When Debility Provides a Future: Preventing Vertical Transmission of HIV

Abstract

In this article we investigate the way in which viral load assays are used to assess the viruses of Human Immunodeficiency Virus (HIV)-positive pregnant women who are cared for in an HIV-specialist antenatal clinic in London. One of the viral load assays has been made more sensitive to subtypes of the virus that are considered to be local, possibly reading the viruses of those who have ‘foreign’ subtypes as undetectable. Consequently, the patient might not be offered the kind of care needed to prevent transmission of HIV, as her body is not recognised as sufficiently debilitated. Thus, being identified as a debilitated body in this setting facilitates the prevention of vertical transmission of HIV and the management of the HIV-positive pregnant patient's virus. Further to this, we argue that in our example, having a debilitated body as constructed by the viral load assay is thus a ‘privilege’ that is accorded to HIV-positive persons depending on the geographic origin of their virus. Using Karen Barad's agential realism, we argue that the manner in which HIV is read through the viral load assay constructs a specific woman/foetus/HIV phenomenon. The specificity of this phenomenon directly impacts on the course of care, opening up or foreclosing the possibility of her child having a future free from HIV.

Imaginings of Empowerment and the Biomedical Production of Bodies

“…Although my own work is in conversation with these studies, what I am interested in is the ways in which these experiences and voices come to be articulated through social science and as such become part of the apparatus of bodily production of microbicide development. Such a performative scope is in line with an emerging body of HIV research that explicitly foregrounds the materialities of HIV, bodies and prevention technologies and biomedicine's constitutive role herein (see for instance Rosengarten, 2009;Race, 2009;Montgomery, 2012;McKnight and Van der Zaag, 2015). That is to say, I am interested in how bodies come to matter in microbicide development as a materialdiscursive performative process that includes the articulations of materiality, experiences and ideals.…”

Replacement feeding and the HIV Diaspora: A case of ontological multiplicity and fluid technologies

“…The HIV that is transmitted is gendered, in that it is transmitted from mother to baby but not between the mother and her male sexual partner(s) and it is also racialised and decoupled from the material real of the virus. Having said this, practitioners in the clinic are actively aware that HIV as it is displayed in the clinic by the technologies that are used to come to know HIV – such as viral load assays that ‘read’ the amount of virus in blood samples – do not produce information about the material reality of the HIV in a patient's body in real‐time (McKnight & van der Zaag, 2015). Thus, the HIV displayed in the clinic is not ‘unaffected by technologies involved in [its] representation’ (Rosengarten, 2009, p. 24).…”