War and Sexual Violence — Mental Health Care for Survivors

Abstract

Over the past half-century, historians have used episodes of epidemic disease to investigate scientific, social and cultural change. Underlying this approach is the recognition that disease, and especially responses to epidemics, offers fundamental insights into scientific and medical practices, as well as social and cultural values. As historian Charles Rosenberg wrote, “disease necessarily reflects and lays bare every aspect of the culture in which it occurs.”1 Many historians would consid- er it premature to write the his- tory of the HIV epidemic. After all, more than 34 million people are currently infected with HIV. Even today, with long-standing public health campaigns and highly active antiretroviral ther- apy (HAART), HIV remains a major contributor to the burden of disease in many countries. As Piot and Quinn indicate in this issue of the Journal (pages 2210– 2218), combating the epidemic remains a test of our expanding knowledge and vigilance. Nonetheless, the progress made in addressing this pandemic and its effects on science, medicine, and public health have been far- reaching (see timeline). The chang- es wrought by HIV have not only affected the course of the epi- demic: they have had powerful effects on research and science, clinical practices, and broader policy. AIDS has reshaped conven- tional wisdoms in public health, research practice, cultural atti- tudes, and social behaviors. Most notably, the AIDS epidemic has provided the foundation for a revolution that upended tradition- al approaches to “international Related article, p. 2210 health,” replacing them with in- novative global approaches to dis- ease. Indeed, the HIV epidemic and the responses it generated have been crucial forces in “in- venting” the new “global health.”