‘Just take a tablet and you’ll be okay’: medicalisation, the growth of stigma and the silencing of HIV

Introduction This article explores the growth and impact of the medicalisation of HIV and HIV-related stigma. Since the early days of the virus when treatments were unavailable, political voices for HIV advocacy were powerful; public discourse reflected these changes with growing public-health campaigns that began to demystify HIV as a concept. However, with the development of antiretroviral therapy (ART) the voices powerfully associated with HIV have largely moved away from the campaign and advocacy groups, having switched to, and accruing dominance from, the biomedical establishment through the medicalisation of HIV. This has led to a parallel system in which people today are living longer with HIV treatment and their standards of living are getting better; however, the once powerful process of demystification and public discourses discussing HIV and its stigma, have become much more muted. HIV in the public realm has become largely ‘silenced’ outside the work of HIV organisations and biomedical institutions and so has yet to develop into a ‘post-HIV’ stage of public understanding and acceptance. This article uses the work of Ghaziani and applies his three-stage model of community change, arguing that HIV as a concept has not begun the final stage of acceptance where HIV stigma is tackled through public discourse because of the medicalisation process itself [1].