Eleanor Pitt

Women, Poverty, and AIDS : Sex, Drugs, and Structural Violence, a collection of essays edited by Paul Farmer, Margaret Connors, and Janie Simmons. Published by Common Courage Press in Monroe, Maine in 1996. 474 pages. Includes a 75 page bibliography including more than 1,000 authors with their relevant articles in chronological order, a short glossary, and a 30 page annotated list of community outreach programs all over the world that target poor women diagnosed with HIV and AIDS. Does not contain illustations.

As recently as 1990, so-called AIDS experts have denied that women would ever constitute a significant part of those infected with HIV. Now less than twenty years after the first cases of AIDS were identified, HIV and AIDS-related illnesses account for the majority of deaths of women aged 25-44. According to the authors of Women, Poverty, and AIDS, the first in a series of books dedicated to health and social justice, women's voices have been excluded from debates and research concerning AIDS since it's discovery in 1981. This books attempts to rectify that mistake by reexamining the AIDS epidemic through "the eyes of a person living in poverty."

The book is divided into three parts: Rethinking AIDS, a section dedicated to viewing the epidemic from often neglected perspectives, that of poor women throughout the world; Rereading AIDS, which seeks to analyze the plight of poor women with AIDS and HIV from sociological, epidemiological, and clinical points of view; and finally, Reconceptualizing Care: Pragmatic Solidarity, which looks at obstacles to this new conceptualization and includes an annotated list of community outreach programs that target poor women who have been diagnosed with HIV or AIDS.

The articles are all written by the editors and other collaborators, and try to construct a global perspective of the issues of poverty, women's roles and rights, and the AIDS epidemic. In an effort to establish the book as a forum for the voices of poor women who have been marginalized in the overall debate on AIDS, Paul Farmer examines the lives of three women in the title article. These women represent three very different cultures and modes of HIV infection. The stories are accompanied by comments from the women themselves regarding their backgrounds, infection, diagnosis, and subsequent treatment. In the following articles, however, women's voices are neglected, as the authors instead pose questions relating to health and social justice, such as:

• How are sex, money, and drugs tied together for poor women, and why are their risks thereby increased?
• How does the "war on drugs" affect poor women, in particular?
• What is the link between isolation, powerlessness, and the spread of HIV?

These questions are then explored in concise yet thorough arguments that abandon personal voices in favor of behavior analysis and recitation of statistics.

The book is intended for readers interested in the making of health care policies, social activism, and intercultural relations. Written more from a sociological perspective than a biological one, the book focuses on gender roles in different cultures and how these predispose women to be victims of AIDS and HIV, rather than the different modes of transmission that place women at a greater risk for contracting the disease. The essays illuminate often overlooked socio-economic factors that put women at risk and analyze the effect that AIDS and HIV can have on women's issues and solidarity. However, the book is approximately three years old, so many of the statistics and information are out of date. Because of this, it's less effective as a source of useful data and statistics than as a guide to a way of thinking about epidemics in general, and the effect of the AIDS epidemic on poor women in particular.