Rights Language and HIV Treatment: Universal Care or Population Control?

Patton, Cindy

doi:10.1080/02773945.2011.575328

Cited by 26 publications

(28 citation statements)

References 11 publications

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“…These examples indicate that additional sources of NPT education need to be developed that are both accessible and high quality; combination and integration of various approaches, with their associated strengths and weaknesses, may provide a means to this end. This is especially important as prevention messaging continues to shift away from established, relatable safer sex messaging – such as condom use – and towards complex, medicalized forms of prevention – such as viral load sorting (Patton, 2011). …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, scholars have problematized the underlying ethics of this prevention paradigm (Nguyen, Bajos, Dubois-Arber, O’Malley, & Pirkle, 2011). Patton (2011) argues that the introduction of TasP has seen a profound movement away from a model premised on individual, humanized, rights-based prevention and toward population-based, dehumanized, and medicalized prevention. This shift has reconstructed HIV as a concept that can only be addressed by “objective” medical experts and does not allow for the meaningful incorporation of the experiences of people living with HIV (Patton, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Patton (2011) argues that the introduction of TasP has seen a profound movement away from a model premised on individual, humanized, rights-based prevention and toward population-based, dehumanized, and medicalized prevention. This shift has reconstructed HIV as a concept that can only be addressed by “objective” medical experts and does not allow for the meaningful incorporation of the experiences of people living with HIV (Patton, 2011). Other scholars have emphasized that the implementation of TasP has come with increased medical surveillance and regulation, while also transforming the subjectivity of people living with HIV as the language of “undetectability” has been taken up on a community level.…”

Section: Introductionmentioning

confidence: 99%

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Gay Men’s Understanding and Education of New HIV Prevention Technologies in Vancouver, Canada

et al. 2017

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Effective rollout of HIV treatment-based prevention such as pre-exposure prophylaxis and Treatment as Prevention has been hampered by poor education, limited acceptability, and stigma among gay men. We undertook a thematic analysis regarding the education sources and acceptability of these New Prevention Technologies (NPTs) using fifteen semi-structured interviews with gay men in Vancouver, Canada who were early adopters of NPTs. NPT education was derived from a variety of sources, including the Internet, healthcare providers, community organizations, sexual partners, and peers; participants also emphasized their own capacities as learners and educators. Acceptable forms of NPT education featured high-quality factual information, personal testimony, and easy access. Stigma was highlighted as a major barrier. In order for public health, policy makers, and gay communities to optimize the personal and population benefits of NPTs, there is a need for increased community support and dialogue, anti-stigma efforts, early NPT adopter testimony, and personalized implementation strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gay Men’s Understanding and Education of New HIV Prevention Technologies in Vancouver, Canada

et al. 2017

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“…The language used to describe the TasP model reduces HIV-positive individuals to numbers, with those vulnerable to infection and potentially at higher risk of developing drug resistance, being examined in terms of cost-saving units, or potential future expenditures (Patton, 2011). The rights language developed to fight for individuals' rights to affordable, accessible HIV treatment are lost, and the argument centring on access to such treatments is now defined as economically 'cost effective', instead of 'ethically just'.…”

Section: Global Public Healthmentioning

confidence: 99%

Programmatic and ethical challenges in the implementation of treatment-as-prevention in the context of HIV and drug-resistant tuberculosis co-infection in sub-Saharan Africa

Melesse

Becker

McClarty

et al. 2014

Global Public Health

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There is limited literature on programmatic challenges in the implementation of a treatment-as-prevention (TasP) strategy among human immunodeficiency virus (HIV) and drug-resistant tuberculosis (DR-TB) co-infected individuals in sub-Saharan Africa (SSA). This paper highlights specific programmatic challenges surrounding the implementation of this strategy among HIV and DR-TB co-infected populations in SSA. In SSA, limitations in administrative, human and financial resources and poor health infrastructure, as well as increased duration and complexity of providing long-term treatment for HIV individuals co-infected with DR-TB, pose substantial challenges to the implementation of a TasP strategy and warrant further investigation. A comprehensive approach must be devised to implement TasP strategy, with special attention paid to the sizable HIV and DR-TB co-infected populations. We suggest that evidence-informed and human rights-based guidelines for participant protection and strategies for programme delivery must be developed and tailored to maximise the benefits to those most at risk of developing HIV and DR-TB co-infection. Assessing regional circumstances is crucial, and TasP programmes in the region should be complemented by combined prevention strategies to achieve the intended goals.

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“…This was sometimes experienced as debilitating, especially for those who had already experienced ill health (Barroso, 1997;Sowell, et al, 1998;Brashers, et al, 1999;Anderson, et al, 2000;Pierret, 2007). The imperative to manage uncertainty and risk also became part of the work of forging new HIV positive identities (Green & Sobo, 2000;Halkitis, et al, 2005;Flowers, et al, 2006;Baumgartner, 2007) and this imperative is operationalised within regulatory regimes for people with HIV (Kinsman, 1996;Lupton, 1999;Adam, 2005;Keogh, 2008;Patton, 2011).…”

Section: Anticipating Tasp: Public Health Perspectives Vs Those Of Pmentioning

confidence: 99%

Embodied, clinical and pharmaceutical uncertainty: people with HIV anticipate the feasibility of HIV treatment as prevention (TasP)

Keogh

2016

Critical Public Health

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Evidence of the efficacy of HIV treatment as prevention (TasP) precipitated a highly optimistic global response and a radical re-design of HIV policy. Sociologists and others have framed TasP within promissory or enterprising discourses which require HIV prevention planners and people with HIV to engage in anticipatory assessments of risk and uncertainty. In 2013, I conducted focus groups with people with HIV in London, UK to explore their understandings and anticipations of TasP.An environment of economic constraint obliged participants to triage clinical need and presentation and they expressed scepticism about the sustainability of pharmaceutical investment in treatment innovation. These perceptions were informed by an embodied knowledge of HIV which implies a construction of health as a form of capital that is finite and must be conserved. This is contrasted with a bio-medical construction of health as a form of capital that can be exponentially generated through investment. The imperative of conservation entailed by people with HIV's anticipations contrasts with the speculative economy of biomedical production entailed in planners' anticipations of TasP.Rather than researching 'TasP acceptability' and considering whether people with HIV's behaviours constitute an obstacle to TasP's effectiveness, we should recognise that people with HIV are already involved in shaping what TasP is, what it will be and ultimately how it 'works'.

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Rights Language and HIV Treatment: Universal Care or Population Control?

Cited by 26 publications

References 11 publications

Gay Men’s Understanding and Education of New HIV Prevention Technologies in Vancouver, Canada

Gay Men’s Understanding and Education of New HIV Prevention Technologies in Vancouver, Canada

Programmatic and ethical challenges in the implementation of treatment-as-prevention in the context of HIV and drug-resistant tuberculosis co-infection in sub-Saharan Africa

Embodied, clinical and pharmaceutical uncertainty: people with HIV anticipate the feasibility of HIV treatment as prevention (TasP)

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