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Accepted Paper:

Constructing HIV “Treatment Kinds”: Emergent HIV-Positive Subjectivities and Markets in a Time of Expanding Treatment Options  
Vishnu Subrahmanyam (University of Texas Medical Branch at Galveston)

Short abstract:

This paper highlights how market actors and US federal agencies construct new biomedical subjectivities for people living with HIV in a time of expanding treatment options and describes how this defers addressing the social determinants of HIV treatment adherence.

Long abstract:

Adherence to HIV treatment regimens has been a long-standing concern for healthcare providers, public health institutions, and people living with HIV (PLHIV). Adherence is critical to maintaining a suppressed viral load, enabling long-term health while making one’s HIV untransmissible. Although dominant narratives moralize the “irresponsibility” of PLHIV who miss daily medication doses, several scholars in STS highlight adherence as more than consuming a pill every day, revealing numerous human and non-human actors that shape adherence. Amidst these debates, pharmaceutical companies have capitalized on HIV treatment adherence, designing novel regimens such as long-acting injectables that require less frequent dosing (e.g., every two months). Long-acting treatments are aimed at PLHIV whose competing priorities undermine daily adherence. In this paper, I analyze pharmaceutical infographics, advertisements, and regulatory applications related to long-acting injectable treatments, revealing how market actors and federal agencies construct new categories of people living with HIV. I theorize these biosocial positions as “treatment kinds” – different biomedical subjects diagnosed with HIV understood to need specialized interventions to remain adherent. Developing products around particular treatment kinds enables state and market actors to reconfigure treatment adherence as a site of pharmaceutical intervention that can afford PLHIV agency to navigate competing priorities. I argue that HIV "treatment kinds" do empower some people living with HIV, while also creating niche markets for pharmaceutical profit-making. Organizing novel HIV treatments around treatment kinds thus allows market actors and public health institutions to defer addressing the social determinants of HIV treatment adherence in favor of medicalized solutions.

Traditional Open Panel P333
Knowledge of HIV/AIDS in STS: archives, science, and participation
  Session 1