we read through the passages, we see that in many ways and forms this crisis is manifesting globally and locally today. Additionally, women and people of color have often been completely left out of the history of HIV/AIDS crises, and this volume seeks to correct this inequity of media and scholarly coverage. Any of us in the health care field who interact with patients, work in health policy, teach or work with future physicians or learners, or are interested in global health should read this compilation. The writing is illuminating, engaging and eye-opening.

One of the most unique and interesting aspects of this volume is the inclusion of “Dispatches.” These are three chapters spread out through the volume, in which readers see a collection of responses to a question posed to the experts in the field. These dispatches are asynchronous discussions between activists, scholars, journalists, and artists. They highlight, rather than smooth over, the various opinions and perspectives on the topics presented. The first of the dispatches discusses the globalization of the AIDS crisis, and the responses range from a passage about AIDS in the Soviet Union in 1985 to the effects of pharmaceutical companies on the experience and treatment of AIDS and the local and global power pharmaceutical companies have over the crisis. The second dispatch discusses the revisitation of the commonly known story of the emergence of the AIDS crises and the globalization of AIDS. With the third dispatch at the end of the volume, the editors focus on the future of AIDS activism in the political environment of 2018. The responses are about regrouping and forging ahead with activism while acknowledging the toll it takes on the activists themselves.

As readers move through the other chapters, they will find immersive stories that were previously left out of the common narrative of the AIDS pandemic. One such passage shares how early internet regulation in the mid-1990s in the United States had the consequence of blocking safe sex education and online AIDS activism. The writer recalls that the court case to amend this regulation absurdly, although not surprisingly, involved the witness needing to explain to a judge what the internet was and how it worked! Many chapters address the misconception that the advent of antiretrovirals solved the AIDS crises by taking the reader into stories of the AIDS crisis in full bloom. Other chapters highlight the ways in which women and people of color are ignored and uncounted in published statistics and how different the history is when they are included.

Overall, as I read through this volume, I found the narrative that I had in my mind of the AIDS crises evolving with the new information and perspectives shared and highlighted by the editors. This broader, more inclusive narrative has inspired me to a more inclusive approach to the practice of medicine.

Lead Author

Shruti Varadarajan, MD

Affiliations: Baylor College of Medicine Department of Family and Community Medicine, Houston, TX

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