Referat Aids- about the virus, what happens, when someone has hiv ?, the search for an hiv vaccine

AIDS

o     INTRODUCTION

o     ABOUT THE VIRUS

o     WHAT HAPPENS, WHEN SOMEONE HAS HIV ?

o     THE SEARCH FOR AN HIV VACCINE

BOOK REPORTS:

o     JONATHAN DEMME - PHILADELPHIA

o     JEANNE BLAKE - RISKY TIMES

o     ADELE MINCHIN - THE BEAT GOES ON

o     ALICE HOFFMANN - AT RISK

AIDS

Introduction

AIDS (acquired immunodeficiency syndrome) results from the late stage of infection with HIV (human immunodeficiency virus). In adults, the onset of AIDS can take up to ten or more years, and new drug therapies can delay the progression of the disease into AIDS even longer. Thus, a person infected with HIV may look and feel healthy for many years, but he or she can still transmit the virus to someone else, which is why it is very important for individuals to get tested.

Today, the global AIDS crisis affects 43 million people, but in the West people have become complacent to the dangers. The AIDS epidemic has so far left 50 million people infect with HIV worldwide, 16 million have already died. That leaves 34 million people who are living with the infection. Africa has been the worst hit- 5.500 people die from AIDS-related illnesses there every day. There are new fears, that Asia may eclipse Africa in severity of infection levels. However, the steepest rise in infections in the world during 1998 was in the former Soviet Union and Eastern Europe. There are 1, 4 million children with Aids worldwide.

Campaigners say people who are too young to remember the massive AIDS-campaigns of the 1980s are becoming complacent about the risks of the disease. People are still ignorant about the risks of becoming infected with HIV, one in ten people wrongly believe there is a cure for AIDS and a further one in ten are not sure. Only a third of people aged 15-24 say that knowledge of HIV has made them change their lifestyle in some way - an 11% drop on the year before.

There is still no cure, the new and effective drugs have been responsible for fewer people developing full-blown AIDS and increasing the numbers of HIV positive cases.

About the Virus

HIV is present in infectious quantities in blood and blood products, semen and possibly pre-cum, vaginal and cervical secretions and also breast milk. During invasive surgical procedures healthcare workers may also come into contact with the following bodily fluids, which contain significant amount of HIV: Amniotic fluid, cerebrospinal fluid and synovial fluid around bone joints.

HIV us also present in negligible quantities in tears and blister fluid, but is not present in urine, vomit and sweat.

Generally the fragile nature of the virus prevents it from surviving for a substantial amount of time in the open air. The only studies on the survival of HIV outside the body have been conducted in the laboratory under controlled scientific conditions. These studies have found HIV is not affected by extreme cold, but it is destroyed by temperatures of 60 degrees centigrade and above.

Scientific studies have found that HIV can sometimes survive in dried blood at room temperature for up to six days. It is extremely difficult to assess exactly the length of survival of HIV outside the body in a non-laboratory setting.

HIV can't create itself under any circumstances. The virus has to be present in a person's body and then passed on to someone else. HIV doesn't develop in a person's body of its own accord like for example cancer.

HIV is a transmissible infection, which is passed from one person to another. The only way that a person can become infected with HIV is if bodily fluids of an infected person get into the body of an uninfected person. The main ways in which HIV transmissions takes place are through unprotected vaginal or anal sexual intercourse, e.g. sex without a condom. Through blood to blood contract, usually infection in this way is the result of sharing needles with an infected person. Finally infection may take place from an infected mother to her child either in the womb at birth, or through breast-feeding.

Although it is possible to become infected through oral sex, the risk of becoming infected in this way is much lower than the risk of infection through unprotected sexual intercourse with a man or a woman. When giving oral sex to a man, a person could become infected with HIV if infected semen got into any cuts, sores or receding gums a person might have in their mouth. Giving oral sex to a woman is also considered relatively low risky. Transmission could take place if infected sexual fluids from a woman got into the mouth of her partner, the likeliness of infection occurring might be increased if there is menstrual blood involved or the woman is infected with another disease.
While research suggests that high concentrations of HIV can sometimes be detected in pre-cum, it's difficult to judge whether HIV is present insufficient quantities for infection to occur. To guard against the possibility of an infection with HIV or any other sexual diseases it is best to practice safer sex, with a condom.

Deep kissing is a very low risk activity in terms of HIV transmission. HIV is only present in saliva in very minute amounts, insufficient to cause infection with HIV alone. There has been only one documented case of someone becoming infected with HIV through kissing, a result of exposure to infected blood during intensive kissing.

What happens when someone has HIV?

Most people who become infected with HIV don't notice that they have been infected. A few weeks after infection, the body's immune system reacts to the virus by producing antibodies. Some people with HIV have a short "seroconversation" illness at the time these antibodies are created. The likely symptoms are the normal response to many other infections, and may include a sore throat, a fever or a rash.

Someone living with HIV will have their CD4 count and viral load regularly monitored by means of simple blood tests. The results of these tests vary in response to infections, stress, exercise and the time of day, but it's of primary importance in indicating how their health is holding up under the assault of HIV. When someone has lived with HIV for a long time and their immune system has been severely damaged, there is a risk of opportunistic infections. Increasingly, it is possible to prevent or treat opportunistic infections, which may arise in someone living with HIV using drugs. For example, Pneumocistis carinii pneumonia (PCP) was a frequent cause of death in people with AIDS or late stage infection in the early years of the epidemic. Doctors are now able to prevent PCP with drugs, or to treat it quickly if it occurs. Death from PCP is now rare among people with HIV in industrialised countries.

The most effective way to attack HIV is with a combination of anti-HIV drugs. Combination therapy is a huge advance in the treatment of HIV, and many people have done very well on it. Combination therapy is not a cure and, because of complex rules governing how drugs need to be taken, various drug regimens can be difficult to take or adhere to.

But combination therapy has greatly reduced the number of people dying from HIV. As a consequence of combination therapy, today in Europe five times fewer people are dying of HIV infection than in 1995.

The search for an HIV vaccine

Soon after the identification of the virus in 1983, some health officials were predicting that a vaccine would be developed within a few years. Although it proved to be much more difficult, scientists are confident that an HIV vaccine will be discovered.

In 1987 the first human trial of a candidate HIV vaccine was conducted in the US. About 30 experimental vaccines have since been tested in about 60 trials.

So far, most of the trials have been staged in industrialised countries, but now trials are increasingly being done in developing countries also. During the 90s, several vaccine initiatives were launched in developing countries, including Africa.

A vaccine will not be a panacea, nor will it be an alternative to prevention. Because an eventual vaccine is unlikely to be 100% effective, it will have to be used alongside wide-ranging and effective prevention programmes. In fact, once a vaccine is developed, awareness-raising and prevention efforts will need to be redoubled in order to counter the risk of complacency. An HIV vaccine must benefit all humanity. Once discovered, the vaccine will have to be made available to everyone with minimum delay, in sufficient quantities and at affordable prices. Early planning is needed to ensure that this is achieved.

The peculiarities of the virus make the development of a vaccine an arduous and expensive process. Still lacking, for instance, is the clear scientific understanding required to guide the pharmaceutical development of specific candidate vaccines.

HIV/AIDS differs profoundly from most other infectious diseases. In the case of the latter, the body develops and immune response to an infection in order to protect itself and help it recover from disease. A successful vaccine against such diseases therefore stimulates effective immune responses, leaving them incapable of controlling infection or preventing disease.

Most existing vaccines are based on an entire microorganism (virus or bacterium) that has been killed or rendered harmless. In the case of HIV, however, those classical vaccine approaches are not considered sufficiently safe. Experimental HIV vaccines therefore are based on parts of the virus (to ensure that vaccination does not result in HIV infection). This makes the development of a vaccine even more challenging.

Ten subtypes of the HI-Virus have already been identified. Scientists do not yet know whether a vaccine will have to be prepared for each subtype or whether a more broadly protective vaccine will be possible. That, coupled with the fact that the subtypes in developing countries differ from those prevalent in the industrialised world, makes it essential that experimental vaccines be developed simultaneously in the North and South.

Scientists know that the development of a vaccine is possible (because animals can be protected against HIV infection), but they remain uncertain as to whether that success can be extrapolated to humans. For that reason, the search for an HIV vaccine has to include human trials, which are costly and time-consuming.

BOOK REPORTS:

Philadelphia

By Jonathan Demme

The director:

Was born on February 22^nd in New York. Jonathan Demme emerged from the halcyon days of low-budget genre filmmaking--he began as a member of Roger Corman's stable of writers in the 1970s--to become one of Hollywood's most critically admired directors in the 80s and 90s. He learned the craft of directing making cheapie action crime films like 'Caged Heat' (1974) and 'Crazy Mama' (1975). Demme enhanced his reputation with a series of lyrical sketches of rural Americana but is now best known for his fast-paced, hip, urban style. 'The Silence of the Lambs' (1991) finally brought him huge commercial success, the strongest reviews of his career, and several major awards, including a Best Director Oscar.  

The characters:

Andrew Beckett:

He's the main character of this drama about AIDS and homosexuality; at the very beginning of the story he works for a big firm of solicitors called "Wyant, Wheeler". Because of his intelligence, power of deduction, competence and love of the law he's depicted as a promising young talent. He feels the desire to fight against injustice, and he tries to reach this aim with all his might, which sometimes goes too far - you could call him a kind of workaholic. This character-trait has bad consequences for his physical condition, in the course of the story his health gets worse and worse.

He's a big fan of classical music, especially of Bruckner, whose music he likes to listen to when he's stressed or just has received bad news (for instance his dismissal). He's quite a well-balanced person and the peacemaker in the relationship to Miguel.

Miguel:

He's Andrew' lover and of course he's gay, too. He works as a teacher of art, is creative and interested in painting. He isn't as calm and peaceful as Andrew, on the contrary he reacts in a very emotional way, and he allows his emotions to reign freely. He's very concerned about Andrew's health, he's aware of the sad future of his partner and tries to look after him as good as he can.

Joe Miller:

Like Andrew he's a lawyer, too, but of course he isn't that successful and well-known as his client although he is "quick on his feet". At the beginning of the story he's like everybody else: He has an aversion of gays.

After his first contact with Andrew (when he shakes his hand) he consults his doctor and inquires him about AIDS. But in the course of the book he undergoes a profound change, he's also influenced by his open-minded wife Lisa.

The plot:

Andrew lives a kind of double-life: In his job he's successful, ambitious, happy and popular. But in the evening, when he comes home, he has to face his biggest problem: he is HIV positive.

The book starts with the description of a trial about a building made of limestone; with his well-founded and cogent arguments Andrew wins the trial against his black opponent Joe Miller, who tries to convince the judge with his rather emotional tactics. Of course Andrew wins the trial - but whereas Joe now can go home to his wife Lisa, Andrew has to go to hospital and let Dr. Gillman look after his bloodwork before he can return to his lover Miguel.

At this point his state of health is quite stable, and so his boss, Charles Wheeler, entrusts him with one of the biggest cases his firm has ever had, ostensibly not knowing about Andrew's deadly illness.

Andrew concentrates upon this case, knowing that his future and his excellent reputation depend on the outcome of it. Regardless of his health he throws himself into this nerve-racking work which turns out to be the beginning of his end. His psychical condition deteriorates constantly, after some weeks his lesions become so big that he decides to stay at home in order to keep quiet about his illness (and sexual orientation); he converts his apartment into his office, some days later he collapses in the bathroom and has to be taken to hospital. There a telephone call of his secretary lets his level of adrenalin increase: a file about this important case is missing. Andrew moves heaven and earth to find it and finally the desperate search is crowned with success. Nevertheless Andrew gets sacked the next day under the pretext that he's nearly ruined his firm.

Now Andrew's fight against discrimination, prejudice and personal affection and aversion starts. He believes that the reason for his dismissal wasn't the nearly lost complaint, but the fact that he's gay and infected with AIDS. It turns out to be nearly impossible to find a lawyer who has the courage to sue one of the biggest law-firms of the state; finally Joe Miller takes on this difficult work, having discussed with his wife. Joe is critical of gays, too, he has the same prejudices like everyone else, decisive for his decision is the obvious discrimination against Andrew (e.g. the request of a member of the staff of a library to read his book in an extra room). First Andrew talks to his family to ensure the moral help of them. Then "Wyant, Wheeler" offer a piddling sum of money to him in order to steer clear of a defamatory trial, but Andrew refuses to withdraw his indictment.

Now the real courtroom-drama starts: Joe tries to point out that Andrew has been a perfect lawyer, that he's been more than only a talent, that he's been successful, that some partners did know about him having AIDS and that he had only been fired because of his illness and sexual orientation - that the reason for the lost file must have been a complot. The council of the defense, Mrs. Conine, wants to persuade the jury that Andrew's just been mediocre, that he has lost the complaint and that he's only been sacked because of his incompetence.

She denies that there's been a conspiracy, she tries to make the jury show emotions, she wants to point out the differences between the "normal" average chap from your neighborhood and "abnormal", disgusting "queers". Dozens of witnesses are questioned, and the longer the trial goes on, the more "Wyant, Wheeler" get caught up in a web of lies and contradictions. The critical stage is when Mr. Kenton - a very homophobic lawyer - tells one episode about his life at the Navy, the methods of punishing gays which is nothing short of a confession.

In the course of the trial Joe's attitude towards homosexuals changes for the better - he gets open-minded and treats them like normal people -, whereas Andrew's physical condition deteriorates, he finally breaks down in court.

In the end Joe's strategy turns out to be the better one, he wins the trial and tells Andrew the outcome of the trial on his deathbed - Andrew dies in the arms of his lover.

Interpretation:

"Philadelphia" - the name of the city where the story takes place - is a powerful plea for equality of rights for hetero- and homosexuals, for healthy men and people who are infected with AIDS. It isn't written in a very complicated way, you won't succeed in finding lyrical expressions or stylistic devices - it's written for the folk, it's written in a straight, direct way and wants to show the problems everyone is confronted with.

If you try to analyze the different characters of "Philadelphia", you can identify with them; e.g. after shaking hands with Andrew, Joe consults a doctor to ask him about AIDS. I think nowadays everyone knows about how to get infected with this deadly illness, but nevertheless you'd hesitate to get in physical contact with AIDS-infected persons.

Christopher Davis and Ron Nyswaner try to make us get rid of our prejudices and anxieties, although it may seem to be normal to show negative emotions towards homosexuals; many people think that it has to be - that it is disgusting, nasty and simply ugly to kiss someone who has the same gender, but homosexuals could also think that it has to be disgusting, nasty and ugly to kiss someone who hasn't got the same gender, even if this is "normal".

Apart from various character-traits Davis and Nyswaner also want to show the polarization of the population, the differences within it and the resulting problems. They want to point out that there are two extremely different opinions and want to tune us to more tolerance.

Personal opinion:

I think it was a good idea to read a book like "Philadelphia", not only because it urges us to show more morality. It isn't written in a very difficult way, you understand all actions and even the (deeper?) meaning without thinking for hours. It's fluently written, and it was no problem for me to read dozens of pages in one go.

All in all I'd say that Davis and Nyswaner wrote an interesting, heart-warming and deeply moving story about a serious theme, although some scenes strike me as rather overdrawn.

Risky Times

By Jeanne Blake

Plot:

This book is a guide for teenagers, with a lot of short stories about HIV-infected persons, their history of becoming infected and their way to handle with this serious disease.

These many stories are mostly very tragic: a woman who never had any relations with drug-addicted persons or homosexual men fell in love with a cute man, who seems to be as healthy as everyone. Years after this relation, the woman already had success in her job and a loving family, she found out that she is infected with HIV, and that her children are infected too.

A successful artist, who is homosexual but has always used a condom for sexual intercourse, gets infected just because a condom tore.

A nurse, who always made the greatest efforts in her job, because her main goal was to help as many people as possible, got infected when she tried to treat a drug-addicted person.

A teenager, who had the usual problems in his youth, but also couldn't resist the temptation of drugs, got addicted to cocaine first, and to heroin afterwards. He didn't think that the consequence of sharing a needle with other persons could be so terrible. He got infected at 19 years, two years later he was already dead.

All these stories are very tragic, and they seem very unfair. But is it more fair, when a homeless drug-addict gets infected, who doesn't have a family or a home, but is judged to die? It doesn't matter if you are

The book shows, that every one of us is very endangered to become HIV infected, and its main topic is how to prevent getting Aids. The best way of prevention is still using condoms, but not even this is absolutely safe, as the story of the homosexual artist shows. It is very important, that every human being is familiar with this disease in its entire details, so people might think twice before they have sex with another man or another woman, they might be more careful and will have more respect to infected persons.

Jeanne Blake's wants every juvenile and every adult, who doesn't know everything about Aids, to read her book. Prevention, as best as it could be, can only be reached through information, safer sex and understanding.

The book contains every single detail about Aids, the risks of getting infected, drugs and their relation with Aids, stories about infected persons and it answers a lot of questions.

Interpretation:

The author's goal was to create an alternative kind of protection, which is to clear up at best everyone. With tragic stories and useful tips, but also explanation of everything which is important to know, I think she reached her goal.

Personal Comment:

I can only recommend this book to everyone, because the author did her job very well, and managed to write a high-quality Aids-guide. It shows the deep frustration of infected persons, and also how easy it is to become infected. The short stories are very tragic and make the reader very concerned about this topic.
Kids, who are not familiar with the great risk of getting Aids, will understand the whole topic after reading this book.

The Beat Goes on

By Adele Minchin

Author:

Adele Minchin is 28 and has worked in PR for four years, first at Campaign against the Arms Trade and then in publishing. She also volunteers at Body and Soul, the self-help organisation supporting adults and young people living with and affected by HIV/AIDS. She lives in London. The Beat Goes On is her debut novel.

Characters:

Leyla:

She is 15 years old, and lives in a small town near Manchester. Her mother makes her life hard, when she sometimes acts like if she was the queen or just not understanding her greatest hobby, which are playing the drums. Leyla is a girl with courage, ambition and sensitivity. Emma is her cousin and "soul mate", the two girls are unseperatable.

Emma:

Her mother Jean is Leylas aunt, but is much more relaxed and seems very happy, so is Emma a happy and outgoing person too. She is beautiful and intelligent, sensible and funny. She broke up school to work as a mechanic, but after a little time she gave that up, too. So she went to school again, and everything was ok again. That freedom was over when she found out that she's HIV positive, what changed her and Aunty Jean's life dramatically.

Darren:

He is not the typical 18-year-old guy he seems to be, he has succes in whatever he does, so as skateboarding, DJ-ing and school. Leyla is the first girl he really loves, his patience and tenderness make Leyla's heart obey him. Although he is not involved with the problem, he knows there's something wrong, and without asking and being curious, he tries to do his best to support Leyla with her stress.

Plot:

Leyla is a 15-year-old girl, and because of her boring life, in which everything seems to be the same everyday, she wants a positive drama to happen, with her involved.
One day, she has her drama, but not one with a happy end. Her cousin and best friend, Emma, wakes her up to tell her that doctor's found out that she is infected with HIV. She also tells her how that mistake has happened, it was just as usual: She was on a school-trip, and got drunk like all her friends too. Then she met a nice boy, and the rest should be clear. She never dared to think he was HIV positive.

It is a terrible shock for both of them, but Leyla promises not to tell a third person, but also that she would support her cousin in every possible way.

The two girls try to handle this situation as best as they could, Leyla gets more and more informed about Emma's disease and they try to have as much fun as possible.

They join a great gig by a high-school-band, which they both enjoy very much. Leyla meets a young and attractive guy, called Darren. She and Sarah, her best friend from school, have a very secret place and the next day Darren appears.

He invites them to another, even greater gig the next weekend and Leyla finds out that Darren feels attracted to her either. So the three girls go to the gig, first disappointed that there is no alcohol for teenagers, but also satisfied with the good music, Darren plays as a DJ.

Emma joins a self-help-centre, and a group from kids at her age, who suffer the same as she does - HIV. It helps her a lot, to talk to these people, with the same fears and hopes as she has.
One day, Emma wants Lelya to join this group too - as a drummer-teacher, but Leyla feels that her own prejudices are becoming apparent, she tells Emma she would feel like the odd one out, what makes Emma feel very disappointed and hurt. After thinking about this conversation, Leyla finally agrees and everything is alright again.

Leyla and Darren's relationship gets more and more intensive, they start kissing and both agree to be a pair right now.

One day at Emma's house, Emma falls from a really good and positive mood into a deep depression, she's aggressive against everything and doesn't understand why HIV is a "dirt disease", not as cancer is a normal one. People with these diseases are treat differently. After a terrible break-down, she gets normal again, slowly. Emma's mum Jean and Leyla hug her and so she calms down.

The first time Emma joins the people of the centre, she is very nervous and feels helpless, but as Emma told her, everyone in there is very happy to see the person who makes the music group possible, and soon Leyla feels very comfortable. She likes the relaxed atmosphere there, which does her something good because at home she is much stressed by her family. On the other hand, Emma, who is always very extroverted and outgoing, gets as shy as if it is her first date, when she meets the group.

Emma is very happy for Leyla's bond with Darren, but it makes her sad too. She recognizes that the chance for her to experience the same as Leyla is very small. Emma's mood changes by minutes, from happy to sad, from sad to depressive.

The first performance as a band is very successful for Leyla, she feels very proud and she likes working with these people, although it's not always easy. Leyla is very shocked and surprised, when she's looking for the restrooms and suddenly Darren appears who is much happier about that meeting than Leyla. He is also in a band, which practices in the same complex as Leyla's group. She still tries everything to keep her secret as such, although it is very hard for her.

On day, Sarah and Leyla go to a party Darren invited them to. Darren is as gentle as usual, and when they locked themselves in the bathroom he asks her if she'd like to have sex with him. She agrees, but insists in using a condom, which they don't find. So Darren is sad first, but soon everything is ok again.

The next day in sports at Leyla's school, she trips and cuts her knee. Before her teacher can help her, the greatest bully of the school, Claire Higgins shouts out loudly that Leyla has AIDS and everyone should avoid contact with her, because she's bleeding. Immediately Leyla slaps her hard in the face, which results in an audience at the headmaster's office. It was Darren, who has told other people about meeting Leyla and her HIV-positive friends, and Claire soon heard about it too.
Leyla explains everything to the headmaster, who immediately calls her parents. They are very angry, narrow-minded and intolerant, so they forbid Leyla to continue her volunteer work with the group. That forces Aunty Jean, Emma's mum, to talk to Leyla's parents. She explains everything, and as expected both of them are really shocked. From then, they didn't talk a word about this issue, allowing Leyla to continue her Saturday meetings with the group, but also avoiding to get involved in any way.

Emma's self-help-centre falls into great financial problems, so Leyla has the idea to produce a CD to get some new sponsors. First there are big problems, but Darren makes it possible. He finds a producer who offers them his recording studios and the production totally free.

But then Aunty Jean decides to take Emma to London, because there's much more help for her daughter. Soon after their arrival, Emma gets sick and is already strapped in a hospital bed. HIV has developed into AIDS, and she suffers a serious stomach disease. Leyla wants to visit her immediately, but her mum disagrees. Nevertheless, Leyla leaves her home with tears in her eyes, but while she waits for the bus her mother takes her with the car.

They talk like they'd never did before, and then Leyla falls asleep, just to be woken up by her own song, played by the local radio. She feels Emma close to her, and thinks about her former wish of a good drama in her life. After all experiences she has experienced, she now wants to have a good life in her drama, for her and all people she loves.

Interpretation:

This novel shows how hard it is to live with HIV in today's community. Not only because of the prejudices, and there are a lot. People, who only know that there is a disease called AIDS but nothing else, tend to believe and act in crucial ways.

It shows how hard it must be for a relative, or a friend, to live with HIV indirectly. You can get easily involved, and although chances for good and educated people from Europe are not as big as from third world humans, everyone is much more at risk than we would believe.

This novel is very social-critical. As soon as Leyla's performing with the group gets public, she is HIV infected. Leyla's parents, who really believe HIV can be transmitted by touching an infected person, are not alone with their non-knowledge.

The tragedy, which happens at the end, doesn't seem to be just another good drama which makes romantic women cry. The whole story is reality, and happens every day.

The author wanted to show problems of infected people, but also the problems this disease takes with it, how surrounded people are affected as well.

Personal comment:

This novel makes the reader believe that he is involved in the story. It shows how helpless infected people are, but also that it's not senseless to continue living with HIV. It is very tragic and ironic, but you will barely laugh while reading. The story is written in the view of Leyla, a 15-year-old girl, who feels not strong enough to give enough help and support. While reading, I often thought about how easy it is, to get infected. But soon afterwards, how hard it must be to live with HIV, and how impossible it is, just to take a medicin like for headache.

The story is told with honesty and intensity, reflected by reality.

At Risk

By Alice Hoffmann

Characterisation:

Amanda:

She is a happy, eleven-year-old girl, who already has found her true vocation which is becoming a professional gymnast. She loves school, and earns top-marks, although she doesn't have to study as much as many other children at her age. She loves her family and even when she knows how bad things seem, she is not really afraid of death. The thing she is concerned most about is missing school during her last few weeks, and only when she couldn't really breathe anymore, she gave up the dream of the gymnast finals.

Ivan:

He is an astronomer and scientist, who always seem to have a possible solution for everything. That's the reason why he suffers most of all, he has always protected his family in every way, but when they found out Amanda has AIDS not even he could safe her. He is a strong but peaceful man, and even in the final period of Amanda's fight he tries to find someone he can blame for this situation.

Polly:

Polly is a professional photograph and she's very successful. It seems she loves her work more than everything, but from when she found out Amanda's sick she didn't work anymore. She fights against the prejudices and fears of others, but soon she realizes this won't lead to anything but anger. She's desperate, and everything seems so strange to her, as if it was only a nightmare.

Charlie:

Although he's just eight, he is very well informed about anything, including AIDS. Like young brothers are, he teases Amanda and makes his parents worry when he brings animals of every kind at home. He is very happy, but too intelligent to ignore Amanda's problem. He feels neglected, but soon he handles with it and understands, that now Amanda is the centre point in their family. He shows greatness when he accepts this, and until his sister dies he placed his own desires in the background, supporting his family as much as possible.

Plot:

Picture an ordinary American family, living right next to Boston in a small city. They are four, Polly the mother, Ivan the father, Amanda the eleven-year old daughter, who has all signs of becoming a teenager, and Charlie, eight years old, who seems only to be interested in dinosaurs, amphibien, and nature.
Amanda is a very succesfull girl, with certain goals she wants to reach. She is a gymnast, and probably the best in her town, so she competes at any tournament with success. She visits a kind of summer-school, because she has the ambitions to be a very good student too.

One day, after another successful competition, she breaks down and gets high fever. Polly tells her it would be better the next morning, but not this time.

When the fever holds on, she takes her daughter to the local doctor and friend, Ed Reardon, who takes blood and stool samples for the laboratory. A few days later, he has the terrible news for Ivan first: Amanda has AIDS, she was infected when she had a surgery five years ago, and a transfusion with contaminated blood had been given to her.

From now, as expected, things start getting difficult. Amanda is too young for being able to accept this drastical change of her life, she doesn't even know much about AIDS. Her first question is how long she must stay away from school. Her brother Charlie is much better informed about AIDS, he knows more than his parents and his personality towards Amanda changes from the typical aggressive between children to a very sensitive way.
Another problem appears, soon Amanda's disease gets public and so many parents are concerned of their own child, sitting right next to an HIV positive child in school. Even Polly's partner in work, Betsy Stafford, whose son Sevrin is Charlie's best friend since they were three, avoids contact with the whole family. She even forces Sevrin to change to a private school. All these things are very difficult for Amanda's parents and also Charlie, who feels neglected and no longer loved. The fact that Amanda seems not to care much about the situation, because she is too young, makes it even worse for Polly, who feels alone although her husband is as concerned as she is. Ivan starts calling a help-hotline, found by a group of gays in Boston. But he does that without his family's knowledge, but that's the way he feels as best as he can. To Polly, he seems more and more to be a stranger, he doesn't trust the usual therapies and searches for natural alternatives.

Amanda starts going to school, and her best friend, the coach's daughter Jessie supports her in every way, but Amanda starts thinking about her disease and death. Amanda gets weaker and weaker, so the coach has to do a difficult decision. Because of the risk of the girl getting injured because of her weakness, he tells her sadly that the following competition would be her last one. Amanda cries and is desperate, because ever since gymnastics was everything for her. She makes her routine, the best she ever had. And from then, she knows she wouldn't ever be back on stage, just watching her mates competing. She feels weak and tired. So Dr. Reardon examines her, finding out she has a serious lung disease, which forces her to stay in hospital.

At the same time, Ivan's friend Brian from the hotline gets sick and is about to die. So he's going to see him in Boston, in an unbearable status. He is loosing his only friend, the only person he could talk to in this situation.

Amanda has a last wish, which is to get rid of her braces she has worn now over three years. It is hard for Polly and Ivan to fulfil her wish, because their dentist refuses to treat AIDS patients. This makes Ivan developing cruel intentions, he wants to take a shotgun and visit the doctor. But he finds an alternative, he calls Brian who immediately finds a solution, a different doctor who really helps Amanda. After the procedure she looks in a mirror, unable to do anything else than smiling. So she knows, she would have been beautiful.  

Amanda's status gets critical, her lungs are filled with fluid, and she suffers a high-grade pneumocystis. Dr. Reardon insists in taking her to the hospital again, but Amanda and her parents refuse. It will be her last few days, no matter if she is at home or in the hospital. Amanda makes her testament, and the few things she loves go to her parents, Charlie, her grand-parents and her best friend Jessie.

When she has gone, Charlie takes her gym bag with his mother's camera and rides to the secret pond, where he and Sevrin sometimes went to see turtles.

He thinks about not forgetting her, he'll always say if he's asked that he has one sister, Amanda. He will even tell his kids everything about her, so she will live forever in all their hearts.

Interpretation:

The story of a young girl who has AIDS is tragic, but the way this novel is written makes the reader feel with the girl, with her family. The author chose a story, which surely happened many times in real-life. It shows the intolerance and the fears, which even the young class-mates of Amanda have. The parents are helpless; they just have to wait for her daughter's death to come and although they try to make it as easy as possible for her, that seems not to be enough.

Reading this story is not fun, and the heaviest thing is, that it seems so much real.

Personal Comment :

Although I've seen many tragic films or books, and although I think I'm tough and immune against things worse as this story, reading this novel made me feel almost depressive. It is one thing to be sentenced to death, but another thing is if the person is only eleven years old, successful and hopefully to reach many further goals. The deep sadness her family suffers, the problems they have with the community seem to be expected, but not as tragic as this.

For me, this is the best novel according to this topic I read, although sometimes during reading I almost refused continuing, not because it was boring but too touching. I recommend this novel to everyone, who is only a bit interested and concerned in AIDS.