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AIDS and men. Taking risks or taking responsibility?

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    AIDS and men. Taking risks or taking responsibility? Martin Foreman, ed. (Pp 240; price not stated). London: The Panos Institute and Zed books Ltd, 1999. ISBN: 1870670 40X pb; 185649 7445 hb.

    AIDS and men is a contribution of the Panos AIDS programme from the Panos Institute, which was founded in 1986, to stimulate the debate on global environment and development issues, particularly on the marginalised sectors of society. Funding for the Panos AIDS programmes comes from the Norwegian Red Cross, the Swiss Agency for Development and Cooperation, the Swedish International Development Cooperation Agency and also from the Royal Danish Ministry of Foreign Affairs and the Ford Foundation.

    Since the programme's first publication, AIDS and the Third World (1986) Panos has provided information on the AIDS epidemics in many ways. Briefings and sheets were circulated worldwide. Other titles from Panos are On the margins by Neil McKenna (1996) about the relation between HIV and sex between men in the developing word. A forthcoming publicationThe Silent Epidemic, is a shorter and updated summary of the AIDS epidemic.

    AIDS and men is a collective book. Their main message is about the limitation to consider women as a primary target of many AIDS prevention programmes. In fact, women are contracting HIV at a faster rate than men. Furthermore, women with the virus may pass it to their future children. Also, at home and in hospital, women assume greater responsibility for caring for the sick. But, most of these prevention programmes have little impact on the overall course of the epidemic. Perhaps because the men usually decide whether women can protect themselves and because men are more likely than women to transmit the virus to others. Men determine the path of the disease. For that, we need prevention programmes that directly tackle men's sexual and drug taking behaviour to reduce the epidemic spreads.

    The book is divided into two parts. The 50 pages of part one are an examination of the very relevant aspects, in the editor's opinion, of the evolution of the epidemic. As the author's conviction about the importance of men's behaviour in the spread of the epidemic, each of four chapters of this first part are considering specific issues. For instance, “Men, sex and HIV”, explains the differences in sex behaviour between men and women and the role of the physical factors for contagion. But this part also includes some reflections on masculinity and virility (“What makes a man?”), about the factors on the female vulnerability despite the recent improvements in the status of women in many parts of the world, like smaller income than men or, still most important, their dependence on men in sexual activities; and lastly, a claim to “Changing men's behaviour” .

    The second part has been written by journalists from 11 countries (Ghana; Ivory Coast; Kenya; Malawi; Tanzania and Uganda from Africa, Brazil and Mexico from America, Bangladesh and Thailand from Asia, and Russia) to illustrate many different aspects of the relation between men's actions and AIDS—from machismo in Mexico to homosexuality in Kenya. These country reports share a humanistic approach as well as the goal to promote the discussion, at the local level if it is possible.

    The book has great interest for public health practitioners because it offers an intersectorial picture on several aspects related to the AIDS prevention in men.