HIV and chemoprophylaxis, the importance of considering social structures alongside biomedical and behavioral intervention

Eric T. Roberts and Derrick D. Matthews

Social Science & Medicine, 2012, vol. 75, issue 9, 1555-1561

Abstract: This manuscript draws connections between chemoprophylaxis and the biomedical model of disease that emphasizes individual behavior. We argue that chemoprophylactic HIV interventions have limited utility at the population-level, and that structural interventions need to be prioritized. We use the recent CAPRISA 004 and iPrEx trials to (a) critique the utility of these trials from a public health perspective by highlighting the difference between efficacy and effectiveness, (b) apply an alternative theory of health behavior as a way to reorient the field toward the discussion of the need to employ structural interventions, and (c) examine two aspects of HIV prevention efforts – funding structures and iatrogenic effects of biomedical approaches – as a means of overcoming obstacles to more widespread adoption of structural interventions.

Keywords: HIV; Structural; Prophylaxis; Microbicide; Randomized control trial (search for similar items in EconPapers)
Date: 2012
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Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:75:y:2012:i:9:p:1555-1561

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DOI: 10.1016/j.socscimed.2012.02.016

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