Faculty of Health Sciences, University of Hull, Hull, HU6 7RX, United Kingdom.
J Med Humanit. 2020 Jun;41(2):95-105. doi: 10.1007/s10912-017-9433-9.
This paper reflects on the meanings of 'post-AIDS' in the Global North and South. I bring together contemporary arguments to suggest that the notion of 'post-AIDS' is, at best, misplaced, not least because its starting point remains a biotechnical one. Drawing on aspects of the sub-Saharan African experience, this essay suggests that, despite significant shifts in access to antiretroviral therapy (ART), HIV continues to be fundamentally shaped by economic determinants and social and cultural practices. In this essay, I question the certainty of the discourse of (Western biomedical) 'positive progress' (Johnson et al. 2015), which underpins the 'post-AIDS' narrative, and suggest that living with HIV and AIDS in our contemporary global context is a life lived with ongoing complexity, stigma and chronicity. I suggest that HIV in the Global North shares many characteristics with HIV in the Global South yet differs in significant ways, not least in the fact that a resource-rich context generates an environment where health and social care support is possible, and, mostly, usual. In both contexts, however, the experience of living with a highly stigmatized illness with no cure in both the Global South and North suggests that this is a point of shared experience.
这篇论文反思了“艾滋病后时代”在全球北方和南方的含义。我结合了当代的观点,认为“艾滋病后时代”的概念最多是错位的,尤其是因为它的起点仍然是生物技术的。本文借鉴了撒哈拉以南非洲地区的经验,表明尽管在获得抗逆转录病毒疗法(ART)方面取得了重大进展,但艾滋病毒仍然主要受到经济决定因素和社会文化实践的影响。在本文中,我质疑支撑“艾滋病后时代”叙事的(西方生物医学的)“积极进步”话语的确定性,并认为在我们当代的全球背景下,艾滋病毒的存在以及艾滋病的存在是一种充满持续复杂性、污名和慢性的生活。我认为,北方国家的艾滋病毒与南方国家的艾滋病毒有许多共同特征,但也存在显著差异,尤其是在资源丰富的环境中,健康和社会关怀支持是可能的,而且通常是这样的。然而,在这两种情况下,在南方和北方都没有治愈方法的高度污名化疾病的生活体验表明,这是一个共同的经历。