Explaining the Absence of the Lay Voice in Sexual Health Through Sociological Theories of Healthcare

Regulating sexual bodies or addressing health needs? Men who have sex with men and partner notification

“…Nonetheless, post-structuralist power is not theorised as absolute. Foucault theorises human agency and the power to resist dominant knowledge systems in three ways in different periods of his work (Hyde et al 2004, Lohan andColeman 2005). First, Foucault's scholarship was based on what he referred to as the 'genealogical method' (2001), or establishing an 'archaeology of knowledge ' (1972) aimed at uncovering the origins of established knowledge systems and how they come to dominate ways of thinking about the nature of reality.…”

“…However, in a similar vein to the concept of resistance, it is generally acknowledged that the concept of 'technologies of the self' is a relatively weak theorising of agency or the power of individuals to resist the dominant disciplining knowledge systems of the day (e.g. Giddens 1982, McNay 1992, Colwell 1994, Smart 1998, Delanty 1999, Jones 2001, Lohan and Coleman 2005.…”

“…Unlike Foucault, Habermas, adopts a strong normative position that we should seek to redress this imbalance of power by compelling system decision-making to the 'circulation of power' (Habermas 1996, p. 373). For Habermas, expert decision-making is not necessarily problematic if it can be re-formulated away from the imposition of system rationalities towards an engagement in genuine communication between system and lifeworlds or expert and lay worlds (Coleman and Lohan 2005). In Between Facts and Norms (1996), Habermas develops his ideas of 'deliberative' or 'discursive' democracy.…”

“…Syphilis is associated with an increased risk of transmission of HIV, and a six-fold increase in co-diagnosis of HIV and syphilis was reported in Dublin from 2000 to 2001 (Hopkins et al 2002). As a result of this outbreak, a heightened public health campaign was launched to combat syphilis, which included a primary focus on increasing partner notification among men who have sex with men (MSM) (Lohan and Coleman 2005). Partner notification (PN) is the process by which people who are thought to have been exposed to sexually acquired infections are traced, informed about their exposure and invited to attend clinical services.…”

“…However, internationally there has been a failure to investigate lay perspectives on partner notification with any patient group (for exceptions, but mainly relating to HIV, see Jones et al 1990, Gorbach 2000, Tyde´n and Ramstedt 2000, Maman et al 2001, Carballo-Dieguez et al 2002, Golden et al 2003, Lichtenstein and Schwebke 2005, Coleman and Lohan 2007. Research into lay perspectives on PN is critical because the effectiveness of PN depends upon a very significant lay response in terms of a willingness to disclose details of sexual partners and sexual practices and the further voluntary response of the sexual partners who have been traced Coleman 2005, Coleman andLohan 2007).…”