title: 'The world has changed': pharmaceutical citizenship and the reimagining of serodiscordant sexuality among couples with mixed HIV status in Australia.
abstract: In this article, I revisit the question of whether HIV can ever be reimagined and re-embodied as a potentially non-infectious condition, drawing on a current qualitative study of couples with mixed HIV status (serodiscordance) in Australia. Recent clinical trials have consolidated a shift in scientific understandings of HIV infectiousness by showing that antiretroviral treatment effectively prevents the sexual transmission of HIV. Contrary to common critiques, I explore how the increasing biomedicalisation of public health and the allied discourse of 'normalisation' can in fact de-marginalise stigmatised relationships and sexualities. Invoking Ecks's concept of 'pharmaceutical citizenship', I consider whether the emerging global strategy of HIV 'treatment-as-prevention' (TasP) can open up new trajectories that release serodiscordant sexuality from its historical moorings in discourses of risk and stigma, and whether these processes might re-inscribe serodiscordant sexuality as 'normal' and safe, potentially shifting the emphasis in HIV prevention discourses away from sexual practice toward treatment uptake and adherence.
authors.affiliation: Centre for Social Research in Health, UNSW, Australia.
authors.forename: Asha
authors.initials: A
authors.lastname: Persson
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001315:Australia; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012307:Risk Factors; D012747:Sexual Partners / Q000523:psychology; D019529:Sexuality; D057545:Social Stigma
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; biomedicine; qualitative methods; risk; sexuality; stigma