'Ending AIDS' in the Age of Biopharmaceuticals

This book considers the change in rhetoric surrounding the treatment of AIDS from one of crisis to that of 'ending AIDS'. Exploring what it means to 'end AIDS' and how responsibility is framed in this new discourse, the author considers the tensions generated between the individual and the state in terms of notions such as risk, responsibility and prevention. Based on analyses public health promotions in the UK and the US, HIV prevention science and engaging with the work of Foucault, this volume argues that the discourse of 'ending AIDS' implies a tension-filled space in which global principles and values may clash with localised needs, values and concerns; in which evidence-based policies strive for hegemony over local, tacit and communal regimes of knowledge; and in which desires compete with national and international ideas about what is best for the individual in the name of 'ending AIDS' writ large. As such, it will appeal to scholars of sociology and media studies with interests in the sociology of medicine and health, medical communication and health policy.

Tony Sandset is Research Fellow in the Faculty of Medicine at the University of Oslo, Norway, and the author of Color that Matters: A Comparative Approach to Mixed Race Identity and Nordic Exceptionalism.

Chapter 1: Introduction How to have theory at the end of AIDS? The Problem of HIV and the Problematization of the End of AIDS On Method Chapter 2: A Short History towards the End of AIDS From Treatment and Prevention to Treatment as Prevention: The Second Wave of Pharamasuticalization and the possibility of an 'HIV Free Generation' Role of Targets and Indicators: The Logic Behind the End of AIDS 90-90-90: Three metrics, one goal, many gaps, and issues? People and Places: Focusing on the 'Right Places and the Right People' Synchronizing the End of AIDS Reviewing the Numbers: What about the 10-10-10? Chapter 3 - Viral load maps: The entanglements between the individual, the community, and space Introduction Epidemiological Maps: Spatializing disease and visualizing cases Spatializing the End of AIDS: The role of the community viral load Viral Maps and the Media Spaces of Risk: Viral Load Maps and the Governmentality of the End of AIDS Ending (Community) AIDS? Communities at risk, and the governmental logic of surveillance Chapter 4: Molecular HIV Surveillance: Issues of Consent, Ethics, and Molecular Truth Telling Introduction Defining Molecular HIV Surveillance: From Clinical Usage to Epidemiological Surveillance Molecular Truth-Telling: Uncovering hidden risk groups, networks, and desires Inferring the Role of Immigration on 'HIV Dynamics': The Figure of the Immigrant Uncovering 'Risk Groups': Molecular Truth Telling, Non-Disclosed Men Who Have Sex with Men and Heterosexual Men Who Have Sex with Transgender Women Molecular Truths, Surveillance, and Subjectivities: Speaking Truthfully About Sex and HIV The Ethics of it All: Consequences of Translation Chapter 5: PrEP: The Public Life of an Intimate Drug Introduction 'Truvada Whores and the Truvada Wars' Framing the Truvada Whore Reclaiming the Inner Whore in the Name of Prevention PrEP: Poison, Cure and the Scapegoating of PrEP Users Marx on PrEP? Austerity, Cost, Access and Responsibility: Whose responsibility and whose risk is it anyway? NHS England versus 'The People': PrEP, Policy, and Uncertainty Responsibility: Fiscal and Moral? Ending AIDS Through PrEP: A public controversy over a reluctant object Chapter 6 - 'HIV both Starts and Stops with Me': Health Promotions, Neoliberalism and Responsibility Introduction Responsibility both Starts and Stops with Me: Know Your Status and Access Drugs! Framing Responsibility through Choice: It Starts with Me A Note on Neoliberalism at the End of AIDS Sex, Choice, Prevention and the Individual: Playing Sure to End AIDS Disciplining for Pleasure: Anticipating, Pre-emption, Planning and Pleasure Chapter 7: 'The Category is: Suppress! Disclose! Survive!', 'Positive Living' in Health Promotions for People Living With HIV in the Era of the End of AIDS Suppress! Disclose! Survive! Heroic Suppression The Detectables? What undetectable can tell us about new norms for HIV status, and the notion of viral suppression as success criteria Disclosure: Positive Talk as Care of the Self The Detectables? Concluding Remarks Chapter 8: Conclusion: A tentative end to AIDS? The Post in Post-AIDS and the End in Ending AIDS Attending to the Future: Speculation as Method