Ronald J. Mancoske and James Donald Smith (Eds.), Practice Issues in HIV/AIDS Services.

Ronald J. Mancoske and James Donald Smith (Eds.), Practice Issues in HIV/AIDS Services. Binghamton, NY, 2004. $39.95 hardcover, $24.95 papercover.

The spread of HIV/AIDS has emerged as a major health crisis both in the developed and developing countries. In many African countries and in small sub populations in developed countries, the rates of infection are alarmingly high. Perhaps two prominent characteristics of this crisis are: a) the rates of infection are dissimilar across various social and demographic categories such as drug users and Hispanics. b) the causal factors associated with the rate of infection are not the same across various social and demographic dimensions. Social researchers and practitioners engaged in the fight against AIDS have responded to this diversity by publishing a number of books in recent years. These books describe the rates as well as correlates of infection within sub populations such as women and minorities. Several of these books inform us of the various aspects of the demand structure of social services necessary for the prevention, treatment and management of the disease.

Understandably, a large number of social workers are engaged in the fight against AIDS. Social workers are closely involved with the provision of HIV/AIDS services at all levels ranging from the micro to macro. Social workers use a number of tools to help populations at risk. However, a book was needed that could instill not only confidence in what social workers do, but also provide broad guidelines and suggestions useful for social service delivery to diverse populations with AIDS. This book is a welcome addition in this regard.

The book is a collection of chapters mostly written by social work scholars whose research is among HIV infected minority populations. A few practitioners, with several years of experience with HIV infected populations, also are among the contributors. This mix is very welcome as it reinforces the notion that theoretical discussions on social service delivery should not be divorced from practical experiences on the ground with provision of social service to the HIV infected. The very first chapter describes the potential and usefulness of the generalist model for social work among the HIV infected. The editors also endeavor to portray the magnitude of the current epidemic among sub populations that are hard to reach, neglected, stigmatized and socially excluded. Thus, service providers and social workers in general are made aware of the magnitude of the task they confront with regard to social service delivery and professional social work among socially excluded groups.

There is a general suggestion in the book that the case management approach is a useful one in the provision of social work services to the HIV infected. The editors suggest that case management in general is less based on treatment approaches and is more focused on community based multidimensional models of care. As a word of caution, the case management model will have to be flexible and be able to accommodate medical breakthroughs in the treatment of AIDS.

Two chapters discuss social practice with intravenous drug users. The usefulness of the harm reduction philosophy with this special population is considered in detail. The harm reduction approach is non-judgmental, promoting strategies for safer and managed use, and to the extent possible, abstinence. However, the United States restricts funding and other forms of support for needle exchange programs. This has ethical and legal implications for social work.

Four chapters discuss the role of social work among sub populations such as, Mexican migrant farm workers, African Americans, African Americans in the Delta region, and Louisiana African American women. Cultural values and roles play a very important part in the rate of infection in any given population. Among Mexican migrant farm workers for example, traditional values and definitions of masculinity bring about secrecy about homosexual relationships. Familism and situational factors such as drug use and drinking also influence the risk of exposure. Social workers have a responsibility to reach out to the socially excluded. A number of practical suggestions have been made to achieve this social justice goal. For example, in the case of Mexican farm migrants, the following recommendations have been made: information be made available in Spanish, outreach efforts be made gender specific, role playing be incorporated in order to induce social learning, and folk theater such as the Chicano theatre for communication should also be used.

Among African Americans, familial influences still remain strong. This is an immense resource in giving care to AIDS victims and in bringing about harm reduction. In the Delta, in addition to the family, the church also exerts a powerful influence on the values and ideals that people hold. An asset-based approach is proposed for working with and within community. The social networks and informal organizations that are fostered by the church in particular are seen as assets to be utilized in helping the community.

This book is valuable for scholars as well as well practitioners. Scholars will find a number of suggestions pertaining to the theoretical validity of the generalist model in addressing the issues of HIV/AIDS among socially excluded populations. The practitioners will find a number of suggestions, tips and valuable insights necessary to help marginalized AIDS victims. Among helping professions, social workers perhaps have the most useful and pivotal role to play in containing and managing the AIDS pandemic. This book is highly recommended to anyone who is interested in issues of social service delivery to those who suffer from AIDS.

Vijayan K. Pillai

University of Texas at Arlington