Gay & Lesbian Issues and Psychology Review, Vol. 7, No. 1, 2011
ISSN 1833-4512 © 2011 Australian Psychological Society
BOOK REVIEW
PETER B. TODD
Davis, Mark and Squire, Corinne. (2010). HIV
Treatment and Prevention Technologies: An
International Perspective. London: Palgrave
Macmillan, pp 210, ISBN:9780230238190.
This edited collection of chapters explores the
biomedical and social technologies which have
been used to control the HIV/AIDS pandemic.
Through such qualitative research methods as
case studies and critical commentaries within
a distinct sociopolitical and cross cultural
framework, the volume engages treatment
access in both the developed and developing
worlds while examining the apparent tension
which has existed historically between the
objectives of prevention of HIV transmission
and treatment with antiretroviral drugs.
One of the strengths of the book is its empha-
sis upon the tendency for complacency in-
duced by the belief that HIV/AIDS is a chronic
manageable disease, and the role of this in
minimising the importance of adopting behav-
iours to prevent HIV transmission. It could
indeed be argued that this is a manifestation
of defensive denial of the implications of pro-
digious mutation in HIV and the phenomenon
of multiple drug resistance in an era of highly
active antiretroviral therapies. Kane Race’s
chapter on the culture of barebacking
(whereby seropositive persons negotiate un-
protected sexual encounters in disregard of
the risk of reinfection with another strain of
HIV) might well be a case in point.
Perhaps the most insightful and illuminating
chapter is Paul Flower’s contribution concern-
ing “HIV Transitions: Consequences for the
Self in an era of Medicalization”. This chapter
examines the impact on self-definition of the
stigma associated with HIV seropositive status
and such conspicuous bodily changes as
lipidystrophy due to the long term use of anti-
retroviral medications. Flowers, while noting
the tendency to minimize psychosocial issues
due to the medicalization and normalization of
HIV infection, notes empirical evidence for the
frequency of major depressive disorder in
seropositive persons to be twice that observed
in seronegative individuals.
Todd (2009) has argued that psychosocial and
unconscious mental factors are significant de-
terminants of HIV progression and mortality
via their impact upon the neuroendocrine and
immune systems. The authors of the book
claim to have brought the psychosocial fea-
tures of HIV “back into relationship with an
ascendant biotechnological” focus in which
the salience of such factors has tended to be
disregarded (p. 201). In so doing they high-
light well the ethical, political and cultural di-
mensions of HIV/AIDS in what they refer to as
the “treatment possibility era”. However, ap-
parently missing is any comprehensive review
of quantitative research into the role of psy-
chosocial factors in either prevention or treat-
ment.
The need for ongoing quantitative research in
the HIV/AIDS field is important due to serious
Kuhnian anomalies including rapid HIV muta-
tion and multiple drug resistance as well as
difficulties with vaccine development. Immu-
nologist Ted Steele (2009) has also pointed
out that the continued use of anti-reverse
transcriptase drugs may not only inhibit HIV
replication, but also the generation of anti-
body diversity which requires reverse tran-
scription. This implies the need for more not
less research into fundamental physiology and
molecular mechanisms as well as the predic-
TODD: BOOK REVIEW
tive significance of psychosocial factors im-
pacting upon immunological and psychic self
integration.
In conclusion, the book contains many impor-
tant insights into the cross-cultural experience
of living with HIV/AIDS. However, its ambiva-
lence towards quantitative research is I be-
lieve misguided given the unresolved anoma-
lies and gaps in our present understanding.
Author Note
Peter B. Todd BA (Hons, Psychology) MAPS
graduated from Sydney University in 1968. He
started work as a postgraduate research psy-
chologist at the School of Surgery, St George
Hospital (University of New South Wales). This
research was essentially a psychoanalytic
study of quantified unconscious ego-defences
and affects as predictors of behavior and out-
come in women with symptoms of breast can-
cer. This was among the first successful at-
tempts in the world to quantify unconscious
mental processes. Research was published in
the British Journal of Medical Psychology,
1978.
Subsequently, Peter held a position as re-
search psychologist at the Neuropsychiatric
Institute, Prince Henry Hospital, Sydney, be-
came a member of the biopsychosocial AIDS
Project at the University of California in San
Francisco, consultant at the department of
immunology at St. Vincent’s Hospital, and re-
search psychologist at the Albion Street AIDS
Clinic Sydney. He has published numerous
peer-reviewed papers, his most recent being
in the interdisciplinary journal ‘Mind and Mat-
ter’, 2009. Currently he works as a registered
psychoanalytically oriented psychologist and
psychotherapist in private practice in Sydney.
References
Steele, E.J. (2009). Lamarck and Immunity:
Somatic and Germline Evolution of Anti-
body Genes. Journal of the Royal Society
of Western Australia, 92, 427-446.
Todd, P.B. (2009). Unconscious Mental Fac-
tors in HIV Infection. Mind and Matter, 6
(2), 193-206.
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