New struggles over hegemony in the governance of HIV: Listening to critics of molecular HIV surveillance in US HIV civil society

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Dr Stephen Molldrem outdoors, wearing a black shirt You are invited to an ARCSHS Research and Practice Seminar by Dr Stephen Molldrem.

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Wednesday 16 June 2021 04:00 pm (Add to calendar)
Dr Renae Fomiatti
Presented by:
Dr Stephen Molldrem
Type of Event:
Public Lecture; Public

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This talk reports results from a recent interview study I conducted with stakeholders in U.S. HIV civil society who self-identify as having criticisms or concerns about the rollout of molecular HIV surveillance (MHS) and cluster detection and response (CDR) programs in the United States. MHS and CDR programs involve re-uses of HIV genetic sequence data – “molecular” HIV data – that are electronically reported to departments of public health when clinicians order HIV genotype tests for patients living with HIV. In clinical contexts, these data can reveal drug resistance and help providers prescribe medications. In public health contexts, mutations in HIV genetic sequences can be analyzed to identify “clusters” of people whose HIV genetic sequences are closely related, suggesting recent transmission. Since 2018, the U.S. Centers for Disease Control and Prevention (CDC) has required domestic departments of public health to implement MHS and CDR programs aimed at identifying and contacting people in clusters. The rollout has been controversial, involving gatherings, protests, and advocacy by HIV stakeholders – often led by networks of people living with HIV. I have studied these controversies since 2018, describing stakeholders’ concerns about lacking consent affordances in public health data infrastructures, risks of HIV criminalization stemming from MHS/CDR, and related issues. As I describe the views of U.S. critics of MHS/CDR, I also articulate a new theory of HIV civil society. Drawing on the work of Antonio Gramsci and the Gramscian tradition, I frame conflicts over MHS/CDR as new sites of struggle over hegemony in the governance of HIV.

About Dr Stephen Molldrem

Stephen Molldrem, PhD is a UC President’s Postdoctoral Fellow in the University of California, Irvine Department of Anthropology and an incoming Assistant Professor at the University of Texas Medical Branch at Galveston in the Department of Preventive Medicine and Population Health, with membership in the Institute for Bioethics and Health Humanities. Stephen is a qualitative researcher primarily situated in Science and Technology Studies and critical bioethics. He has an interest in using Marxist frameworks to analyze key problems in health policy, public health ethics, and the governance and use of infectious disease data across domains of practice.

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La Trobe University



18th Oct 2021 7:41pm

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