Treating risk, risking treatment

Experiences of iatrogenesis in the HIV/Aids and opioid epidemics

Bibliographic Data

ID8244277
AuthorsLauren Textor (0000-0003-1242-2967, Department of Anthropology and David Geffen School of Medicine at UCLA, Los Angeles, California, USA), William Schlesinger (0000-0001-5492-2631, Department of Anthropology and David Geffen School of Medicine at UCLA, Los Angeles, California, USA, corresponding author)
Year2021
Volume28
Issue2
Pages239-254
Publication date2021-04-03
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAnthropology and Medicine (JOURNAL)
Journal identifiersISSN: 1364-8470 • E-ISSN: 1469-2910
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/13648470.2021.1926916
PMID34190020
OpenAlexW3174137439
LanguageEN
Citations received5
References cited56

This paper explores how poor health outcomes in the HIV/AIDS and opioid epidemics in the United States are undergirded by iatrogenesis. Data are drawn from two projects in Southern California: one among men who have sex with men (MSM) engaging with pre-exposure prophylaxis to HIV (PrEP) and the other in a public hospital system encountering patients with chronic pain and opioid use disorder (OUD). Ethnographic evidence demonstrates how efforts to minimize risk via PrEP and opioid prescription regulation paradoxically generate new forms of risk. Biomedical risk management paradigms engaged across the paper's two ethnographic field sites hinge on the production and governance of deserving patienthood, which is defined by providers and experienced by patients through moral judgments about risk underlying both increased surveillance and abandonment. This paper argues that the logic of deservingness disconnects clinical evaluations of risk from patients' lived, intersectional experiences of race, class, gender, and sexuality. This paper's analysis thus re-locates patients in the context of broader historical and sociopolitical trajectories to highlight how notions of clinical risk designed to protect patients can in fact imperil them. Misalignment between official, clinical constructions of risk and the embodied experience of risk borne by patients produces iatrogenesis

Human immunodeficiency virus (HIV · Intensive care medicine · Opioid · Opioid epidemic · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Prenatal Substance Exposure Effects · Internal Medicine · Virology

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Open DOIOpen Access