High roads and low roads in HIV/AIDS programming: plea for a diversification of itinerary

摘要

The acquired immune deficiency syndrome (AIDS) epidemic has given rise to multiple responses at multiple levels. In this article, a distinction is made between high-road and low-road solutions. High-road solutions typically address the disease and people as patients, focus on cure, treatment and pharmaceutical programmes, are noteworthy biomedical and technological, typically seen as ‘hard’ and top-down. Low-road solutions typically promote health and wellness among communities, focus on care, prevention and educational programmes, are often noteworthy rights based and holistic, typically seen as ‘soft’ and bottom-up. Whereas the sexual and reproductive health and rights movement characteristically takes the low road, human immunodeficiency virus (HIV)/AIDS programming seems to have drifted away from this broader agenda [Germain, A., Dixon-Mueller, R., and Sen, G., 2009. Back to basics: HIV/AIDS belongs with sexual and reproductive health. Bulletin of the World Health Organization, 87, 840-845] and to increasingly prefer the high road. This article critically reflects on those developments, understanding them within a context of conservative moralism, medicalisation of sexuality, neoliberal economics and corporate financial interests. The main argument is that the merits of high-road programming are many, but that it does not well provide for important structural solutions for the larger population, nor are larger development issues well served. The present advances in the direction of itinerary change and restoring the necessary balance with low-road programming are being considered.View full textDownload full textKeywordsHIV/AIDS, sexual and reproductive health and rights, prevention, medicalisation, developmentRelated var addthis_config = { ui_cobrand: "Taylor & Francis Online", services_compact: "citeulike,netvibes,twitter,technorati,delicious,linkedin,facebook,stumbleupon,digg,google,more", pubid: "ra-4dff56cd6bb1830b" }; Add to shortlist Link Permalink http://dx.doi.org/10.1080/09581596.2010.539594