Comments on: Addressing Publics Positively: Some Developments in HIV Prevention http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/ Notes and Queries in Anthropology — A Group Blog Thu, 24 May 2012 01:47:51 +0000 hourly 1 http://wordpress.org/?v=3.3.2 By: Strong http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/comment-page-1/#comment-124401 Strong Sun, 07 Oct 2007 04:53:56 +0000 http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/#comment-124401 Hi again, and thank you for your response. You make a great point about how serious thinking about HIV and AIDS defies the easy orthodoxies of either a (U.S.) liberal or conservative sort, especially as these impinge upon politics in other countries. I appreciate your taking the time to comment further. Stepping away from the question of whether promoting condoms is a magic bullet for preventing HIV-transmission in all places, there is another question that doesn't cleave easily along left (anti-market, say) and right (anti-welfare, say) lines and this pertains to making lifesaving drugs available to people who already have HIV.</p><br /><br /><br /><br /><br /><br /><br /> <p>First, it's possible that these drugs might never have been developed. The story of _how_ they were developed is complex, and it crisscrosses divides between science, the market, and activist communities, as "Steven Epstein":http://books.google.fi/books?id=kZOso0FMsrMC&dq=&pg=PP1&ots=CVfs5PeVP-&sig=usiJxZVKphfWK83n3xsETL_riUA&prev=http://www.google.fi/search%3Fclient%3Dfirefox-a%26rls%3Dorg.mozilla%253Aen-GB%253Aofficial%26channel%3Ds%26hl%3Den%26q%3Dimpure%2Bscience%26meta%3D%26btnG%3DGoogle%2BSearch&sa=X&oi=print&ct=title has shown. I remember many arguments with other AIDS activists in the early 1990s about whether our clarion call for "more (state) funding" for AIDS research was the best way to hasten the development of lifesaving treatments. Some argued that the market, and naked financial interest, would be the most effective forces for getting the drugs developed. Of course, it is worth remembering that ACT UP and other AIDS activist organizations, including ACT UP's Treatment Action Group, were operating in an extremely hostile environment, in which getting _anyone_ (including US Presidents) even to _talk_ about AIDS was something of an accomplishment. Yet, the ostensibly radical politics of a group like ACT UP were sparked by the personal efforts and passionate rhetoric of "Larry Kramer":http://en.wikipedia.org/wiki/Larry_Kramer who combined moral outrage at the disgusting neglect of HIV by politicians and others with a more practical outrage about the sex habits he imputed to the gay male community. Likewise, "Randy Shilts":http://en.wikipedia.org/wiki/And_the_Band_Played_On crossed over and between easy left/right orthodoxies in his majesterial and still vital history of HIV and AIDS in America.</p><br /><br /><br /><br /><br /><br /><br /> <p>OK, so the development of ARVs, as well as HIV prevention tactics, in the _US_ represents a history that can't be reduced to platitudes about left and right. So what about today, right now? I mean, we now HAVE the means to save millions of lives through anti-retroviral drugs that are extremely expensive. What are the politics involved? There are issues concerning intellectual property rights and finding ways to speed production of the drugs in poor countries, for example. If commercial interest in part provided the motive for development of drugs, would relaxing the property laws that make that interest profitable undermine the system that generated them (the drugs) in the first place?</p><br /><br /><br /><br /><br /><br /><br /> <p>I think the best writing and thinking on this problem, and its politics, is by an anthropologist! His name is "Joao Biehl":http://www.princeton.edu/main/news/archive/S17/06/97S70/index.xml?section=featured and he sensitively and complexly portrays the ways in which Brazil has made ARVs available. However, it is worth pointing out that "Jean Comaroff":http://www.publicculture.org/articles/volume_19_number_1/beyond_bare_life_aids_bio_politi has recently criticized Biehl for being insufficiently attentive to and critical of the commodity-form that anti-HIV treatment takes today. So does promoting ARVs constitute a kind of commodity fetishism, where the drug in contemporary global orders is a kind of ur-Commodity because it weds capital's interest in profit to the state's biopolitics? I am _thinking_ about this stuff and these disputes in relation to research I want to do and I haven't made up my mind, basically. My writing on this blog that pertains to HIV is an effort to sketch a set of ill-formed ideas that are nascent and inchoate. But as AIDS-HIV morph from a terminal syndrome in every instance to a potentially chronic disease, it will be important for us to re-think all the old analyses, their politics, and the way they inform the way we perceive the epidemic <em>today</em>. I really think this is vital today, because so much of the culture of HIV continues to be ruled by debates that were relevant to the 1980s and 1990s. </p><br /><br /><br /><br /><br /><br /><br /> <p>So yes, you are absolutely right when you write: "This may be difficult to process through the conventional lens of American conservatism–liberalism polemics," a statement you make regarding Uganda, but that can be extended to a number of situations, including oddly enough the US itself.</p><br /><br /><br /><br /><br /><br /><br /> <p>OK. I do think that you are imputing to this post an 'attack' that simply isn't there, and it could have something to do with the snarky tone attributed to most writing on the web. (I do not imply that web writing is not often snarky.) If anything, the main thing criticized in the sections of this post that bother you is an article in Anthropology News that failed to consult other anthropologists who hold different views about HIV prevention, some of whom replied with letters to the publication. The post does not say that conservatism is fashionable; it does say that the article positions you carefully ('gingerly') _between_ (as in: not in either camp) academic anthro and conservative politics. I frankly do not know enough about the Ugandan situation to say very much at all about it: which is why this post is not about Uganda, nor about your work, but rather about some shifts in thinking and action around HIV that are going on in the US.</p></p></p></p></p></p></p> Hi again, and thank you for your response. You make a great point about how serious thinking about HIV and AIDS defies the easy orthodoxies of either a (U.S.) liberal or conservative sort, especially as these impinge upon politics in other countries. I appreciate your taking the time to comment further. Stepping away from the question of whether promoting condoms is a magic bullet for preventing HIV-transmission in all places, there is another question that doesn’t cleave easily along left (anti-market, say) and right (anti-welfare, say) lines and this pertains to making lifesaving drugs available to people who already have HIV.</p><br /><br /><br /><br /><br /><br />
<p>First, it’s possible that these drugs might never have been developed. The story of _how_ they were developed is complex, and it crisscrosses divides between science, the market, and activist communities, as “Steven Epstein”:http://books.google.fi/books?id=kZOso0FMsrMC&dq=&pg=PP1&ots=CVfs5PeVP-&sig=usiJxZVKphfWK83n3xsETL_riUA&prev=http://www.google.fi/search%3Fclient%3Dfirefox-a%26rls%3Dorg.mozilla%253Aen-GB%253Aofficial%26channel%3Ds%26hl%3Den%26q%3Dimpure%2Bscience%26meta%3D%26btnG%3DGoogle%2BSearch&sa=X&oi=print&ct=title has shown. I remember many arguments with other AIDS activists in the early 1990s about whether our clarion call for “more (state) funding” for AIDS research was the best way to hasten the development of lifesaving treatments. Some argued that the market, and naked financial interest, would be the most effective forces for getting the drugs developed. Of course, it is worth remembering that ACT UP and other AIDS activist organizations, including ACT UP’s Treatment Action Group, were operating in an extremely hostile environment, in which getting _anyone_ (including US Presidents) even to _talk_ about AIDS was something of an accomplishment. Yet, the ostensibly radical politics of a group like ACT UP were sparked by the personal efforts and passionate rhetoric of “Larry Kramer”:http://en.wikipedia.org/wiki/Larry_Kramer who combined moral outrage at the disgusting neglect of HIV by politicians and others with a more practical outrage about the sex habits he imputed to the gay male community. Likewise, “Randy Shilts”:http://en.wikipedia.org/wiki/And_the_Band_Played_On crossed over and between easy left/right orthodoxies in his majesterial and still vital history of HIV and AIDS in America.</p><br /><br /><br /><br /><br /><br />
<p>OK, so the development of ARVs, as well as HIV prevention tactics, in the _US_ represents a history that can’t be reduced to platitudes about left and right. So what about today, right now? I mean, we now HAVE the means to save millions of lives through anti-retroviral drugs that are extremely expensive. What are the politics involved? There are issues concerning intellectual property rights and finding ways to speed production of the drugs in poor countries, for example. If commercial interest in part provided the motive for development of drugs, would relaxing the property laws that make that interest profitable undermine the system that generated them (the drugs) in the first place?</p><br /><br /><br /><br /><br /><br />
<p>I think the best writing and thinking on this problem, and its politics, is by an anthropologist! His name is “Joao Biehl”:http://www.princeton.edu/main/news/archive/S17/06/97S70/index.xml?section=featured and he sensitively and complexly portrays the ways in which Brazil has made ARVs available. However, it is worth pointing out that “Jean Comaroff”:http://www.publicculture.org/articles/volume_19_number_1/beyond_bare_life_aids_bio_politi has recently criticized Biehl for being insufficiently attentive to and critical of the commodity-form that anti-HIV treatment takes today. So does promoting ARVs constitute a kind of commodity fetishism, where the drug in contemporary global orders is a kind of ur-Commodity because it weds capital’s interest in profit to the state’s biopolitics? I am _thinking_ about this stuff and these disputes in relation to research I want to do and I haven’t made up my mind, basically. My writing on this blog that pertains to HIV is an effort to sketch a set of ill-formed ideas that are nascent and inchoate. But as AIDS-HIV morph from a terminal syndrome in every instance to a potentially chronic disease, it will be important for us to re-think all the old analyses, their politics, and the way they inform the way we perceive the epidemic <em>today</em>. I really think this is vital today, because so much of the culture of HIV continues to be ruled by debates that were relevant to the 1980s and 1990s. </p><br /><br /><br /><br /><br /><br />
<p>So yes, you are absolutely right when you write: “This may be difficult to process through the conventional lens of American conservatism–liberalism polemics,” a statement you make regarding Uganda, but that can be extended to a number of situations, including oddly enough the US itself.</p><br /><br /><br /><br /><br /><br />
<p>OK. I do think that you are imputing to this post an ‘attack’ that simply isn’t there, and it could have something to do with the snarky tone attributed to most writing on the web. (I do not imply that web writing is not often snarky.) If anything, the main thing criticized in the sections of this post that bother you is an article in Anthropology News that failed to consult other anthropologists who hold different views about HIV prevention, some of whom replied with letters to the publication. The post does not say that conservatism is fashionable; it does say that the article positions you carefully (‘gingerly’) _between_ (as in: not in either camp) academic anthro and conservative politics. I frankly do not know enough about the Ugandan situation to say very much at all about it: which is why this post is not about Uganda, nor about your work, but rather about some shifts in thinking and action around HIV that are going on in the US.</p></p></p></p></p></p></p>

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]]> By: Edward C Green http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/comment-page-1/#comment-124337 Edward C Green Sat, 06 Oct 2007 22:29:50 +0000 http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/#comment-124337 The author or Webmeister wrote of my response "I do not see how this post can be construed as an ‘ad hominen’ attack." Well, I guess not, if calling someone a fashionable conservative who flies around with drug company CEOs is considered a complement--to a left-wing, get-out-of-Palestine-and-Iraq-Today anthropologist. To understand the difference between an indigenous response to AIDS rather than a corporate Euro-American commodities-driven response, you only need follow the money, as they say. My view on these matters aims to empower people-- individuals--to take some control of their destiny. It is patronizing in the extreme to think that we social engineers, we Grandiose Planners from Washington, Geneva, and London know what is best for the World’s poor, including in AIDS matters. Or to patronizingly dismiss behavior change efforts as of no use because “we” know poor people have no control over economic forces or their male hormones. Indeed, the position I argue is “bad for business,” since it questions the need for multi-billion dollar AIDS programs based on expensive drugs, medical devices, and—most of all—expensive “technical consultants” like myself and my friends and colleagues. Surely challenging Big Business, Big Pharma, Big Consulting is not conservatism as we usually know it. It seems more like democracy, but the real thing and not what Bush & Cheney promote with shock-and-awe ordnance in the Middle East. The annual cost of the world’s first clear AIDS success story was almost embarrassingly low. [for a calculation of cost of original program: http://www.nationsencyclopedia.com/economies/Africa/Uganda.html “The population of Uganda was estimated at 22,459,000 in 2000 by the United Nations Economic Commission for Africa, an annual average increase of 2.5 percent from the 1995 population of 19,689,000” So, estimate 18.9 mil for 1990. Low-Beer in Financial Times: “One of the best kept secrets in HIV is that the critical Ugandan programme cost only $21,676,000 over five years.” So divide the 5 year cost by 5 = 4,335,200 expense per year, = 23 cents per person per year (or nearly half that if we only consider ages 15-49 (Ref. Daniel Low-Beer, “Personal view: 'This is a routinely avoidable disease'.” Financial Times; Nov 28, 2003) What does the Merk-USAID-Gates Foundation-Kaiser Foundation-Bono-fundraising AIDS prevention programs of Botswana and South Africa cost? Somewhere in the many hundreds of dollars per person, per year. Forget pennies, this is Science! Yet unlike Uganda's original program, these expensive programs have not worked. This may be difficult to process through the conventional lens of American conservatism –liberalism polemics. If so, I suggest abandoning attempts to understand this as an American. But it ought to at least be clear that the Big Business approach to AIDS prevention (the approach that has had success in Thailand and Cambodia but never in Africa) is not the one I have been promoting since 1993. Postscript: Alas, the Big International Donors have effectively stripped Ugandan AIDS prevention of the elements that made it effective in the period 1986-95 (perhaps because no US commodities were involved? Putting a lot of White Folks out of business?). Multi-partner sex and HIV prevalence are again on the rise in Uganda. The Corporate West seems to have prevailed in the end, I am sorry to say, with the help of well-meaning US activists who thought they were on the right side of this issue... -Ted Green The author or Webmeister wrote of my response “I do not see how this post can be construed as an ‘ad hominen’ attack.”

Well, I guess not, if calling someone a fashionable conservative who flies around with drug company CEOs is considered a complement–to a left-wing, get-out-of-Palestine-and-Iraq-Today anthropologist.

To understand the difference between an indigenous response to AIDS rather than a corporate Euro-American commodities-driven response, you only need follow the money, as they say.

My view on these matters aims to empower people– individuals–to take some control of their destiny. It is patronizing in the extreme to think that we social engineers, we Grandiose Planners from Washington, Geneva, and London know what is best for the World’s poor, including in AIDS matters. Or to patronizingly dismiss behavior change efforts as of no use because “we” know poor people have no control over economic forces or their male hormones.

Indeed, the position I argue is “bad for business,” since it questions the need for multi-billion dollar AIDS programs based on expensive drugs, medical devices, and—most of all—expensive “technical consultants” like myself and my friends and colleagues. Surely challenging Big Business, Big Pharma, Big Consulting is not conservatism as we usually know it. It seems more like democracy, but the real thing and not what Bush & Cheney promote with shock-and-awe ordnance in the Middle East.

The annual cost of the world’s first clear AIDS success story was almost embarrassingly low. [for a calculation of cost of original program:
http://www.nationsencyclopedia.com/economies/Africa/Uganda.html
“The population of Uganda was estimated at 22,459,000 in 2000 by the United Nations Economic Commission for Africa, an annual average increase of 2.5 percent from the 1995 population of 19,689,000” So, estimate 18.9 mil for 1990. Low-Beer in Financial Times:
“One of the best kept secrets in HIV is that the critical Ugandan programme cost only $21,676,000 over five years.”

So divide the 5 year cost by 5 = 4,335,200 expense per year, = 23 cents per person per year (or nearly half that if we only consider ages 15-49
(Ref. Daniel Low-Beer, “Personal view: ‘This is a routinely avoidable disease’.” Financial Times; Nov 28, 2003)

What does the Merk-USAID-Gates Foundation-Kaiser Foundation-Bono-fundraising AIDS prevention programs of Botswana and South Africa cost? Somewhere in the many hundreds of dollars per person, per year. Forget pennies, this is Science!

Yet unlike Uganda’s original program, these expensive programs have not worked.

This may be difficult to process through the conventional lens of American conservatism –liberalism polemics. If so, I suggest abandoning attempts to understand this as an American. But it ought to at least be clear that the Big Business approach to AIDS prevention (the approach that has had success in Thailand and Cambodia but never in Africa) is not the one I have been promoting since 1993.

Postscript: Alas, the Big International Donors have effectively stripped Ugandan AIDS prevention of the elements that made it effective in the period 1986-95 (perhaps because no US commodities were involved? Putting a lot of White Folks out of business?). Multi-partner sex and HIV prevalence are again on the rise in Uganda. The Corporate West seems to have prevailed in the end, I am sorry to say, with the help of well-meaning US activists who thought they were on the right side of this issue…

-Ted Green

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]]> By: Strong http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/comment-page-1/#comment-105572 Strong Tue, 17 Jul 2007 09:36:11 +0000 http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/#comment-105572 Hi Ted, Thank you for your comment! I do not see how this post can be construed as an 'ad hominen' attack. I point to an article in Anthropology News that *celebrated* your work (although I gesture to the lack of dissenting voices in the piece) and to letters by other experts who disagree with you. If you had read the whole post, you might see that the dispute in AN served as a segue for talking about some developments in HIV prevention in the US *not* in Africa. Indeed, this post is not about prevention per se, but how messages pertaining to prevention shape what HIV/AIDS means. Hi Ted, Thank you for your comment! I do not see how this post can be construed as an ‘ad hominen’ attack. I point to an article in Anthropology News that *celebrated* your work (although I gesture to the lack of dissenting voices in the piece) and to letters by other experts who disagree with you. If you had read the whole post, you might see that the dispute in AN served as a segue for talking about some developments in HIV prevention in the US *not* in Africa. Indeed, this post is not about prevention per se, but how messages pertaining to prevention shape what HIV/AIDS means.

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]]> By: Ted Green http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/comment-page-1/#comment-105520 Ted Green Tue, 17 Jul 2007 06:26:06 +0000 http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/#comment-105520 <p>I only read the first couple of para’s attacking me for breaking the silence about AIDS. If the writer cares about evidence rather than maintenance of a multi-billion dollar industry, he/she will have to eventualy face facts:<br /> African AIDS is not like American AIDS. African AIDS is not caused or driven by poverty, gender inequality or social/civil strife. Nor is one “protected” by using American or any other condoms. What a cruel hoax on Africans.</p> <p>All the popular things the major donors fund: condom social marketing, treatment of STIs, and VCT are about as effective in Africa as Bush’s war policy is in Iraq. Or Israel’s policy of “fighting terror” is in Palestine.</p> <p>The writer can atack me personally all he wants, but his/her faith-based consensus approach to AIDS will continue to have no effect in Africa. I suggest the writer begin with looking at recent DHS data for SSA, then check at some recent studies:</p> <p>Gregson S; Adamson S; Papaya S; Mundondo J; Nyamukapa CA; Mason PR; Garnett GP; Chandiwana SK; Foster G; Anderson RM. (2007) Impact and process evaluation of integrated community and clinic-based HIV-1 control: A cluster-randomised trial in eastern Zimbabwe PLOS MED. 4: 545-555;</p> <p>Quigley M, Kamali A, Kinsman J, Kamulegeya I, Nakiyingi JS, et al. (2004) The impact of attending a behavioural intervention on HIV incidence in Masaka, Uganda. AIDS 18: 2055–2063</p> <p>Sherr L et al. Voluntary HIV testing in rural Zimbabwe – what is the uptake, impact on sexual behaviour and HIV incidence 3 years later? Third South African AIDS Conference, Durban, abstract 46, 2007.</p> <p>Matovu JKB et al. Voluntary HIV counselling and testing acceptance, sexual risk behaviour and HIV incidence in Rakai, Uganda. AIDS 2005, 19: 503-511.</p> <p>Increased prevalence of HIV: Not a casualty of war</p> <p>Prevalence of HIV infection in conflict-affected and displaced people<br /> in seven sub-Saharan African countries: a systematic review<br /> Paul B Spiegel MD, Anne Rygaard Bennedsen BSc, Johanna<br /> Claass MD, Laurie Bruns MA, Njogu Patterson MD, Dieudonne<br /> Yiweza MD and Marian Schilperoord MA.<br /> The Lancet 2007; 369:2187-2195, DOI:10.1016/S0140-6736(07)61015-0</p> <p>Remember: truth usually wins in the end. Ad hominen attacks do not.</p> <p>Ted</p> I only read the first couple of para’s attacking me for breaking the silence about AIDS. If the writer cares about evidence rather than maintenance of a multi-billion dollar industry, he/she will have to eventualy face facts:
African AIDS is not like American AIDS. African AIDS is not caused or driven by poverty, gender inequality or social/civil strife. Nor is one “protected” by using American or any other condoms. What a cruel hoax on Africans.

All the popular things the major donors fund: condom social marketing, treatment of STIs, and VCT are about as effective in Africa as Bush’s war policy is in Iraq. Or Israel’s policy of “fighting terror” is in Palestine.

The writer can atack me personally all he wants, but his/her faith-based consensus approach to AIDS will continue to have no effect in Africa. I suggest the writer begin with looking at recent DHS data for SSA, then check at some recent studies:

Gregson S; Adamson S; Papaya S; Mundondo J; Nyamukapa CA; Mason PR; Garnett GP; Chandiwana SK; Foster G; Anderson RM. (2007) Impact and process evaluation of integrated community and clinic-based HIV-1 control: A cluster-randomised trial in eastern Zimbabwe PLOS MED. 4: 545-555;

Quigley M, Kamali A, Kinsman J, Kamulegeya I, Nakiyingi JS, et al. (2004) The impact of attending a behavioural intervention on HIV incidence in Masaka, Uganda. AIDS 18: 2055–2063

Sherr L et al. Voluntary HIV testing in rural Zimbabwe – what is the uptake, impact on sexual behaviour and HIV incidence 3 years later? Third South African AIDS Conference, Durban, abstract 46, 2007.

Matovu JKB et al. Voluntary HIV counselling and testing acceptance, sexual risk behaviour and HIV incidence in Rakai, Uganda. AIDS 2005, 19: 503-511.

Increased prevalence of HIV: Not a casualty of war

Prevalence of HIV infection in conflict-affected and displaced people
in seven sub-Saharan African countries: a systematic review
Paul B Spiegel MD, Anne Rygaard Bennedsen BSc, Johanna
Claass MD, Laurie Bruns MA, Njogu Patterson MD, Dieudonne
Yiweza MD and Marian Schilperoord MA.
The Lancet 2007; 369:2187-2195, DOI:10.1016/S0140-6736(07)61015-0

Remember: truth usually wins in the end. Ad hominen attacks do not.

Ted

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]]> By: Strong http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/comment-page-1/#comment-99875 Strong Mon, 02 Jul 2007 18:33:57 +0000 http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/#comment-99875 A spat has broken out between Gabriello Rotello and Andrew Sullivan regarding the current state of the AIDS/HIV epidemic among U.S. gay men. Rotello's recent post at Huffington Post links to Sullivan and responds. The dispute partly concerns the idea of 'sero-sorting' as a prevention strategy, which I comment on in the above item. http://www.huffingtonpost.com/gabriel-rotello/deadly-error-alert-andre_b_54626.html A spat has broken out between Gabriello Rotello and Andrew Sullivan regarding the current state of the AIDS/HIV epidemic among U.S. gay men. Rotello’s recent post at Huffington Post links to Sullivan and responds. The dispute partly concerns the idea of ‘sero-sorting’ as a prevention strategy, which I comment on in the above item.

http://www.huffingtonpost.com/gabriel-rotello/deadly-error-alert-andre_b_54626.html

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]]> By: Strong http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/comment-page-1/#comment-83235 Strong Sat, 09 Jun 2007 10:43:33 +0000 http://savageminds.org/2007/01/06/addressing-publics-positively-some-developments-in-hiv-prevention/#comment-83235 Anyone running across this should also see the following article: Technology and Affect: HIV/AIDS Testing in Brazil. By: Biehl, João; Coutinho, Denise; Outeiro, Ana Luzia. Culture, Medicine & Psychiatry, Mar2001, Vol. 25 Issue 1, p87-129 Anyone running across this should also see the following article:

Technology and Affect: HIV/AIDS Testing in Brazil. By: Biehl, João; Coutinho, Denise; Outeiro, Ana Luzia. Culture, Medicine & Psychiatry, Mar2001, Vol. 25 Issue 1, p87-129

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