Table of Contents
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About the
Author |
iii |
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A Quarter
Century of AIDS and Counting |
ix |
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AIDS Update
2008 |
xiv |
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Preface |
xvi |
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Introduction |
Histories
of Global Pandemics, AIDS, Its Place in History, Overview of HIV/AIDS,
International AIDS Conferences and Means of Remembering—the AIDS Quilt,
Candlelight Memorial, and World AIDS Day |
1 |
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1 |
AIDS:
Defining the Disease and Finding its Cause |
17 |
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The New Millennium |
17 |
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AIDS: A Disease or a
Syndrome? |
18 |
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First Reaction to
AIDS; Denial |
18 |
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What Causes AIDS? |
19 |
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How Does HIV Cause
AIDS? |
20 |
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The Centers for
Disease Control and Prevention Reports |
22 |
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Discovery of the
AIDS Virus |
23 |
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Defining the
Illness: AIDS Surveillance |
25 |
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Summary |
27 |
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Review Questions |
27 |
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2 |
What Causes
AIDS: Origin of the AIDS Virus |
28 |
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The Cause of AIDS
the Human Immunodeficiency Virus (HIV) |
28 |
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Evidence that HIV
Causes AIDS |
33 |
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Origin of HIV: The
AIDS Virus |
35 |
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Summary on the
Origin of HIV |
41 |
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Summary |
42 |
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Review Questions |
42 |
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3 |
Biological
Characteristics of the AIDS Virus |
44 |
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Viruses Need a Host
Cell in Order to Reproduce |
44 |
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Viruses are Parasites |
44 |
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Viruses Specific to
Cell Type |
45 |
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Retroviruses |
45 |
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Description of HIV;
How It Attaches to a Host Cell and Buds Out of the Cell |
45 |
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Human
Immunodeficiency Virus (HIV): Its Life Cycle |
48 |
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The HIV Life Cycle |
48 |
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How HIV Escapes the
Infected Cell |
52 |
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Basic Genetic
Structure of Retroviral Genomes |
52 |
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Genetic Revolution |
57 |
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Formation of Genetic
Recombination in HIV |
58 |
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Distinct Genotypes
(Subtypes/Clades)
of HIV-1 “Worldwide Based on ENV and GAG Proteins |
59 |
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Summary |
62 |
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Review Questions |
62 |
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4 |
Anti-HIV Therapy |
64 |
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Anti-HIV Therapy |
65 |
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Eradication
Update—2007 |
65 |
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Antiretroviral
Therapy (ART) Drugs with FDA-Approval |
66 |
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The HIV Medicine
Chest: ART Drugs Receiving FDA Approval |
66 |
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FDA-Approved
Nucleoside/Non-Nucleoside Analog Reverse Transcriptase Inhibitors and
Protease Inhibitors |
69 |
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Use of
Non-Nucleoside Analog Reverse Transcriptase Inhibitors |
71 |
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FDA-Approved
Protease Inhibitors |
72 |
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Protease Inhibitors |
73 |
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Entry Inhibitors and
Problems |
75 |
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Development and
Selection of HIV Drug-Resistant Mutants |
75 |
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Development of HIV
Drug Resistance to Protease Inhibitors |
76 |
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How Combination Drug
Therapy can Reduce the Chance of HIV Drug Resistance |
79 |
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HIV Treatment
Regimen Failure |
82 |
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Viral Load: Its
Relationship to HIV Disease and AIDS |
84 |
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Medical
Complications Associated with Anti-HIV Drug Therapies (ART) |
85 |
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The Smart Trial was
Cancelled on January 11.2006. |
95 |
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Disclaimer |
98 |
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Summary |
98 |
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Some AIDS Therapy
Information Hotlines |
99 |
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Review Questions |
99 |
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5 |
The Immunology of HIV Disease/AIDS |
101 |
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The Immune System |
101 |
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Human Lymphocytes: T
Cells and B Cells |
103 |
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Antibodies and HIV
Disease |
110 |
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Immune System
Dysfunction |
112 |
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Original Antigenic
Sin |
113 |
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The Search for
Additional Receptors (Coreceptors)
to CD4: FUSIN or CXCKR-4 (R-4) |
115 |
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CCKR-5 (R-5) Receptor |
115 |
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Emergence of HIV
Strains that Vary in their Lethal Abilities |
115 |
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In Search of Genetic
Resistance to HIV Infection |
116 |
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T4 Cell Depletion
and Immune Suppression |
118 |
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Impact of T4 Cell
Depletion |
120 |
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Role of Monocytes and
Macrophages in HIV Infection |
120 |
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Where Do T4 or CD4+
Cells Become HIV Infected? |
121 |
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Summary |
124 |
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Review Questions |
124 |
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6 |
Opportunistic
Infections and Cancers Associated with HIV Disease/AIDS |
126 |
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What is an
Opportunistic Disease? |
126 |
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The Prevalence of
Opportunistic Diseases |
127 |
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Prophylaxis Against
Opportunistic Infections |
127 |
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Opportunistic
Infections in HIV-Infected People |
127 |
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TB and HIV |
139 |
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Cancer or Malignancy
in AIDS Patients |
140 |
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Disclaimer |
145 |
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Summary |
145 |
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Review Questions |
145 |
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7 |
A Profile
of Biological Indicators for HIV Disease and Progression to AIDS |
146 |
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HIV Disease Defined |
146 |
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Stages of HIV
Disease (Without Drug Therapy) |
150 |
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HIV Disease without
Symptoms, with Symptoms, and AIDS |
157 |
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Aspects of HIV
Infection |
157 |
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Production of
HIV-Specific Antibodies |
157 |
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Prognostic
Biological Markers Related to AIDS Progression |
163 |
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HIV Infection of the
Central Nervous System (CNS) |
167 |
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Neuropathies in HIV
Disease/AIDS Patients |
171 |
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Pediatric Clinical
Signs and Symptoms |
171 |
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Summary |
171 |
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Review Questions |
172 |
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8 |
Epidemiology and Transmission of the
Human Immunodeficiency Virus |
173 |
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We must Stop HIV
Transmission Now! |
175 |
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Epidemiology of HIV
Infection |
175 |
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Transmission of Two
Strains of HIV (HIV-1/HIV-2) |
176 |
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Is HIV Transmitted
by Insects? |
176 |
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HIV Transmission |
177 |
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HIV Transmission in
Family/Household Settings |
178 |
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Noncasual Transmission |
179 |
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Gay Men Putting
Themselves at High Risk for HIV Infection |
188 |
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Problem |
194 |
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Injection-Drug Users
and HIV Transmission |
205 |
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United States:
Heterosexual Injection-Drug Use (IDU) |
205 |
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Cesarean Section |
217 |
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Conclusion |
219 |
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National AIDS
Resources |
219 |
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Summary |
219 |
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Review Questions |
220 |
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9 |
Preventing
the Transmission of HIV |
222 |
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The AIDS Generation:
“I Knew Everything about It, and I Still Got It!” |
223 |
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Prevention, not
Treatment, is the Least Expensive and most Effective Way to Stop the Spread
of HIV/AIDS |
223 |
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Global Prevention |
224 |
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Antiretroviral Drugs
Having an Impact on Prevention, but “We can’t Treat Our Way out of this
Pandemic |
224 |
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Advancing HIV
Prevention: New Strategies for a Changing Epidemic |
227 |
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Preventing the
Transmission of HIV |
228 |
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Sexual Risk Taking
Depends on Sexual Activity |
232 |
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New Rules to an Old
Game: Promoting Safer Sex |
235 |
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The Male Condom |
239 |
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The Female Condom or
Femidom
(Vaginal Pouch) |
246 |
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An Alternative to
Condoms: Vaginal Microbicides |
248 |
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Injection-Drug Use
and HIV Transmission: The Twin Epidemics |
249 |
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HIV Prevention for
Injection-Drug Users |
251 |
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Prevention of Blood
and Blood Product HIV Transmission |
253 |
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Infection Control
Procedures |
254 |
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Sexual Partner
Notification: Disclosure |
259 |
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The U.S. Federal
Government has Now Adopted Partner Notification as its Cornerstone in its
Effort to Help Control the Spread of HIV |
259 |
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Vaccine Development
and its Role in Prevention |
263 |
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Types of
Experimental HIV Vaccines |
268 |
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DNA Vaccine |
268 |
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Coverage, or who
Gets the Vaccine |
269 |
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Impact Summary of an
HIV Vaccine |
269 |
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Problems in the
Search for HIV Vaccine |
271 |
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Summary |
272 |
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Review Questions |
274 |
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Prevalence
of HIV Infections, AIDS Cases, and Deaths Among Select Groups in the |
275 |
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A Word About
HIV/AIDS Data |
276 |
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The Millennium: Year
2008 |
280 |
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Formula for
Estimating HIV Infections |
282 |
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Behavioral Risk
Groups and Statistical Evaluation |
284 |
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Estimates of HIV
Infection and Future AIDS Cases |
294 |
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Newly Infected |
296 |
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Shape of the HIV
Pandemic: United States |
296 |
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Shape of AIDS
Pandemic: United States |
297 |
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Estimates of Deaths
and Years of Potential Life Lost Due to AIDS in the United States |
300 |
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Prevalence and
Impact of HLV/AIDS |
302 |
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Connected but
Separate |
302 |
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Workforce - South
Africa: Some Examples |
306 |
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Education: Teachers
and Students — South Africa and Some Countries in Southern Africa |
307 |
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Other HIV/AIDS Time
Bombs: Asia, India, China, and Russia |
308 |
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Summary |
312 |
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Review Questions |
313 |
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11 |
Prevalence
of HIV Infection and AIDS Cases Among Women and Children |
314 |
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AIDS is Defining the
Lives of Millions of Women |
315 |
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Even Day a Tragedy |
315 |
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Triple Jeopardy |
315 |
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Annual International
Women’s Day—March 8 |
315 |
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Women: AIDS and HIV
Infections Worldwide |
316 |
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Women: HIV-Positive
and AIDS Cases—United States |
317 |
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Childbearing Women |
332 |
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Internet |
333 |
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Pediatric
HTV-Positive and AIDS Cases—United States |
333 |
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Orphaned Children
due to HIV Infection and AIDS |
334 |
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The Phenomenon of
AIDS Orphans |
335 |
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Summary |
341 |
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Review Questions |
342 |
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12 |
Prevalence of HIV Infection and AIDS
Among Young Adults, Ages 13 to 24 |
343 |
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Global HIV
Infections in Young Adults |
343 |
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Addressing the AIDS
Pandemic Among Young Adults |
344 |
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How Large is the
Young Adult Population in the United States? |
345 |
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HIV/AIDS won’t
Affect Us! |
346 |
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Estimate of
HIV-Infected and AIDS Cases Among Young Adults in the United States |
347 |
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Summary |
355 |
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Internet |
355 |
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Other Useful Sources |
355 |
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Review Questions |
355 |
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13 |
Testing for Human Immunodeficiency Virus |
356 |
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Determining the
Presence of Antibody Produced When HIV is Present |
357 |
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Requests for HIV
Testing |
357 |
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Reasons for HIV
Testing |
357 |
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Laboratory Methods
for Detecting HIV |
359 |
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ELISA HIV Antibody
Test |
360 |
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Western Blot Assay |
366 |
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New ELISA Antibody
Testing and Viral Load Procedures Reveal Early versus Late HIV Infection |
369 |
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Rapid HIV Testing |
371 |
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FDA Approves Two
Home HIV Antibody Test Kits |
375 |
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Some Screening and
Confirmatory Tests for HIV |
376 |
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Deciding Who and
When to Get an HIV Test |
379 |
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Why is HIV Test
Information Necessary? |
380 |
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Immigration into the
United States |
381 |
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Testing, Competency,
arid Informed Consent |
384 |
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Summary |
390 |
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Review Questions |
391 |
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14 |
AIDS and Society: Knowledge,
Attitudes, and Behavior |
392 |
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HIV/AIDS is a Story
in Our Lifetime |
392 |
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The New Millennium
and HIV/AIDS |
393 |
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HIV/AIDS is an
Unusual Social Disease |
395 |
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AIDS is Here to Stay |
395 |
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AIDS |
395 |
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Blame Someone, Déjà
Vu |
396 |
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Fear: Panic and
Hysteria Over the Spread of HIV/AIDS in the United States |
397 |
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Whom is the General
Public to Believe? |
398 |
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AIDS Education and
Behavior |
402 |
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The Character of
Society |
410 |
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Dealing with
Discrimination: The Americans with Disabilities Act |
414 |
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Federal and Private
Sector Financing: Creation of an AIDS Industry |
417 |
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U.S. Government
Believes HIV/AIDS is a Threat to National Security |
420 |
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Global HIV/AIDS
Funding for Underdeveloped Nations |
421 |
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Forms of U.S.
Monetary Assistance for HIV/AIDS |
427 |
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Summary |
430 |
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Review Questions |
431 |
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Answers to
Review Questions |
433 |
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Glossary |
439 |
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References |
447 |
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Index |
468 |
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