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

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  • Roberts, Eric T.
  • Matthews, Derrick D.
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    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.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612001906
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 9 ()
    Pages: 1555-1561

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:9:p:1555-1561

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    Related research

    Keywords: HIV; Structural; Prophylaxis; Microbicide; Randomized control trial;

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    1. Krieger, Nancy, 1994. "Epidemiology and the web of causation: Has anyone seen the spider?," Social Science & Medicine, Elsevier, vol. 39(7), pages 887-903, October.
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    Cited by:
    1. Stadler, Jonathan & Delany-Moretlwe, Sinead & Palanee, Thesla & Rees, Helen, 2014. "Hidden harms: Women's narratives of intimate partner violence in a microbicide trial, South Africa," Social Science & Medicine, Elsevier, vol. 110(C), pages 49-55.

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