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In Australia, the response to HIV, hepatitis C and hepatitis B has largely been through the constructed category of 'blood borne viruses' which treats these viruses as an interconnected set of conditions with respect to their mode of transmission. In this paper, we explore how people understand their viral infection, and compare the logics underpinning these different understandings. In-depth interviews were conducted with 61 participants who were either living with a blood borne virus or were the family members of people living with them. Our analysis reveals that the viral infection was often described as 'just a condition that needs to be managed', albeit in potentially exhausting ways. This understanding hinged upon a biomedical logic in which viral invasion was seen as causing illness and in turn necessitating biomedical intervention. In contrast, some participants with hepatitis B presented their infection as a condition unintelligible through Western biomedical logics, defined instead by symptomology – in terms of 'liver disease', and/or 'liver inflammation'. This focus on symptomology calls into question the soundness of prevention and management responses to hepatitis B based in biomedical logics and reveals the extent to which living with a virus involves multiple, sometimes incompatible, cultural logics. The different logics underpinning HIV, hepatitis C and hepatitis B reveal shortcomings of framing these viruses together as a coherent single construct. [ABSTRACT FROM AUTHOR]

In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs). [ABSTRACT FROM AUTHOR]

This paper explores how experiences of disclosure and passing among heterosexuals living with HIV in Australia can be meaningfully conceptualised beyond therapeutic discourses and habitual metaphors. It engages in a dialogue between qualitative research material, HIV disclosure literature and theory. It is first argued that an emphasis on the therapeutic value of disclosure in much of the literature obscures the complexities of HIV stigma as socially produced and lived. Next, the paper considers the concepts of 'the closet' and 'coming out', which have become short-hand for a range of social stigmas. Although parallels are found between the productive effects of the closet and the research material, the idea of 'coming out' fails to capture the cultural context of HIV in Australian heterosexual society. This raises questions about the contemporary tendency to invoke the closet as a presumedly universal metaphor. Foucault's idea of heterotopia is proposed as an alternative way of conceptualising the lived worlds of disclosure and passing in this research study, with the hope of opening out future discussion and theorising. [ABSTRACT FROM AUTHOR]

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The roles of clinicians and investigators have been increasingly intertwined over the past 30 years. This study explores the tensions of performing both roles in the context of HIV medicine. Clinicians, who are also investigators, were interviewed in Australia during the course of an intensive phase II clinical trial. Clinicians described both positive and negative outcomes of participating in clinical trials. The clinicians considered it beneficial to be able to offer potentially effective therapies at an early stage to their patients and found research broadened their work and experience. They also thought it less disruptive to the patients to be able to enrol at their usual site of health care delivery. Difficulties encountered in engaging in clinical trials were described as problems with the time involved in clinical trial work, and ethical dilemmas in recruitment and retention. Further tensions were associated with the often conflicting demands of patients' interests and research goals. Depuis une trentaine d'années, les rôles de clinicien et de chercheur ont tendance à se confondre de plus en plus. Cet article étudie, dans le contexte de la médecine du VIH, les conflits qui apparaissent lorsque ces deux rôles sont remplis simultanément. Lors d'un essai clinique intensive de phase II effectuéen Australie, nous avons interrogédes cliniciens qui étaient des aussi chercheurs. Ces cliniciens ont decrit les retombées positives et négatives de leur participation à des esscus cliniques. Parmi les aspects positifs, les praticiens considéraient comme bénéfique le fait de pouvoir proposer à leurs patients à un otude précoce des thérapies potentiellement efficaces, et ils ont trouvéque faire de la recherche avait élargi le champ de leur activitéet leur expérience. Ils ont également estimé qu'il était moins perturbant pour leurs patients de pouvoir participer aux études à l'endroit où ils reçoivent habituellement des soins. Parmi les obstacles rencontrés par les praticiens s'engageant dans des études cliniques, ont été mentionnés des problémes lís au temps consacre aux essais, et des dilemmes éthiques concernant le recrutement et le mantier des participants dans un essai. D'autres tensions sont nés de la difficulté à combiner deux exigences contradictoires : l'intérét des patients et les objectifs de la recherche. Los papeles de los médicos clínicos y los investigadores se han entrelazado cada vez más en los últimos 30 años. Este estudio explora las tensiones entre ambos papeles en la practica medica que estudia el VIH. Durante el curso de un ensayo clínico intenso de fase II, fueron entrevistados en Australia médicos cliacute;nicos, que también son investigadores. Estos médicos describieron los resultados de su participación en los ensayos clínicos, tanto positiva como negativamente. Creían que era beneficioso ser capaz de ofrecer a los pacientes terapias potencialmente eficaces en las primeras etapas y pensaban que la investigación ampliaba su trabajo y experiencia. También opinaron que era menos perjudicial para los pacientes que pudieran ir a sus centros usuales de sanidad. Encontraron dificultades en la participación ensayos clínicos ya que representan un problema por el tiempo dedicado al trabajo clíico de los ensayos y un dilema ético alrededorde la selección de pacientes y su retención. Otras tensiones se relacionan con las demandas, a menudo conflictivas, entre los intereses de los pacientes y los objetivos de la investigación. [ABSTRACT FROM AUTHOR]