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Doody's Review ServiceReviewer: John A. Robinson, MD (Loyola University Stritch School of Medicine)
Description: This is a manual written for healthcare practitioners by 23 authors, 5 of whom are physicians.
Purpose: The purpose is to provide a "readable" approach for clinicians and students taking care of patients with HIV.
Audience: The targeted audience should include healthcare providers other than physicians.
Features: This manual, like many others, is a well-intended work suffering from an identity crisis. To be a complete tome, it attempts unsuccessfully to incorporate almost the entire world of T-cell immunology into a few short pages and to provide detailed HIV virology in a half-size primer that clearly is directed toward healthcare practitioners other than clinicians and basic scientists. Why attempt this when these topics are covered in definitive HIV texts? The truncated coverage of virology and immunology, laboratory data interpretation, and clinical care approaches results in a manual that is not very useful for medical students and residents; indeed, its briefness may provide a harmful temptation for readers who need in-depth reading on the topic. There is also a definite subtext throughout that advocates decision making by primary care physicians and paramedical personnel. Although these healthcare providers have important roles in the care of patients with HIV/AIDS, patients do best with care by infectious disease specialists and other pertinent subspecialists. One example suggests a need for updated writing: A chapter on counseling states that "anyone engaged in sex within the past 14 years, unless with a mutually monogamous uninfected partner, should be tested for HIV." Better gear up some overtime help in the AIDS testing industry — that's a lot of people. Perhaps a better approach would have been to update the 1987 criteria listed for justifying such a recommendation.
Assessment: Although the intent is admirable, the outcome is less so. I pray for a moratorium on HIV manuals.