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A flame-throwing epidemiologist talks about sex, drugs, and the mistakes (dismal), ideologies (vicious), and hopes (realistic) of international AIDS prevention.
When people ask Elizabeth Pisani what she does for a living, she says, "sex and drugs." As an epidemiologist researching AIDS, she's been involved with international efforts to halt the disease for fourteen years. With swashbuckling wit and fierce honesty, she dishes on herself and her colleagues as they try to prod reluctant governments to fund HIV prevention for the people who need it most—drug injectors, gay men, sex workers, and johns.Pisani chats with flamboyant Indonesian transsexuals about their boob jobs and watches Chinese streetwalkers turn away clients because their SUVs aren't nice enough. With verve and clarity, she shows the general reader how her profession really works; how easy it is to draw wrong conclusions from "objective" data; and, shockingly, how much money is spent so very badly. "Exhibit A": the 45 billion taxpayer dollars the Bush administration is committing to international AIDS programs. 12 illustrations
- Sales Rank: #408653 in Books
- Published on: 2008-06-17
- Original language: English
- Number of items: 1
- Dimensions: .95" h x .13" w x .65" l, 1.55 pounds
- Binding: Hardcover
- 400 pages
Review
'[A] rollicking, eye-opening, hilarious account of the underbelly of international AIDS research ... Forget everything you've ever gleaned from boilerplate stories about AIDS research: The Wisdom of Whores vibrates with "I've been there" authenticity' Philadelphia Enquirer 'An absorbing read - Her book has freshness, charm and innocence, reminding us of the core elements that remain at the heart of this epidemic' Independent '[A] wonderful book on the salamagundi of money, politics, hypocrisy and obduracy (or possibly just plain stupidity) in what she calls the business of AidsA"' Telegraph 'A beguilingly rigorous expose - engaging, well written and entertaining' Times 'A major book' Daily Telegraph 'Pisani packs quite a punch. Her book - ignited a mini-firestorm of controversy - It exploded several prevalent myths about the diseases' Irish Sunday Independent
About the Author
Elizabeth Pisani has lived in Indonesia at various times over the past twenty-five years, originally as a journalist and later as an HIV epidemiologist. The author of The Wisdom of Whores and Indonesia Etc., she is based in London.
Most helpful customer reviews
3 of 3 people found the following review helpful.
Sex and Drugs…
By John P. Jones III
…is what Elizabeth Pisani says she does for a living. She says that it is a lot easier than trying to explain that she is an epidemiologist working in HIV/AIDS prevention and treatment. She is feisty, irreverent, provocative, knowledgeable, and deeply caring; a human who can be brought to tears simply by looking at numbers – and knowing what they truly represent. Her outlook is admirably captured by the title to her book. She does not specifically cite Thomas Pynchon’s “Proverbs for Paranoids”, the one that posits: “If you have them asking the wrong questions, you don’t have to worry about the right answers,” but she sure did act upon those truths. In the preface, she relates what the professor at the London School of Hygiene and Tropical Medicine asked at the end of the first lecture: “Why was there a fourteen-year gap between the first case-controlled study showing a strong association between smoking and lung cancer, and the first US Surgeon General’s report on the dangers of smoking?” She reports that there was only stony silence in the classroom, so she dared to break the ice with: “You’re asking the wrong question…Surely the key question is: how much money did British American Tobacco and Philip Morris give to US Senate campaigns in that fourteen-year interval? As with Big Tobacco, time and time again Pisani will reinforce the eternal truth that “follow the money” will provide the answer to a given action in the field of HIV / AIDS.
Before getting into “sex and drugs,” Pisani was a reporter for Reuters. Her media background, her ability to speak Chinese, and her medical scientific training has provided a strong background for being able to explain both the HIV / AIDS epidemic as well as the political and medical establishments’ responses. Admittedly I had never heard of the phrase “beating it up,” which is journalist-speak for “making a mountain out of a molehill,” as Pisani explains. How does one successfully “cook up” an epidemic – in the sense of getting serious money allocated to treat people who are engaged in “deliberate, disgusting and revolting conduct,” to use the description of Senator Jesse Helms? Market the “innocents”! The stay-at-home wives and their to-be-born children infected by their philandering husbands. A small element of truth that was “beat up” into very large appropriations spearheaded by Helms and the religious right (bless ‘em).
Down and dirty. The author can do spreadsheets, and sit in the back row at the international conferences playing *** Bingo while also asking provocative questions with the best of them. But she also does “HIV surveillance,” a nice neutral term that means she is out in the upscale gay clubs of Jakarta as well as along the railway tracks talking (and gaining the confidence!) of waria. Waria? Pisani says that it is a “smush-up” of a term, deriving its letters from the Indonesian words for “woman” and “man.” She develops an understanding for their lives, and what they truly do, and conveys it all to the reader in straightforward, “plain speaking” prose? “Bottoms.” A term of the trade along the railroad tracks, and Pisani discovers the percentage of times they become “Tops,” thus learning how HIV is so readily transmitted through the “community,” a term she proves is often not operative. In terms of “plain speaking,” the author’s chapter “The Naked Truth” is truly excellent on describing how HIV is actually transmitted.
Another truly excellent chapter is entitled “The Honesty Box.” It explains the many difficulties involved in epidemiological work in trying to obtain accurate numbers that truly depict an epidemic. There is simple miscoding of the survey forms. There are dispositive survey differences brought about via decentralization (everyone “doing their own thing.”) There is “survey bias,” i.e., receiving different answers depending on who is asking the questions. And on and on, including, of course, asking the wrong questions, or ones inappropriately formulated, in months, instead of yesterday.
Equally informative are chapters on the dominance of ideology over science (and how the scientists quietly try to circumvent this), particularly with American funding for HIV / AIDS, as well as the many intergovernmental and inter-NGO squabbles over the distribution of the now ample “sugar” of funding that is now in the pot. And then there is her own assessment why she herself, might not always undertake the appropriate protective measures (he is a “nice boy” through the second bottle of wine). Equally powerful is her discussion of her (apparently one-time) husband’s drug addiction problem and how she did not want to talk about it… but wanted strangers to talk about theirs. Yes, the ironies.
With an estimated 40 million dead from HIV /AIDs, and the fact that almost all of them would be alive today if they had used either a simple piece of latex and/or a clean needle, I felt it would have been useful if Pisani could have devoted a chapter to why people don’t, which would have expanded on her own reasons. In terms of inaccuracies, I was stunned with her description (and calculations!!) of Muslim religious beliefs concerning sex and Ramadan. First, it is only during the DAYLIGHT hours that Muslims must refrain from food, drink, sex. And during my 1979 visit to Indonesia, during Ramadan, I asked the rickshaw driver about the fast: “That is only something rich people do.” And then there is the “survey bias” that she did not seem to account for (p. 91-96).
Still, an excellent book that should be a required part of any course in Public Health… or for the “general” public who wants to know more about the epidemic of our times. 5-stars.
3 of 3 people found the following review helpful.
A reality check on HIV Prevention
By Value Brand
I hate boring books - they have the power to drive me to sleep. The Wisdom of whores does not fall in the category of "boring".
Perhaps I liked it so much because a lot of what Pisani talks about makes a lot of sense to me - I have worked in International NGOs that attempted to "fight" HIV but always had misgivings. In fact, I was introduced to this book by one of the Directors of a program that I was working on, and was very glad to find that my "suspicions" were not too outlandish.
I agree with Pisani that we cannot deal with the HIV pandemic by pretending/burying our heads in the sand and investing in "token" activities that do not actually "work". The things we need to do are probably distasteful to many, but we must ask ourselves whether we truly want to reduce the incidence of HIV or whether we want to engage in morality debates and wait for HIV to affect many more people. It truly is a wake up call, but perhaps is a bitter pill for many out there to swallow :-) I found it entertaining and educating.
3 of 3 people found the following review helpful.
Intriguing and informative
By Holly
I ordered this booked after watching Elizabeth Pisani's TED talk and wanting to know more about HIV/AIDS and her research. I just finished it and I thoroughly enjoyed every page. I rarely read any non-fiction and I did not expect to enjoy it nearly as much as it did but it keep my interest the whole way through. Everything from Pisani's stories about her time in China and Indonesia to the vast amount of information she offers about HIV/AIDS kept me wanting to learn more. I recommend this to anyone who's even remotely interested in learning more about the HIV/AIDS crisis and how it is handled around the globe, even if this type of book isn't your usual cup of tea.
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