Navigating HIV citizenship

Identities, Risks and Biological Citizenship in the Treatment as Prevention Era

Bibliographic Data

ID7429987
AuthorsIsabel Young (0000-0002-1242-5992, University of Edinburgh, corresponding author), Mark D M Davis (0000-0003-4075-0466, Monash University), Paul Flowers (0000-0001-6239-5616, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK), Lisa Mcdaid (0000-0002-7711-8723, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK)
Year2019
Volume21
Issue1-2
Pages1-16
Publication date2019-01-31
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Risk & Society (JOURNAL)
Journal identifiersISSN: 1369-8575 • E-ISSN: 1469-8331
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/13698575.2019.1572869
PMID31105468
OpenAlexW2912644611
LanguageEN
Citations received31
References cited36

The use of HIV Treatment as Prevention (TasP) has radically changed our understandings of HIV risk and revolutionised global HIV prevention policy to focus on the use of pharmaceuticals. Yet, there has been little engagement with the very people expected to comply with a daily pharmaceutical regime. We employ the concept of HIV citizenship to explore responses by people living with HIV in the UK to TasP. We consider how a treatment-based public health strategy has the potential to reshape identities, self-governance and forms of citizenship, domains which play a critical role not only in compliance with new TasP policies, but in how HIV prevention, serodiscordant relationships and (sexual) health are negotiated and enacted. Our findings disrupt the biomedical narrative which claims an end to HIV through scaling up access to treatment. Responses to TasP were framed through shifting negotiations of identity, linked to biomarkers, cure and managing treatment. Toxicity of drugs – and bodies – were seen as something to manage and linked to the shifting possibilities in serodiscordant environments. Finally, a sense of being healthy and responsible, including appropriate use of resources, meant conflicting relationships with if and when to start treatment. Our research highlights how HIV citizenship in the TasP era is negotiated and influenced by intersectional experiences of community, health systems, illness and treatment. Our findings show that the complexities of HIV citizenship and ongoing inequalities, and their biopolitical implications, will intimately shape the implementation and sustainability of TasP

Serodiscordant · Treatment as prevention · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Sex work and related issues

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