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US hardback
Oct 2005
AIDS and the Ecology of Poverty
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Oxford University Press
ISBN 0195169271
272 pp
AIDS and the Ecology of Poverty
by Eileen Stillwaggon

Although it accepts the conventional interpretation of widespread African sicknesses as resulting from infection by HIV, this book, criticizes those who try to blame sexual behaviour as the leading factor, based on exotic notions about Africans. Differences in sexual behavior cannot explain 50-fold differences around the world in the incidence of the conditions various diagnosed as "AIDS." US college campuses, where rates of chlamydia and genital herpes are as high as 30 to 40 percent, do not have high rates of positive reaction to the tests taken to be indicative of HIV. Yet global AIDS prevention policy relies almost entirely on behavioural interventions in the form of preaching abstinence and distributing condoms. These efforts would be more successful, Stillwaggon argues, if they focused instead on "biological and socio-economic factors" that can be addressed relatively easily and cheaply. The immune systems of impoverished people are weakened by malnutrition and parasitic illnesses, which make it hard for new cells to be built, including the CD4 cells that protect the body from infections.

And who knows? If those factors were to be dealt with on a concerted basis in the relatively simple and inexpensive ways that proved so effective in the decades following 1950, it might be found that "HIV" isn't the demon that it's made out to be, after all.

Eileen Stillwaggon is a professor of economics at Gettysburg College.

"[T]he world has been waiting for this brilliant book. It shows in detail how flawed analysis, ineffectual policies, and demeaning stereotypes resulted in a narrow focus on changing individual sexual and drug-using behavior, but failed to incorporate the underlying poverty determinants of malnutrition, other illnesses, and parasitic infections. . . . To redeem the future, policy and practice must extend beyond current fire-fighting measures and engage with the underlying causes of the AIDS epidemic through simple and low-cost solutions such as those proposed in this book."

--M. J. Kelly, S.J., former Professor of Education, University of Zambia, Lusaka

"Imaginative, innovative, integrative, and critical in the best scholarly tradition: an outstanding contribution to debates about HIV/AIDS in poor countries and communities. This book should be read by all working in the field, but above all by those working in prevention."

--Tony Barnett, ESRC Professorial Research Fellow, London School of Economics

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