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On the Margins of Pharmaceutical Citizenship: Not Taking HIV Medication in the “Treatment Revolution” Era
Author(s) -
Persson Asha,
Newman Christy E.,
Mao Limin,
Wit John
Publication year - 2016
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1111/maq.12274
Subject(s) - citizenship , biomedicine , nexus (standard) , normative , misinformation , context (archaeology) , sociology , human immunodeficiency virus (hiv) , public health , normalization (sociology) , medicine , political science , public relations , politics , social science , law , family medicine , nursing , history , genetics , computer science , biology , embedded system , archaeology
With the expanding pharmaceuticalization of public health, anthropologists have begun to examine how biomedicine's promissory discourses of normalization and demarginalization give rise to new practices of and criteria for citizenship. Much of this work focuses on the biomedicine–citizenship nexus in less‐developed, resource‐poor contexts. But how do we understand this relationship in resource‐rich settings where medicines are readily available, often affordable, and a highly commonplace response to illness? In particular, what does it mean to not use pharmaceuticals for a treatable infectious disease in this context? We are interested in these questions in relation to the recent push for early and universal treatment for HIV infection in Australia for the twin purposes of individual and community health. Drawing on Ecks's concept of pharmaceutical citizenship, we examine the implications for citizenship among people with HIV who refuse or delay recommended medication. We find that moral and normative expectations emerging in the new HIV “treatment revolution” have the capacity to both demarginalize and marginalize people with HIV.