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Book Review: Textbook of AIDS Medicine, Second Edition

Edited by: Thomas Merigan, John Bartlett, and Dani Bolognesi

Williams and Wilkins, 1998, 1063 pages

Review by Michael Walker

When I originally started writing the "Life, Love, and AIDS" column in Oasis, I predicted this column to serve as a resource for queer youth and perhaps their parents and other concerned adults. At the time, my co-author and I never expected that this effort would become any sort of resource for health care professionals involved in the care of gay youth, people with extensive health expertise but who had only recently come into contact with gay youth (or at least with openly gay youth) and with the effects of AIDS on youth in general. Physicians, nurses, school counselors, school nurses, health educators, and teachers alike wrote to our column almost as often as queer youth did, claiming that they seriously lacked sources of information about queer youth and AIDS. In turn, we tried to provide references, links to other web sites, public agencies, books, and everything else we could think of to help these people help the youth they serve. That was in 1996 and since then a lot has been published about queer youth, their health needs, and about AIDS in adolescents in general, yet there are still few comprehensive resources for those who need broad information about AIDS but who are not located in or affiliated with a major teaching hospital or medical center. The rural doctor, the school nurse in a small high school, the liberal-arts college librarian: all these people are well-intentioned and eager to help, but cannot spend hours searching for information on AIDS-related topics nor can they be expected to buy every single book on all aspects of AIDS or read every medical journal. Besides these professionals, lay-people with a serious interest in understanding the social and biomedical aspects of AIDS have often written in asking for an encyclopedic work on these topics.

So for everyone who needs or desires a truly comprehensive text regarding nearly every aspect of AIDS but focusing most of its attention on clinical aspects of the disease, I can recommend the Textbook of AIDS Medicine, Second Edition. This book was published less than a year ago and is about as current as any medical text on AIDS could be expected to be, thoroughly written with contributions from some of the leading researchers working on the mysteries of AIDS all over the world. This book simply cannot be called brief: it numbers over a thousand pages and is dense in the information it presents, geared towards a primary audience of clinical health care professionals. What I found most remarkable about this book in comparison with other medical books about AIDS is its extensive treatment of prevention, education, and legal issues and the stress it places on social aspects throughout the course of treatment of AIDS in a medical context. The strictly scientific information presented regarding research on the virology and etiology of AIDS and means of treating the disease is breathtaking in its depth, detail, and clarity. While by necessity this book is written in medical prose and geared towards readers with a high literacy of medical terminology, all the chapters read well and clearly, never becoming murky in their presentation and always seemingly aware that different readers shall bring varying experiences and amounts of knowledge about the chapter topics. Given that over one hundred authors contributed to the fifty-eight chapters, the book is very uniform and continuous in its delivery and tone.

Although the bulk of this text is concerned with clinical manifestations of AIDS and related disease-states that would interest physicians and others treating patients, I would like to emphasize the usefulness and significance of the non-clinical, sociological, contributions to this book. Chapters on the epidemiology of HIV sexual transmission (authored by S. Vermund, P. Tabereaux, and R. Kaslow) and on public health aspects of HIV and AIDS (by June Osborn) are excellent and answer a lot of questions that even those who study and work with AIDS in various capacities may often ask. One aspect of AIDS that is less true with other infectious diseases is that AIDS has an expansive social legacy in its wake that brings non-medical professionals into the discourse of the disease. Important contributions to our understanding of how the disease is transmitted via sexual contact and needle-sharing among drug abusers have come from applied sociological research and this is reflected in this text. Far too many clinical textbooks on AIDS circumvent the social side of AIDS medicine and feel that this approach is a great mistake as clinicians not devoted to AIDS medicine (e.g., those in primary care) may only purchase one or two such texts and should be able to turn to these resources for information on all aspects of AIDS prevention and care. The Textbook of AIDS Medicine is the first text I have encountered that really offers up social information in a way that it is useful and pragmatic for clinical professionals.

The more clinical, biomedical, information in the book is also noteworthy because, as I stated before, this information is presented in a clear enough manner (though in technical language, as it must be for its primary readership) that persons other than health care providers can utilize it to deepen their knowledge of AIDS-related topics. I see this as a clear benefit to people such as school counselors who may on occasion have gay youth and other students approach them with more technical questions about AIDS. I also see this as a benefit to those who are AIDS activists and planners of AIDS education and prevention strategies. Much of the more recent controversy in the gay community over AIDS has arisen out of a lack of biomedical knowledge on the behalf of AIDS activists and commentators who have spoken of the mechanisms of transmission of AIDS before really understanding these means of transmission. I hate to make this statement, but it is the truth. No matter how well-intentioned, AIDS activists need to back their passion and profound concern up with accurate facts, and the Textbook of AIDS Medicine is a resource--unlike many popular, secondary, sources of information--that offers medical facts that have been carefully checked and re-checked by professionals for an audience of professionals. While there is still plenty that we do not understand about HIV and AIDS, many of the rumors prevalent in the gay community regarding the disease are plainly myths, and often dangerous ones at that. A higher level of communication between health professionals and activists in our community needs to arise to allow for both greater accuracy and broader understanding of the more technical side of AIDS information. I sincerely hope that The Textbook of AIDS Medicine and books of its nature will help enable that level of communicative discourse.

All in all, this book is a triumph, a placement of information of the highest quality and broadest scope on AIDS into a single volume. It is an example of how medical publishing at the turn of this century still reserves a consummate and authoritative place for a paper textbook in the midst of the digital revolution in information accessibility. The Textbook of AIDS Medicine, Second Edition, should be in every college library and not just medical libraries, but those where undergraduate students and leaders of campus AIDS awareness efforts may find it and it should be made accessible to public school health officials at every level. Although I will admit that it is something of a personal "soapbox" cause of my own, I believe that gay AIDS activists desperately need to become more educated about AIDS in such a way that they can spread their knowledge clearly and accurately to their communities. With a resource like this, there is no reason why anyone with ample determination and patience cannot become aware enough of the many aspects of AIDS and utilize that information in their own way whether as a health professional, educator, activist, or something else entirely to help fight and prevent this disease from claiming more victims.

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MICHAEL WALKER is the Science and Medical Editor of Oasis Magazine. He has also contributed research proceedings, review articles, and essays on queer youth and medical, legal, and social issues that face them to a variety of other popular and academic publications. He can be reached at:MCWalker@hotmail.com


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