Epidemiologists social scientists and the structure of medical research on AIDS in Africa. Comment.

摘要: This commentary on the Packard and Epstein critique of AIDS research in Africa reiterates some important points discussion. It is noteworthy that paper challenges a dominant epidemiologic paradigm makes accurate albeit uncomfortable historical comments. Although argument strident it also familiar clash between successful biomedical weaker social science perspective. pointed out prevention efforts were medicalized emphasized individual behavior change. The persuasive depicting interpretation explanation as based promiscuity exotic risk-taking customs stipulating this inherent African character culture (not multiple complex situations current political economic life) lacking input multidisciplinary effort. Mechanistic explanations replaced multicausal explanations. strengths limitations are sharply outlined. While gives reality HIV virus epidemiological one maps distribution disease seropositivity these insufficient to help changing pattern distribution. A noncontroversial approach should be pursued well policy or behavioral research. Political strife migration urbanization other changes an context consider terms options. question posed whereabouts researchers change spread new diseases. Anthropologists identified focusing demonstrate importance relevance discipline. practices reported mapped against prevalence represent worst sort correlation fishing expedition. readiness authorities accept immortality offset with counterproposal alternative (needles sticks urban traditional medical procedures) important. However there strong evidence support sexual pathway primary mode transmission. But point made factors have not been addressed by efforts. Research agendas which illuminate interactions light failure programs.