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Sociol Health Illn. 2016 Mar;38(3):380-95. doi: 10.1111/1467-9566.12347. Epub 2015 Sep 11.

'The world has changed': pharmaceutical citizenship and the reimagining of serodiscordant sexuality among couples with mixed HIV status in Australia.

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Centre for Social Research in Health, UNSW, Australia.


In this article, I revisit the question of whether HIV can ever be reimagined and re-embodied as a potentially non-infectious condition, drawing on a current qualitative study of couples with mixed HIV status (serodiscordance) in Australia. Recent clinical trials have consolidated a shift in scientific understandings of HIV infectiousness by showing that antiretroviral treatment effectively prevents the sexual transmission of HIV. Contrary to common critiques, I explore how the increasing biomedicalisation of public health and the allied discourse of 'normalisation' can in fact de-marginalise stigmatised relationships and sexualities. Invoking Ecks's concept of 'pharmaceutical citizenship', I consider whether the emerging global strategy of HIV 'treatment-as-prevention' (TasP) can open up new trajectories that release serodiscordant sexuality from its historical moorings in discourses of risk and stigma, and whether these processes might re-inscribe serodiscordant sexuality as 'normal' and safe, potentially shifting the emphasis in HIV prevention discourses away from sexual practice toward treatment uptake and adherence.


HIV; biomedicine; qualitative methods; risk; sexuality; stigma

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