Beyond the discourses of policy and power: HIV, AIDS, and community perspectives on the lived pandemic

Afr J AIDS Res. 2023 Dec;22(4):261-268. doi: 10.2989/16085906.2023.2289392. Epub 2023 Dec 20.ABSTRACTAs HIV unfolded in the 1980s, HIV and AIDS were heard and seen through the lives of those whom it touched directly. Personal histories were foregrounded, centred by the inevitable mortality attached to HIV infection, the courage of circumstance in the face of illness, and the activism necessary to make a difference. In the later part of the decade, the impacts of HIV were most apparent in East Africa, where community responses and political leadership coalesced to reduce new HIV infections. The 1990s marked a turn towards centralised policy, funding, and the reification of biomedically oriented approaches and systems that are intrinsically top-down. This biomedical turn centred on foregrounding the widespread availability of low-cost antiretroviral therapy and was articulated in the 90-90-90 and subsequent targets. Biomedicalisation reinforces individualised approaches to health primarily focused on biomedical technologies and health service provision that do not rely on community or social organisation formats. Emphasis on HIV treatment, along with the promise of reduced HIV transmission through viral load suppression, contributed to limiting socio-behavioural approaches to HIV prevention. While the importance of community-led response was highlighted in the 2016 United Nations Political Declaration on Ending AIDS, community-led response has devolved towards concepts such as ...
Source: African Journal of AIDS Research - Category: African Health Authors: Source Type: research