Public Health Aspects of HIV/AIDS in Low and Middle Income Countries

It has now been 25 years since the apocryphal report in the CDC Morbidity and Mortality Weekly Report dated June 5, 1981 entitled, “Pneumocystis Pneumonia - Los Angeles”, which announced what was to become HIV/AIDS. HIV has now affected virtually all countries that have looked for it and has had a devastating impact on the public health and medical care infrastructure around the world. HIV/AIDS has also disproportionately affected nations with the least capacity to confront it, especially the developing world nations in Sub-Saharan Africa, South and Southeast Asia, and the emerging republics of Eastern and Central Asia. The pandemic, unlike any other disease of our time, has had profound impacts on the practice of public health itself: bringing affected communities into decision making; demanding North-South partnerships and collaborations; and changing the basic conduct of clinical and prevention trials research. While much has been written in scholarly publications for medical, epidemiologic and disease control specialists, there is no comprehensive review of the public health impact and response to HIV/AIDS in the developing world.

This edited volume seeks to systematically describe the emergence and form of the epidemics (epidemiology), the social, community and political response, and the various measures to confront and control the epidemic, with varying levels of success. Of particular importance are strategies that appear to have been useful in ameliorating the epidemic, while contrasting the situation in a neighboring country or region where contrasting prevention or care initiatives have had a deleterious outcome. Common to all responses has been the international multi-sectoral response represented by the Global Fund for HIV/AIDS, Malaria and Tuberculosis, the President's Emergency Plan for AIDS Relief, and the Gates Foundation, among others, to promote HIV pharmacologic therapy in resource-poor settings. The chapter authors will explore the political challenges in meeting HIV/AIDS prevention and care in concert with the public health realities in specific country and regional context.

• AIDS
• AIDS epidemics
• AIDS prevention
• HIV
• HIV prevention
• HIV/AIDS
• Malaria
• Prevention
• Public Health
• developing countries
• disease prevention
• epidemiology
• primary prevention
• third world
• vaccine

"... A scientifically based account of the current global situation is needed to guide opinion leaders and decision makers in different sectors of society, as well as all those people engaged in activities against HIV/AIDS. ... Public Health Aspects of HIV/AIDS in Low and Middle Income Countries offers just such an account, with the help of many contributors with expert knowledge of the affected countries. The value of the book lies partly in the comprehensive presentation in one volume of up-todate and wide-ranging knowledge and also in its impartiality, since it might be perceived to be more independent than official publications by the UN or governments." -Lars O Kallings, The Lancet, Vol 372

"'Why is the world’s response to AIDS failing?' Public Health Aspects of HIV/AIDS in Low and Middle Income Countries will be an outstanding resource for students, researchers, and public health and medical professionals seeking answers to this crucial question. The book both instructs and challenges readers to learn from the first 25 years of the HIV pandemic and to use this knowledge to shape its future." -R. Scott McClelland, MD, MPH, JAMA, August 5, 2009, Vol 302, No. 5

• Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, USA

  David D. Celentano, Chris Beyrer

David D. Celentano is a Professor in the Department of Epidemiology and Director of the Infectious Diseases Epidemiology Program at the Johns Hopkins Bloomberg School of Public Health. His research integrates behavioral science theory and research with epidemiology, in the study of behavioral and social epidemiology. Celentano is the Principal Investigator of four NIH-supported studies in Thailand, focusing on interventions to influence the association between opiate use, methamphetamine use, and other drugs on HIV.

Chris Beyrer is Associate Professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. He is also the Founder and Director of the Center for Public Health and Human Rights at Johns Hopkins. He is a co-editor of Public Health and Human Rights: Evidence-Based Approaches, to be published in 2006 by Johns Hopkins University Press.

Policies and ethics