New Generation Struggles

Chapter 4 traces a set of ‘new generation struggles’ that have emerged following the large-scale provision of HIV medicines through South Africa’s public health system. Just as HIV precipitated forms of embodied vulnerability when medicines were not readily available, so too have HIV medicines generated new forms of embodied vulnerability, including side effects, treatment fatigue and viral resistance. These struggles are less frequently discussed or considered when looking at the history of the struggle for HIV medicines, but they are increasingly important as they often lead to poor treatment adherence and sometimes death. The economic context in which people navigate their treatment regimens has also been shown to affect whether or not people are able to adhere to their medicines: some medicines need to be kept refrigerated, and without money for electricity or access to electricity, this renders medicines ineffective. These linked struggles, around the embodiment of HIV medicines and the socio-economic context in which these medicines are taken, are foregrounded through ethnographic accounts drawn from my own research in South Africa and also from current research elsewhere in Africa, Latin America and South East Asia.