Mapping AIDS: Visual Histories of an Enduring Epidemic by Lukas Engelmann (review)

Lukas Engelmann's intensely theoretical book addresses the changing visualization of HIV/AIDS with a focus on AIDS atlases. He locates his narrative within the historiography of both the theory and visual elements of medicine. In so doing, Engelmann's study of how the challenges of "seeing" the AIDS epidemic have changed since the 1980s adds to the growing body of social research on HIV/AIDS, particularly Paula Treichler's work that established medicine as a legitimate focus for cultural analysis and made social research a core response for researching the epidemic.

Engelmann structures his book in three sections, utilizing different versions of the AIDS atlas produced between 1986 and 2008 to trace different ways of seeing (or not seeing) the disease. He chronicles how the visualization of AIDS began with clinical photographs of HIV and AIDS patients. Next, he maps how a global view of the epidemic emerged. Lastly, Engelmann examines how different representations of the virus have come to dominate our understanding of it. Starting with the early atlas produced by Charles Farthing and his colleagues at St. Stephen's Hospital (now Westminster Hospital), Engelmann reveals how the emergence of the epidemic crisis was only resolved through visual methods, as people sought to define and see a "person with AIDS" (p. 37). The photograph, Engelmann argues, sustained the relationship between the "who" and the "what" in enduring uncertainty (p. 41), while also revealing where the disease was heading. The second atlas series that Engelmann analyzes was published in the United States, where the chief editor was Alvin E. Friedman-Kien, reputed for his expertise on Kaposi's Sarcoma. Yet it was not only the publication of the atlas that moved, but understandings about the location of AIDS. Maps shifted the idea that disease was not only based around the body and a person to how the AIDS picture differed around the globe. They also revealed the global burden of AIDS. Such spatial visions of the disease and variations of understanding contributed to the shift to more scientific and laboratory-based representations of the virus.

Hence, perceptions of AIDS became a moving parameter. Yet the changing representations of the virus enabled methods that gradually located the core of the disease. Indeed, Engelmann views the latest version of the AIDS atlas, the International Atlas of AIDS (2008), as a directory or index of possibilities for visualizing the epidemic. Yet this is not the end of AIDS or the final way of viewing the disease, and Engelmann challenges the reader to continually reexamine the conceptualization of the epidemic. It would be nice to understand how AIDS patients conceptualized their needs and wishes surrounding their HIV care or where and how health education efforts influenced visualization of the disease across the globe. This is not to detract from Engelmann's work, but rather to suggest that there is further research to be done on the visualization of AIDS.

Mapping AIDS is based on Engelmann's German Ph.D. thesis. The translation into English is somewhat cumbersome and made parts of the densely argued text difficult to follow. With that in mind, this book is probably more appropriate for postgraduate than undergraduate students. It would be especially of interest to those following Foucauldian ideas about representations of disease in specific spheres. Engelmann's argument is an interesting one that highlights not only some of the many ways to view an epidemic, but also the challenges associated with contextualizing theories, particularly ones that cross cultural boundaries. In this case, the cultural boundaries do not simply relate to the disease, but also to the AIDS atlas as it moved from the United Kingdom to the United States, becoming a different series under a different publisher.