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Research Articles

Being naturalised, being left behind: the HIV citizen in the era of treatment possibility

Pages 401-427 | Received 09 Oct 2009, Accepted 19 Aug 2010, Published online: 20 Nov 2010
 

Abstract

With around five million people accessing anti-retroviral treatment, which significantly reduces mortality and extends life, the HIV pandemic now exists in a context of treatment possibility, if not access. This article discusses ways in which the pandemic is becoming naturalised through medicalisation, normalisation and marketisation, and how these processes undermine themselves internally. The article goes on to examine some further denaturalising discontinuities in how the contemporary HIV era is lived, which derive from HIV's specific biological, socioeconomic and psychological characteristics, and which leave many at some distance from the relatively hopeful HIV present. This article argues that naturalisation and aspects of ‘being left behind’ are important elements of HIV experience which require continued attention. Throughout, it examines the significance of naturalising and denaturalising processes for HIV citizenship. The article draws on narrative data from studies of HIV support in the UK, 1993–2010, and in South Africa, 2001–2004, to make these arguments.

Notes

1. This expression is taken from the title of a song in Roger Bourland's (Bourland and Hall 1993) Hidden Legacies cycle, but it has been used in many other contexts within the pandemic.

2. Of course, this medicalised skewing is not unique to HIV (Sanders et al. Citation2008, Wills and Douglas Citation2008).

3. Kenya's recent achievement of 50% testing by door-to-door request is an exception.

4. Current international treatment policies reemphasise these elements (UNAIDS Citation2010).

5. Many thanks to Dr Lillian Cingo for her understanding of this point.

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