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‘The world has changed’: Pharmaceutical citizenship and the reimagining of serodiscordant sexuality among couples with mixed HIV status in Australia

Sociology of Health & Illness

Published online on

Abstract

In this article, I revisit the question of whether HIV can ever be reimagined and re‐embodied as a potentially non‐infectious condition, drawing on a current qualitative study of couples with mixed HIV status (serodiscordance) in Australia. Recent clinical trials have consolidated a shift in scientific understandings of HIV infectiousness by showing that antiretroviral treatment effectively prevents the sexual transmission of HIV. Contrary to common critiques, I explore how the increasing biomedicalisation of public health and the allied discourse of ‘normalisation’ can in fact de‐marginalise stigmatised relationships and sexualities. Invoking Ecks's concept of ‘pharmaceutical citizenship’, I consider whether the emerging global strategy of HIV ‘treatment‐as‐prevention’ (TasP) can open up new trajectories that release serodiscordant sexuality from its historical moorings in discourses of risk and stigma, and whether these processes might re‐inscribe serodiscordant sexuality as ‘normal’ and safe, potentially shifting the emphasis in HIV prevention discourses away from sexual practice toward treatment uptake and adherence.