Ashamed to Die begins with the Pegram family long before the AIDS epidemic swept the country. It's a simple story of a family burdened by tragic circumstances that were all too familiar to poor Southern communities in the age of Jim Crow. Skerrit immediately commands your attention as he describes the gut-wrenching prognosis of Tricia Ann Starr's little sister Carolyn and her losing battle with AIDS and addiction.

Skerritt accurately parallels the struggles of the Pegram family with the turbulent '60s, '70s and '80s and the political changes of a nation in turmoil after the civil-rights movement and the onslaught of the 20th Century's biggest epidemic, AIDS. Skerritt even shows how the foundation for an epidemic had already been laid by widespread syphilis and gonorrhea and how silence on these matters stemming from religious and cultural influence kept people from seeking help.

Akin to And the Band Played On, this book shows readers a fascinating look at how the medical community of the South reacted to one of America's best-kept secrets. Readers will feel the same frustration of the early doctors who tried to keep an open forum going about a disease many viewed as "God's punishment for gays", a disease those afflicted with refused to admit to themselves and loved ones.

Structure plays a big part in this book, as the author's chapters of medical research are very distinct from those pertaining to the narrative of the Pegrams. And through this vignette-style structure, Skerritt's character development technique mimics the lifespan of HIV as it turns to AIDS and eventual death in these documented cases.

Skerrit's voice and use of cultural vernacular also gives this book a human quality not often seen in traditional non-fiction or journalism. His ability to blend elements of dramatic storytelling with well-researched history make for a very readable text. It's also a very informative book about the disease in terms those not directly familiar with HIV/AIDS can easily understand. However, a basic knowledge of current and former AIDS medications certainly made a few passages more clear.

Tricia Ann serves as the book's main character and as Skerritt recreates her painful memories of those lost to AIDS his skills as a writer show through in moments of insightful reflection, which are often chilling and profound. A moment where Tricia Ann and her husband confront the ex-boyfriend responsible for giving Carolyn HIV will leave you speechless as it exemplifies the apathy and denial which enable the disease to keep spreading.

Powerful imagery keep you reading but also makes you cringe. That's the point of this book, to take you to the trenches, to show you the truth. Those who read this book will not to be quick to forget the agonizing final hours of Tricia Ann's sister, niece and friends as they succumb to AIDS. No detail is spared and at times you want to scream, stop! This book is written to make readers uncomfortable because out of discomfort grows change.

Not all of the striking images created by Skerritt will make readers squirm. One fact given by the author is that in 2005 half of the funerals for people with AIDS were held in the South, and though that statistic may seem sad, the funerals Skerritt writes are bittersweet celebrations of life. In these scenes Skerritt elicits so much emotion in his prose that it's enough to bring tears to your eyes and raise the hair on your arms. Ashamed to Die at its core is about people and their stories, some sad, and some hopeful.

This powerful story of loss and accomplishment shouldn't be missed. To skip this book is to deny the ongoing struggle with rural poverty and AIDS. Though the subject matter can be at times depressing, it's also a story of how a community takes care of each other in the aftermath of disaster and what is more American than that?