Conclusion: Eventuating the Methodology of Trials

Abstract

This book has been about biomedical innovation and the practical, local, analytic, distributed efforts to determine whether a relatively mundane intervention (a pre-existing pharmaceutical drug or a combination of pre-existing pharmaceutical drugs for the treatment of HIV infections) amounts to a viable prophylactic against HIV infection. Toward the beginning of this book, we drew a contrast between mundane and exotic technologies as a way of situating PrEP and yet, as we have illustrated throughout, this distinction is not easy to sustain (see especially Chapter 3). All sorts of novelties and multiplicities flow in the wake of PrEP’s testing — novel bodies, relations, virus, pharmaceuticals, politics, clinical and social arguments. So, despite the comparative lack of innovation that ostensibly marks PrEP, it has occasioned all sorts of inventiveness. In this respect it is no different from other sorts of mundane technology which have precipitated novelty (conversely, it is the mirror image of supposedly exotic technologies which simply reproduce or reinforce existing values or functions — see, for example, Michael, 2000; Barry, 2001). So, this book has concerned itself with tracing some of the patterns of invention and non-invention that have characterized the recent history of PrEP, its randomized control trialling and accompanying bioethics.