Dissertation Research: Resistant to Treatment: Medicine, Molecules, and the Global Politics of Drug-Resistant HIV

论文研究：治疗耐药：药物、分子和耐药艾滋病毒的全球政治

• 批准号: 0450673
• 负责人: Vincanne Adams
• 金额: --
• 依托单位: University of California-San Francisco
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-02-15 至 2006-01-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=0450673&HistoricalAwards=false
• 关键词: Dissertation; Research; Resistant; Treatment; Medicine

This Science and Technology Studies Dissertation Improvement Grant is a multi-sited ethnographic research project, and will involve qualitative interviews with HIV scientists and participant-observation at selected sites relevant to the production of knowledge about drug-resistant HIV. Research will be conducted over 14 months, beginning in August 2004. Twelve of these months will involve fieldwork based in the San Francisco Bay Area, where interviews and participant-observation will be conducted with North American researchers studying HIV drug resistance in the U.S. and in Africa. In addition, interviews and participant-observation will be conducted at several scientific conferences over the course of the 14-month fieldwork period. NSF funds will primarily support the remaining three months spent conducting fieldwork in Uganda, where interviews and participant-observation will be conducted with Ugandan scientists and clinicians involved in research on HIV treatment and drug resistance. The background for this fieldwork is that the certainty expressed by some researchers and health policymakers regarding the danger of drug-resistant HIV emerging from Africa contrasts sharply with the uncertainty surrounding the scientific definition and measurement of antiretroviral resistance. Following in the tradition of the social study of science, this dissertation project seeks to examine this paradox by examining how scientific uncertainty over the measurement, description, and meaning of resistance to antiretroviral medications is negotiated in the context of politically and racially charged debates over the role of the industrialized West in preventing and treating AIDS in Africa. Specifically, the project will pursue two interrelated research questions: first, how (through what practices and technologies) do scientists construct knowledge about antiretroviral resistance; and second, in doing so, how do they construct knowledge about Africa? This project makes two principal contributions to social science knowledge and theory. First, it makes an innovative contribution to the anthropology of AIDS by applying the analytic tools of the social study of science to the global epidemic. Currently there is very little social science scholarship that critically examines the biology of HIV/AIDS, antiretroviral medication, or drug resistance. Secondly, this project will contribute to the development the anthropology of science by contextualizing the science of HIV drug resistance within a broader network of social, political, and economic relations. Within the last year and a half, there has been a substantial increase in international support for AIDS treatment in Africa. As treatment access expands, the science and politics of antiretroviral resistance is likely to become both more prominent and more complex. Biological questions about the pharmacogenomics of drug resistance in Africans, the genetic and geographic diversity of HIV strains, and clinically optimal treatment will emerge deeply enmeshed with political questions regarding cost-effectiveness, international pharmaceutical patents, race, geography, and inequality. The increasingly complex biology of HIV drug resistance will remain inextricable from the global politics of HIV treatment. By tracking the biopolitics of drug-resistant HIV, this project aims to expand our understanding of the relationship between science and policymaking and to contribute to the growing efforts to improve access to antiretroviral medications in the developing world.

这项科学和技术研究论文改进补助金是一个多地点的人种学研究项目，将涉及与艾滋病毒科学家的定性访谈，以及在与产生抗药性艾滋病毒知识有关的选定地点进行参与观察。研究将从2004年8月开始，为期14个月。 其中12个月将在旧金山弗朗西斯科湾区进行实地考察，在那里将与研究美国和非洲艾滋病毒耐药性的北美研究人员进行访谈和参与观察。此外，在为期14个月的实地考察期间，还将在几次科学会议上进行访谈和与会者观察。 美国国家科学基金会的资金将主要支持在乌干达进行实地工作的剩余三个月，在那里将对参与艾滋病毒治疗和耐药性研究的乌干达科学家和临床医生进行采访和参与者观察。这项实地工作的背景是，一些研究人员和卫生政策制定者对非洲出现耐药艾滋病毒的危险表示肯定，这与围绕抗逆转录病毒耐药性的科学定义和衡量的不确定性形成鲜明对比。 在科学的社会研究的传统之后，本论文项目旨在通过研究如何在对抗逆转录病毒药物的抗性的测量，描述和意义的科学不确定性进行谈判的背景下，在政治和种族上充满活力的辩论在预防和治疗艾滋病在非洲的工业化西方的作用来研究这个悖论。 具体而言，该项目将探讨两个相互关联的研究问题：第一，科学家如何（通过何种做法和技术）构建关于抗逆转录病毒耐药性的知识;第二，在此过程中，他们如何构建关于非洲的知识？ 该项目对社会科学知识和理论做出了两个主要贡献。 首先，它通过将科学社会研究的分析工具应用于全球流行病，对艾滋病人类学做出了创新性贡献。目前，很少有社会科学奖学金，批判性地审查艾滋病毒/艾滋病，抗逆转录病毒药物或耐药性的生物学。 其次，该项目将有助于科学人类学的发展，将艾滋病毒耐药性科学置于更广泛的社会，政治和经济关系网络中。 在过去一年半中，国际社会对非洲艾滋病治疗的支持大幅增加。 随着获得治疗机会的扩大，抗逆转录病毒耐药性的科学和政治可能变得更加突出和复杂。 非洲人耐药性药物基因组学、艾滋病毒株的遗传和地理多样性以及临床最佳治疗等生物学问题将与成本效益、国际药品专利、种族、地理和不平等等政治问题深深交织在一起。 日益复杂的艾滋病毒耐药性生物学仍将与艾滋病毒治疗的全球政治密不可分。 通过跟踪耐药艾滋病毒的生物政治，该项目旨在扩大我们对科学与决策之间关系的理解，并为改善发展中国家获得抗逆转录病毒药物的日益努力做出贡献。