I learned a lot by reading these three articles, because most of the research that I have done on HIV is based in the social sciences rather than the natural sciences. It was interesting to read the different studies and compare this more “factual” style of writing to the work done in the social sicences. While reading these three articles, I was reminded of articles that I have read within feminist epistemology studies. Epistemology is basically the study of knowledge (sounds repetitive, I know) and it looks at how and why we know what we know. Many feminists, Donna Haraway being one of the most well-known, argue that “knowledge” about a certain subject is culturally situated. In other words, “truth” is not natural or found a certain source, be the source scientific or otherwise. Feminist scholars such as Marsha Rosengarten (2004) and Susan Craddock (2000) have argued that what we know about HIV is part of a situated knowledge that is culturally flexible. Craddock argues that the institution of medicine produces a certain discourse about HIV which impacts studies of the virus or certain “vulnerable groups” (and I hate this term) that are affected by it, and it also affects the image of the person/groups of people who we see as being infected with HIV. I was reminded of Rosengarten and Craddock’s work as I was reading these articles.
One thing that caught my attention me about the articles by Resch and Hongaro was the heavy focus on economics. It almost seemed like these two studies were being performed less for the purpose of providing ART (Resch) or for providing palliative care (Hongaro), and more for the purpose of saving money. I understand that fiscal considerations are of paramount importance when trying to coordinate methods of prevention and treatment, but when Resch et al. suggests that current distribution levels of ART in lower and middle-income countries should be monitored and not increased too drastically because economic returns are thus less likely, I found this to be a little heartless. Are we treating people for HIV disease because if we don’t it’s costing money, or are we treating them because as human beings they have a right to be healthy? Furthermore, I find it upsetting that all of the resasons that this team suggests for increasing access to ART are discussed in monetary terms. For example, the team argues that more people should be put on ARV therapy because this would restore a large percentage of labor productivity and save more money from going into orphanages. Pardon me, but this seems a little ridiculous. Why are other reasons, like putting more patients on ARV therapy will help patients to feel better and will decrease the prevalence of HIV in the community not the first things on the list?! Are we caring for people – people with a human right to enjoy their health – or are we doing research? Are we serving these people, or are we doing economic surveys and writing papers about how to save money?