Elizabeth Pisani, The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS
I picked this up when it briefly was a free ebook giveaway in 2010. Was that less than a year ago? Seems like a long time. I had not got through Jonathan Engels, The Epidemic: A Global History of AIDS, finding it not-global and spending too much time emphasising that the AIDS activists from the gay community really should have understood that they were viewed as sinners. Or that’s how I remember it now. I’m still interesting in the story of AIDS in the US, but I want it billed as such.
Anyway, Pisani’s book is an epidemiologist’s view of working in HIV research and prevention in (mostly) Indonesia. It’s partly a story and partly an argument that HIV/AIDS funding and approaches need some revision. In particular: prevention is cheaper than treatment, so while treatment is essential she thinks prevention is very underfunded. The approaches used successfully in the high-infection-risk communities in the US don’t all translate well to other high-risk groups. Emphasis on “everyone’s at risk” is nice for funding but is essentially bogus in most cultures: in most cultures sex workers, drug users, and people who have anal sex with multiple partners are at risk. (She argues the African epidemic is due to multiple long-lived concurrent heterosexual relationships being very common in some African cultures. This means that when someone has a primary HIV infection, one of the most contagious times, that they will often have more than one partner to potentially transmit to.)
I simply don’t know how valid her arguments are, because I know next to nothing about epidemiology, public health or HIV/AIDS, really. One of many books (almost anything outside my expertise) where I wish I could see expert reviews to read alongside it.
Read it if: you are interesting in HIV/AIDS, the UN, charity and NGO stuff, Indonesia, trans issues, sex worker issues.
Caution for: every so often she likes to add in a teaspoon of “I’m not PC!” She actually is, somewhat, anyway, but she likes to revel a touch in how her hip UN “AIDS mafia” crew were just such good buddies they could throw the lingo (about trans people, drug users, sex workers) in the bin. Also you may not actually agree with her on where HIV/AIDS funding should go, but it’s a book, you run that risk.