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An Unfinished History: A Story of Ongoing Events and Mutating HIV Problems

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Remaking HIV Prevention in the 21st Century

Part of the book series: Social Aspects of HIV ((SHIV,volume 5))

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Abstract

By reflecting on the thinking that has come to prevail with regard to women and HIV and, doing so, by working back through an albeit brief outline genealogy of the development of PrEP, I examine how the relevancies of HIV prevention regimes have become folded into a particular scientific logic and why this should concern us. Without disputing the affordances of PrEP, in either pill or long-term acting form, I suggest that the WHO/UNAIDS 90-90-90 goals and, no less, an optimism for a future end to the dynamics of the epidemic is founded on a misplaced conception of what is at stake. Drawing on a branch of process philosophy that has earned the term ‘event-thinking’, I propose that if biomedicine is to be responsive to the relevancies of those affected by HIV, a more open conception of what is assumed by international health authorities as the ‘dynamics of the epidemic’ may be warranted.

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Notes

  1. 1.

    The interview is titled ‘Dr. Fauci Discusses Ending the HIV Epidemic from the 2019 IAS Conference on HIV Science’. It was was conducted by Anne Rancourt and is available online at https://www.niaid.nih.gov/news-events/ias-2019-fauci-discussion [accessed November 2019]

  2. 2.

    There are a host of reasons that might be offered to explain why women did adhere to using PrEP in these two trials and not the others. For instance, knowing that a sexual partner is HIV positive was likely to be significant in the Partners PrEP trial. However, the smaller Botswana trial did not involve serodiscordant couples. Arguably, the most plausible is that the situated nature of the trials affected the outcome (see Rosengarten and Savransky 2018).

  3. 3.

    I have purposely resisted speculating on what might comprise this multi-factorial terrain. First, because I do not want to attempt to speak for the women. Second, consistent with what I later propose of possibles, I do not want to impose a conventional and, no doubt, frequently pragmatically helpful disciplinary distinction of a social and a biological realm. As Whitehead remarks: ‘No one ever says, here I am and I have brought my body with me’ (Whitehead 1938/1968, p. 114).

  4. 4.

    For process thinkers, ethics can be more constructively appreciated as immanent to the value created by the dynamics of its situated happening (see for example: Savransky 2014; Sehgal 2018).

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Authors and Affiliations

  1. Goldsmiths, University of London, London, UK

    Marsha Rosengarten

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  1. Marsha Rosengarten
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Correspondence to Marsha Rosengarten .

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Editors and Affiliations

  1. School of Public Health, University of Sydney, Sydney, New South Wales, Australia

    Sarah Bernays

  2. Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia

    Adam Bourne

  3. Social Policy Research Centre, UNSW Sydney, Kensington, New South Wales, Australia

    Susan Kippax

  4. Centre for Social Research in Health, UNSW Sydney, Kensington, New South Wales, Australia

    Peter Aggleton

  5. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA

    Richard Parker

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Rosengarten, M. (2021). An Unfinished History: A Story of Ongoing Events and Mutating HIV Problems. In: Bernays, S., Bourne, A., Kippax, S., Aggleton, P., Parker, R. (eds) Remaking HIV Prevention in the 21st Century. Social Aspects of HIV, vol 5. Springer, Cham. https://doi.org/10.1007/978-3-030-69819-5_21

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  • DOI: https://doi.org/10.1007/978-3-030-69819-5_21

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