Making the ideal real: Biomedical HIV prevention as social public health

This chapter interrogates how assumptions about biomedical HIV prevention configure social factors as largely secondary to effectiveness, either as barriers to rollout and uptake of treatment as prevention (TasP), or as the pliable conduits for the same processes. They also gloss over the reflexivity of people who are the subjects of biomedical HIV prevention, ignoring the often unanticipated effects it may have in their social and sexual lives. Like previous approaches to HIV prevention, a biomedical approach needs to engage with the limitations inherent in the assumptions it makes and view itself as open to modification. In doing so, there may be value in understanding biomedical HIV prevention as an assemblage of biomedical, social and political forces and effects, each of which is necessary for it to effectively serve all who are in need of it.