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The Epidemic: A Global History of AIDS
From the Castro bathhouses to AZT and the denial of AIDS in South Africa, this sweeping look at AIDS covers the epidemic from all angles and across the world. Engel seamlessly weaves together science, politics, and culture, writing with an even hand—noting the excesses of the more radical edges of the ACT UP movement as well as the conservative religious leaders who thought AIDS victims deserved what they got. The story of AIDS is one of the most compelling human dramas of our time, both in its profound tragedy and in the extraordinary scientific efforts impelled on its behalf. For gay Americans, it has been the story of the past generation, redefining the community and the community's sexuality. For the Third World, AIDS has created endless devastation, toppling economies, social structures, and whole villages and regions. And the worst may yet be to AIDS is expanding quickly into India, Russia, China, and elsewhere, while still raging insub-Saharan Africa. A distinguished medical historian, Engel lets his characters speak for themselves. Whether gay activists, government officials, public health professionals, scientists, or frightened parents of schoolchildren, they responded as best they could to tragic happenstance that emerged seemingly from nowhere. There is much drama here, and human weakness and heroism too. Writing with vivid immediacy, Engel allows us to relive the short but tumultuous history of a modern scourge.
400 pages, Hardcover
First published January 1, 2006
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November 18, 2016
I do not recommend this book as a comprehensive history of the AIDS pandemic, as promised in the title, and still less as an introduction to the subject. Engel, a graduate of Yale's history of medicine program, covers an interesting spread of issues, but at least a moderate amount of background reading on HIV/AIDS, particularly the early history of the disease in the US, is absolutely essential for wading through this decidedly mixed-bag. The book suffers from a muddled treatment of important subjects and occasionally alarming lapses in basic research.
The author’s discussion of Reagan’s handling of the nascent AIDS epidemic falls into the first category. Engel sketches Reagan’s record in almost entirely laudatory terms. At worst, the president is portrayed as tone-deaf in his long failure to overtly acknowledge the crisis, but with his heart essentially in the right place. Engel dispenses with the prevailing negative assessment of Reagan with one sentence blaming inter-agency fighting over the allegedly copious funding for AIDS research. As anyone who has read Randy Shilts’ And the Band Played On knows, such inter-agency squabbling certainly existed at stultifying levels. It does not, however, explain Reagan’s willfully lackadaisical and dismissive stance during the early years of the epidemic. Engel also does not make clear how difficult it was for scientists in the trenches to obtain a slice of the much-contested funding. Bewilderingly, after apparently exonerating Reagan, Engel declares in his conclusion on the subject that Reagan’s record on AIDS is actually “middling to poor” and finally mentions the president’s “latent homophobia.” Better late in the discussion than never, I guess?
Even more troublingly, on the second page of this book I hit a glaring medical error. Engel reverses the ordinary pathologies of pneumocystis carinii pneumonia (PCP) and the skin cancer Kaposi’s sarcoma (KS). Both these conditions were common in early cases of AIDS and were included in the official diagnostic criteria for the disease. It was an unusual spike in requests for the medication to treat PCP that initially alerted the CDC that something strange and new was unfolding. So inseparable from the early ravages of AIDS was KS that it famously came to be called “gay cancer." Point being, the basic details on these conditions can be found in almost any source that covers the early history of AIDS. This book is not primarily concerned with the clinical aspects of AIDS, but reversing the simple descriptions of seminal conditions associated with the disease is shockingly sloppy.
Engel’s depiction of celebrated AIDS activist Larry Kramer manages to highlight all this book’s problems. Kramer was a divisive figure in the 1980s, but is now acknowledged as one of the prescient heroes of the early AIDS fight. While Engel must concede Kramer’s outsized role in efforts to assist AIDS victims and draw attention to their plight, his discussion is constantly tempered by strangely disparaging asides. Engel seems determined to strike out against received opinion in a misjudged bid to appear even-handed-- a recurring problem with his entire account of the disease in the US. Considering how prominent a figure Kramer cuts in this and any chronicle of early AIDS history, you’d think Engel would manage to get the basic details of his life correct. In referencing Kramer’s famous op-ed “1,112 and Counting,” however, Engel mistakenly places the date of Kramer’s own infection in 1983, the year of the article's publication, rather than in 1988. As a result, he mischaracterizes Kramer’s work as the product of intense frustration “at the inability of the government to cure him, or even define his illness;” that is, as essentially selfishly motivated, instead of as the desperate and angry appeal of a man contemplating the decimation of his community. By getting wrong this well-known fact, Engel completely changes the tone of one of the early epidemic's most fundamental works. Again, shockingly sloppy and illustrative of the agenda that Engel brings to bear on the material.
I found Engel’s treatment of the pandemic in Africa and Asia better than his chapters on the US, but this could very well be because I am less well-versed in the history of the disease in these places and therefore could not readily spot where he went astray. His discussion of the rest of the world is also a broader overview and so lacks many of the fine details he gets wrong on the US side.
The author’s discussion of Reagan’s handling of the nascent AIDS epidemic falls into the first category. Engel sketches Reagan’s record in almost entirely laudatory terms. At worst, the president is portrayed as tone-deaf in his long failure to overtly acknowledge the crisis, but with his heart essentially in the right place. Engel dispenses with the prevailing negative assessment of Reagan with one sentence blaming inter-agency fighting over the allegedly copious funding for AIDS research. As anyone who has read Randy Shilts’ And the Band Played On knows, such inter-agency squabbling certainly existed at stultifying levels. It does not, however, explain Reagan’s willfully lackadaisical and dismissive stance during the early years of the epidemic. Engel also does not make clear how difficult it was for scientists in the trenches to obtain a slice of the much-contested funding. Bewilderingly, after apparently exonerating Reagan, Engel declares in his conclusion on the subject that Reagan’s record on AIDS is actually “middling to poor” and finally mentions the president’s “latent homophobia.” Better late in the discussion than never, I guess?
Even more troublingly, on the second page of this book I hit a glaring medical error. Engel reverses the ordinary pathologies of pneumocystis carinii pneumonia (PCP) and the skin cancer Kaposi’s sarcoma (KS). Both these conditions were common in early cases of AIDS and were included in the official diagnostic criteria for the disease. It was an unusual spike in requests for the medication to treat PCP that initially alerted the CDC that something strange and new was unfolding. So inseparable from the early ravages of AIDS was KS that it famously came to be called “gay cancer." Point being, the basic details on these conditions can be found in almost any source that covers the early history of AIDS. This book is not primarily concerned with the clinical aspects of AIDS, but reversing the simple descriptions of seminal conditions associated with the disease is shockingly sloppy.
Engel’s depiction of celebrated AIDS activist Larry Kramer manages to highlight all this book’s problems. Kramer was a divisive figure in the 1980s, but is now acknowledged as one of the prescient heroes of the early AIDS fight. While Engel must concede Kramer’s outsized role in efforts to assist AIDS victims and draw attention to their plight, his discussion is constantly tempered by strangely disparaging asides. Engel seems determined to strike out against received opinion in a misjudged bid to appear even-handed-- a recurring problem with his entire account of the disease in the US. Considering how prominent a figure Kramer cuts in this and any chronicle of early AIDS history, you’d think Engel would manage to get the basic details of his life correct. In referencing Kramer’s famous op-ed “1,112 and Counting,” however, Engel mistakenly places the date of Kramer’s own infection in 1983, the year of the article's publication, rather than in 1988. As a result, he mischaracterizes Kramer’s work as the product of intense frustration “at the inability of the government to cure him, or even define his illness;” that is, as essentially selfishly motivated, instead of as the desperate and angry appeal of a man contemplating the decimation of his community. By getting wrong this well-known fact, Engel completely changes the tone of one of the early epidemic's most fundamental works. Again, shockingly sloppy and illustrative of the agenda that Engel brings to bear on the material.
I found Engel’s treatment of the pandemic in Africa and Asia better than his chapters on the US, but this could very well be because I am less well-versed in the history of the disease in these places and therefore could not readily spot where he went astray. His discussion of the rest of the world is also a broader overview and so lacks many of the fine details he gets wrong on the US side.
January 17, 2018
I started reading Jonathan Engel’s The Epidemic - A Global History of AIDS, because I am still looking for information about the spread if HIV that’s not focused primarily on the US, or on the origins of AIDS, which tend to end once the virus reaches American soil.
The story of how the epidemic started, how it spread through west and central Africa, and how it reached the US is pretty clear to me at this point, as are many of the details of the battle to identify the caused and contain the epidemic in the US. But I am interested in what’s happened, what is happening, in other parts of the world too, and that information seems harder to find in the popular literature.
Engels is an academic with a background in the history of public health policy and administration. His history of the AIDS epidemic tends to view the issues through this lens, rather than the research/epidemiological and political/journalistic perspectives of other books I have recentky read on this topic.
Engels bypasses the early years of the epidemic’s history, when it was primarily confined to certain regions of Africa, and begins his account with the appearance of AIDS-related opportunistic infections among the members of the gay communities in New York and San Francisco. Engels moves the narrative forward with some dispatch, although he spends perhaps a little too much time lingering over somewhat titillating descriptions of bathhouse sexual activities. His account of the events of the early years of the epidemic in the US is mostly consistent with the more detailed accounts of authors such as Randy Shilts and David France, though clearly penned by someone whose perspective is situated outside of the gay community, but he also touches on aspects of the public health efforts not covered in those more narrowly focused books, such as the response of the US military and the prison system to the threat of AIDS.
I did find several aspects of Engel’s narrative of the epidemic in America problematic. Despite the fact that little funding was made available for research, and the Reagan government seemed unable to even say anything about the disease for far too long, Engel repeatedly states that the funding was adequate and he seems to think that homophobia played no part in government decisions and actions. I suspect that in this, he has taken public announcements made by administration officials at face value rather than investigating to see if promises of funding were followed through with, or allocated appropriately, as one thing that has been consistent in other accounts is statements by researchers on the ground that the money was never there, or came too late and too little.
He also tends at times to use judgmental language in discussing the spread of AIDS in the gay community, referring at one point to “strange and bizarre sexual practices.” This despite his comments elsewhere in the narrative about the need for and indeed, the history of, non-judgmental decision making in public health, where the populations served are often those stigmatised by public opinion. He speaks against homophobia expressed against the gay community, while, perhaps unwittingly, sometimes shows glimpses of such attitudes himself.
On the other hand, Engel devotes, relatively speaking, more attention to the issues facing the black and Hispanic communities, where IV drug use was a significant risk factor, than some other chroniclers, and directly references the solidarity shown by some lesbians, who were in many ways one of the population groups at least risk of contracting the disease.
I also found somewhat troubling his tendency to dismiss the potential for HIV infection “escaping” into the general heterosexual beyond the risks to the partners of IV drug users. As research into how patterns of sexual behaviour has shown, a shift toward more concurrent relationships among the non-IV using heterosexual population could tip the balance far more easily than he suggests. Given the known fact that HIV infection is greater among the black heterosexual population in America, it would be interesting to know if this is indeed due to greater IV drug use and a greater tendency to deny homosexual behaviours among men, as Engel suggests, or if the black population in America, like that in Africa, is more likely to follow a pattern of concurrent sexual relationships.
When Engels turns his attention to the global presence if AIDS, his reporting echoes the kinds of misinterpretations of behaviour that other writers have noted. He focuses on the “highly sexualised” nature of African societies and the “promiscuity” and “insalubrious sexual mores” of African peoples as reasons for the prevalence of HIV infection among heterosexuals in Africa, touching briefly on the issue of lower rates of male circumcision and failing to mention the different patterns of sexual relationships - concurrent rather than serial relationships - found among heterosexuals in Africa and America. As in his descriptions of sexual practices among some elements of the gay community, I had the feeling that he was engaging in a degree of sensationalism, and overlooking the historical conditions that led to the situations he discusses, from dislocation of family life to poverty and lack of medical care.
Engel also looks at the development of the HIV epidemic in Asian countries. He identifies IV drug use, and heroin in particular, as the most significant pathway of infection, with sex tourism and prostitution also playing a role in certain countries, most notably in Thailand.
Engel dies make two very useful points in his summary. The first is the importance of educating and empowering women in the ongoing struggle to contain AIDS. If women - and especially sex workers, though Engel does not make this point explicitly - are able to negotiate safer sex with their partners, then the spread of HIV in the population at large is virtually stopped. Unfortunately, doing this on a global scale is an enormous task involving the eradication of many widespread attitudes toward women and sexuality in culture around the world.
He also reminds us that HIV is a fragile virus, and can be stopped by a few simple behaviours - safer sex (including universal use of condoms except between fluid-bonded sexual partners), safer injection drug behaviours, and screening of donated blood products. Again, to bring this about isn’t easy, especially among poor IV drug users, although decriminalisation and safe injection sites would be a start.
All in all, I was disappointed with the book. Despite calling itself a global history of the epidemic, relatively little attention was paid to Africa or Asia, and almost no information provided about the spread of the disease in Europe or in Central and South America. The issues in the Americas of HIV infection in indigenous populations were completely ignored, and you’d think HIV never reached Australia based on this discussion. There are other flaws as well, which I have noted above. I can’t recommend the book, even as a general summary of the epidemic in North America.
The story of how the epidemic started, how it spread through west and central Africa, and how it reached the US is pretty clear to me at this point, as are many of the details of the battle to identify the caused and contain the epidemic in the US. But I am interested in what’s happened, what is happening, in other parts of the world too, and that information seems harder to find in the popular literature.
Engels is an academic with a background in the history of public health policy and administration. His history of the AIDS epidemic tends to view the issues through this lens, rather than the research/epidemiological and political/journalistic perspectives of other books I have recentky read on this topic.
Engels bypasses the early years of the epidemic’s history, when it was primarily confined to certain regions of Africa, and begins his account with the appearance of AIDS-related opportunistic infections among the members of the gay communities in New York and San Francisco. Engels moves the narrative forward with some dispatch, although he spends perhaps a little too much time lingering over somewhat titillating descriptions of bathhouse sexual activities. His account of the events of the early years of the epidemic in the US is mostly consistent with the more detailed accounts of authors such as Randy Shilts and David France, though clearly penned by someone whose perspective is situated outside of the gay community, but he also touches on aspects of the public health efforts not covered in those more narrowly focused books, such as the response of the US military and the prison system to the threat of AIDS.
I did find several aspects of Engel’s narrative of the epidemic in America problematic. Despite the fact that little funding was made available for research, and the Reagan government seemed unable to even say anything about the disease for far too long, Engel repeatedly states that the funding was adequate and he seems to think that homophobia played no part in government decisions and actions. I suspect that in this, he has taken public announcements made by administration officials at face value rather than investigating to see if promises of funding were followed through with, or allocated appropriately, as one thing that has been consistent in other accounts is statements by researchers on the ground that the money was never there, or came too late and too little.
He also tends at times to use judgmental language in discussing the spread of AIDS in the gay community, referring at one point to “strange and bizarre sexual practices.” This despite his comments elsewhere in the narrative about the need for and indeed, the history of, non-judgmental decision making in public health, where the populations served are often those stigmatised by public opinion. He speaks against homophobia expressed against the gay community, while, perhaps unwittingly, sometimes shows glimpses of such attitudes himself.
On the other hand, Engel devotes, relatively speaking, more attention to the issues facing the black and Hispanic communities, where IV drug use was a significant risk factor, than some other chroniclers, and directly references the solidarity shown by some lesbians, who were in many ways one of the population groups at least risk of contracting the disease.
I also found somewhat troubling his tendency to dismiss the potential for HIV infection “escaping” into the general heterosexual beyond the risks to the partners of IV drug users. As research into how patterns of sexual behaviour has shown, a shift toward more concurrent relationships among the non-IV using heterosexual population could tip the balance far more easily than he suggests. Given the known fact that HIV infection is greater among the black heterosexual population in America, it would be interesting to know if this is indeed due to greater IV drug use and a greater tendency to deny homosexual behaviours among men, as Engel suggests, or if the black population in America, like that in Africa, is more likely to follow a pattern of concurrent sexual relationships.
When Engels turns his attention to the global presence if AIDS, his reporting echoes the kinds of misinterpretations of behaviour that other writers have noted. He focuses on the “highly sexualised” nature of African societies and the “promiscuity” and “insalubrious sexual mores” of African peoples as reasons for the prevalence of HIV infection among heterosexuals in Africa, touching briefly on the issue of lower rates of male circumcision and failing to mention the different patterns of sexual relationships - concurrent rather than serial relationships - found among heterosexuals in Africa and America. As in his descriptions of sexual practices among some elements of the gay community, I had the feeling that he was engaging in a degree of sensationalism, and overlooking the historical conditions that led to the situations he discusses, from dislocation of family life to poverty and lack of medical care.
Engel also looks at the development of the HIV epidemic in Asian countries. He identifies IV drug use, and heroin in particular, as the most significant pathway of infection, with sex tourism and prostitution also playing a role in certain countries, most notably in Thailand.
Engel dies make two very useful points in his summary. The first is the importance of educating and empowering women in the ongoing struggle to contain AIDS. If women - and especially sex workers, though Engel does not make this point explicitly - are able to negotiate safer sex with their partners, then the spread of HIV in the population at large is virtually stopped. Unfortunately, doing this on a global scale is an enormous task involving the eradication of many widespread attitudes toward women and sexuality in culture around the world.
He also reminds us that HIV is a fragile virus, and can be stopped by a few simple behaviours - safer sex (including universal use of condoms except between fluid-bonded sexual partners), safer injection drug behaviours, and screening of donated blood products. Again, to bring this about isn’t easy, especially among poor IV drug users, although decriminalisation and safe injection sites would be a start.
All in all, I was disappointed with the book. Despite calling itself a global history of the epidemic, relatively little attention was paid to Africa or Asia, and almost no information provided about the spread of the disease in Europe or in Central and South America. The issues in the Americas of HIV infection in indigenous populations were completely ignored, and you’d think HIV never reached Australia based on this discussion. There are other flaws as well, which I have noted above. I can’t recommend the book, even as a general summary of the epidemic in North America.
December 24, 2024
I have a fairly limited understanding of the world history of AIDS, but this seemed a little too America-centered and way too forgiving of Reagan’s complete ineptitude and culpability towards the deaths of hundreds of thousands of people. It was interesting because the topic is interesting, but greatly lacking.
6/10
6/10
July 17, 2013
Virology is something of a new interest for me, so I decided to look at one of the more well-known modern diseases. I had read one or two historical books on smallpox--the most compelling parts of which were the primary records of each individual case, and the hunt for the disease's cause and treatment. Assuming that AIDS was at least as well-documented, I picked up this book.
Much to my disappointment, the books was less about the discovery and treatment of the disease; and even less about individual cases. As far as I can tell, Engel wrote this book to remind people that HIV-AIDS are statistically found only in groups of people that make poor life choices (or conversely, have their life decisions made by irrational people); and that HIV-AIDS are relatively preventable.
If AIDS is your thing, or if you're into the condemnation of civil libertarians (who often occur Engel's wrath) you should check this out.
Much to my disappointment, the books was less about the discovery and treatment of the disease; and even less about individual cases. As far as I can tell, Engel wrote this book to remind people that HIV-AIDS are statistically found only in groups of people that make poor life choices (or conversely, have their life decisions made by irrational people); and that HIV-AIDS are relatively preventable.
If AIDS is your thing, or if you're into the condemnation of civil libertarians (who often occur Engel's wrath) you should check this out.
October 27, 2010
Just, awful! Seriously, this has got to be one of the most frustratingly written, intellectually limited, and just plain offensive books I've ever read. I am ashamed that this man came out of harvard's Hist of Sci undergrad and Yale's HSHM PhD program. Just, plan awful!
August 12, 2007
retread of the same old stuff with weird opinions inserted
July 15, 2024
When I got to the end of this book, I felt deja vu. Whenever the world has been affected by a major disease we as humans start to play the ‘blame game’. In this book the second that scientists even considered the recent cases of pneumonia were caused by the same virus it had been pinned on a group of people. i.e like the book says ‘By time the syndrome had a name, or rather two names– AIDS for acquired immunodeficiency syndrome, and GRID for gay-related immunodeficiency.’ The point the author is trying to make is that when humans are put under the pressure of disease, we find it necessary to instantly point the finger at someone therefore initiating the blame game. When we spend all our time pointing our fingers at each other we forget that we have to solve the problem, and we also end up trying to ‘fix the person’ rather than fix the problems. The book offers a great example: “One New York doctor warned that gay men whose lifestyle consisted of ‘anonymous encounters’ would need to do some ‘serious rethinking,’ while another physician encouraged his colleagues to try to ‘rehabilitate’ highly promiscuous homosexuals.” When we place the blame on the victims over the virus it brings an underlying stigma to a group. We as a society have already chosen who we will blame before the virus has even emerged. Whichever group of people who does not share the same beliefs as the majority of society is often put under a microscope, and the second something bad happens it enables the media to promote a bias. The start of the AIDS pandemic was almost 50 years ago so you would hope that the human race would have moved past the blame game but sadly not. During Covid the number of Asian people who faced racism in New Zealand increased by 40% (Stuff). Of course people are becoming more accepting of different beliefs, but it seems that when society is put under the pressure of a pandemic the cracks will begin to form. Even though the first cases of Covid happened in China, the reason why there was so much hate towards the Chinese was more due to the distrust the western culture felt towards their government . Once again the western world picked who they were going to blame before the facts were available. When I got to the end of this book, I felt deja vu. Remember, just because a group of people is more at risk that does not make it their fault, just because a disease originated in a foreign country it doesn't make it their fault and just because your culture or way of life differs from a group of people it doesn’t make it their fault.
January 1, 2018
"AIDS is strangely preventable, yet stubbornly resistant to modern medical intervention. The virus has proven itself a formidable foe, evading vaccines and antidotes, while mocking our own imprudence. It has exposed much of what is worst in human nature, while giving us little opportunity to shine. It is a mirror that selectively reflects our ugliest warts and deepest weaknesses."
Overall, this book provided a competent social and medical overview of the first twenty years of the AIDS pandemic. However, there are some serious issues which must be noted.
First, the author has a tendency to use unnecessary and politically loaded language. Oddly, though, Engel uses this sort of language to describe nearly every organization involved in the epidemic, so his agenda--if he has one--is uncear. For example, in the space of a few pages, he describes the gay community as extreme and decadent, while lambasting the Catholic church as recalcitrant and backward. Perhaps this was an attempt to be balanced, but it comes across as unnecessarily combative. There is already enough controversy about the AIDS pandemic without courting more.
Second, the book suffers from excessive brevity and poor editing. There are some topics which are covered in a page or two, but deserve entire chapters to themselves--the overall Christian response to the pandemic is one of the most obvious examples. Other areas contain unnecessary repetition, and obvious typoes that should have been caught.
Overall, this book provided a competent social and medical overview of the first twenty years of the AIDS pandemic. However, there are some serious issues which must be noted.
First, the author has a tendency to use unnecessary and politically loaded language. Oddly, though, Engel uses this sort of language to describe nearly every organization involved in the epidemic, so his agenda--if he has one--is uncear. For example, in the space of a few pages, he describes the gay community as extreme and decadent, while lambasting the Catholic church as recalcitrant and backward. Perhaps this was an attempt to be balanced, but it comes across as unnecessarily combative. There is already enough controversy about the AIDS pandemic without courting more.
Second, the book suffers from excessive brevity and poor editing. There are some topics which are covered in a page or two, but deserve entire chapters to themselves--the overall Christian response to the pandemic is one of the most obvious examples. Other areas contain unnecessary repetition, and obvious typoes that should have been caught.
February 2, 2019
This book was a disappointment, and in my eyes, it was not a success. Falsely claiming to be a "global history", it is ridiculously Americentric. Its like 90% USA, 7% Africa, 3% Asia. Most of the world is ignored, and even the sections on Africa are terrible + fail to illuminate. I did not like the writing style, nor did it succeed in telling me what I wanted to know. Didn't think the author had done the reading on many points (Cuba, origin conspiracy theories, racial issues)
By the end of it, I was pretty sick of his glib crap
I do not recommend this.
By the end of it, I was pretty sick of his glib crap
I do not recommend this.
November 10, 2019
This was a great summary of the history of HIV/AIDS. It was thorough and fleshed out with plenty of details, and was easy to read. The book flowed well, and each paragraph/section/chapter reinforced the key points with supplemental information well. The chapter covering the epidemiology of the virus explained its structure well, without overwhelming the reader with scientific terminology or concepts. I finished this book feeling a lot more informed about AIDS.
Want to read
September 10, 2019Huh. This book has so many one-star reviews that I almost want to read it for that reason alone, just to see if I agree.
didn-t-finish
May 5, 2020Since half the quotes come from Randy Shilt’s masterpiece And The Band Played On, do yourself a favor and just read that book.
February 3, 2012
RESEARCH BOOK.
There's a great deal of information here but Engel isn't great about keeping the ball rolling without feeling bogged down or repetitive. It took me forever to read, even though I'm incredibly interested in the AIDS pandemic.
There definitely seems to be an emphasis on downplaying current threats to "general" populations, which has some root in reality but only, in my opinion, serves to further marginalize high-risk groups and third-world nations. I was also uncomfortable with the spotlight on the behaviour of gay men which, again, had plenty of basis in fact, but felt a lot like telling us how weird and Not Like Us gay men were/are. I absolutely understand that this was the point, and it's worth looking at an examination of how the desire of some to not marginalize may have set up false assumptions about the disease. That said, in general by the book's end AIDS was pretty much relegated to belong to The Other.
The book did a great job of examining AIDS on a global level and how different cultures led to different paths/infection rates/etc.
(read: 13)
There's a great deal of information here but Engel isn't great about keeping the ball rolling without feeling bogged down or repetitive. It took me forever to read, even though I'm incredibly interested in the AIDS pandemic.
There definitely seems to be an emphasis on downplaying current threats to "general" populations, which has some root in reality but only, in my opinion, serves to further marginalize high-risk groups and third-world nations. I was also uncomfortable with the spotlight on the behaviour of gay men which, again, had plenty of basis in fact, but felt a lot like telling us how weird and Not Like Us gay men were/are. I absolutely understand that this was the point, and it's worth looking at an examination of how the desire of some to not marginalize may have set up false assumptions about the disease. That said, in general by the book's end AIDS was pretty much relegated to belong to The Other.
The book did a great job of examining AIDS on a global level and how different cultures led to different paths/infection rates/etc.
(read: 13)
June 5, 2014
Excellent book about AIDS that starts with the American epidemic and expands outwards for a carefully paced and laid out global overview, with a great job detailing the different challenges faced due to cultural differences. Fascinating emphasis placed on the dangers of politicizing the disease - from both liberal and conservative sides.
The layout of the book was one that I thought was very interesting. Rather than attempting to go through issues chronologically, which would've been extremely difficult given the many overlapping areas and sheer range of the research, Engel instead breaks it down topic by topic. This results in some of the repetition that other reviewers complained about, but I didn't find it intrusive. Rather, information was able to build on previous areas explained.
I read this after Randy Shilts's incredible And The Band Played On and Elizabeth Pisani's The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS. The Epidemic is an excellent addition to these works.
The layout of the book was one that I thought was very interesting. Rather than attempting to go through issues chronologically, which would've been extremely difficult given the many overlapping areas and sheer range of the research, Engel instead breaks it down topic by topic. This results in some of the repetition that other reviewers complained about, but I didn't find it intrusive. Rather, information was able to build on previous areas explained.
I read this after Randy Shilts's incredible And The Band Played On and Elizabeth Pisani's The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS. The Epidemic is an excellent addition to these works.
January 25, 2008
This was a carefully researched and easy to read history of the outbreak, discovery, and trajectory of HIV/AIDS. The author makes excellent use of quotes from his sources to allow politicians, advocates, and others speak for themselves. I'm no expert in the field, so I don't know how this book compares to any other books about the same topic, but I found the book extremely informative and readable. I'd recommend it to anyone interested in reading a fairly concise history of AIDS and the world's response to it.
June 2, 2015
Very complete and detailed description of the history of the HIV virus, since the West African jungles, passing through Castro and NYC, until the disease became chronicle instead of a death sentence. The way of telling the story is very engaging. It includes all aspects of the disease impact in the world, talking about the social, political and economic impacts.
The only missing point is that the history doesn't get to the most recent innovations in the treatment such as PEP and PrEP, and Truvada.
The only missing point is that the history doesn't get to the most recent innovations in the treatment such as PEP and PrEP, and Truvada.
May 21, 2011
this was, by far, one of the best books that anyone can read about the history of HIV and AIDS. it's not amerocentric, homocentric, or ethnocentric. it gives a wonderful account of its discovery and origins (something i am still curious about) and how it has transformed public health. i wish that there were a volume II to this book to help understand what has gone on since its publication.
August 17, 2011
A comprehensive survey of the AIDS epidemic from its first detection in the 80s to the present. Engel hits on the science and politics of AIDS, focusing on how various groups manipulated the crisis for their own ideological goals. There's also a bit on the controversies within the scientific community over discovery and the eccentric denialism of molecular biologist Peter Duesberg.
March 23, 2008
Cool book. Gave me a good understanding of the history of the politics of AIDS. I would now feel more comfortable learning about more specific events in detail with regard to the AIDS issue. Very sad at times. Will probably use it as a reference later. Thanks to Dr. Henry for the book.
October 3, 2012
great information, but the narrative was disjointed. i agree with other reviewers that engel often repeated himself. i understand why he didn't tell the story in a more linear way, but it did decrease the readability.
May 16, 2010
Very informative and interesting. I enjoyed the author's writing style.
November 5, 2013
Great summary of post GRID epidemic, made me uncomfortable frequently with frank discussion of at risk groups
June 29, 2014
Lots of information but not biased towards any one side.
March 16, 2015
Phenomenal. Really opened my eyes to the atrocity of this epidemic and my cultural past.
November 1, 2015
Very informative book.
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December 29, 2017A couple of reviewers mention factual errors in the book, which I didn't notice. I did notice the author being judgmental. I appreciated the mention of how leaders of some countries in Africa and Asia say that there was no same-sex sex between men before white Americans and Europeans came to their land. I believe that many former European colonies still have the sodomy laws in place from the 1800s that the colonizers made. The European countries have become more liberal since then. Denial has been a large part of the spread of the epidemic in many countries.
The author noted some homophobia in the U.S., but defended how the Reagan administration handled the AIDS crisis. I was not impressed by that defense. There are some: "Here's the level of homophobia in the U.S. at the time" explanations, and some analyses that I saw as homophobia directly from the author. I'd say it's a fairly informative book, with some errors and biases.
The author noted some homophobia in the U.S., but defended how the Reagan administration handled the AIDS crisis. I was not impressed by that defense. There are some: "Here's the level of homophobia in the U.S. at the time" explanations, and some analyses that I saw as homophobia directly from the author. I'd say it's a fairly informative book, with some errors and biases.
February 10, 2019
Although this book is a little over a decade old, most of its history is still relevant to the equation when one speaks of HIV/AIDS. The history of the male-homosexual community combined with the history of IV-drug-user community combined with Asian/African transmissions is still locked in many of the same patterns that were present in 2006. Engel does a strong job of telling their stories and in so doing, telling the story of one of the worst plagues in recent history.
The saddest thing about AIDS is that it preys upon some of our outcast peoples: IV drug users, male homosexuals, prostitutes, sub-Saharan Africa, South Asia. Perhaps it is our fault for casting them out, but these populations doo not need additional stigma to be heaped upon them. But stigma, HIV/AIDS brought on.
This book highlights the simple fact that transmission of HIV is simple: One only needs to be part of an at-risk group, like someone who shares needles, engages in sex with many sexual partners, or engages in anal sex. Preventing the transmission of HIV is as simple as stopping those practices or using techniques to sanitize them.
It is sad that Reagan did not slow or stamp out the disease in the earliest years as this book well attests. HIV eradication is a long way away, but at least HAART treatment covers much of the infected, at least in the Western world. Africa and Asia still suffer from not being able to afford HAART treatment.
If you care about the outcast and those not in the center of society, this book is for you.
The saddest thing about AIDS is that it preys upon some of our outcast peoples: IV drug users, male homosexuals, prostitutes, sub-Saharan Africa, South Asia. Perhaps it is our fault for casting them out, but these populations doo not need additional stigma to be heaped upon them. But stigma, HIV/AIDS brought on.
This book highlights the simple fact that transmission of HIV is simple: One only needs to be part of an at-risk group, like someone who shares needles, engages in sex with many sexual partners, or engages in anal sex. Preventing the transmission of HIV is as simple as stopping those practices or using techniques to sanitize them.
It is sad that Reagan did not slow or stamp out the disease in the earliest years as this book well attests. HIV eradication is a long way away, but at least HAART treatment covers much of the infected, at least in the Western world. Africa and Asia still suffer from not being able to afford HAART treatment.
If you care about the outcast and those not in the center of society, this book is for you.
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