STRIVE researcher Shelley Lees

STRIVE at 2nd International Conference for the Social Sciences and Humanities in HIV

09 August 2013
Alexandra Hyde and Shelley Lees

STRIVE researcher Shelley Lees shares some highlights from a conference exploring the social meanings of HIV prevention and treatment.

The Association for the Social Sciences and Humanities in HIV (ASSHH) held its second international conference in Paris last month. STRIVE researcher Shelley Lees reports back on research addressing the structural drivers of HIV.

Although not all research contributed new knowledge in this area, the breadth of work presented affirmed the existence of structural barriers in a wide range of contexts, and the many challenges involved in tackling them. Dr Lees observed:

The conference explored the question of the successes and failures of biomedical approaches by acknowledging the complexity of social life and in particular, our poor understanding of individuals’ interactions with technologies such as pills, gels and condoms.

Researchers from LSHTM contributed to a panel on comparative ethnographies of “ideal” sites for HIV research in Africa. In the context of the growing presence of international researchers in Africa and their support for national health services, presentations illustrated how colonial and national histories shape both tensions and possibilities for research and care across the continent.  

As part of this panel Shelley Lees’ presentation looked at the meanings, practices and social relations of an HIV prevention clinical trial in Tanzania. It demonstrated how the imaginings of scientists converged with participants’ ideas of power and subjectivity to shape the possibility of ethical practice within the trial. Download the presentation and full notes as a PDF (1.5MB) here.

In a presentation on the social construction of biomedical HIV prevention, Richard Parker from Columbia University highlighted five paradigm shifts in approaches to HIV prevention over the course of the epidemic:

  • Community based and culturally meaningful approaches, including the invention of "safe sex" as an act of caring and reduction of risk before any public health interventions (1980s);
  • Psychological and behavioural approaches in HIV prevention and education, especially drawing on health behaviour change theories (1990s);
  • Ideas about structural violence as a driver of HIV, focusing on economic exclusion, gender inequalities and policies that shape both risk and vulnerability (early 2000s);
  • Biomedical approaches that use new technologies (and reinvent old ones) to prevent HIV transmission (late 2000s);
  • Combination approaches that include behavioural, structural and biomedical aspects (current).

Parker argued that current combination approaches fail to pay attention to the community based approaches of the earliest years of the epidemic. Across all of these paradigms, he illustrated that that complex political and social issues have been poorly attended to and require the ongoing attention of social scientists. 

Other presentation highlights included:

The social and ethical dimensions of introducing HIV self-testing technologies by Nicola Desmond, Liverpool School of Tropical Medicine. Desmond set out the background to research into HIV self-testing and presented an interesting framework to explore its impact on gender based violence.

An experiment in topological thinking: Novel methods for inventive problem making/solving by Bill Gaver, Goldsmiths, University of London. Gaver discussed the use of design-led research methods using technologies to produce interesting interactions with users.  

Download the conference programme via ASSHH.