Transformations in the medicalization of sex: HIV prevention between discipline and biopolitics

This article examines transformations in HIV prevention strategies from the 1980s to the present. Drawing on the concepts of medicalization (Conrad, 2007 ), discipline and biopolitics (Foucault, 1976/ 1988 ), and biomedicalization (Clarke, Fishman, Fosket, Mamo, & Shim, 2003 ), it explores the shift from behavioral to biomedical and surgical prevention techniques-a shift symbolic of a more general trend toward the biomedicalization of sexuality. It argues that, although biomedical and surgical approaches (chemoprevention and male circumcision) have certain benefits, their efficacy is limited and uncertain. They do not guarantee individual protection. The aim is no longer the modification of sexual behavior through disciplinary strategies aimed at the development of subjective and sexual awareness, but the modification of health behavior as a positive response to biomedical recommendations. Through the use of preventative or curative drugs, the same type of sexual awareness is seen as no longer required.