Biomedical moralities: a syndemic approach to stigma, community, and identity in HIV-positive Boston
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Stigma is multi-faceted and intersects with other damaging forms of social suffering. The evolving nature of HIV stigma is particularly evident in HIV communities, where community members adopt hegemonic views of biomedicine and incorporate them into their shared social space. I argue that such structural discrimination is a product of embracing “biomedical moralities,” where older community members adopt biomedically defined medical management as the standard of conduct. Such standards of living become so pervasive that HIV stigma nearly functions as a form of structural violence producing negative stereotypes of members who do not demonstrate “correct” ways of living with HIV. Such “biomedical moralities” lie at the nexus of community formation, contingent identities, and perceived stigma that members of HIV communities enact and embody. In this work I propose a newly identified stigma-linked syndemic which is thought to contribute to HIV spread, pose challenges for HIV medication adherence, and promote known syndemic interactions between HIV and other STIs. Through ethnographic research I present HIV communities’ experiences with stigma and how that can worsen overall health effects. I suggest that such research highlights needed improvements in anti-stigma campaigns and calls for an expansion of existing stigma-related HIV syndemics research.