Global Health Futures: Ethno-Sexuality and HIV in South Africa

Friday, February 20, 2015 - 2:00pm - 3:30pm
639 Williams Hall
Speaker:Kirk J. Fiereck, Ph.D., M.Phil., M.P.H.
Andrew Mellon Postdoctoral Fellow in Sexuality and Queer Studies (2014-2016)
University of Pennsylvania
About the paper:The HIV prevention technology known as pre-exposure prophylaxis, or PrEP, has created new health inequalities and corporeal vulnerabilities along lines of race, ethnicity and sexuality in the context of South Africa. How has it come to be that a public health intervention, like PrEP, paradoxically creates health inequalities? One could argue that the future of global health is increasingly influenced by a logic of financial speculation, or what I call global health futures. PrEP is a pharmaceutical HIV prevention intervention whereby ‘healthy’ individuals who are determined to be at high-risk for HIV are indicated for daily antiretroviral (ARV) treatment. Other scholars have argued that the practice of medications when one is healthy produces surplus health specifically through the practices of consuming risk information, and treating these risks to preempt the onset of chronic disease or exposure to a disease agent. In the context of HIV, I argue that, as the inevitable inverse of surplus health, surplus risk is created for people who are understood to be at high risk for HIV, or are HIV positive, but lack access to ARVs. This paper explores how global health knowledge production mediates the relation between surplus health and surplus risk in South Africa. I explore these processes by drawing upon my ethnographic study of research participants enrolled within the South African arm of a global, multi-sited PrEP clinical trial and the global health experts who are implementing PrEP in South Africa. In these particular contexts, I compare the distributions of bodies that are consumed by risk through the creation of clinical knowledge in the space of drug trials with other bodies that consume risk knowledge in the context of ever-expanding pharmaceutical markets. Such distributions of risk and health surfeits are complex, and are mediated by race, class, gender and sexuality.
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