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Surveying risk subjects: Public health surveys as instruments of biomedicalization

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Abstract

In recent years, epidemiologists have conducted dozens of surveys asking men around the world if they would be willing to be circumcised to reduce their HIV-risk. Men’s responses in turn constitute an important factor in predicting the overall success of circumcision campaigns. Whereas researchers often position survey responses as passive reflections of attitudes, my analysis reveals a more complex picture. The reviewed surveys invite men to consider a part of their bodies as posing a risk to themselves, their partners or their communities, and its removal as a means to permanently transition from the ‘high’ to the ‘low’ risk category. In the process, they position some bodies as inherently riskier than others, thereby carving out new HIV-risk subject positions based not on identity or behavior, but the body itself. Because claims about what one can do to mitigate the spread of HIV are not easily disentangled from what one ought to do, I suggest that these surveys simultaneously imbue willingness to be circumcised with a sense of ethical obligation. In doing so, I argue that circumcision-willingness surveys constitute a discursive technology integral to male circumcision’s emergence as an HIV-risk reduction strategy, not simply a tool that identifies willing subjects passively awaiting the next public health intervention.

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Notes

  1. A Data Safety and Monitoring Board stopped all three trials early when interim statistical analyses revealed a significant difference in infection rates between the groups (Auvert et al, 2005; Bailey et al, 2007; Gray et al, 2007).

  2. This is not to suggest that one is intended to replace the other.

  3. I also take no position regarding the wisdom of offering circumcision as a risk-reduction strategy, nor do I attempt to adjudicate the likelihood of success, however defined. Instead, my interest concerns how surveys communicate facts about circumcision and HIV-risk to respondents and their potential discursive implications for self-making.

  4. According to WHO/UNAIDS (2007a) estimates, one-third of men worldwide (age 15+) have been circumcised, two-thirds of whom are Muslim. The vast majority of male circumcision occurs in infancy or early childhood most commonly for religious reasons (including Islamic and Jewish traditions), as a marker of social or ethnic identity and/or for its perceived health benefits. It is common in Israel, the United States, Canada, Australia, the Middle East, Central Asia (primarily among Muslims in India, Pakistan and Indonesia), and parts of Africa. In Africa, circumcision practices and prevalence vary widely, but at the population level, prevalence rates are generally much higher in northern and western countries than in southern and eastern countries where there is also greater local variation (WHO/UNAIDS, 2007a).

  5. Pointing to biotechnology’s interpellative character, Bryan (2009) makes a similar point about biotechnological interventions generally when he writes: ‘biotechnology ushers in a way that calls each of us to be concerned about the health and safety of others … . The hailing of a cure does not recruit us; the hailing of a cure shows us that we are always already recruited as the kind of “subject” that is in need of something like a cure’ (pp. 92–93).

  6. There have been other critiques of the RCTs themselves, including the effect of stopping trials early in statistically inflating treatment efficacy (Boyle and Hill, 2011; for explanation, see Bassler et al, 2008), high rates of attrition (Boyle and Hill, 2011), inadequate controls to account for alternate modes of infection (Vines, 2006; Potterat et al, 2006; Van Howe and Storms, 2011), and insufficient explanation of the underlying biological mechanism to account for the observed difference (Dowsett and Couch, 2007). For a response to many of these objections, see Auvert et al (2006). Aside from methodological issues of the trials themselves, concerns have been raised about the potential for risk compensation (Kalichman et al, 2007), different ethical standards for male versus female circumcision (Myers and Myers, 2007), ethical concerns about a shift from adult to neonatal circumcision (Myers and Myers, 2007), Western intrusion upon traditionally circumcising African communities (Gwandure, 2012), unexplained regional differences in the association between circumcision status and HIV-incidence (Dowsett and Couch, 2007; Garenne, 2008), the possibility of stigmatizing uncircumcised men (Peltzer et al, 2007; Sawires et al, 2007) and the impact of male circumcision for women given differential power relations (Sawires et al, 2007). There is not enough space here to adequately address these critiques. Regardless of the legitimacy of the critiques or responses to them, the broader epidemiological community views the RCT results as a sufficient basis on which to proceed with circumcision initiatives in high HIV prevalence areas (WHO/UNAIDS, 2007b) and my argument about the way in which surveys communicate RCT results is not contingent upon their validity.

  7. In the African trials, participants randomized to be circumcised were given instructions regarding post-surgical care, encouraged to abstain from sex without a condom before adequate healing, and warned that circumcision does not mean infection will not occur.

  8. Interview with epidemiologist, 2012.

  9. Interview with epidemiologist, 2012.

  10. Permission to cite obtained from Principal Investigator.

  11. John Law (2004) makes a similar point about scientific methods generally.

  12. Information was provided to respondents in an information pamphlet. Permission to cite obtained from lead author.

References

  • Alcena, V. (1986) AIDS in third world countries. New York State Journal of Medicine 86 (8): 446.

    Google Scholar 

  • Ashcroft, R.E. (2003) Constructing empirical bioethics: Foucauldian reflections on the empirical turn in bioethics research. Health Care Analysis 11 (1): 3–13.

    Article  Google Scholar 

  • Ashcroft, R.E. (2004) Current epistemological problems in evidence based medicine. Journal of Medical Ethics 30 (2): 131–135.

    Article  Google Scholar 

  • Auvert, B. (2007) Male circumcision and HIV prevention in Africa. Talk presented at the 11th European Conference on AIDS; 24–27 October, Madrid, Spain.

  • Auvert, B., Sobngwi-Tambekou, J., Taljaard, D., Lagarde, E. and Puren, A. (2006) Authors’ reply. PLoS Medicine 3 (1): 136–145.

    Article  Google Scholar 

  • Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-Tambekou, J., Sitta, R. and Puren, A. (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Medicine 2 (11): 1112–1122.

    Article  Google Scholar 

  • Bailey, R.C. et al (2007) Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. The Lancet 369 (9562): 643–656.

    Article  Google Scholar 

  • Bailey, R.C., Neema, S. and Othieno, R. (1999) Sexual behaviors and other HIV risk factors in circumcised and uncircumcised men in Uganda. Journal of Acquired Immune Deficiency Syndromes 22 (3): 294–301.

    Article  Google Scholar 

  • Balsamo, A. (1995) Technologies of the Gendered Body: Reading Cyborg Women. Durham, NC: Duke University Press.

    Google Scholar 

  • Baron, R.M. and Kenny, D.A. (1986) The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51 (6): 1173–1182.

    Article  Google Scholar 

  • Bassler, D., Montori, V.M., Briel, M., Glasziou, P. and Guyatt, G. (2008) Early stopping of randomized clinical trials for overt efficacy is problematic. Journal of Clinical Epidemiology 61 (3): 241–246.

    Article  Google Scholar 

  • Benatar, M. and Benatar, D. (2003) Between prophylaxis and child abuse: The ethics of neonatal male circumcision. American Journal of Bioethics 3 (2): 35–48.

    Article  Google Scholar 

  • Bijker, W.E., Hughes, T.P. and Trevor, J. (eds.) (1987) The Social Construction of Technological Systems: New Directions in the Sociology and History of Technology. Cambridge, MA: MIT Press.

    Google Scholar 

  • Boyle, G.J. and Hill, G. (2011) Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns. Journal of Law and Medicine 19 (2): 316–334.

    Google Scholar 

  • Bradburn, N.M., Sudman, S. and Wansink, B. (2004) Asking Questions: The Definitive Guide to Questionnaire Design – For Market Research, Political Polls, and Social and Health Questionnaires. San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Brito, M.O., Caso, L.M., Balbuena, H. and Bailey, R.C. (2009) Acceptability of male circumcision for the prevention of HIV/AIDS in the Dominican Republic. PLoS One 4 (11): 1–6.

    Article  Google Scholar 

  • Bryan, B. (2009) ‘Hail the cure!’: Althusser, biotechnology, and biopolitics. In: S.J. Murray and D. Holmes (eds.) Critical Interventions in the Ethics of Healthcare: Challenging the Principle of Autonomy in Bioethics. Surrey, UK: Ashgate Publishing.

    Google Scholar 

  • Campbell, D.T. and Stanley, J.C. (1966) Experimental and Quasi-experimental Designs for Research. Chicago, IL: Rand McNally College Publishing.

    Google Scholar 

  • Clarke, A., Mamo, L., Fosket, J.R., Fishman, J.R. and Shim, J. (eds.) (2010) Biomedicalization: Technoscience, Health, and Illness in the U.S. Durham, NC: Duke University Press.

    Google Scholar 

  • Conrad, P. (2007) The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  • Crawford, R. (1994) The boundaries of the self and the unhealthy other: Reflections on health, culture and AIDS. Social Science & Medicine 38 (10): 1347–1365.

    Article  Google Scholar 

  • Donoval, B.A. et al (2006) HIV-1 target cells in foreskins of African men with varying histories of sexually transmitted infections. American Journal of Clinical Pathology 125 (3): 386–391.

    Article  Google Scholar 

  • Dowsett, G. and Couch, M. (2007) Male circumcision and HIV prevention: Is there really enough of the right kind of evidence? Reproductive Health Matters 15 (29): 33–44.

    Article  Google Scholar 

  • Dumit, J. (2012) Drugs for Life: How Pharmaceutical Companies Define Our Health. Durham, NC: Duke University Press.

    Book  Google Scholar 

  • Dworkin, S.L. (2010) Masculinity, health, and human rights. Hastings International and Comparative Law Review 33 (1): 461–478.

    Google Scholar 

  • FDA (2012) FDA Press Release: FDA approves first drug for reducing the risk of sexually acquired HIV infection, http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm, accessed 16 July 2012.

  • Fink, A.J. (1986) A possible explanation for heterosexual male infection with AIDS. The New England Journal of Medicine 315 (18): 1167.

    Google Scholar 

  • Fischetti, L., Barry, S.M., Hope, T.J. and Shattock, R.J. (2009) HIV-1 infection of human penile explant tissue and protection by candidate microbicides. AIDS 23 (3): 319–328.

    Article  Google Scholar 

  • Fosket, J.R. (2004) Constructing ‘high-risk women’: The development and standardization of a breast cancer risk assessment tool. Science, Technology & Human Values 29 (3): 291–313.

    Article  Google Scholar 

  • Foucault, M. (1980) Power/Knowledge: Selected Interviews and Other Writings 1972–1977. New York: Pantheon.

    Google Scholar 

  • Foucault, M. (1990) The History of Sexuality, Volume 1: An Introduction. Translated By R. Hurley. New York: Vintage.

    Google Scholar 

  • Garenne, M. (2008) Long-term population effect of male circumcision in generalised HIV epidemics in sub-Saharan Africa. African Journal of AIDS Research 7 (1): 1–8.

    Article  Google Scholar 

  • Gifford, S.M. (1986) The meaning of lumps: A case study of the ambiguities of risk. In: C.R. Janes, R. Stall and S.M. Gifford (eds.) Anthropology and Epidemiology: Interdisciplinary Approaches to the Study of Health and Disease. Boston, MA: D. Reidel Publishing.

    Google Scholar 

  • Gigerenzer, G. (1990) Statistics of the mind. In: G. Gigerenzer, Z. Swijtink, T. Porter, L. Daston, J. Beatty and L. Krüger (eds.) The Empire of Chance: How Probability Changed Science and Everyday Life. Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Gigerenzer, G. (2003) Calculated Risks: How to Know When Numbers Deceive You. Oxford: Oxford University Press.

    Google Scholar 

  • Gollaher, D. (2000) Circumcision: A History of the World’s Most Controversial Surgery. New York: Basic Books.

    Google Scholar 

  • Gray, R.H. et al (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial. The Lancet 369 (9562): 657–666.

    Article  Google Scholar 

  • Gwandure, C. (2012) The ethical concerns of using medical male circumcision in HIV prevention in sub-Saharan Africa. South African Journal of Bioethics and Law 4 (2): 89–94.

    Google Scholar 

  • Hacking, I. (1990) The Taming of Chance. Cambridge, UK: Cambridge University Press.

    Book  Google Scholar 

  • Hallett, T.B., Singh, K., Smith, J.A., White, R.G., Abu-Raddad, L.J. and Garnett, G.P. (2008) Understanding the impact of male circumcision interventions on the spread of HIV in southern Africa. PLoS One 3 (5): 1–9.

    Article  Google Scholar 

  • Halperin, D.T. and Epstein, H. (2008) Why is HIV prevalence so severe in southern Africa? The role of multiple concurrent partnerships and lack of male circumcision-implications for HIV prevention. Southern African Journal of HIV Medicine 8 (1): 19–25.

    Google Scholar 

  • Heath, A., Fisher, S. and Smith, S. (2005) The globalization of public opinion research. Annual Review of Political Science 8: 297–333.

    Article  Google Scholar 

  • Herek, G.M. and Capitanio, J.P. (1998) Symbolic prejudice or fear of infection? A functional analysis of AIDS-related stigma among heterosexual adults. Basic and Applied Social Psychology 20 (3): 230–241.

    Article  Google Scholar 

  • Higgins, J.A., Hoffman, S. and Dworkin, S.L. (2010) Rethinking gender, heterosexual men, and women’s vulnerability to HIV/AIDS. American Journal of Public Health 100 (3): 435–445.

    Article  Google Scholar 

  • Holmes, D., Murray, S.J., Perron, A. and Rail, G. (2006) Deconstructing the evidence-based discourse in health sciences: Truth, power and fascism. International Journal of Evidence-based Healthcare 4 (3): 180–186.

    Google Scholar 

  • Igo, S.E. (2007) The Averaged American: Surveys, Citizens, and the Making of a Mass Public. Cambridge, MA: Harvard University Press.

    Book  Google Scholar 

  • Jain, S.L. (2010) The mortality effect: Counting the dead in the cancer trial. Public Culture 22 (1): 89–117.

    Article  Google Scholar 

  • Jasanoff, S. (2004) States of Knowledge: The Co-production of Science and Social Order. London and New York: Routledge.

    Book  Google Scholar 

  • Kahn, J.G., Marseille, E. and Auvert, B. (2006) Cost-effectiveness of male circumcision for HIV prevention in a South African setting. PLoS Med 3 (12): 2349–2358.

    Article  Google Scholar 

  • Kalichman, S., Eaton, L. and Pinkerton, S. (2007) Circumcision for HIV prevention: Failure to fully account for behavioral risk compensation. PLoS Medicine 4 (3): e138.

    Article  Google Scholar 

  • Lau, J.T.F. et al (2011) Acceptability of circumcision as a means of HIV prevention among men who have sex with men in China. AIDS Care 23 (11): 1472–1482.

    Article  Google Scholar 

  • Lau, J.T.F. et al (2012) How willing are men who have sex with men in China to be circumcised for the sake of protecting his female sex partner? The Journal of Sexual Medicine 9 (7): 1904–1912.

    Article  Google Scholar 

  • Law, J. (2004) After Method: Mess in Social Science Research. New York: Routledge.

    Google Scholar 

  • Linville, P.W., Fischer, G.W. and Fischhoff, B. (1992) AIDS risk perceptions and decision biases. In: J.B. Pryor and G.D. Reeder (eds.) The Social Psychology of HIV Infection. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Loe, M. (2004) The Rise of Viagra: How the Little Blue Pill Changed Sex in America. New York: NYU Press.

    Google Scholar 

  • Löwy, I. and Gaudilliere, J.P. (2008) Localizing the global. Science, Technology & Human Values 33 (3): 299–325.

    Article  Google Scholar 

  • Marks, H.M. (2000) The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900–1990. Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Mattson, C.L., Bailey, R.C., Muga, R., Poulussen, R. and Onyango, T. (2005) Acceptability of male circumcision and predictors of circumcision preference among men and women in Nyanza Province, Kenya. AIDS Care 17 (2): 182–194.

    Article  Google Scholar 

  • Mavhu, W. et al (2011) Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe. Tropical Medicine & International Health 16 (5): 589–597.

    Article  Google Scholar 

  • Maxwell, S.E. and Delaney, H.D. (2004) Designing Experiments and Analyzing Data: A Model Comparison Perspective, Vol. 1. London: Lawrence Erlbaum.

    Google Scholar 

  • Mayo Clinic (2012) HIV/AIDS risk factors. http://www.mayoclinic.com/health/hiv-aids/ds00005/dsection=risk-factors, accessed 23 August 2012.

  • Milman, G. and Sharma, O. (1994) Mechanisms of HIV/SIV mucosal transmission. AIDS Research and Human Retroviruses 10 (10): 1305–1312.

    Article  Google Scholar 

  • Mohun, A. (2005) On the frontier of the empire of chance: Statistics, accidents, and risk in industrializing America. Science in Context 18 (3): 337–357.

    Article  Google Scholar 

  • Montaner, J.S. (2011) Treatment as prevention – A double hat-trick. The Lancet 378 (9787): 208–209.

    Article  Google Scholar 

  • Moses, S., Bailey, R.C. and Ronald, A.R. (1998) Male circumcision: Assessment of health benefits and risks. Sexually Transmitted Infections 74 (5): 368–373.

    Article  Google Scholar 

  • Murray, S.J., Holmes, D., Perron, A. and Rail, G. (2007) No exit? Intellectual integrity under the regime of ‘evidence’ and ‘best-practices’. Journal of Evaluation in Clinical Practice 13 (4): 512–516.

    Article  Google Scholar 

  • Myers, A. and Myers, J. (2007) Male circumsion – The new hope? South African Medical Journal 97 (5): 338–341.

    Google Scholar 

  • Mykhalovskiy, E., McCoy, L. and Bresalier, M. (2004) Compliance/adherence, HIV, and the critique of medical power. Social Theory & Health 2 (4): 315–340.

    Article  Google Scholar 

  • Mykhalovskiy, E. and Weir, L. (2004) The problem of evidence-based medicine: Directions for social science. Social Science & Medicine 59 (5): 1059–1069.

    Article  Google Scholar 

  • Nagelkerke, N.J.D., Moses, S., De Vlas, S.J. and Bailey, R.C. (2007) Modelling the public health impact of male circumcision for HIV prevention in high prevalence areas in Africa. BMC Infectious Diseases 7: 1–16.

    Article  Google Scholar 

  • National AIDS Council, & UNFPA (2009) Zimbabwe National Behaviour Change Strategy Interim Survey Questionnaire. Harare, Zimbabwe: NAC & UNFPA.

  • Ngalande, R.C., Levy, J., Kapondo, C.P.N. and Bailey, R.C. (2006) Acceptability of male circumcision for prevention of HIV infection in Malawi. AIDS and Behavior 10 (4): 377–385.

    Article  Google Scholar 

  • Nguyen, V.K. (2005) Antiretroviral globalism, biopolitics, and therapeutic citizenship. In: A. Ong and S.J. Collier (eds.) Global Assemblages: Technology, Politics, and Ethics as Anthropological Problems. Malden, MA: Blackwell.

    Google Scholar 

  • Nguyen, V.K., Bajos, N., Dubois-Arber, F., O’Malley, J. and Pirkle, C.M. (2011) Remedicalizing an epidemic: From HIV treatment as prevention to HIV treatment is prevention. AIDS 25 (3): 291–293.

    Article  Google Scholar 

  • Oster, E. (2012) HIV and sexual behavior change: Why not Africa? Journal of Health Economics 31: 35–49.

    Article  Google Scholar 

  • Peltzer, K. et al (2007) Male circumcision, gender and HIV prevention in sub-Saharan Africa: A (social science) research agenda. Journal of Social Aspects of HIV/AIDS 4 (3): 658–667.

    Article  Google Scholar 

  • Porter, T.M. (1995) Trust in Numbers: The Pursuit of Objectivity in Science and Public Life. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Potterat, J.J., Brewer, D.D., Muth, S.Q. and Brody, S. (2006) The protective effect of male circumcision as a faith lift for the troubled paradigm of HIV epidemiology in sub-Saharan Africa. PLoS Medicine 3 (1): 136.

    Article  Google Scholar 

  • Powers, K.A., Poole, C., Pettifor, A.E. and Cohen, M.S. (2008) Rethinking the heterosexual infectivity of HIV-1: A systematic review and meta-analysis. The Lancet Infectious Diseases 8 (9): 553–563.

    Article  Google Scholar 

  • Preda, A. (2005) AIDS, Rhetoric, and Medical Knowledge. New York: Cambridge University Press.

    Book  Google Scholar 

  • Press, N., Fishman, J.R. and Koenig, B.A. (2000) Collective fear, individualized risk: The social and cultural context of genetic testing for breast cancer. Nursing Ethics 7 (3): 237–249.

    Article  Google Scholar 

  • Quigley, M.A., Weiss, H.A. and Hayes, R.J. (2001) Male circumcision as a measure to control HIV infection and other sexually transmitted diseases. Current Opinion in Infectious Diseases 14 (1): 71–75.

    Article  Google Scholar 

  • Riska, E. (2006) Masculinity and Men’s Health: Coronary Heart Disease in Medical and Public Discourse. Lanham, MD: Rowman & Littlefield.

    Google Scholar 

  • Rose, G. (1981) Strategy of prevention: Lessons from cardiovascular disease. British Medical Mournal (Clinical Research Edition) 282 (6279): 1847–1851.

    Article  Google Scholar 

  • Rose, N. (2001) The politics of life itself. Theory, Culture & Society 18 (6): 1–30.

    Article  Google Scholar 

  • Rose, N. (2007) The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-first Century. Princeton, NJ: Princeton University Press.

    Book  Google Scholar 

  • Rose, N. and Novas, C. (2005) Biological citizenship. In: A. Ong and S.J. Collier (eds.) Global Assemblages: Technology, Politics, and Ethics as Anthropological Problems. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Sawires, S.R., Dworkin, S.L. and Coates, T.J. (2007) Male circumcision and HIV/AIDS: Opportunities and challenges. AIDS Policy Development Center at the David Geffen School of Medicine (pp. 1–57), University of California, Los Angeles; chipts.ucla.edu/TEMPMAT/PDF/SectionA/Male_Circumcision_020107.pdf, accessed 5 January 2010.

  • Schneider, J.A. et al (2010) Initial commitment to pre-exposure prophylaxis and circumcision for HIV prevention amongst Indian truck drivers. PLoS One 5 (7): e11922.

    Article  Google Scholar 

  • Siegfried, N., Muller, M., Deeks, J.J. and Volmink, J. (2009) Male Circumcision for Prevention of Heterosexual Acquisition of HIV in Men (Review). Chichester, UK: John Wiley & Sons.

    Google Scholar 

  • Sontag, S. (1989) AIDS and Its Metaphors. New York: Farrar, Straus and Giroux.

    Google Scholar 

  • Tieu, H.V. et al (2010) Acceptability of male circumcision for the prevention of HIV among high-risk heterosexual men in Thailand. Sexually Transmitted Diseases 37 (6): 352–355.

    Google Scholar 

  • Timmermans, S. and Berg, M. (2003) The Gold Standard: The Challenge of Evidence-based Medicine and Standardization in Health Care. Philadelphia, PA: Temple University Press.

    Google Scholar 

  • Tourangeau, R., Rips, L.J. and Rasinski, K.A. (2000) The Psychology of Survey Response. Cambridge, UK: Cambridge University Press.

    Book  Google Scholar 

  • Treichler, P.A. (1988) AIDS, homophobia, and biomedical discourse: An epidemic of signification. In: R.G. Parker and P. Aggleton (eds.) Culture, Society and Sexuality: A Reader. London: UCL Press.

    Google Scholar 

  • Tsela, S. and Halperin, D. (2006) Knowledge, attitudes and practices regarding male circumcision in the Manzini (central) region of Swaziland. AIDS 2006 – XVI International AIDS Conference: Abstract no. CDC0611.

  • Tversky, A. and Kahneman, D. (1981) The framing of decisions and the psychology of choice. Science 211 (4481): 453–458.

    Article  Google Scholar 

  • Van Howe, R.S. and Storms, M.R. (2011) How the circumcision solution in Africa will increase HIV infections. Journal of Public Health in Africa 2 (1): e4.

    Article  Google Scholar 

  • Vermund, S.H. and Qian, H.-Z. (2008) Circumcision and HIV prevention among men who have sex with men. The Journal of the American Medical Association 300 (14): 1698–1700.

    Article  Google Scholar 

  • Vines, J. (2006) Major potential confounder not addressed. PLoS Medicine 3 (1): 136.

    Article  Google Scholar 

  • Waldby, C. (1996) AIDS and the Body Politic: Biomedicine and Sexual Difference. London: Routledge.

    Google Scholar 

  • Waldby, C., Kippax, S. and Crawford, J. (1995) Epidemiological knowledge and discriminatory practice: AIDS and the social relations of biomedicine. Journal of Sociology 31 (1): 1–14.

    Article  Google Scholar 

  • Waldeck, S. (2003) Using male circumcision to understand social norms as multipliers. University of Cincinnati Law Review 72 (1): 455–526.

    Google Scholar 

  • Walker, K. (2009) My life? My choice? Ethics, autonomy, and evidence-based practice in contemporary clinical care. In: S.J. Murray and D. Holmes (eds.) Critical Interventions in the Ethics of Healthcare: Challenging the Principle of Autonomy in Bioethics. Surrey, UK: Ashgate.

    Google Scholar 

  • Waters, E., Stringer, E., Mugisa, B., Temba, S., Bowa, K. and Linyama, D. (2011) Acceptability of neonatal male circumcision in Lusaka, Zambia. AIDS Care 24 (1): 12–19.

    Article  Google Scholar 

  • Wawer, M.J. et al (2009) Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: A randomised controlled trial. The Lancet 374 (9685): 229–237.

    Article  Google Scholar 

  • Weiss, H.A., Hankins, C.A. and Dickson, K. (2009) Male circumcision and risk of HIV infection in women: A systematic review and meta-analysis. The Lancet Infectious Diseases 9 (11): 669–677.

    Article  Google Scholar 

  • Weiss, H.A., Halperin, D., Bailey, R.C., Hayes, R.J., Schmid, G. and Hankins, C.A. (2008) Male circumcision for HIV prevention: From evidence to action? AIDS 22 (5): 567–574.

    Article  Google Scholar 

  • WHO/UNAIDS (2007a) Male circumcision: Global trends and determinants of prevalence, safety and acceptability. http://whqlibdoc.who.int/publications/2007/9789241596169_eng.pdf, accessed 1 December 2010.

  • WHO/UNAIDS (2007b) New data on male circumcision and HIV prevention: Policy and programme implications. http://data.unaids.org/pub/Report/2007/mc_recommendations_en.pdf, accessed 14 March 2009.

  • WHO/UNAIDS (2010) Scaling-up male circumcision programmes in the Eastern and Southern Africa Region: Country update meeting to share lessons, explore opportunities and overcome challenges to scale-up. http://www.who.int/hiv/pub/malecircumcision/country_progress_meeting_report_jun10.pdf, accessed 18 June 2013.

  • Williams, B.G. et al (2006) The potential impact of male circumcision on HIV in sub-Saharan Africa. PLoS Medicine 3 (7): 1032–1040.

    Article  Google Scholar 

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Acknowledgements

I am grateful to Joe Dumit, Cristiana Giordano, Gregory Herek, Ozzie Zehner, two anonymous reviewers and the UC Davis Science and Technology Studies graduate group for their helpful comments on earlier drafts of this article. I also thank the UC Davis Psychology department for financial support during the manuscript preparation.

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Norton, A. Surveying risk subjects: Public health surveys as instruments of biomedicalization. BioSocieties 8, 265–288 (2013). https://doi.org/10.1057/biosoc.2013.20

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