(Re)distribution of blame: examining the politics of biomedical HIV knowledge in Lesotho

Abstract

Until recently the HIV epidemic in low-income countries was largely managed through prevention and palliative care efforts given insufficient funds and infrastructure for biomedical interventions. As such, biomedical knowledge of HIV has become an important tool for populations and individuals in the fight against infection, promoted by neoliberal economic policies of privatisation and individual agency. Biomedical knowledge, like other technologies, has been unequally distributed, is culturally embedded, and a product of a particular historical, political and social context. This article explores how the spread of biomedical HIV knowledge through its multitude of government, non-government and private channels has impacted the explanatory accounts and practices of youth in Lesotho. Three interwoven issues aim to illustrate the significance of HIV knowledge in contemporary debates about health equity. The first addresses how biomedical HIV knowledge is created, circulated and received. The second explores how biomedical knowledge about HIV is acted on in particular sociocultural settings. Finally, the impact that HIV knowledge has on whom, and why, is discussed. Rather than empowering individuals to utilise knowledge for the maintenance of health, the focus on biomedical knowledge acquisition has disempowered individuals, as they are held responsible for the inappropriate lifestyles that result in HIV infection.

Keywords:

• HIV/AIDS
• inequality
• knowledge
• southern Africa