Treating risk, risking treatment: experiences of iatrogenesis in the HIV/AIDS and opioid epidemics.
Anthropol Med
; 28(2): 239-254, 2021 Jun.
Article
en En
| MEDLINE
| ID: mdl-34190020
ABSTRACT
This paper explores how poor health outcomes in the HIV/AIDS and opioid epidemics in the United States are undergirded by iatrogenesis. Data are drawn from two projects in Southern California one among men who have sex with men (MSM) engaging with pre-exposure prophylaxis to HIV (PrEP) and the other in a public hospital system encountering patients with chronic pain and opioid use disorder (OUD). Ethnographic evidence demonstrates how efforts to minimize risk via PrEP and opioid prescription regulation paradoxically generate new forms of risk. Biomedical risk management paradigms engaged across the paper's two ethnographic field sites hinge on the production and governance of deserving patienthood, which is defined by providers and experienced by patients through moral judgments about risk underlying both increased surveillance and abandonment. This paper argues that the logic of deservingness disconnects clinical evaluations of risk from patients' lived, intersectional experiences of race, class, gender, and sexuality. This paper's analysis thus re-locates patients in the context of broader historical and sociopolitical trajectories to highlight how notions of clinical risk designed to protect patients can in fact imperil them. Misalignment between official, clinical constructions of risk and the embodied experience of risk borne by patients produces iatrogenesis.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Actitud del Personal de Salud
/
Infecciones por VIH
/
Epidemia de Opioides
/
Enfermedad Iatrogénica
/
Trastornos Relacionados con Opioides
Tipo de estudio:
Etiology_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Anthropol Med
Asunto de la revista:
ANTROPOLOGIA
/
MEDICINA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos