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Mapping HIV community viral load: space, power and the government of bodies

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HIV plasma viral load testing has become more than just a clinical tool to monitor treatment response at the individual level. Increasingly, individual HIV plasma viral load testing is being reported to public health agencies and is used to inform epidemiological surveillance and monitor the presence of the virus collectively using techniques to measure ‘community viral load’. This article seeks to formulate a critique and propose a novel way of theorizing community viral load. Based on the salient work of Michel Foucault, especially the governmentality literature, this article critically examines the use of community viral load as a new strategy of government. Drawing also on the work of Miller and Rose, this article explores the deployment of ‘community’ through the re-configuration of space, the problematization of viral concentrations in specific micro-locales, and the government (in the Foucauldian sense) of specific bodies which are seen as ‘risky’, dangerous and therefore, in need of attention. It also examines community viral load as a necessary precondition – forming the ‘conditions of possibility’ – for the recent shift to high impact prevention tactics that are being scaled up across North America.
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Keywords: HIV; community; governmentality; power; space; surveillance; viral load

Document Type: Research Article

Affiliations: 1: Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road Ottawa, ON K1H 8M5, Canada 2: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

Publication date: December 1, 2012

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