Accepted Paper:

Living and working in spite of antiretroviral therapies: HIV between control and resistance  


Matteo Carlo Alcano (Università degli Studi di Milano-Bicocca)

Paper short abstract:

This paper examines the sociality of antiretroviral drugs and shows how HIV emerges as a culturally constructed pathology, in the negotiation between biomedical control and individual 'rituals of resistance', through a specific use of biomedical technologies.

Paper long abstract:

Biomedical discourse has progressively come to redefine HIV as a chronic disease, and HIV-positive individuals as chronic patients. Antiretroviral therapies work as a clinical device to control and "chronicize" the pathology. Monthly blood tests, CD4+ T cell counts and oscillations in viral load indicate the stage of infection, determinate treatment, and reveal patients' adherence to therapies, ultimately redefining individuals as mere clinical data. Antiretroviral therapies, however, are extremely invasive: their posology shatters the individual's local world and forces a redefinition of the self, of one's ossibilities and priorities, thus greatly influencing drug consumption and adherence to treatment. In this sense we may speak of local strategies of resistance or, as I will suggest, of local 'rituals of resistance' which are performed by HIV-positive individuals in the attempt to negotiate their role of patients within the limits of the biomedical discourse.

Drawing upon fieldwork research conducted in Milan, Italy, in 2007 and 2008, I intend to explore the sociality of antiretroviral drugs, from their prescription to their consumption, in the attempt to show how HIV emerges as a culturally constructed experience through a specific use of biomedical technologies. I will focus on the case study of Italian construction workers as they are engaged in a constant and strategic process of negotiation of their adherence to therapy, which is influenced by the importance and need of "being able to go to work", as well as shaped by the need to "feel good and strong when going to work", as many patients have claimed. HIV will then be analyzed as a social construction, as what originates from the interplay of biomedical categories and the more intimate meanings that patients attach to the ideas of "work", "strength", "energy" and "health".

Therapy adherence will ultimately shed light on local forms of social suffering.

Panel IW02
Rethinking the body: biotechnology and sociality