Socialising the Biomedical Turn in HIV Prevention

Susan Kippax, Niamh Stephenson

Description

A compelling and wide-ranging study on why an informed and locally relevant social response to HIV is the only way forward

This book concerns HIV prevention.  In it the authors argue that until the world focuses its attention on the social issues carried and revealed by AIDS, it is unlikely that HIV transmission will be eradicated or even significantly reduced. The book argues that we are currently witnessing the remedicalisation or the continuing biomedicalisation of HIV prevention, which began in earnest after the development of successful HIV treatment, and that this biomedical trajectory continues with the increasing push to use HIV treatments as prevention, undermining what has been in many countries a successful prevention response. This wide-ranging study argues that HIV prevention involves enabling people and communities to discuss sex, sexuality and drug use and, informed by these discussion, devising locally effective strategies for promoting safe sexual and drug injection practices.

Acknowledgements; List of Figures and Tables; Introduction; 1. Mapping a Social Disease; 2. ‘Owning’ Uganda; 3. The Australian Partnership; 4. The Biomedical Narrative of HIV/AIDS; 5. Risk and Vulnerability; 6. Social Practices of Communities; 7. Researching Social Change, Working with Contingency; References; Index

Sujets

• Sociologie, société et politique
• Health

Informations

• Publié par: Anthem Press
• Date de parution: 28 juin 2016
• Nombre de lectures: 0
• EAN13: 9781783085071
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Socialising the Biomedical Turn in HIV Prevention
Key Issues in Modern Sociology
This series publishes scholarly texts by leading social theorists that give an accessible exposition of the major structural changes in modern societies. The volumes in the series address an academic audience through their relevance and scholarly quality, and connect sociological thought to public issues. The series covers both substantive and theoretical topics, as well as addresses the works of major modern sociologists. The series emphasis is on modern developments in sociology with relevance to contemporary issues such as globalization, warfare, citizenship, human rights, environmental crises, demographic change, religion, postsecularism and civil conflict.
Series Editor
Simon Susen - City University London, UK
Editorial Board
Thomas Cushman - Wellesley College, USA
Peter Kivisto - Augustana College, USA
Rob Stones - University of Western Sydney, Australia
Richard Swedberg - Cornell University, USA
Stephen Turner - University of South Florida, USA
Darin Weinberg - University of Cambridge, UK
Socialising the Biomedical Turn in HIV Prevention
Susan Kippax
and
Niamh Stephenson
Anthem Press
An imprint of Wimbledon Publishing Company
www.anthempress.com
This edition first published in UK and USA 2016
by ANTHEM PRESS
75-76 Blackfriars Road, London SE1 8HA, UK
or PO Box 9779, London SW19 7ZG, UK
and
244 Madison Ave #116, New York, NY 10016, USA
Copyright Susan Kippax and Niamh Stephenson 2016
The moral right of the authors has been asserted.
All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above publisher of this book.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Names: Kippax, Susan, author. | Stephenson, Niamh, author.
Title: Socialising the biomedical turn in HIV prevention / Susan Kippax &
Niamh Stephenson.
Description: London, UK ; New York, NY : Anthem Press, an imprint of
Wimbledon Publishing Company, 2016. | Includes bibliographical references.
Identifiers: LCCN 2016003918 | ISBN 9781783085040 (hardback : alk. paper)
Subjects: LCSH: HIV infections-Prevention. | AIDS (Disease)-Prevention. |
HIV infections-Social aspects. | AIDS (Disease)-Social aspects. |
HIV-positive persons-Sexual behavior.
Classification: LCC RA643.8 K46 2016 | DDC 614.5/99392-dc23
LC record available at http://lccn.loc.gov/2016003918
ISBN-13: 978 1 78308 504 0 (Hbk)
ISBN-10: 1 78308 504 5 (Hbk)
This title is also available as an e-book.
This book is dedicated to Robert Ariss, Tim Carrigan and Brett Tindall - three gay men whose lives and work informed this research, and who died of AIDS
CONTENTS
List of Figures
List of Tables
Acknowledgements
Introduction
Part I EFFECTIVE HIV PREVENTION
1. Mapping a Social Disease
2. Owning Uganda
3. The Australian Partnership
Part II SOCIAL TRANSFORMATION
4. The Biomedical Narrative of HIV/AIDS
5. Risk and Vulnerability
6. Social Practices of Communities
7. Researching Social Change, Working with Contingency
Notes
References
Index
FIGURES 1.1 HIV prevalence among South African pregnant women aged 15-49 years 1.2 Malaysian reported HIV notification rate (1986-2013) 2.1 Median HIV prevalence of ANC attendees from major towns and outside (1997-2008) 2.2 UNAIDS country information, Uganda 2.3 HIV prevalence rates (%) in pregnant women surveyed at antenatal sentinel surveillance sites in Uganda in urban Kampala, other urban sentinel sites, and rural sites (1985-2001) 2.4 Annual procurement and distribution of male condoms in Uganda (2007-2011) 2.5 Percentage of people with 2+ partners using condoms during last sexual intercourse by gender 3.1 HIV diagnoses in Australia per year (1985-2013) 3.2 HIV/AIDS incidence by exposure (1982-2008) 3.3 Proportion of men engaging in any unprotected anal intercourse with casual partner(s) (1998-2009) 3.4 Proportion of men engaging in any unprotected anal intercourse with regular partner(s) (1998-2009) 3.5 Proportion of non-positive gay men in Australia ever tested (1998-2009) 3.6 Proportion of non-positive gay men in Australia tested in the previous 12 months (1998-2009) 3.7 Proportion of men engaging in any unprotected anal intercourse with casual partner(s) (1998-2013)
TABLES 3.1 Forms of contact with HIV among non-HIV-positive men 4.1 UNAIDS Timeline 4.2 Updated UNAIDS Timeline: 2005-2014 4.3 Efficacy of HIV-prevention strategies established by experiment 4.4 Efficacy of HIV-prevention strategies established without experiment 4.5 Effectiveness of HIV-prevention strategies
ACKNOWLEDGEMENTS
The thinking in this book arises from years of collective discussion, debate and research. Many researchers and colleagues working on various aspects of HIV have fuelled our thinking through their encouragement, uptake and reworking of ideas presented here. For this ongoing discussion and provocation we are deeply grateful to Barry Adam, Peter Aggleton, Judith Auerbach, Michael Bartos, Don Baxter, Steve Bell, Alan Brotherton, Liviana Calzavara, Raewyn Connell, June Crawford, Mary Crewe, Ross Duffin, Gary Dowsett, Jeanne Ellard, Sam Friedman, Martin Holt, Paul Kinder, Brent Mackie, Limin Mao, Ann McDonald, Peter McDonald, Ted Myers, Christy Newman, Kane Race, Patrick Rawstorne, Edward Reis, Robert Reynolds, Juliet Richters, Celia Roberts, Marsha Rosengarten, Gary Smith, Paul Van de Ven, Cathy Waldby, Alex Wodak, Heather Worth and Iryna Zablotska. We are also thankful to two readers whose comments have helped to sharpen our argument. And we thank Bryan Turner for encouraging us to write the book.
We are very glad to have had the opportunity to work over elements of this book with students of the Masters in Public Health in the School of Public Health and Community Medicine at the University of New South Wales: their thinking about our approach has helped its development; in particular, thanks to Rosemary Amalo, Hayden Jose, Yves-Laurent Jackson, Evelyn Kwagala and Josephine Okwera Akullu.
The ideas in this book were further developed and challenged by discussions with colleagues whose research involves theorising social relations: Lone Bertelsen, Jayne Bye, Mark Davis, Ros Diprose, Rebecca Edwards, Elisabetta Magnani, Catherine Mills, Anna Munster, Andrew Murphie, Brett Neilson, Dimitris Papadopoulos, Ernst Schraube, Sheila Shaver and kylie valentine.
Also the institutional backing of the University of New South Wales and the collegial support of our colleagues in the Social Policy Research Centre in the Faculty of Arts and Social Sciences and the School of Public Health and Community Medicine in the Faculty of Medicine has been vital in helping us bring this book to publication, as has the ongoing support of Brian Stone and Tej Sood of Anthem Press. We are immensely thankful to Brooke Thompson whose sense of social connectedness gave rise to the cover.
And, finally, a special thanks to Michael Edwards who, in many different ways, supported our work over many, many months with good humour and patience.
Susan Kippax and Niamh Stephenson
December 2015
INTRODUCTION
This book concerns HIV prevention. In it we argue that until the world focuses its attention on the social issues both carried and revealed by AIDS (Fassin, 2007), it is unlikely that HIV transmission will be eradicated or even significantly reduced. The continuing and growing biomedicalisation of HIV prevention, which began in earnest in 1996-1997 after the development of successful HIV treatment and continues with the increasing push to use HIV treatments as prevention, runs the risk of undermining what has been - at least in many countries - a successful prevention response.
Our argument is that at least until such time as biomedicine develops an effective prophylactic vaccine and a cure for the human immunodeficiency virus (HIV), the world must rely on the everyday responses of people and communities to combat HIV. The world must rely on communities and the practices forged by these communities that reduce the risk of HIV transmission (primarily safe sexual and safe drug injection practices); on people s willingness to be identified as infected with HIV (HIV testing practices); and, for people living with HIV, on people s commitment to keep AIDS at bay (HIV treatment practices).
Combating HIV also relies on governments to ensure access to HIV-prevention tools, including condoms and sterile needles and syringes, as well as to biomedical prevention technologies, including those derived from successful antiretroviral treatment (ART) - pre-exposure prophylaxis (PrEP), microbicides and post-exposure prophylaxis (PEP) and male circumcision. It relies on governments to develop robust health infrastructures to support and enable regular HIV testing and to provide access to treatments for those living with HIV. It relies on governments to adopt pragmatic policies that are not deflected by moralistic or conservative ideologies. More broadly, combating HIV depends on civil society resisting HIV stigma and discrimination against those infected and affected by HIV, thereby enabling people and communities to discuss sex and sexuality and drug use in w