Adherence and the Lie in a HIV Prevention Clinical Trial
The authors explore this assertion from the perspective of a pre-exposure prophylaxis trial to prevent HIV in South Africa
The lie has been presented as a performance that protects identities against moral judgment in the context of power imbalances. The authors explore this assertion from the perspective of a pre-exposure prophylaxis trial to prevent HIV for African women in South Africa, in which context biological evidence of widespread lying about product adherence was produced, resulting in a moral discourse that opposed altruistic and selfish motivations.
In this article, they seek to understand the meaning of the lie from the perspective of women trial participants. Seeing the trial as representing a hopeful future, and perfect adherence as sustaining their investment in this, participants recited scripted accounts of adherence and performed the role of the perfect adherer, while identifying other participants as dishonest. Given that clinical trials create moral orders and adherence is key to this, they argue that women embraced the apparatus of the clinical trial to assert their moral subjectivities.
This research is funded under the Department for International Development’s STRIVE Programme which is led by the London School of Hygiene and Tropical Medicine
Jonathan Stadler, Fiona Scorgie, Ariane van der Straten, Eirik Saethre (2016) Adherence and the Lie in a HIV Prevention Clinical Trial, Medical Anthropology, 35:6, 503-516, DOI: 10.1080/01459740.2015.1116528