AIDS: Acquired Immune-Deficiency Syndrome

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Abstract

The AIDS epidemic of the 1980s shone a dark light on the assumptions of contemporary biomedicine. The world was confronted with a disease which it did not understand, could not treat, and which often attacked previously healthy young men. It had echoes of the great plagues of medieval times that decimated the cities of Europe and Asia. Theories abounded about its cause, until it was discovered that a previously unknown retrovirus instigated the destruction of human immune cells. What was particularly challenging about AIDS was its impact on society that extended beyond the usual concerns of biological medicine. Western medicine prided itself on its research methodology and development of new instruments and techniques to study organic processes. What medicine did not do particularly well at the time was to attend to the psychological, social, political, and ethical dimensions of the illness. The onslaught of AIDS altered all of that and forced the biomedical world to broaden its conception of illness and consider elements that went beyond the physical basis of pathology. Every aspect of this illness compelled medicine to ask new questions, challenge old assumptions, and build new collaborative relations with the patients. This article deals with the history of the HIV infection, its clinical manifestations and course, and issues in understanding its virology and immunology. It considers contemporary treatment options and the psychological and economic issues that they generate. It also discusses the neuropsychiatric complications of HIV disease, the psychosocial stressors accompanying the infection, and ethical and policy issues regarding diagnosis and treatment, as well as special problems confronted by minorities, women, care givers and their families, and people living with HIV from resource-limited countries.

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