Beyond the Distinction Between Biomedical and Social Dimensions of HIV

Published: April 18, 2012

Developing effective HIV prevention requires that we move beyond the historical but problematic
distinction between biomedical and social dimensions of HIV. The current claim that prevention has
failed has led to a strong interest in the role of treatment as HIV prevention; however, the turn to
“biomedical prevention,” “test and treat,” and “combination prevention” instances pervasive confusions
about prevention. These confusions arise from a failure to realize that all HIV prevention interventions
must engage with the everyday lives of people and be integrated into their social relations
and social practices. We challenge the claim that prevention has failed (illustrating this with discussion
of prevention in Australia, Uganda, and Zimbabwe). We explain the enduring appeal of misguided approaches to prevention by examining how 1996 can be seen as a pivotal moment in the history of the
global response to HIV, a moment marked by the rise and fall of distinct biomedical and social narratives
of HIV. (Am J Public Health. 2012;102:789–799. doi:10.2105/AJPH.2011.300594).

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