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Erschienen in:
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2017 | OriginalPaper | Buchkapitel

7. Context Matters! But Why?

verfasst von : Hakan Seckinelgin

Erschienen in: The Politics of Global AIDS

Verlag: Springer International Publishing

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Abstract

Most RCT-related knowledge claims explicitly stress the importance of adherence. Although context may additionally be mentioned in addition to adherence, I argue that all adherence is a function of context. In the light of this, this chapter considers what is meant by ‘context’ within discussions of Global AIDS and compares this with some discussions of context within the social sciences more generally. After considering briefly arguments about Voluntary Medical Male Circumcision as an HIV-related intervention, I focus on the structural drivers’ debate as one attempt to pay serious attention to notions of context as part of the global AIDS response. I conclude that knowledge needs and claims within Global AIDS system systematically misunderstands the idea of context. This, I argue, diverts attention away from individual and collective experience of HIV and AIDS as part of everyday life.

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Vorheriges Kapitel Evidence-Based Policy: Randomised Controlled Trials’ Knowledge Claims to AIDS Policy
Nächstes Kapitel Conclusion: Emergency, Sustainability and Success
Fußnoten
1
For instance Barry Adam recognizes major challenges in relation to this debate, pointing out that moving from the idea of the population to the individual carries interpretive risks: ‘Accomplishing widespread viral undetectability, even in highly-resourced settings, then appears to pose major challenges.
Shifting perspective from the population level to that of people who must manage risk in their everyday lives brings quite another range of considerations into view’ (2011:5).
 
2
Questions of gender relations and gendered attitudes towards sex (Connell 1995; Morell 2001) are important to consider here. Similarly, discussion of sex and sexuality in relation to health behaviour is central to understanding how particular outcomes may be brought about. There is also a need to take into account ‘concern with “intersubjective” cultural meanings related to sexuality and their shared and collective qualities’ (Corrêa et al. 2008: 133; see also Boyce 2012; Rohleder and Swartz 2012).
 
3
Lack of interest in these issues is evident when Wamai et al. argue that the review by Weiss et al. (2010) ‘noted there was “little evidence” of any adverse effect on sexual satisfaction or function following MC’ (2015:643). The original statement in Weiss et al. concerned lack of evidence on the issue and did not reach a definitive conclusion about it (2010: S66–S67).
 
4
This framing is much in evidence in a review article published by the Lancet to provide a state of the art analysis about the HIV infections at the time of AIDS 2014a, b, c in Melbourne. Gary Maartens, Connie Selum and Sharon R. Lewin list a number of breakthroughs in the abstract of the article, which ‘include male medical circumcision, antiretrovirals to prevent mother-to-child transmission, antiretroviral therapy in people with HIV to prevent transmission, and antiretrovirals for pre-exposure prophylaxis’ (2014: 258).
 
5
One of these was the securitization debate linking insecurity to HIV transmission in conflict contexts. I have discussed this extensively elsewhere (Seckinelgin 2012a, 2009b). Another area is related to Catherine Campbell’s work on ‘HIV competent communities’ (2013). I decided to focus here on the broader framework of structural drivers as this has become more widely termed in policy circles.
 
6
As an aside, this quote also makes an interesting observation about the impact of the Global AIDS system as a political and policy structure within which people are located.
 
7
The aids2031 initiative was established in 2007 to review existing interventions and to signal future directions http://​www.​aids2031.​org
 
8
It is interesting to note how over this period prevention priorities competed with the question of treatment roll-out in resource poor settings as a global policy priority.
 
9
This is observable in the following statement: ‘[T]hree approaches and case studies are considered in this paper: (1) Increasing the economic status of women (parts of sub-Saharan Africa); (2) Addressing violence against women (South Africa); and (3) Changing harmful gender norms (Latin America, south-east Asia).
While programmes addressing these factors have succeeded in reducing vulnerability in some settings, these successes are necessarily context-specific, and likely to have resulted from a more complex interplay of factors than might be apparent from the summaries presented below (Rao Gupta et al. 2011: S372).
 
10
For instance, the important point is made that ‘Gender norms particularly for men also commonly promote, or at least condone, ‘homophobia’, or antihomosexuality. Evidence indicates, however, that programmes to address unequal gender norms among young men can reduce HIV vulnerability and enhance AIDS resilience by increasing respect for women, reducing the numbers of sexual’ (Rao Gupta et al. 2011: S374). However, given lack of detailed contextual knowledge concerning the production and reproduction of gender norms, such recognition may only lead to general gender empowerment interventions without addressing the dynamics of the production of particular norms (see Seckinelgin 2012a, b).
 
11
This addresses the ‘social and structural factors, such as poverty, gender inequality, and human rights violations, that are not easily measured that increase people’s vulnerability to HIV infection’ (UNAIDS 2007).
 
12
According to one academic expert, during a discussion with UNAIDS and other policy actors on structural drivers in Geneva, he was directly asked whether he could identify five drivers that would allow policy makers to understand the approach and allow them to develop their work.
 
13
An alternative approach to considering behaviour change and condom use can be seen in Kane Race’s discussion of gay men’s ‘reflexive mediation between embodied habits and medical opinion’. This provides an example of how the analysis can be turned around to look at practices which take into account experiences of AIDS with context (2003: 377).
 
14
In another example of this tendency, Seeley et al. in introducing a journal special issue highlight the importance of paying attention to the centrally of structural intervention in treatment as prevention. They conclude that ‘[A]lthough the focus of the papers is largely from east and southern Africa, the findings are unlikely to be unique to these regions, as issues of marginalization (and associated stigma) and economic and gender inequality are all too common globally, and apply also to other at risk populations, such as men who have sex with men and persons who inject drugs’ (2012:1–3). Arguably, one set of social factors and particular ways of dealing with their implications are seen as sufficiently general from within the Global AIDS system to engage with different risk groups.
 
15
The concept of ‘retrofitting’ existing policy thinking to concerns with the social aspects of AIDS is also a relevant refection here (Richey 2008: 217–218). Another lens to consider this is how it turns people’s lives into projects via processes of what Whyte et al. (2013: 143) have called ‘projectification’.
 
Literatur
Adam, B. D. (2011). Epistemic fault lines in biomedical and social approaches to HIV prevention. Journal of International AIDS Society, 14(Suppl. 2), S2.CrossRef
Anscombe, E. (2000/1957). Intention (2nd ed.). Cambridge, MA: Harvard University Press.
Auerbach, J. (2009). Transforming social structures and environments to help in HIV prevention. Health Affairs, 28(6), 1655–1665.CrossRef
Auerbach, J., Parkhurst, J. O., & Cáceres, C. F. (2011). Addressing social drivers of HIV/AIDS for the long-term response: Conceptual and methodological considerations. Global Public Health: An International Journal for Research, Policy and Practice, 6(Suppl. 3), S293–S309.CrossRef
Bailey, R. C., Moses, S., Parker, C. B., Agot, K., Maclean, I., Krieger, J. N., Williams, C. F., Campbell, R. T., & Ndinya-Achola, J. O. (2007). Male circumcision for HIB prevention in your men in Kisumu, Kenya: A randomised controlled trial. Lancet, 369(9562), 643–656.CrossRef
Baldwin, P. (2005). Disease and democracy: The industrialized world faces AIDS. Berkeley: University of California Press.
Baral, S. D. (2011). A cross-sectional assessment of the burden of HIV and associated individual- and structural-level characteristics among men who have sex with men in Swaziland. Journal of International Aids Society, 16(4 Suppl. 3), 18768.
Blankenship, K. M., Bray, S. J., & Merson, M. H. (2000). Structural interventions in public health. AIDS, 14(Suppl. 1), S11–S21.CrossRef
Bosso, C. J. (1994). The contextual bases of problem definition. In D. A. Rochefort & R. W. Cobb (Eds.), The politics of problem definition: Shaping the political agenda (pp. 182–203). Lawrence: Kansas University Press.
Bourdieu, P. (1990). The logic of practice. Stanford: Stanford University Press.
Boyce, P. (2012). The ambivalent sexual subject: HIV prevention and male-to-male intimacy. In P. Aggleton, P. Boyce, H. L. Moore, & R. Parker (Eds.), Understanding global sexualities: New frontiers (pp. 75–88). London: Routledge.
Campbell, C. (2013). Building ‘HIV competent communities’ in resource poor settings: Creating contexts that enable effective community mobilization. In R. A. Smith (Ed.), Global HIV/AIDS politics, policy and activism: Persistent challenges and emerging issues (pp. 107–134). New York: Praeger.
Cartwright, N., & Hardie, J. (2012). Evidence-based policy: A critical guide to doing it better. New York: Oxford University Press.CrossRef
Chandler, C. L. (2011). Creating a different international HIV response for young people. Global Public Health: An International Journal for Research, Policy and Practice, 6(Suppl. 3), S344–S356.CrossRef
Connell, R. W. (1995). Masculinities. London: Polity.
Corrêa, S., Petchesky, R., & Parker, R. (2008). Sexuality, health and human rights. London: Routledge.
Foley, E. E., & Hendrixson, A. (2011). From population control to AIDS: Conceptualising and critique the global crisis model. Global Public Health: An International Journal for Research, Policy and Practice, 6(Suppl. 3), S310–S322.CrossRef
Fox, A. M., Goldberg, A. B., Gore, R. J., & Bäringhausen, T. (2011). Conceptual and methodological challenges to measuring political commitment to respond to HIV. Journal of the International AIDS Society, 14(Suppl. 2), S2–S5.
Geertz, C. (1973). The interpretation of cultures. New York: Basic Books.
Giddens, A. (1984). The constitution of society: Outline of the theory of structuration. Cambridge: Polity Press.
Goffman, E. (1961). The presentation of self in everyday life. London: Penguin.
Goffman, E. (1968). Stigma. London: Penguin.
Gray, R. H., Kigozi, G., Sewadda, D., Makumbi, F., Watya, S., Nalugoda, F., Kiwanuka, N., Moulton, L. H., Chaudhary, M. A., Chen, M. Z., Sewankambo, N. K., Wabwire-Mangen, F., Bacon, M. C., Williams, C. F. M., Opendi, P., Reynolds, S. J., Laeyendecker, O., Quinn, T. C., & Wawer, M. J. (2007). Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial. Lancet, 369(9562), 657–666.CrossRef
Gupta, R. G., Parkhurst, J. O., Ogden, J. A., Aggleton, P., & Mahal, A. (2008). Structural approaches to HIV prevention. Lancet, 372(9640), 764–775.CrossRef
Gupta, R. G., Ogden, J., & Warner, A. (2011). Moving forward on women’s gender-related HIV vulnerability: The good news, the bad, and what to do about it. Global Public Health: An International Journal for Research, Policy and Practice, 6(Suppl. 3), S370–S382.CrossRef
Hacking, I. (1995). The looping effects of human kinds. In D. Sperber, D. Premarck, & A. Premack (Eds.), Causal cognition: An interdisciplinary approach. Oxford: Oxford University Press.
Hankins, C. A., & de Zalduondo, B. O. (2010). Combination prevention: A deeper understanding of effective HIV prevention. AIDS, 24, S70–S80.CrossRef
Hoppe, R. (2011). The governance of problems: Puzzling, powering and participation. Bristol: The Policy Press.
Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection: Epidemiology, pathogenesis, treatment, and prevention. Lancet, 384, 258–271.CrossRef
Morell, R. (Ed.). (2001). Changing men in Southern Africa. London: Zed Books.
Ogden, J., Gupta, R. G., Fisher, W. F., & Warner, A. (2011a). Looking back, moving forward: Towards a game-changing response to AIDS. Global Public Health: An International Journal for Research, Policy and Practice, 6(Suppl. 3), S285–S292.CrossRef
Parker, G. R., Easton, D., & Klein, C. H. (2000). Structural barriers and facilitators in HIV prevention: A review of international research. AIDS, 14(Suppl. 1), S22–S32.CrossRef
Parkhurst, J. (2014). Structural approaches for prevention of sexually transmitted HIV in general populations: Definitions and an operational approach. Journal of International AIDS Society, 17, 19052.CrossRef
Piot, P. (2010). Setting new standards for targeted HIV prevention: The Avahan initiative in India. Sex Transmitted Infections, 86(1).
Race, K. (2003). Revaluation of risk among gay men. AIDS Education and Prevention, 4, 369–381.CrossRef
Richey, L. A. (2008). Population politics and development: From the policies to the clinics. New York: Palgrave MacMillan.CrossRef
Rohleder, P., & Swartz, L. (2012). Disability, sexuality and sexual health. In P. Aggleton, P. Boyce, H. L. Moore, & R. Parker (Eds.), Understanding global sexualities: New frontiers (pp. 138–152). London: Routledge.
Seckinelgin, H. (2012a). International security, conflict and gender ‘HIV/AIDS is another war’. London: Routledge.
Seckinelgin, H. (2012b). The global governance of success in HIV/AIDS policy: Emergency action, everyday lives and sen’s capabilities. Health and Place, 18(3), 453–460.CrossRef
Seeley, J., Watts, C. H., Kippax, S., Russell, S., Lori, H., & Whiteside, A. (2012). Addressing the structural drivers of HIV: A luxury or necessity for programmes? AIDS, 15(Suppl. 1), 17397.
Shriver, M. D., Everett, C., & Morin, F. S. (2000). Structural interventions to encourage primary HIV prevention among people living with HIV. AIDS, 14(Suppl. 1), S57–S62.CrossRef
Sumartojo, E. (2000). Structural factors in HIV prevention: Concepts, examples, and implications for research. AIDS, 14(Suppl. 1), S3–S10.CrossRef
Tillion, G. (2000). Fragments de vie. Paris: Éditions du Seuil.
UNAIDS. (2007). Practical guidelines for intensifying HIV prevention: Towards universal access. Geneva: UNAIDS.
Verhoeven, J. C. (1993). An interview with Erving Goffman 1980. Research on Language & Social Interaction, 26(3), 317–348.CrossRef
Wamai, R. G., Morris, B. J., Bailey, R. C., Kalusner, J. D., & Boedicker, M. N. (2015). Male circumcision for protection against HIV infection in sub-Saharn Africa: The evidence in favour justifies the implementation now in progress. Global Public Health, 10(5–6), 639–666.CrossRef
Whyte, S. R., Whyte, M. A., Meinert, L., & Twebaze, J. (2013). Therapeutic citizenship: Belonging in Uganda’s projectified landscape of AIDS care. In J. Biehl & A. Petryna (Eds.), When people come first: Critical studies in global health (pp. 140–166). Oxford: Princeton University Press.
Wohlfeiler, D. (2000). Structural and environmental HIV prevention for gay and bisexual men. AIDS, 14(Suppl. 1), S52–S56.CrossRef
Metadaten
Titel
Context Matters! But Why?
verfasst von
Hakan Seckinelgin
Copyright-Jahr
2017
Buch
The Politics of Global AIDS

Print ISBN: 978-3-319-46011-6

Electronic ISBN: 978-3-319-46013-0

Copyright-Jahr: 2017

DOI
https://doi.org/10.1007/978-3-319-46013-0_7