Biomedical constructions of health and illness as objective categories have long been challenged by social theorists. As part of this critique, an analytic distinction is made between the domains of doctors and patients to highlight differences in perspective and power. Illness narratives and phenomenological studies foreground how patient experiences and understandings of health are complex, socially embedded and often conflict with medical models. This article, however, asks how patients make sense of their health at the interface of these domains. This question is explored with reference to 16 men living with HIV and the ways in which they negotiate medical discourse and technology in relation to lived experience and, conversely, how they interpret their own bodily symptoms in light of clinical construction of health. These negotiations contest the authority of biomedical definitions, but also reveal a more dynamic and technologically mediated negotiation within patient experience than some phenomenologically oriented theories on health allow.
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References
1.
Ariss, R. (1997). Against death: The practice of living with AIDS. Amsterdam: Gordon & Breach .
2.
Bologh, R.W. (1981). Grounding the alienation of self and body: A critical, phenomenological analysis of the patient in western medicine . Sociology of Health and Illness, 3(2), 188-206 .
3.
Bury, M. (1982). Chronic illness as biographical disruption . Sociology of Health and Illness, 4(2), 167-182 .
4.
Cassell, E.J. (1985 [1976]). The healer's art. Cambridge: The MIT Press .
5.
Comaroff, J. (1982). Medicine, symbol and ideology. In P. Wright and A. Treacher (Eds.), The problem of medical knowledge: Examining the social construction of medicine, pp. 49-68. Edinburgh: Edinburgh University Press .
6.
Crawford, R. (1984). A cultural account of `health': Control, release and the social body. In J.B. McKinlay (Ed.), Issues in the political economy of health care, pp. 1347-1365. London: Tavistock .
7.
De Certeau, M. (1984). The practice of everyday life. Berkeley, CA: University of California Press .
8.
Eisenberg, L. (1977). Disease and illness: Distinctions between professional and popular ideas of sickness . Culture, Medicine and Psychiatry, 1, 9-23 .
9.
Fee, E. and Fox, D. (1992). AIDS: The making of a chronic disease. Berkeley, CA: University of California Press .
10.
Foucault, M. (1990 [1976]). The history of sexuality, vol. I. London: Penguin Books .
11.
Foucault, M. (1991 [1975]). Discipline and punish: The birth of the prison. London: Penguin Books .
12.
Frank, A.W. (1995). The wounded storyteller: Body, illness and ethics. Chicago, IL & London: University of Chicago Press .
13.
Frank, A.W. (1998). Stories of illness as care of the self: A Foucauldian dialogue . health:, 2(3), 329-348 .
14.
Freund, P. and McGuire, M. (1991). Health, illness and the social body: A critical sociology. Engelwood Cliffs, NJ: Prentice Hall .
15.
Good, B.J. (1994). Medicine, rationality, and experience. Cambridge: Cambridge University Press .
16.
Haraway, D. (1991). Situated knowledges: The science question in feminism and the privilege of partial perspective. In Simians, cyborgs and women: The reinvention of nature, pp. 183-196. London: Free Association Press .
17.
Helman, C. (1990). Culture, health and illness. London & Boston, MA: Wright .
18.
Hurley, M. (2001). Rethinking the clinic: Doctors, people living with HIV and AIDS and cultures of care . Paper presented at 13th Annual Conference of Australasian Society for HIV Medicine, Melbourne, October.
19.
Jackson, M., Ed. (1996). Things as they are: New directions in phenomenological anthropology. Indiana, IN: Indiana University Press .
20.
James, W. (1970 [1907]). Pragmatism. Cleveland & New York: Meridian Books .
21.
Kavanagh, A. and Broom, D. (1998). Embodied risk: My body, myself? Social Science and Medicine, 46(3), 437-444 .
22.
Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books .
23.
Kleinman, A. (1995). Writing at the margin: Discourse between anthropology and medicine. Berkeley, CA: University of California Press .
24.
Leder, D. (1990). The absent body. Chicago, IL: University of Chicago Press .
25.
Lock, M. and Gordon, D., Eds. (1988). Biomedicine examined. Dordrecht & London: Kluwer Academic Publishers .
26.
Merleau-Ponty, M. (1962). Phenomenology of perception. London: Routledge & Kegan Paul .
27.
Mishler, E.G. (1989). Critical perspectives on the biomedical model. In P. Brown (Ed.), Perspectives in medical sociology. Belmont, CA: Wadsworth .
28.
Moore, A., Candlin, C.N. and Plum, G.A. (2001). Making sense of HIV-related viral load: One expert or two? Culture, Health and Sexuality, 3(4), 429-450 .
29.
Parsons, T. (1951). The social system. London: Routledge & Kegan Paul .
30.
Race, K. (1998). The private space of HIV . Paper presented at the HIV/AIDS and Society Conference, Macquarie University, Sydney, October.
31.
Race, K. (2000). Crisis in compliance . Paper presented at the HIV/AIDS and Related Diseases Social Research Conference, Sydney, May.
32.
Race, K. (2001a). The undetectable crisis: Changing technologies of risk . Sexualities, 4(2), 167-189 .
33.
Race, K. (2001b). Incorporating clinical authority: A new test for people with HIV. In N. Watson and S. Cunningham-Burley (Eds.), Reframing the Body. Hampshire & New York: Palgrave .
34.
Race, K., Cristaudo, P., Wilkins, R. and Prestage, G. (1997). Pills, health, capacity: The significance of HIV health practices. Sydney: National Centre in HIV Social Research .
35.
Race, K., McInnes, D., Wakeford, E., Kleinert, V., McMurchie, M. and Kidd, M. (2001). Adherence and communication: Reports from a study of HIV general practice. Sydney: National Centre in HIV Social Research .
36.
Radley, A. and Billig, M. (1996). Accounts of health and illness: Dilemmas and representations . Sociology of Health and Illness, 18(2), 220-240 .
37.
Radley, A. and Green, R. (1987). Illness as adjustment: A methodology and conceptual framework . Sociology of Health and Illness, 9(2), 179-207 .
38.
Shaw, I. (2002). How lay are lay beliefs? health:, 6(3), 287-299 .
39.
Skultans, V. (2000). Narrative illness and the body . Anthropology and Medicine, 7(1), 5-13 .
40.
Taussig, M. (1980). Reification and the consciousness of the patient . Social Science and Medicine, 14B, 3-13 .
41.
Toombs, S.K. (1988). Illness and the paradigm of lived body . Theoretical Medicine, 9, 201-226 .
42.
Toombs, S.K. (1992). The meaning of illness. Dordrecht & London: Kluwer Academic Press .
43.
Wakeford, E. (2000). Living with HIV suppression: An exploration of side effects . Paper presented at the HIV/AIDS and Related Diseases Social Research Conference, Sydney, May.
44.
Wikan, U. (1992). Beyond the words: The power of resonance . American Ethnologist, 19, 460-482 .
45.
Williams, S. (1996). The vicissitudes of embodiment across the chronic illness trajectory . Body and Society, 2(2), 23-47 .
46.
Williams, S. (2000). Chronic illness as biographical disruption or biographical disruption as chronic illness? Reflections on a core concept . Sociology of Health and Illness, 22(1), 40-67 .
