HIV interventions

The arrival of modern biomedical tools has changed how HIV is understood and managed. Antiretroviral therapies, first used in 1996, marked a turning point, allowing many thousands of people to live with the virus without developing AIDS. These drugs have brought their own difficulties, including the challenge of keeping patients on schedule, the emergence of drug-resistant virus, and illness caused by the treatment itself. They have also complicated the ethics of medicine and altered how people judge risk and manage it, which creates new hurdles for prevention. Marsha Rosengarten argues that developing safer and more effective approaches to treatment, prevention, and perhaps a cure requires a clear grasp of how HIV, medical technology, and beliefs about the body relate to one another.

Rosengarten treats HIV as something that is shaped by, and also shapes, the material and informational settings around it. In her view, the medical science of the virus and the way it appears in individuals and communities feed into each other, and recognizing this exchange offers a fresh foundation for rethinking the epidemic and designing responses to it. Her evidence comes from a wide range of sources, including drug advertising, pill designs, research papers, clinical trials, diagnostic results, images of the virus, and interviews with people living with HIV and with those who work in the field. Through these, she shows how elements of the epidemic such as bodies, viral resistance, test results, and safer sex are produced through ongoing interactions.

These developments raise questions for existing prevention models and for ethics more broadly, especially as newer tools such as pre-exposure and post-exposure prophylaxis, and the prospects of vaccines and microbicides, move closer to use. The book will interest scholars and practitioners working on the social and ethical sides of biomedicine, biotechnology, and genomics. It also offers analytic tools and new perspectives to researchers in the sciences and social sciences, clinicians and clinical researchers, social researchers, policy makers, and prevention educators who must keep pace with a virus that continues to persist and, importantly, keeps changing.