PubMed Health⌕ Search

PubMed · 11270667

Technology and effect: HIV/AIDS testing in Brazil.

Abstract

Contemporary techno-scientific and medical developments are restructuring social interactions and the very processes by which individual subjectivity is formed. This essay elaborates on the experiential and ethical impact of such transformations from the perspective of people who, in ordinary and unexpected ways, act science and technology out. We carried out ethnographic research in an HIV/AIDS Testing and Counseling Center (CTA) in northeastern Brazil, combining participant observation with epidemiological analyses and clinical survey. We found a high demand for free testing by low-risk clients, largely working and middle class, experiencing anxiety and complaining of AIDS-like symptoms. Most of the clients were sero-negative and many returned for a second and third testing. We understand this to be a new techno-cultural phenomenon and call it imaginary AIDS. Throughout this essay, we describe CTA's routine practices, place these practices in historical, political, economic and cross-cultural perspective, and analyze the subjective data we collected from the clients of our pilot study. We explore how clinical epidemiological expertise and HIV testing technology are integrated into new forms of bio-politics aimed at specific marketable and disease-free populations, and on the affective absorption of bio-technical truth and the engendering of a technoneurosis in this testing center.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

J Biehl, D Coutinho, A L Outeiro. 2001. Technology and effect: HIV/AIDS testing in Brazil.. https://doi.org/10.1023/a%3A1005690919237

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Can increasing awareness of HIV seropositivity reduce infections by 50% in the United States?

BACKGROUND: In 2003, US Centers for Disease Control and Prevention (CDC) announced an HIV prevention initiative that emphasized increasing the proportion of persons living with HIV who are aware of their positive serostatus. Previously, CDC set a national HIV prevention goal of reducing new infections by 50% by 2005, with increasing serostatus awareness a central goal. The objectives of this article are to examine the national epidemiologic consequences of increasing serostatus awareness and the important question of how far increasing awareness could lead toward achieving CDC's goal of a 50% reduction in incident infections. METHODS: Scenario analysis methods were used to project incident HIV infections over 1- and 10-year time horizons at varying levels of HIV seropositivity awareness. Because HIV transmission rates are several times higher for those who are unaware of their HIV seropositivity than for those who are aware, we modeled the effects of increasing awareness via HIV counseling and testing and moving people from the higher to the lower transmission category. RESULTS: Increasing awareness of HIV seropositivity via HIV counseling and testing in the United States from a baseline 75% to 95% has the potential of reducing new infections by as much as 32% in a single year. Achieving the national goal of 50% reduction seems out of reach, however. CONCLUSIONS: Reduction of new infections by 50% in the United States requires a combination of prevention services to reduce further the already low HIV transmission rate from persons aware of their HIV seropositivity and HIV risk reduction interventions for at-risk persons. Counseling and testing alone seems insufficient to meet the 50% incidence reduction goal.

AIDS Serodiagnosis↗

Estimating HIV incidence in voluntary counseling and testing clients in Uganda (1992-2003).

OBJECTIVES: To estimate HIV incidence from first-time testers among voluntary counseling and testing (VCT) clients in Uganda. METHODS: Data on 203,000 VCT clients tested from 1992 through 2003 were adjusted for temporal changes in the testing population. Differential mortality rates by HIV status were used to derive expected prevalence at future times from baseline prevalence within 5-year birth cohorts. Incidence was computed as the proportion of HIV-uninfected persons who seroconverted divided by the proportion negative at baseline. RESULTS: Annual HIV incidence per 100 uninfected persons increased from 0.9 (95% confidence interval [CI]: 0.8 to 1.1) in 1993 to 2.3 (95% CI: 2.2 to 2.5) in 2003 (chi test for trend, P < 0.001). Prevalence decreased from 23% to 13% in 1999 to 2000 and increased to 15% in 2003. Women had a higher incidence. Peak incidence shifted to older age groups over time. CONCLUSIONS: Estimating incidence from routine data presents a practical way of tracking HIV incidence and is a useful tool in targeting and evaluating the impact of prevention programs. Our analysis reveals a new phase of the HIV epidemic in Uganda: decreasing prevalence and increasing incidence, especially among middle-aged persons. These findings support the need for intensified prevention interventions among middle-aged persons in Uganda.

AIDS Serodiagnosis↗