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Resistance and the regimen: The microthanatopolitics of Venezuelan antiretroviral scarcity and HIV drug adherence failures

Irons, Rebecca; (2024) Resistance and the regimen: The microthanatopolitics of Venezuelan antiretroviral scarcity and HIV drug adherence failures. Social Science & Medicine , 358 , Article 117177. 10.1016/j.socscimed.2024.117177. Green open access

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Abstract

The Venezuelan State does not provide adequate antiretroviral therapy (ART) for the population living with HIV, resulting in pharmaceutical scarcity, involuntary treatment pauses, and adherence failures. Such a situation may result in the development of resistance to certain ART drugs, meaning that Venezuelans with HIV may have their treatment options reduced for the remainder of their lives. It can take a number of years for a person to acquire late-stage HIV/AIDS and for death to occur, and so I focus on the microbiological death of CD4 cells over time – a concept I call ‘microthanatopolitics’. In this paper I argue that the microthanatopolitics of ART scarcity deprives those living with HIV of future treatment options, encourages resistance to ART drugs, and ultimately may contribute towards ill health long after treatment availability changes in Venezuela. To explore this in depth, the paper draws upon 6 interviews with Venezuelan HIV activists in Venezuela (2024), supported by 40 testimonies from Venezuelan migrants living with HIV in Colombia (2021–2024), with and without known ART resistance. It will be concluded that not only is this an issue for those currently living in Venezuela, but also for migrants and the global HIV response who will suffer from the promotion and circulation of ART-resistant viral strains in the long run. This microthanatopolitics is influenced by both the current Venezuela political system as well as humanitarian aid from the Global North; an important consideration of coloniality in post-colonial Latin America.

Type: Article
Title: Resistance and the regimen: The microthanatopolitics of Venezuelan antiretroviral scarcity and HIV drug adherence failures
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.socscimed.2024.117177
Publisher version: http://dx.doi.org/10.1016/j.socscimed.2024.117177
Language: English
Additional information: © 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10196522
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