Gena Correa, The Invisible Epidemic: The Story of Women and AIDS, 356pp, Harper Perennial, 1992

This book chronicles the slow awakening of the American public and of the medical community to the realization that not only homosexual men were susceptible to the frightening new epidemic of AIDS. Women were dying of this disease too from the beginning, but it was underground, away from public interest or even notice. IV drug use and heterosexual sex spread the disease just as easily as male homosexual intercourse, and female homosexual intercourse might very well do so as well, but no one was seeking definite answers to these issues. The medical care of even affluent financially advantaged women is inadequate in this country, and AIDS was hitting disadvantaged and "invisible" communities hard in the early years of the epidemic, as it does today. Only when prison chaplains, social workers, clinic doctors, and others working in these places of poverty began to realize that a lot of young women were dying for mysterious reasons did the first push to force realization of the disease's inevitable spread through female sex as well as the male truly begin.

A struggle taken up by feminist groups, gay rights groups, female physicians, and individuals with HIV, the fight to bring awareness of AIDS and HIV in women to the public's attention has been a hard one and is not yet over by any means. Shown in this book are the diverse communities of solidarity such dire need can create; communities including respected research doctors, prostitutes, middle-class white housewives, grandmothers of HIV-infected children, nuns, gay men, and countless others. Although the disease has caused incredible suffering to the human race, the continued threat of its existence has brought people together and empowered many. The stories gathered here are at the same time heart breaking and inspirational.

The basic goals of the activists followed in this book were:

• To initiate funding for clinical research trials studying the effects of AIDS and HIV on the health of female patients, including whole-body health as well as gynecological.
• To initiate the inclusion of women in clinical research trials of how various AIDS therapies affected patients. Was there a difference of the effects of AZT, for example, in women than in men? All trials being conducted at the time (the early through late 1980's) contained a handful, if any, women, and there was no inquiry into the effects of the drugs on health issues specific to women.
• To shift the attention onto women as patients and not merely as vectors of disease to men and children.
• To have the gynecological manifestations of AIDS symptoms and those of accompanying opportunistic infections acknowledged by the CDC diagnostic screening list. Thrush was listed as a possible symptom of AIDS, but not Vaginal Candidaisis. The same opportunistic microbes were responsible, only their physical location was different.
• To promote the AIDS education of women so that prevention might be more possible in at-risk communities, and also promote the AIDS education of the public at large to create the understanding that "at-risk communities" truly contain us all. If you are human, you may contract HIV.
• To promote study of how preventative measures might be made more possible for women to undertake. The male medical world was showing little understanding of the limitations of sexual protection available-designed for men yet the concern of women.

It can hardly be claimed that this story is over now and and ended happily ever after, but an important beginning was set into motion. Victories such as the record of the National Conference on Women and HIV Infection in December of 1990 that concludes the book are in the rear-view mirror, but there is still much to be done.

This book provides different benefits to different reader groups. I think that to male readers it can provide new understanding of issues in women's health and why they are still so important and contested. To female readers it can provide much information not particularly public before-I consider myself conversant with much of the history of the feminist movement and was shocked to discover the existence of U.S. internment camps for women infected with syphilis near army bases during World War II. An ugly little secret in our nation's past, and one everyone should know about. The book is a gripping read and the personal stories within are hard to soon forget, bringing home with shocking immediacy that disease does not in reality affect "others" but in fact affects people much like us and that we could be among those affected more easily than we care to imagine. The notes and sources cited in the text are diverse and authoritative, and Correa wisely lets the voices of those whose stories are being told to ring out in their full character in a way statistics and generalizations never could. The main bias evident in the text is an understandable frustration in the face of the mass denial present in our culture towards the "otherness" of many groups. Depending on the perspective, anyone can be an "other", a danger that must always be kept in mind. Discrimination is ever-present in our society, and it not only prevents proper care of those with disease, it can foster the continued spread of disease, if no one cares to help or educate those discriminated against for other reasons. In the world of AIDS and HIV, discrimination aids the spread of AIDS.