Download or read book The Production and Governance of Risky Sexual Subjectivity in the Era of Pre Exposure Prophylaxis PrEP to HIV written by William James Schlesinger and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pre-exposure prophylaxis (PrEP) to HIV is a promising yet controversial new technology in the biomedical HIV prevention toolkit. Despite PrEP's demonstrated effectiveness in reducing the risk of HIV acquisition by up to 99% when taken daily, PrEP utilization remains not only modest overall but also inequitably distributed in patterns that directly contradict epidemiological data regarding greatest need and most significant potential benefit. While incidence rates have begun to decrease, disparities are in some cases widening, exacerbating the disproportionate representation of racialized men who have sex with men (MSM) in the epidemic. This dissertation questions: what does the failure of PrEP to catalyze a significant overall reduction in new HIV diagnoses in the United States reveal about the biomedical production and sociopolitical governance of risky sexual subjectivity? Utilizing data collected through semi-structured interviews, participant observation, and autoethnography, this project: i) elucidates PrEP's effects on sexual subjectivity vis-à-vis the historical present of HIV prevention discourse and practice; ii) evaluates how encounters with risk shape access to and persistence on PrEP and vice versa; and iii) contextualizes clinician and PrEP non/user engagement with PrEP within broader processes of biomedicalization. For men who have sex with men (MSM), claims to moral sexual subjectivity are linked to notions of responsible risk management. By enabling condomless anal sex with significantly diminished likelihood of seroconversion, PrEP can work not only as a harm reduction intervention in epidemiological terms, but also to remodel the way MSM experience and relate to risk. The capacity of PrEP as a biopharmaceutical means to achieve these ends, however, is constrained by the risk compensation debate and the "purview paradox," which limit uptake of this vital prevention resource among individuals vulnerable to HIV. While redressing these roadblocks is critical to enhancing PrEP's real-world effectiveness, the goal of ending the HIV epidemic will necessitate addressing the structural conditions that produce HIV acquisition risk. Technological solutions like PrEP to social problems like HIV transmission will continue to exacerbate disparities within a capitalist health care system that profits from pathology.
Download or read book The Ambiguity of Hiv Risk in Pre exposure Prophylaxis prep Administration in New York written by Elisabeth Arndt and published by . This book was released on 2020 with total page 177 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Risk" has become a ubiquitous concept in American healthcare settings, drawing both on objective biostatistics and on subjective, morally-charged interpretations. In particular, past epidemiological categorizations of a patient's identity or behavior-like their race or sexual practices-as "risk factors" for contracting HIV has promoted the sociocultural interpretation of HIV risk and stigmatized individuals in those groups. Nonetheless, with the advent of the pharmacologic Pre-Exposure Prophylaxis (PrEP) to prevent HIV transmission, such epidemiological categories of HIV risk are being even more broadly applied. The first medication used for PrEP was Truvada (emtricitabine and tenofovir disoproxil fumarate), an antiretroviral manufactured by the pharmaceutical giant Gilead Sciences that was first approved by the FDA in 2004 to treat HIV-positive patients and then approved again in 2012 as PrEP to prevent HIV infection in HIV-negative patients. Currently, the indications for PrEP prescription are impressively broad and vague, allowing much room for interpretation. Given how past identifications of HIV risk factors negatively implicated entire groups of people, there is a significant need to better understand how HIV risk has been conceptualized, how these concepts may be influenced by the interests of public health agencies and healthcare corporations, and how they play out for health professionals and patients in the clinical setting.In this dissertation, I examine the concepts of HIV risk that come into play in the administration of PrEP, considering how these concepts are understood by individual health professionals and patients alike and how such representations may align with the goals of healthcare corporations and public health agencies. Using ethnographic research techniques, I contrast the perspectives of HIV-negative patients identified as candidates for PrEP, HIV- positive patients, and health professionals administering PrEP to capture how they may understand HIV "risk" and PrEP's role in treating it. I conducted the fieldwork for this dissertation in a New York community health center network that provides PrEP and HIV services to diverse patient populations. I interviewed patients, clinic administrators, social workers, public health workers, and pharmaceutical industry members; observed clinical interactions; reviewed medical charts; and analyzed HIV prevention advertisements, publications, and guidelines. Based upon these collected data, I found that the discourse surrounding HIV risk is ambiguous, PrEP distorts and crystallizes this ambiguity, and structural risk (embedded healthcare structures identifying certain people as "at risk") is a reflective "model of" and constructive "model for" this process in a top-down direction. In doing so, I draw attention to the social significance of the pharmaceuticalization of risk by showing how pharmaceutical marketing can impact how risk is conceptualized, communicated, and experienced.
Download or read book HIV Pre exposure Prophylaxis written by Ellen White and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Association Between Sexual Behavior and Adherence to HIV Pre exposure Prophylaxis Medication in HIV Serodiscordant Couples written by Alexander Kintu and published by . This book was released on 2013 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt: High levels of adherence have been identified as a key factor for effective pre-exposure prophylaxis medication (PrEP). Because PrEP is a new concept in HIV prevention, there are limited data on predictors of adherence, though initial findings indicate that sexual behavior could be an influencing factor. This study examines different aspects of sexual behavior and their associations with monthly rates and patterns of adherence. We enrolled 1147 HIV-negative individuals living in long-term serodiscordant relationships at three sites in Uganda. Sexual behavior was assessed via monthly in-person interviews and adherence was measured through electronic monitoring of pill bottle openings. We used generalized estimation equations to adjust for risk factors of low adherence to PrEP medication. Fifty-three percent of participants were male, 51% were aged between 18 and 34 years, the median number of years they had lived with the HIV-positive partner was 8.5 years and 24.2% were in polygamous relationships. Participants who had sex with other partners and also had less than 100% use of condoms were more than twice as likely to have less than 80% adherence (OR=2.48, 95%CI=1.70-3.62). Per electronic monitoring, 54.7% of cohort participants had at least one 72-hour consecutive gap in adherence. Participants who had sex with other partners and were also had also reported less than 100% use of condoms had a 50% increase in odds of having a 72-hour gap in adherence (OR=1.50, 95%CI=1.19-31.91). Low overall adherence and extended gaps in adherence were more common in participants that abstained from sex and those that reported sex outside their primary partnership. Despite high monthly adherence rates, many study participants had long periods of non-adherence during which they engaged in risky sexual behavior with potential for HIV acquisition.
Download or read book Thinking Ethically about HIV Pre exposure Prophylaxis Retention in Care and Sexually Transmitted Infection Testing in a Southeastern United States Local Health Department in the Time of COVID 19 written by Ellie Purdy and published by . This book was released on 2021 with total page 89 pages. Available in PDF, EPUB and Kindle. Book excerpt: Author's abstract: Local Health Departments (LHDs) are critical providers of Human Immunodeficiency Virus (HIV) and sexually transmitted infection (STI) prevention efforts. HIV Pre-Exposure Prophylaxis (PrEP) is an evolving public health initiative and practitioners should consider PrEP interventions in context of ethical decision-making and a broad STI prevention strategy as global incidence of bacterial STIs remains high and those at-risk for HIV are generally at-risk for other STIs. An evaluation of the Thinking Ethically framework and LHD PrEP services was performed to fill a gap in the literature and support program decision-making. A retrospective review of PrEP user medical records from a LHD in north Georgia from July 2019 to June 2020 was performed and data were assessed using descriptive statistics, negative binomial, and logistic regression. Total STI tests performed by the LHD from July 2018 to June 2020 were calculated to determine the change in STI testing services associated with the onset of the COVID-19 pandemic. The Thinking Ethically framework was valuable to PrEP-related decision-making. There were 63 PrEP users in the study period of which most were White non-Hispanic (60.3%) men who have sex with men (61.9%). Retention in care was associated with clinic site. Most bacterial STI cases diagnosed among PrEP users were asymptomatic (75%). Fifty percent of PrEP users obtained services beyond STI prevention including vaccination and referrals. District STI testing declined between the second quarter of 2020 and 2019 with a decline in HIV testing by 38%, syphilis by 48%, gonorrhea and chlamydia by over 50%. LHD decision-makers can feasibly apply the Thinking Ethically framework to public health practice. Results support the need for LHD continuous quality management as retention in care differed by clinic site, and more resources will be needed to engage hard-to-reach populations at-risk for HIV like injection drug users. The COVID-19 pandemic impacted PrEP and STI services and more data is needed to determine the long-term effects of the COVID-19 pandemic on the STI landscape.
Download or read book PrEParing and Producing the Queer Medical Subject written by Nicholas Flores and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation examines the proliferation of the HIV pharmaceutical drug, Truvada, as an oral chemo pre-exposure prophylaxis, referred to as PrEP in central Ohio. I trace the social and cultural effects of PrEP on individuals and communities whose risks of HIV transmission are particularly elevated and cited in public health and medical literatures. My aim is to show how the distribution of PrEP in central Ohio elucidates meaning-making practices among key actors, stakeholders, structures, and institutional forces that claim efficacy of the drug through ethnic, racial, sexual, and class informed logics regarding the science and technology of PrEP. The objective of this project is to gain insight into how PrEP comes to matter as it moves from pharmaceutical laboratories, clinical sites, community-based organizations, and, finally, into a broader public sphere surrounding HIV/AIDS discourses and practices. As an ethnographer, I employ an interdisciplinary and collaborative research approach that draws from cultural and medical anthropology, literature on sex and sexuality, and critical literatures on race and ethnicity in the United States. I draw on ethnographic, discursive, and historical analysis to address the nature of minority communities’ responses to PrEP by examining three independent yet interrelated moving parts: local community-based medical clinics and pharmacies, individual level knowledge and practices, and the broader HIV/AIDS context in the United States. I conducted sixteen months of ethnographic fieldwork and worked directly with medical providers, pharmacists, PrEP advocates, and minority populations to better understand the uptake and significance of PrEP in a local setting. I argue for expanded conceptualizations of structural racism and justice within the medical field in the United States, one oriented toward health equity, structural competency, and social and racial justice. My research expands upon how we think about social markers of difference in relationship to medical knowledge and practice. My research also highlights how medical mistrust, racism, shame, and stigma around sex practices continue to persist that affect medical encounters and PrEP use. The dissertation elucidates the material, political, and affective work that HIV prevention technologies are made to do in relation to our social and cultural contexts emerging out of contested histories of racialization and sexualization. While this dissertation is interested in PrEP’s proliferation and the reconfiguration of what types of intimacy, pleasure, and affective registers are made available, it is equally invested in how these differential relationships are enacted in HIV prevention work. My project demonstrates that an understanding of HIV prevention must engage multiple convergences and how meanings are produced through the interaction of various phenomena, which include specific biomedical interventions like PrEP, as well as figurations of knowledge production found in multi-media campaigns, clinical practices, educational presentations about PrEP, and the bodies for whom the drug is intended. Each component and entity operates differently and creates their own space, as well as produce values to the practices, networks, and actors that are linked through racialization and sexualization.
Download or read book Mastering the Semi Structured Interview and Beyond written by Anne Galletta and published by NYU Press. This book was released on 2013-06-17 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mastering the Semi-Structured Interview and Beyond offers an in-depth and captivating step-by-step guide to the use of semi-structured interviews in qualitative research. By tracing the life of an actual research project–an exploration of a school district's effort over 40 years to address racial equality–as a consistent example threaded across the volume, Anne Galletta shows in concrete terms how readers can approach the planning and execution of their own new research endeavor, and illuminates unexpected real-life challenges they may confront and how to address them. The volume offers a close look at the inductive nature of qualitative research, the use of researcher reflexivity, and the systematic and iterative steps involved in data collection, analysis, and interpretation. It offers guidance on how to develop an interview protocol, including the arrangement of questions and ways to evoke analytically rich data. Particularly useful for those who may be familiar with qualitative research but have not yet conducted a qualitative study, Mastering the Semi-Structured Interview and Beyond will serve both undergraduate and graduate students as well as more advanced scholars seeking to incorporate this key methodological approach into their repertoire.
Download or read book Ending AIDS in the Age of Biopharmaceuticals written by Tony Sandset and published by Routledge. This book was released on 2020-09-02 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book considers the change in rhetoric surrounding the treatment of AIDS from one of crisis to that of ‘ending AIDS’. Exploring what it means to ‘end AIDS’ and how responsibility is framed in this new discourse, the author considers the tensions generated between the individual and the state in terms of notions such as risk, responsibility and prevention. Based on analyses public health promotions in the UK and the US, HIV prevention science and engaging with the work of Foucault, this volume argues that the discourse of ‘ending AIDS’ implies a tension-filled space in which global principles and values may clash with localised needs, values and concerns; in which evidence-based policies strive for hegemony over local, tacit and communal regimes of knowledge; and in which desires compete with national and international ideas about what is best for the individual in the name of ‘ending AIDS’ writ large. As such, it will appeal to scholars of sociology and media studies with interests in the sociology of medicine and health, medical communication and health policy.
Download or read book International technical guidance on sexuality education written by UNESCO and published by UNESCO Publishing. This book was released on 2018-01-15 with total page 139 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Sexually Transmitted Infections written by National Academies of Sciences, Engineering, and Medicine and published by . This book was released on 2021-12-24 with total page 750 pages. Available in PDF, EPUB and Kindle. Book excerpt: One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Download or read book HIV and the Blood Supply written by Institute of Medicine and published by National Academies Press. This book was released on 1995-10-05 with total page 349 pages. Available in PDF, EPUB and Kindle. Book excerpt: During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease. During this period of great uncertainty, decision-making regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system. The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was doneâ€"and recommends what should be done to produce better outcomes in the face of future threats to blood safety. The committee frames its analysis around four critical area: Product treatmentâ€"Could effective methods for inactivating HIV in blood have been introduced sooner? Donor screening and referralâ€"including a review of screening to exlude high-risk individuals. Regulations and recall of contaminated bloodâ€"analyzing decisions by federal agencies and the private sector. Risk communicationâ€"examining whether infections could have been averted by better communication of the risks.
Download or read book Democratic Biopolitics written by Prozorov Sergei Prozorov and published by Edinburgh University Press. This book was released on 2019-01-22 with total page 261 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sergei Prozorov challenges the assumption that the biopolitical governance means the end of democracy, arguing for a positive synthesis of biopolitics and democracy. By critically re-engaging with canonical theories of biopolitics from Foucault, Agamben and Esposito, and introducing Nancy, Badiou and Lefort to the discussion, he develops a vision of democratic biopolitics where diverse forms of life can coexist on the basis of their reciprocal recognition as free, equal and in common. He demonstrates how this vision can be realised and sustained by using examples of our lived experience.
Download or read book Socialising the Biomedical Turn in HIV Prevention written by Susan Kippax and published by Anthem Press. This book was released on 2016-06-28 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Principles and Practice of College Health written by John A. Vaughn and published by Springer Nature. This book was released on 2020-12-04 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique and comprehensive title offers state-of-the-art guidance on all of the clinical principles and practices needed in providing optimal health and well-being services for college students. Designed for college health professionals and administrators, this highly practical title is comprised of 24 chapters organized in three sections: Common Clinical Problems in College Health, Organizational and Administrative Considerations for College Health, and Population and Public Health Management on a College Campus. Section I topics include travel health services, tuberculosis, eating disorders in college health, and attention deficit hyperactivity disorder among college students, along with several other chapters. Subsequent chapters in Section II then delve into topics such as supporting the health and well-being of a diverse student population, student veterans, health science students, student safety in the clinical setting, and campus management of infectious disease outbreaks, among other topics. The book concludes with organizational considerations such as unique issues in the practice of medicine in the institutional context, situating healthcare within the broader context of wellness on campus, organizational structures of student health, funding student health services, and delivery of innovative healthcare services in college health. Developed by a renowned, multidisciplinary authorship of leaders in college health theory and practice, and coinciding with the founding of the American College Health Association 100 years ago, Principles and Practice of College Health will be of great interest to college health and well-being professionals as well as college administrators.
Download or read book Making Health Communication Programs Work written by and published by DIANE Publishing. This book was released on 1992 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: Discusses key principles relative to specific steps in health communications program development, and includes examples of their use. Covers: planning and strategy selection, selecting channels and materials, developing materials and pretesting (pretesting -- what it can and cannot do, pretesting methods, plan and conduct pretests), implementing your program, assessing effectiveness, feedback to refine program and more. Each chapter includes a 3selected readings2 section. Includes: information sources, sample forms, glossary, bibliography, etc. Photos and drawings.
Download or read book HIV and Gay Men written by Rusi Jaspal and published by Springer Nature. This book was released on 2020-10-29 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book focuses on the clinical, social and psychological aspects of HIV among gay men and examines the complex factors that can contribute to HIV risk in this key population. With the target to end all HIV transmissions in the UK by 2030 in mind, Jaspal and Bayley combine elements of HIV medicine and social psychology to identify the remaining barriers to effective HIV prevention among gay men. The authors take the reader on a journey through the history of HIV, its science and epidemiology and its future, demonstrating the vital role of history, society and psychology in understanding the trajectory of the virus. Underpinned by theories from social psychology and clinical snapshots from practice, this book considers how psychological constructs, such as identity, risk and sexuality, can impinge on physical health outcomes. This refreshing and thought-provoking text is an invaluable resource for scholars, clinicians and students working in the field of HIV.
Download or read book Glossary of HIV AIDS related Terms written by and published by . This book was released on 1995 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt:
