Chandra Shiva, Broom Alex, Ridge Damien, Peterie Michelle, Lafferty Lise, Broom Jennifer, Kenny Katherine, Treloar Carla, Applegate Tanya
Sydney Centre for Healthy Societies, School of Social and Political Sciences, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, New South Wales, Australia.
School of Social Sciences, University of Westminster, London, UK.
Sociol Health Illn. 2025 Jan;47(1):e13832. doi: 10.1111/1467-9566.13832. Epub 2024 Sep 2.
In this article, we examine the current management of sexually transmitted infections (STIs), in the context of rising antimicrobial resistance (AMR), through the lens of 'treatment cultures'. Prevailing treatment cultures-including the prominence of syndromic care for STIs-foster certain possibilities and foreclose others, with important consequences for countering AMR. Drawing on qualitative interviews with STI professionals, experts and industry representatives, we unpack these stakeholders' accounts of STI treatment cultures, drawing out the importance of socio-historical (i.e. taboo and stigma), political-economic (i.e. perceptions of significance, profit-making and prioritisation) and subjective (i.e. patient contexts and reflexivity) dimensions therein. In developing this critical account of how treatment cultures are formed, reproduced and indeed resisted, we reveal how such discourses and practices render the reining in of AMR and shifting antibiotic use difficult, and yet, how productive engagement remains key to any proposed solutions. As such, the article contributes to our understanding of AMR as a highly diversified field, through our exploration of the bio-social dimensions of resistance as they relate to the case of STIs.
在本文中，我们通过“治疗文化”的视角，审视了在抗菌药物耐药性（AMR）不断上升的背景下，性传播感染（STIs）的当前管理情况。当前盛行的治疗文化——包括性传播感染综合征护理的突出地位——促成了某些可能性，同时排除了其他可能性，这对对抗抗菌药物耐药性产生了重要影响。通过对性传播感染专业人员、专家和行业代表的定性访谈，我们剖析了这些利益相关者对性传播感染治疗文化的描述，揭示了其中社会历史（即禁忌和耻辱）、政治经济（即重要性认知、盈利和优先级排序）以及主观（即患者背景和反思性）维度的重要性。在对治疗文化如何形成、复制以及如何被抵制进行这一批判性阐述的过程中，我们揭示了此类话语和实践如何使得控制抗菌药物耐药性和改变抗生素使用变得困难，然而，富有成效的参与对于任何提议的解决方案而言仍然至关重要。因此，通过我们对与性传播感染案例相关的耐药性生物社会维度的探索，本文有助于我们将抗菌药物耐药性理解为一个高度多样化的领域。
