I lived in Africa for 17 years and the last half of my time was spent in the field of aid and development where I came in contact with health workers who were dealing with the AIDS epidemic that was just starting. The world’s first known case of AIDS had been traced to a sample of blood plasma from a man who died in the Democratic Republic of Congo in 1959. Derived from simian viruses the human form arrived in the States nine years later. And by 1992 in the US, AIDS became the leading cause of death for men 24-44 years old. By 1999 AIDS became the fourth biggest killer worldwide. When I came back to the States you couldn’t open a paper without seeing something about AIDS. In the past 20 years that has all changed. AIDS is off the front page - gone from the everyday. This is the result of the large global effort that was mounted and seemingly has paid off as world-wide the number of people newly infected with HIV has declined. In addition, the number of people with HIV receiving treatment especially in resource-poor countries has dramatically increased in the past decade.
What has changed over the past few years, as pointed out by another reviewer of Richardson’s book, is that AIDS is no longer an automatic death sentence, “partly because of more widespread scientific knowledge but largely because those who can access antiretroviral drugs (dispensed free to infected men and women in many countries) can often live a normal life.”
Many of the people who appear in her book were infected in the late ‘80’s when a positive diagnosis meant the sudden end of your life. The advice given to these young people had to do with how to cope until the end arrived. This often brought on depression, panic, suicidal thoughts, a denigration of self and a loss of purpose. They soon realized that in order to survive a positive diagnosis, a positive attitude had to be developed quickly. The amazing thing about the book is how each person went about this. In almost every case they had to reach down inside themselves in order to tap into their emotional and psychological reserves, something that took courage and persistence. This is the remarkable thing about the book, by using their own words taken from spoken and written interviews, an intimacy is created that is impossible to ignore. These people open up their hearts and souls and you can’t look away. What impressed myself and other readers is the fortitude shown.
One of the common themes that runs throughout the book is that, as the author says, it is relationships with others which generally sustain people. Another common theme is that people so affected become more aware of what's happening around them, they begin to enjoy simple things in life like sitting in the middle of London watching the red buses go by, waking up and seeing the sunshine, looking at flowers, seasons changing. And as one person put it, “…thinking, God, I've made it –.”
The author reminds us that much that happened in her book refers to the past, but for people in developing countries the book is still as relevant today as it was then. What seems to have been forgotten by the popular press is that back in East and Southern Africa, the epidemic still rages on. The number of people living with HIV in this region continues to increase, even as huge strides are being made to provide access to antiretroviral treatment and to make the affected people aware that they are living with HIV. Almost 7% of the adult population are still HIV positive. Much of the deadliness of the epidemic in Sub-Saharan Africa is caused by a vicious synergy between HIV and tuberculosis. The two diseases have been inextricably bound together since the beginning of the HIV epidemic. Gay men and heterosexual Africans and their children are still faced with many of the dilemmas voiced by the people in this book, in that respect nothing has changed.
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