Constructing an epidemic: epidemiology, critical medical anthropology,

For twenty years, the HIV epidemic has been defined largely by the dominant Western medical system of biomedicine.1,i Epidemiological studies have identified the virus and its transmission pathways and biomedical institutions, such as the Centers for Disease Control (CDC), have shaped mainstream intervention programs. Theoretically, biomedicine has the information and resources available to control the epidemic. However, the virus still infects millions of people annually, largely in non-Western societies. The continued smolder of the epidemic is tragic evidence that the current response is ineffective. Within this context, the continued spread of HIV therefore serves as an impetus to critically analyze the current medical approaches. I use critical medical anthropologyii (CMA) to establish a framework on which biomedical interpretations of the epidemic are deconstructed and analyzed. This analysis is based on the CDC’s 2001 plan for HIV interventions and other biomedical literature on the epidemic. Critiquing the dominant discourse is vital to understanding the underlying ideologies and theories of the biomedical discourse on HIV. Through the CMA critique, I show how biomedicine is based largely on culturally-specific notions. These views shape the biomedica