Productive Living Strategies for People with AIDS.

This book primarily deals with the many nonmedical problems faced by individuals with acquired immunodeficiency syndrome (AIDS) and also with some of the attitudinal issues in society that affect those individuals with this disease. it is written by people who obviously are very strongly committed to helping persons with AIDS and who therefore attempt to give guidelines for coping with some of these problems. Although not expressly stated in the title, this book is actually part of the Occupational Therapy in Health Care Series. Despite the fact that there are some chapters with contributions by physical therapists, nurses, social workers, and others who are not occupational therapists, both of the editors are listed as occupational therapists, and most of the overall tone and descriptions in the book indicate that occupational therapists are intended as the chief audience.

This book offers a single, brief chapter that gives a very limited overview of the biological and medical aspects of AIDS, with the majority of the chapters devoted to a wide array of psychological and social considerations. Some of the chapters are entitled "Values and Life Goals," Cultural Considerations," "AIDS: The Spiritual Challenge," "Women and AIDS," "AIDS in a Correctional Setting," "Adult Day Care for People with HIV," and "Gay Grief." This is certainly an eclectic group of topics, and this variety is one of the major positive features of the book. In addition to these topics, there are also two chapters that might have more direct interest to physical therapists on a practical level. One is coauthored by Meredith Hinds-Harris and deals with children who have AIDS; the other is written by Mary Lou Galantino, who describes pain management and neuromuscular reeducation.

Most of the chapters are relatively brief, easy to read, and do not get bogged down with large amounts of detailed factual information. This feature becomes more of a defect than an asset because, in general, the book tends to deal with broad concepts without providing enough appropriate supporting information. Many of the recommendations and particular strategies are general in nature and often only represent superficial or common-sense suggestions. I do not automatically oppose a general method of approach to a complex subject, but here it becomes repetitious and amounts to over 200 pages of reading.

There is also what seems to be at least one gravely misleading aspect. in what appears to be an attempt to show that the human immunodeficiency virus (HIV) does not discriminate or limit itself to only certain groups, the first chapter presents a "personal reflection" from three individuals with AIDS that describes the suffering they have faced. These are certainly very moving portrayals, but they represent atypical cases involving two children and a woman who developed AIDS from blood transfusions they received during those relatively brief early years before a blood screening test became available. There is no doubt that AIDS is a devastating illness, regardless of its mode of transmission. Epidemiological data, however, still indicate that when considering the total population of individuals with AIDS, or even the larger group with HIV infection, transfusion-mediated infection represents a very small portion of either group. I am sure the intention is to increase acceptance of all individuals with HIV infection and AIDS and to increase awareness of the problems they face, but this first section essentially ignores the reality of the risk factors for acquiring HIV infection and AIDS.

About half of the chapters offer some study questions at the end, which would seem to make this book appropriate for an educational setting. I would not, however, recommend this book for allied health students unless they are using additional sources of information. I would also not recommend it for physical therapists or physical therapist assistants because it is somewhat out of date and provides mostly general information with little useful documentation of opinions. It might be an appropriate resource for the general public to get some nontechnical overviews of unusual AIDS topics. For health care workers, there are other resources available, such as AIDS and Allied Health Professionals by Hopp and Rogers, that do a better job of providing the necessary biomedical information on AIDS as a disease, while also offering presentations on psychological and social issues facing individuals with the disease.