Table of Contents
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A Quarter Century of
AIDS |
iii |
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AIDS UPDATE 2007 |
viii |
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About the Author |
xv |
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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 |
14 |
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The
New Millennium |
14 |
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AIDS:
A Disease or a Syndrome? |
15 |
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First
Reaction to AIDS: Denial |
15 |
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What
Causes AIDS? |
16 |
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How
Does HIV Cause AIDS? |
17 |
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The
Centers for Disease Control and Prevention Reports |
18 |
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Discovery
of the AIDS Virus |
18 |
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Defining
the Illness: AIDS Surveillance |
21 |
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Summary |
23 |
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Review
Questions |
23 |
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2 |
What Causes AIDS:
Origin of the AIDS Virus |
24 |
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The
Cause of AIDS: The Human Immunodeficiency Virus (HIV) |
24 |
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Evidence
that HIV Causes AIDS |
27 |
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Origin
of HIV: The AIDS Virus |
29 |
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Summary
on the
Origin of HIV |
35 |
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Summary |
36 |
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Review
Questions |
36 |
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3 |
Biological
Characteristics of the AIDS Virus |
37 |
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Viruses
Need a Host Cell in Order to Reproduce |
37 |
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Viruses
Are Parasites |
37 |
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Viruses
Specific to Cell Type |
38 |
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Description
of HIV; How it Attaches to a Host Cell and Buds Out of the Cell |
38 |
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Human
Immunodeficiency Virus (HIV): Its Life Cycle |
41 |
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The
HIV Life Cycle |
41 |
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How
HIV Escapes the Infected Cell |
45 |
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Basic
Genetic Structure of Retroviral Genomes |
45 |
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Genetic
Revolution |
50 |
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Formation
of Genetic Recombination in HIV |
51 |
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Distinct
Genotypes (Subtypes/Clades)
of HIV-1 Worldwide Based on ENV and GAG Proteins |
52 |
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Summary |
55 |
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Review
Questions |
55 |
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4 |
Anti-HIV Therapy |
57 |
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Anti-HIV
Therapy |
58 |
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Anti-Retroviral
Therapy (ART) Drugs with FDA-Approval |
59 |
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The
HIV Medicine Chest: ART Drugs Receiving FDA-Approval |
59 |
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FDA-Approved
Nucleoside/Non-Nucleoside Analog Reverse Transcriptase Inhibitors and
Protease Inhibitors |
62 |
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Use
of Non-Nucleoside Analog Reverse Transcriptase Inhibitors |
64 |
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FDA-Approved
Protease Inhibitors |
64 |
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Protease
Inhibitors |
66 |
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Development
and Selection of HIV Drug-Resistant Mutants |
68 |
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Development
of Drug-Resistant Protease Inhibitors |
68 |
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How
Combination Drug Therapy Can Reduce the Chance of HIV Drug Resistance |
71 |
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HIV
Treatment Regimen Failure |
74 |
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Viral
Load: Its Relationship to HIV Disease and AIDS |
76 |
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Medical
Complications Associated with Anti-HIV Drug Therapies (ART) |
76 |
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The
Smart Trial was Cancelled on January 11,2006 |
81 |
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Disclaimer |
89 |
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Summary |
89 |
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Some
AIDS Therapy Information Hotlines |
90 |
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90 |
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5 |
The Immunology of
HIV Disease/AIDS |
92 |
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The
Immune System |
92 |
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Human
Lymphocytes: T Cells and B Cells |
94 |
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Antibodies
and HIV Disease |
101 |
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Immune
System Dysfunction |
103 |
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Original
Antigenic Sin |
104 |
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106 |
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CCKR-5
(R-5). Receptor |
106 |
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In
Search of Genetic Resistance to HIV Infection |
106 |
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T4
Cell Depletion and Immune Suppression |
109 |
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Impact
of T4 Cell Depletion |
111 |
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Role
of Monocytes
and Macrophages in HIV Infection |
112 |
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Where
Do T4 or CD4+ Cells Become HIV Infected? |
112 |
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Summary |
115 |
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Review
Questions |
115 |
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6 |
Opportunistic
Infections and Cancers Associated with HIV Disease/AIDS |
116 |
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What
is an Opportunistic Disease? |
116 |
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The
Prevalence of Opportunistic Diseases |
117 |
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Prophylaxis
Against Opportunistic Infections |
117 |
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Opportunistic
Infections in HIV-infected People |
117 |
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TB
and HIV |
129 |
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Cancer
or Malignancy in AIDS Patients |
129 |
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Disclaimer |
133 |
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Summary |
133 |
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Review
Questions |
134 |
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HIV/AIDS
Self-Evaluation/Education Quiz |
135 |
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7 |
A Profile of
Biological Indicators for HIV Disease and Progression to AIDS |
136 |
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HIV
Disease Defined |
136 |
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Stages
of HIV Disease (Without Drug Therapy) |
139 |
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HIV
Disease Without Symptoms, with Symptoms, and AIDS |
146 |
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Aspects
of HIV Infection |
150 |
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Production
of HIV-Specific Antibodies |
150 |
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Prognostic
Biological Markers Related to AIDS Progression |
153 |
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HIV
Infection of the Central Nervous System |
157 |
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Neuropathies
in HIV Disease/AIDS Patients |
160 |
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Pediatric
Clinical Signs and Symptoms |
161 |
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Summary |
161 |
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Review
Questions |
161 |
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8 |
Epidemiology and Transmission
of the Human Immunodeficiency Virus |
162 |
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We
Must Stop HIV Transmission Now! |
164 |
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Epidemiology
of HIV Infection |
164 |
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Transmission
of Two Strains of HIV (HIV-l/HIV-2) |
165 |
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Is
HIV Transmitted by Insects? |
165 |
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HIV
Transmission |
166 |
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HIV
Transmission in
Family/Household |
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Noncasual
Transmission |
167 |
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Gay
Men Putting Themselves at High Risk for HIV Infection |
177 |
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Injection-Drug
Users and HIV Transmission |
192 |
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192 |
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Cesarean
Section |
204 |
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Conclusion |
206 |
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National
AIDS Resources |
206 |
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Summary |
206 |
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Review
Questions |
207 |
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9 |
Preventing the
Transmission of HIV |
209 |
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The
AIDS Generation: “I Knew Everything About it, and I Still Got it!” |
210 |
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Prevention,
Not Treatment, is the Least Expensive and |
210 |
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Global
Prevention |
210 |
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Antiretroviral
Drugs Having an Impact on Prevention |
211 |
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Advancing
HIV Prevention: New Strategies for a Changing Epidemic |
213 |
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Preventing the
Transmission of HIV |
214 |
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Sexual
Risk Taking Depends on Sexual Activity |
217 |
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New
Rules to an Old Game: Promoting Safer Sex |
220 |
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The
Male Condom |
224 |
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The
Female Condom (Vaginal Pouch) |
229 |
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An
Alternative to Condoms: Vaginal Microbicides |
232 |
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Injection-Drug
Use and HIV Transmission: The Twin Epidemics |
234 |
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HIV
Prevention for Injection-Drug Users |
234 |
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Prevention
of Blood and Blood Product HIV Transmission |
236 |
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Infection
Control Procedures |
239 |
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Sexual
Partner Notification: Disclosure |
242 |
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The
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242 |
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Vaccine
Development and Its Role in Prevention |
245 |
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Types
of Experimental HIV Vaccines |
249 |
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DNA
Vaccine |
249 |
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Coverage,
or Who Gets the Vaccine |
250 |
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Impact
Summary of an HIV Vaccine |
250 |
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Problems
in the Search for HIV Vaccine |
252 |
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Summary |
253 |
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Review
Questions |
254 |
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10 |
Prevalence of HIV
Infections, AIDS Cases, and Deaths Among Select Groups in the |
256 |
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A
Word About HIV/AIDS Data |
257 |
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The
Millennium: Year 2007 |
261 |
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Formula
for Estimating HIV Infections |
263 |
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Behavioral
Risk Groups and Statistical Evaluation |
265 |
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Estimates
of HIV Infection and Future AIDS Cases |
274 |
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Newly
Infected |
276 |
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Shape
of the HIV Pandemic: |
277 |
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Shape
of AIDS Pandemic: |
280 |
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Estimates
of Deaths and Years of Potential Life Lost Due to AIDS in the |
281 |
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Prevalence
and Impact of HIV/AIDS |
285 |
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Connected
But Separate |
285 |
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Workforce
- |
287 |
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Education: Teachers and
Student? – |
287 |
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Other
HIV/AIDS Time Bombs: Asia, |
288 |
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Summary |
292 |
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Review
Questions |
293 |
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11 |
Prevalence of HIV
Infection and AIDS Cases Among Women and Children |
294 |
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Triple
Jeopardy |
295 |
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International
Women’s Day |
295 |
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Women:
AIDS and HIV Infections Worldwide |
295 |
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Women:
HIV Positive and AIDS Cases - |
299 |
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Childbearing
Women |
310 |
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Internet |
311 |
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Pediatric
HIV Positive and AIDS Cases - |
312 |
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Orphaned
Children Due to HIV Infection and AIDS |
312 |
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The
Phenomenon of AIDS Orphans |
314 |
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Summary |
319 |
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Review
Questions |
320 |
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12 |
Prevalence of HIV
Infection and AIDS Among Young Adults, Ages 13 to 24 |
321 |
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Global
HIV Infections in Young Adults |
321 |
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Addressing
the AIDS Pandemic Among Young Adults |
322 |
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How
Large is the Young Adult Population in the |
323 |
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HIV/AIDS
Won’t Affect Us! |
324 |
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Estimate
of HIV Infected and AIDS Cases Among Young Adults in the |
326 |
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Summary |
331 |
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Internet |
331 |
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Other
Useful Sources |
331 |
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Review
Questions |
331 |
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13 |
Testing for Human
Immunodeficiency Virus |
332 |
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Determining
the Presence of Antibody Produced When HIV is Present |
333 |
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Requests
for HIV Testing |
333 |
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Reasons
for HIV Testing |
333 |
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Laboratory
Methods for Detecting HIV |
335 |
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ELISA
HIV Antibody Test |
336 |
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Western
Blot Assay |
342 |
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New
ELISA Antibody Testing and Viral Load Procedures Reveal Early Versus Late HIV
Infection |
344 |
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Rapid
HIV Testing |
346 |
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FDA
Approves Two Home HIV Antibody Test Kits |
350 |
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Some
Screening and Confirmatory Tests for HIV |
352 |
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Who
Should Be Tested for HIV Infection? |
353 |
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Why
is HIV Test Information Necessary? |
355 |
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Immigration
into the |
355 |
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Testing,
Competency, and Informed Consent |
358 |
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Summary |
363 |
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Review
Questions |
364 |
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14 |
AIDS and Society:
Knowledge, Attitudes, and Behavior |
365 |
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The
New Millennium and HIV/AIDS |
365 |
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HIV/AIDS
is an Unusual Social Disease |
367 |
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AIDS
is Here to Stay |
368 |
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AIDS |
368 |
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Blame
Someone, Déjà Vu |
368 |
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Fear:
Panic and Hysteria Over the Spread of HIV/AIDS in the |
369 |
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Whom is
the General Public to Believe? |
371 |
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AIDS
Education and Behavior |
374 |
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The
Character of Society |
380 |
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Dealing
with Discrimination: The Americans with Disabilities Act |
385 |
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Federal
and Private Sector Financing: Creation of an AIDS Industry |
388 |
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U.S.
Government Believes HIV/AIDS is a Threat to National Security |
391 |
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Global
HIV/AIDS Funding for Underdeveloped Nations |
393 |
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Forms
of |
397 |
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Summary |
400 |
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Review
Questions |
401 |
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Answers to Review
Questions |
403 |
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Glossary |
409 |
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References |
417 |
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Index |
439 |
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