Mary Elizabeth O'Brien. 222 pages. New York: Auburn House; 1992. $49.95.

In the beginning was the epidemic of cases of the acquired immunodeficiency syndrome (AIDS), soon followed by the epidemic of AIDS conferences. Now we are seeing the epidemic of AIDS-related books. Only a few of these should be a part of most medical libraries; Living with HIV: An Experiment in Courage is not one of these. Although it is a well written and obviously compassionate book, its scope and tenor are too narrow to be of general appeal.

The book is based on a study of persons with AIDS that was done in a large Eastern U.S. metropolitan area during the first decade of the human immunodeficiency virus (HIV) outbreak in the United States. As the author points out, the study participants were almost exclusively homosexual men. This is both the strong point of the study and the major weakness of the book. Although Dr. O'Brien clearly outlines the psychosocial stages of HIV infection in this subpopulation, emphasizing living with HIV rather than dying of AIDS, the world view that is delineated here is a small segment of the global HIV picture. This book provides minimal insight into the problems of women, children, injection drug users, heterosexuals, Africans, or Asians who are infected with HIV. Although her first chapter is titled "The World of HIV Infection," her book reflects only a small part of the world's epidemic.

The last five chapters of the book provide a good overview of the stages of coping with AIDS as they have developed within the U.S. metropolitan homosexual community. The insights here are good and the examples well written. The book would be a valuable introduction for nursing and paramedical personnel anticipating working with those patients with HIV who have these particular demographics. Those who have been involved in the epidemic for any length of time have already had experience with most of the findings in the book.

Many other books including AIDS: Living and Dying with Hope by Smith, and The AIDS Epidemic: Balancing Compassion and Justice by Wood and Dietrich, would be more valuable for the practitioner who is facing the broader scope of the HIV epidemic. Finally, the price seems high for a small soft-bound book.