Dissecting the social body: social inequality through AIDS counter-narratives

Understanding Medical Distrust Among African American/Black and Latino Persons Living With HIV With Sub-Optimal Engagement Along the HIV Care Continuum: A Machine Learning Approach

Medical distrust is a potent barrier to participation in HIV care and medication use among African American/Black and Latino (AABL) persons living with HIV (PLWH). However, little is known about sociodemographic and risk factors associated with distrust. We recruited adult AABL PLWH from low socio-economic status backgrounds with insufficient engagement in HIV care (N = 512). Participants completed structured assessments on three types of distrust (of health care providers, health care systems, and counter-narratives), HIV history, and mental health. We used a type of machine learning called random forest to explore predictors of trust. On average, participants were 47 years old (SD = 11 years), diagnosed with HIV 18 years prior (SD = 9 years), and mainly male (64%) and African American/Black (69%). Depression and age were the most important predictors of trust. Among those with elevated depressive symptoms, younger participants had less trust than older, while among those without depression, trust was greater across all ages. The present study adds nuance to the literature on medical distrust among AABL PLWH and identifies junctures where interventions to build trust are needed most.

The Health and Sociocultural Correlates of AIDS Genocidal Beliefs and Medical Mistrust Among African American MSM

This study examined social and health-related correlates of AIDS conspiracy theories among 464 African American men who have sex with men (MSM). Exploratory factor analysis revealed two subscales within the AIDS conspiracy beliefs scale: medical mistrust and AIDS genocidal beliefs. Multiple regression analyses revealed medical mistrust and AIDS genocidal beliefs were both associated negative condom use attitudes and higher levels of internalized homonegativity. Medical mistrust was also associated with lower knowledge of HIV risk reduction strategies. Finally, we conducted bivariate regressions to examine the subsample of participants who reported being HIV-positive and currently taking HIV antiretroviral therapy (ART) to test associations between sexual behavior and HIV treatment and AIDS conspiracy theories. Among this subsample, medical mistrust was associated with having a detectable viral load and not disclosing HIV-status to all partners in the previous 3 months. Collectively, these findings have implications for HIV prevention and treatment for African American MSM.

"It's natural to look for a source": A qualitative examination of alternative beliefs about HIV and AIDS in Cape Town, South Africa

This article highlights how African men and women in South Africa account for the plausibility of alternative beliefs about the origins of HIV and the existence of a cure. This study draws on the notion of a "street-level epistemology of trust"-knowledge generated by individuals through their everyday observations and experiences-to account for individuals' trust or mistrust of official claims versus alternative explanations about HIV and AIDS. Focus group respondents describe how past experiences, combined with observations about the power of scientific developments and perceptions of disjunctures in information, fuel their uncertainty and skepticism about official claims. HIV prevention campaigns may be strengthened by drawing on experiential aspects of HIV and AIDS to lend credibility to scientific claims, while recognizing that some doubts about the trustworthiness of scientific evidence are a form of skeptical engagement rather than of outright rejection.

When Sex and Power Collide: An Argument for Critical Sexuality Studies

Attentive to the collision of sex and power, we add momentum to the ongoing development of the subfield of critical sexuality studies. We argue that this body of work is defined by its critical orientation toward the study of sexuality, along with a clear allegiance to critical modalities of thought, particularly feminist thought. Critical sexuality studies takes its cues from several other critical moments in related fields, including critical psychology, critical race theory, critical public health, and critical youth studies. Across these varied critical stances is a shared investment in examining how power and privilege operate, understanding the role of historical and epistemological violence in research, and generating new models and paradigms to guide empirical and theoretical research. With this guiding framework, we propose three central characteristics of critical sexuality studies: (a) conceptual analysis, with particular attention to how we define key terms and conceptually organize our research (e.g., attraction, sexually active, consent, agency, embodiment, sexual subjectivity); (b) attention to the material qualities of abject bodies, particularly bodies that are ignored, overlooked, or pushed out of bounds (e.g., viscous bodies, fat bodies, bodies in pain); and (c) heteronormativity and heterosexual privilege, particularly how assumptions about heterosexuality and heteronormativity circulate in sexuality research. Through these three critical practices, we argue that critical sexuality studies showcases how sex and power collide and recognizes (and tries to subvert) the various power imbalances that are deployed and replicated in sex research.

The social construction of competence: Conceptions of science and expertise among proponents of the low-carbohydrate high-fat diet in Finland

The article looks at conceptions of science and expertise among lay proponents of the low-carbohydrate high-fat diet in Finland. The research data consist of comments on a webpage related to a debate on the health dangers of animal fats screened in Finnish national television in autumn 2010. The article shows that contrary to the prevailing image advocated by the national nutritional establishment, which is based on the deficit model of public understanding of science, the low-carbohydrate high-fat proponents are neither ignorant about scientific facts nor anti-science. Rather, they express nuanced viewpoints about the nature of science, the place of individual experience in nutritional recommendations and the reliability of experts. Inspired by discussions on the social construction of ignorance, the article argues that the low-carbohydrate high-fat proponents are engaged in what it callsthe social construction of competencewhen they present their position as grounded in science and stylize themselves as lay experts.

Myths or theories? Alternative beliefs about HIV and AIDS in South African working class communities

Despite three decades of public health promotion based on the scientific explanation of HIV/AIDS, alternative explanations of the disease continue to circulate. While these are seen as counter-productive to health education efforts, what is rarely analysed is their plurality and their tenacity. This article analyses the 'AIDS myths' collected by African HIV/AIDS workplace peer educators during an action research project. These beliefs about HIV/AIDS are organised, in this article, around core ideas that form the basis of 'folk' and 'lay theories' of HIV/AIDS. These constitute non-scientific explanations of HIV/AIDS, with folk theories drawing on bodies of knowledge that are independent of HIV/AIDS while lay theories are generated in response to the disease. A categorisation of alternative beliefs about HIV/AIDS is presented which comprises three folk theories - African traditional beliefs, Christian theology, and racial conspiracy - and three lay theories, all focused on avoiding HIV infection. Using this schema, the article describes how the plausibility of these alternative theories of HIV/AIDS lies not in their scientific validity, but in the robustness of the core idea at the heart of each folk or lay theory. Folk and lay theories of HIV/AIDS are also often highly palatable in that they provide hope and comfort in terms of prevention, cure, and the allocation of blame. This study argue that there is coherence and value to these alternative HIV/AIDS beliefs which should not be dismissed as ignorance, idle speculation or simple misunderstandings. A serious engagement with folk and lay theories of HIV/AIDS helps explain the continued circulation of alternative beliefs of HIV/AIDS and the slow uptake of behavioural change messages around the disease.