Kiran Pienaar
Deakin University, Sociology, Faculty Member
- Feminist Theory, Feminist science and technology studies, New Materialism, Sociology of the Body, Feminist Philosophy, Cultural Studies, and 14 moreSociology of Health and Illness, HIV/AIDS, Posthumanism, Social Studies Of Science, Gender Studies, Body Image, Constructions of femininity, Drugs And Alcohol, Drugs And Addiction, Gender and Sexuality, Social Policy, Health Policy, Poststructuralism, and Policy Analysis/Policy Studiesedit
- Dr Kiran Pienaar is a Senior Lecturer at Deakin University with expertise in gender, sexuality, health sociology and ... moreDr Kiran Pienaar is a Senior Lecturer at Deakin University with expertise in gender, sexuality, health sociology and science and technology studies. Kiran's research explores connections between health, gender, sexuality and the body, with a particular interest in drug consumption and sexual cultures, and the social dimensions of pandemics such as COVID-19 and HIV. Her research has appeared in leading journals including Social Science and Medicine; Sociology of Health and Illness; Sexualities; The International Journal of Drug Policy; Qualitative Health Research; Health Sociology Review; and Social Theory and Health. She has published on topics related to drugs, addiction and the self; the COVID-19 and HIV pandemics; public health and drug policy; and drug experiences in LGBTQ cultures. Her first book 'Politics in the Making of HIV/AIDS in South Africa' was published with Palgrave Macmillan.
Kiran’s current research program involves two projects on topics related to gender, sexuality and drug consumption; and digital health interventions. With colleagues at the University of Sydney and the University of New South Wales, she is a Chief Investigator on an ARC Discovery Project titled 'Chemical Practices: Enhancement and Experimentation'. The project explores drug consumption in LGBTQ communities, with a view to generating new insights for service provision on the use of drugs to enhance or transform gender and/or sexual experience. Kiran is also a Chief Investigator on a Monash Interdisciplinary grant on online alcohol and other drug counselling. She retains an affiliate role at Monash University.edit
Objective: This article presents a longitudinal analysis of COVID-19 infection and vaccination coverage in Melbourne metropolitan local government areas (LGAs) during the 2021 Delta wave. Methods: COVID-19 vaccination and infection data... more
Objective: This article presents a longitudinal analysis of COVID-19 infection and vaccination coverage in Melbourne metropolitan local government areas (LGAs) during the 2021 Delta wave. Methods: COVID-19 vaccination and infection data from 12 July to 27 November 2021 were sourced from government websites. Summary statistics and associated 95% confidence intervals (95% CI) were compared by LGA ranked according to socioeconomic status: total "burden" (total infections per thousand), "peak" (highest weekly infection rate), "lag" (interval between peak and 70% double vaccination). Results: LGAs in the bottom five deciles for social advantage experienced higher infection rates (39.0 per thousand [95% CI: 38.5, 39.5] vs. 14.8 [14.7, 14.9]), and had lower two-dose vaccination coverage (23.8% [23.6, 23.9] vs. 32.7% [32.6, 32.7]) compared with LGAs in the top five deciles. LGAs that achieved 70% coverage two weeks or more after the infection peak experienced nearly twice the total infection burden (27.7 per 1000 [27.3, 28.0] compared with 14.9 [14.7, 15.0]) than LGAs with a shorter lag. Conclusions: Exposure and transmission risk factors cluster within disadvantaged LGAs. The potential for large local outbreaks is heightened if vaccination uptake trails in these communities.
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Trauma is increasingly understood to shape a range of alcohol and other drug (AOD)-related problems, including addiction, relapse, mental illness and overdose. However, the merits of understanding AOD-related problems as the effect of... more
Trauma is increasingly understood to shape a range of alcohol and other drug (AOD)-related problems, including addiction, relapse, mental illness and overdose. However, the merits of understanding AOD-related problems as the effect of trauma are uncertain with the nature and implications of such linkages requiring closer scrutiny. Where trauma is linked to AOD-related problems, this relationship is typically treated as self-evident, obscuring the uncertainties in knowledge surrounding the notion of trauma itself. Informed by insights from critical drugs and trauma scholarship that challenge deterministic notions of AOD ‘problems’ and trauma, this essay identifies key issues for social research in this area that warrant further consideration. We argue that there is a pressing need to acknowledge variation and diversity in the relationship between trauma and AOD-related problems, and the gendered and sexual dynamics shaping the expansion of the trauma paradigm. We then outline how critical Indigenist interdisciplinary work can inform culturally specific knowledge on trauma and AOD-related problems, and also suggest targeted research on the delivery and experience of trauma-informed approaches in the AOD context. To this end, we present several recommendations for a social research agenda underpinned by critical, qualitative research into how people experience and manage trauma and AOD-related problems in their everyday lives.
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Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients' experiences of depot buprenorphine and its embodied effects. This... more
Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients' experiences of depot buprenorphine and its embodied effects. This qualitative study aims to explore patients' experiences of depot buprenorphine treatment, including how it feels within the body, experiences of dosing cycles across time, and how this form of treatment relies on wider ecologies of care beyond the clinical encounter. Participants were recruited from sites in Sydney, regional New South Wales, and Melbourne, Victoria, Australia. Thirty participants (16 men, 14 women) participated in semi-structured interviews. Participants had histories of both heroin and prescription opioid consumption, and opioid agonist therapy including daily dosing of buprenorphine and methadone.
Our analysis illuminates: (1) how patients' expectations and concerns about treatment are linked to past embodied experiences of withdrawal and uncertainty about the effectiveness of depot buprenorphine; (2) the diverse meanings patients attribute to the depot buprenorphine substrate 'under the skin'; and, (3) how depot buprenorphine is embedded within wider ecologies of care, such as counselling and social supports. Our analysis destabilises commonplace assumptions about a linear, causal relationship between the pharmacological action of depot buprenorphine and experiences of treatment. Instead, it highlights patients' variable experiences of depot buprenorphine, tracing the everyday practices, embodied feelings, expectations and wider networks of care that shape patient experiences. We conclude with some reflections on the implications of our analysis for alcohol and other drug treatment, specifically how they might inform the design of client education materials and care.
Our analysis illuminates: (1) how patients' expectations and concerns about treatment are linked to past embodied experiences of withdrawal and uncertainty about the effectiveness of depot buprenorphine; (2) the diverse meanings patients attribute to the depot buprenorphine substrate 'under the skin'; and, (3) how depot buprenorphine is embedded within wider ecologies of care, such as counselling and social supports. Our analysis destabilises commonplace assumptions about a linear, causal relationship between the pharmacological action of depot buprenorphine and experiences of treatment. Instead, it highlights patients' variable experiences of depot buprenorphine, tracing the everyday practices, embodied feelings, expectations and wider networks of care that shape patient experiences. We conclude with some reflections on the implications of our analysis for alcohol and other drug treatment, specifically how they might inform the design of client education materials and care.
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Discussions about the social impacts of COVID-19, and most recently, mpox (formerly monkeypox), have been informed by the legacy of the HIV epidemic. Yet despite awareness of the importance of avoiding exclusionary depictions of ‘at-risk’... more
Discussions about the social impacts of COVID-19, and most recently, mpox (formerly monkeypox), have been informed by the legacy of the HIV epidemic. Yet despite awareness of the importance of avoiding exclusionary depictions of ‘at-risk’ populations, some public discourses have drawn on framings that imply certain groups are risky disease vectors who threaten the health of an imagined ‘general’ public. Drawing on Barad's concept of diffraction and Treichler's classic work, How to Have Theory in an Epidemic, we offer a diffractive reading of contemporary pandemic discourses through the lens of HIV. We suggest that thinking with HIV provides an important analytic device for exploring how the history and cultural imaginaries of HIV are threaded through contemporary pandemic discourses and serve to reinforce existing social inequalities. In particular, we highlight the ways in which contemporary discourses on COVID-19 and mpox function as dividing practices, arguing that they produce particular exclusions in relation to already marginalised populations, including queer communities, minority ethnic communities, homeless people and those in residential care. We conclude with reflections on the lessons of the HIV epidemic for forging more compassionate responses to contemporary disease outbreaks.
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Drawing on cultural historian Saidiya Hartman’s (2019) book Wayward Lives, Beautiful Experiments: Intimate Histories of Social Upheaval, this essay reads one woman’s life with drugs and resistance to drug treatment as a feminist act of... more
Drawing on cultural historian Saidiya Hartman’s (2019) book Wayward Lives, Beautiful Experiments: Intimate Histories of Social Upheaval, this essay reads one woman’s life with drugs and resistance to drug treatment as a feminist act of refusal, a ‘wayward life’ in Hartman’s terms. Wayward lives are those that refuse dominant forms of servitude and push open alternative ways of being. Although living in a different time and location to the young black women in Hartman’s book struggling to survive after emancipation in the United States, we see the woman (Kim) in our study in contemporary London, United Kingdom, employing similar acts of cramped resistance in a world that treats her as ‘pathological’ and ‘criminal’. We explore the ways in which Kim resists the law, the tropes of pathology that profess to know her, and the abstinence-based treatment systems that seek to change her. Importantly in following Hartman, we are not dismissing her struggles or romanticising her drug use, but rather looking to assemble a picture of her life that captures its admixture of daily trials and challenges, fleeting triumphs, pleasures and acts of resistance. Here we are making room for the kind of embodied and intimate political work that often gets left out of discussions of more formal anti-prohibitionist activism and organisation.
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Trauma is increasingly understood to shape a range of alcohol and other drug (AOD)-related problems, including addiction, relapse, mental illness and overdose. However, the merits of understanding AOD-related problems as the effect of... more
Trauma is increasingly understood to shape a range of alcohol and other drug (AOD)-related problems, including addiction, relapse, mental illness and overdose. However, the merits of understanding AOD-related problems as the effect of trauma are uncertain with the nature and implications of such linkages requiring closer scrutiny. Where trauma is linked to AOD-related problems, this relationship is typically treated as self-evident, obscuring the uncertainties in knowledge surrounding the notion of trauma itself. Informed by insights from critical drugs and trauma scholarship that challenge deterministic notions of AOD ‘problems’ and trauma, this essay identifies key issues for social research in this area that warrant further consideration. We argue that there is a pressing need to acknowledge variation and diversity in the relationship between trauma and AOD-related problems, and the gendered and sexual dynamics shaping the expansion of the trauma paradigm. We then outline how critical Indigenist interdisciplinary work can inform culturally specific knowledge on trauma and AOD-related problems, and also suggest targeted research on the delivery and experience of trauma-informed approaches in the AOD context. To this end, we present several recommendations for a social research agenda underpinned by critical, qualitative research into how people experience and manage trauma and AOD-related problems in their everyday lives.
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Diagnoses of infectious diseases are being transformed as mass self-testing using rapid antigen tests (RATs) is increasingly integrated into public health. Widely used during the COVID-19 pandemic, RATs are claimed to have many... more
Diagnoses of infectious diseases are being transformed as mass self-testing using rapid antigen tests (RATs) is increasingly integrated into public health. Widely used during the COVID-19 pandemic, RATs are claimed to have many advantages over ‘gold-standard’ polymerase chain reaction tests, especially their ease of use and production of quick results. Yet, while laboratory studies indicate the value of RATs in detecting the SARS-CoV-2 virus antigen, uncertainty surrounds their deployment and ultimate effectiveness in stemming infections. This article applies the analytic lens of biological citizenship (or bio-citizenship) to explore Australia’s experience of implementing a RAT-based mass self-testing strategy to manage COVID-19. Drawing on Annemarie Mol’s (1999, The Sociological Review, 47(1), 74–89) concept of ontological politics and analysing government statements, scientific articles and news media reporting published during a critical juncture of the strategy’s implementation, we explore the kind of bio-citizenship implied by this strategy. Our analysis suggests the emergence of what we call liminal bio-citizenship, whereby citizens are made responsible for self-managing infection risk without the diagnostic certitude this demands. We discuss how the different realities of mass self-testing interact to reinforce this liminal citizenship and consider the implications for the sociology of diagnosis.
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This report presents findings from a national consultation undertaken in 2023 on knowledge gaps and areas for future research on trauma and alcohol and other drug (AOD)-related problems in Australia. Drawing on interviews with Australian... more
This report presents findings from a national consultation undertaken in 2023 on knowledge gaps and areas for future research on trauma and alcohol and other drug (AOD)-related problems in Australia. Drawing on interviews with Australian stakeholders working in the fields of trauma-informed or AOD policy, research and treatment, the report aims to inform research that can improve policy and practice responses.
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As the name 'talk therapy' suggests, a key aim of alcohol and other drug counselling, psychotherapy and other talk therapies is to discuss issues, concerns and feelings with a health professional. Implicit here is the... more
As the name 'talk therapy' suggests, a key aim of alcohol and other drug counselling, psychotherapy and other talk therapies is to discuss issues, concerns and feelings with a health professional. Implicit here is the therapeutic value of talking through issues with a trained professional. But as with all interactions, therapeutic encounters involve silences and pauses as key aspects of the communicative process. Despite their ubiquity in the therapeutic encounter, research tends to either dismiss silences as inconsequential or as having undesirable effects, such as generating awkwardness or even disengagement from treatment. Drawing on Latour's (2002) concept of 'affordance' and a qualitative study of an Australian alcohol and other drug counselling service, we explore the varied functions of silences in online text-based counselling sessions. For clients, these include the role of silence in affording opportunities to engage in other everyday practices, such as socialising, caregiving or working-practices that can generate comfort and reduce distress, which in turn may support the therapeutic encounter. Similarly, for counsellors, temporal silences provide opportunities to confer with other counsellors and provide tailored care. However, protracted silences can raise concerns about the safety and wellbeing of clients who do not respond promptly or who exit encounters unexpectedly. Similarly, the sudden cessation of online care encounters (often associated with technical difficulties) can leave clients feeling frustrated and confused. In tracking these diverse affordances of silence, we draw attention to its generative potential in care encounters. We conclude by exploring the implications of our analysis for conceptions of care that underpin alcohol and other drug treatment.
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COVID-19 responses have cast a spotlight on the uneven impacts of public health policy with particular populations or sites targeted for intervention. Perhaps the starkest example in Australia was the ‘hard’ lockdown of nine public... more
COVID-19 responses have cast a spotlight on the uneven impacts of public health policy with particular populations or sites targeted for intervention. Perhaps the starkest example in Australia was the ‘hard’ lockdown of nine public housing complexes in inner-city Melbourne from 4 to 18 July 2020, where residents were fully confined to their homes. These complexes are home to diverse migrant communities and the lockdown drew public criticism for unfairly stigmatising ethnic minorities. This article draws on media articles published during the lockdown and the Victorian Ombudsman’s subsequent investigation to explore the implications of broad, top-down public health measures for culturally and linguistically diverse (CALD) communities. Drawing on Lea’s (2020) conceptualisation of policy ecology, we analyse the lockdown measures and community responses to explore the normative assumptions underpinning health policy mechanisms, constituting ‘target populations’ in narrow, exclusionary terms. We argue that the lockdown measures and use of police as compliance officers positioned tower residents as risky subjects in risky places. Tracing how such subject positions are produced, and resisted at the grassroots level, we highlight how policy instruments are not neutral interventions, but rather instantiate classed and racialised patterns of exclusion, reinforcing pervasive social inequalities in the name of public health.
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Supplemental material, sj-pdf-1-qhr-10.1177_10497323211003543 for The "Be All and End All"? Young People, Online Sexual Health Information, Science and Skepticism by Adrian Farrugia, Andrea Waling, Kiran Pienaar and Suzanne... more
Supplemental material, sj-pdf-1-qhr-10.1177_10497323211003543 for The "Be All and End All"? Young People, Online Sexual Health Information, Science and Skepticism by Adrian Farrugia, Andrea Waling, Kiran Pienaar and Suzanne Fraser in Qualitative Health Research
This thesis examines the politics of HIV/AIDS in South Africa under former president Thabo Mbeki. Often characterised as "AIDS denialism", Mbeki's controversial position on HIV/AIDS incited conflict with South African civil... more
This thesis examines the politics of HIV/AIDS in South Africa under former president Thabo Mbeki. Often characterised as "AIDS denialism", Mbeki's controversial position on HIV/AIDS incited conflict with South African civil society, including prominent local AIDS organisation, the Treatment Action Campaign (TAC). This conflict is typically depicted in scholarly and popular accounts as polarised into dissident/orthodox positions. The thesis questions this familiar depiction, applying new theoretical tools to rethink received accounts of HIV in South Africa. I argue that it is possible to see important continuities, rather than only differences in TAC and the government's views. For example, my analysis reveals that through their pursuit of the "truth" about HIV/AIDS, both TAC and the government constitute the disease as a matter of fact: a stable, immutable object, possessed of intrinsic attributes. The analysis queries this common sense realist enactment ...
Research Interests: Posthumanism, Political Science, Politics, Materialism, Health Citizenship, and 13 moreSocial Studies Of Science, Feminist science and technology studies, Sociology of Health and Illness, Agential Realism, Biological citizenship, Scholarship, Praxiography, Hiv Aids, Feminist Science Studies, Social Studies of Science, Monash, Uncategorized, and Science and Technology Studies
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Research Interests: Psychology, Artificial Intelligence, Addiction, Australia, Sociology of Health, and 14 moreDrugs And Alcohol, Medicine, Affordances, Drug Policy, Alcohol and drug treatment, Chatbots, Psychological Intervention, Affordance, Chatbot, Sociology of Drugs and Alcohol, Counselling, Psychology and Cognitive Sciences, Medical and Health Sciences, and Referral
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ger and more complex stories than cinema can, making it easier to compromise their heroes morally. Still, sociologists may appreciate the way law professors Naomi Mezey and Mark Niles address the organization of television and cinema... more
ger and more complex stories than cinema can, making it easier to compromise their heroes morally. Still, sociologists may appreciate the way law professors Naomi Mezey and Mark Niles address the organization of television and cinema production and distribution as factors that affect the variety of forms of heroism in stories of lawyers and courts. They conclude that television, though much changed by time-shifting viewing technologies, continues to focus on legally upright and victorious agents of the law more than cinema stories do. Farah Britto and co-editor Cecil Greek likewise find that television stories of evil are distinguished by their focus on human, not supernatural, origins and on their willingness to see spiritually possessed characters killed rather than restored to normalcy. The organization of the book may appear to be somewhat arbitrary, in that the sections on American and international film and television do not offer distinct, coherent lessons; and most contributions address reflection theory and humanist appreciation of stirring art as well as ideological uses of it. For instance, Machura affirms the popular reflection theory that national political economies shape films produced within their borders by noting that ‘‘there is a message behind certain national movies at a given period of time’’ (p. 31). The volume likewise remains focused throughout on the social construction of crime and justice by mainstream media, particularly on the truth claims of popular films. Three contributions, including editor Caroline ‘‘Kay’’ Picart’s look at a Soviet antiNazi account of the death camps and Susan Boyd’s review of Canadian anti-drug films, focus on documentary styles. Each scholar shows how films employ interviews, narration, footage of crime scenes, lawenforcement procedural scenes, and elements of changing visual styles to bolster claims to moral as well as factual truth. Historians will value film scholar Matthew Sorrento’s account of U.S. film regulation and the way it shaped ‘‘documentary’’ classification as well as style, leading from early procedurals and films noirs to recent reinvestigations of controversial cases in such landmark documentaries as Errol Morris’s The Thin Blue Line. Lead editor Picart provides an important review of racism in coverage of serial killing, echoing legal scholar Kimberlé Crenshaw’s intersectional concern that the popular stereotype of such killers as white males leaves much victimization of black women unaddressed. Picart reports that racial hoaxes, respectively featuring black and white fictional killers, arise in the same proportions as criminologists’ counts of black and white serial killers. She speculates that the fictions might be based on those facts in some unspecified way. In this instance and overall, contributors state their arguments and leave the testing of hypotheses to readers so inclined. This volume sustains Picart’s theme of the interrelation and blurring of fact, as provided by criminologists, and fiction, as provided by feature film and television drama. Authors comment on the potential for livening classes with stirring scenes of crime and criminal justice or criticism of factual reports as social constructions, of using fiction to theorize aspects of crime that might remain invisible to scientific means of observation. However, though Britto and Greek mention ‘‘holisticcontent approach’’ and Foucauldian discourse analysis, discussion of categorization and coding contributions are few and too vague to contribute to sociologists’ methods of research. The enterprise is more humanist, focused on the value of these movies in livening conversations about our systems of (in)justice.
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As the name 'talk therapy' suggests, a key aim of alcohol and other drug counselling, psychotherapy and other talk therapies is to discuss issues, concerns and feelings with a health professional. Implicit here is the therapeutic value of... more
As the name 'talk therapy' suggests, a key aim of alcohol and other drug counselling, psychotherapy and other talk therapies is to discuss issues, concerns and feelings with a health professional. Implicit here is the therapeutic value of talking through issues with a trained professional. But as with all interactions, therapeutic encounters involve silences and pauses as key aspects of the communicative process. Despite their ubiquity in the therapeutic encounter, research tends to either dismiss silences as inconsequential or as having undesirable effects, such as generating awkwardness or even disengagement from treatment. Drawing on Latour's (2002) concept of 'affordance' and a qualitative study of an Australian alcohol and other drug counselling service, we explore the varied functions of silences in online text-based counselling sessions. For clients, these include the role of silence in affording opportunities to engage in other everyday practices, such as socialising, caregiving or working-practices that can generate comfort and reduce distress, which in turn may support the therapeutic encounter. Similarly, for counsellors, temporal silences provide opportunities to confer with other counsellors and provide tailored care. However, protracted silences can raise concerns about the safety and wellbeing of clients who do not respond promptly or who exit encounters unexpectedly. Similarly, the sudden cessation of online care encounters (often associated with technical difficulties) can leave clients feeling frustrated and confused. In tracking these diverse affordances of silence, we draw attention to its generative potential in care encounters. We conclude by exploring the implications of our analysis for conceptions of care that underpin alcohol and other drug treatment.
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Since the early days of digital media studies, it has been widely understood that trust in digital technologies has been indispensable for the operation of queer communities. Attaining access to _disinhibition_ is central to queer... more
Since the early days of digital media studies, it has been widely understood that trust in digital technologies has been indispensable for the operation of queer communities. Attaining access to _disinhibition_ is central to queer world-making: not only through coming “out”; and dancing at the gay club, but also by chemically altering your state of mind through alcohol and drug consumption. This panel explores queer ‘digital infrastructures of disinhibition’ through a digitally mediated sexual practice that has attracted significant attention over the last decade: ‘chemsex’, when gay and bisexual men use locative social media such as hook-up apps to organise group sex encounters where certain recreational drugs are consumed. Chemsex is a socio-sexual practice that to an overwhelming degree is _constructed_, _negotiated_, _enacted_, _maintained_ and _critiqued_ via digital platforms. Hook-up apps are key to facilitating chemsex encounters because they allow for instant access to near...
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The COVID-19 pandemic has placed sexual relationships into sharp focus as strict containment measures, including physical distancing and 'stay at home' restrictions, were initiated to control the spread of the virus. Governments... more
The COVID-19 pandemic has placed sexual relationships into sharp focus as strict containment measures, including physical distancing and 'stay at home' restrictions, were initiated to control the spread of the virus. Governments in some jurisdictions prevented contact between non-cohabiting sexual partners (except for couples in pre-existing relationships), while community organisations recommended people avoid casual sexual encounters. This article analyses Australian media articles, commentary and public health messages published during March to October 2020 to explore the normative assumptions underpinning these measures. Applying posthumanist perspectives and Warner's (2002) conceptualisation of 'publics', we consider how COVID-19 public health advice enacts the (human) subject of public health as monogamous, coupled, and living with their partner or nuclear family. Those in non-normative relationships and households are not only excluded from this narrow enactment of the 'ideal' public health subject, but are rendered potentially risky disease vectors by virtue of their alternative kinship arrangements. We explore the implications of these findings for the more-than-human relationalities that shape health inequalities and processes of marginalisation during public health crises, and we offer suggestions for public health measures that address the needs of diverse 'publics'.
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In this article, we investigate young people’s trust in online sexual health resources. Analyzing interviews with 37 young people in Australia using Irwin and Michael’s account of science–society relations and Warner’s conceptualization... more
In this article, we investigate young people’s trust in online sexual health resources. Analyzing interviews with 37 young people in Australia using Irwin and Michael’s account of science–society relations and Warner’s conceptualization of “publics,” we explore the processes by which they assess the credibility of online sexual health information. We suggest that when seeking medical information, young people opt for traditionally authoritative online sources that purport to offer “facts.” By contrast, when seeking information about relationships or sexual practices, participants indicated a preference for websites presenting “experiences” rather than or as well as “facts.” Regardless of content, however, our participants approached online sexual health information skeptically and used various techniques to appraise its quality and trustworthiness. We argue that these young people are productively understood as a skeptical public of sexual health. We conclude by exploring the implic...
Research Interests: Psychology, Scepticism, Australia, Medicine, Qualitative Interviews, and 15 moreReproductive health, Sex Education, Credibility, Publics, Human Sexuality Education, Publics and Counterpublics, Qualitative Analysis, Online Information, Science Technology, Conceptualization, Relationships and Sexuality Education, Comprehensive Sexuality Education, Biomedical Social Sciences, Psychology and Cognitive Sciences, and Medical and Health Sciences
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The consumption of drugs has long been a mainstay of urban queer cultures and it is well-recognised that complex connections exist between sexual minoritisation and desires to chemically alter bodily experience. Yet despite evidence that... more
The consumption of drugs has long been a mainstay of urban queer cultures and it is well-recognised that complex connections exist between sexual minoritisation and desires to chemically alter bodily experience. Yet despite evidence that rates of consumption are higher among LGBTQ populations, research exploring the gendered and sexual dynamics of these forms of consumption is limited and tends to frame such consumption as a response to stigma, marginalisation and discrimination. Against this dominant explanatory frame, this article explores the diverse experiences of LGBTQ consumers, and in so doing highlights both the pleasures and benefits of consumption, as well as potential risks and harms. Contributing to the growing body of ontopolitically oriented research that treats the materiality of drugs as emergent and contingent, we trace the ontologies of drugs, sexuality and gender that LGBTQ subjects generate through specific practices of consumption. Our analysis draws on qualitative interviews with 42 self-identified LGBTQ people from an Australian study designed to explore how sexual and gender-diverse minorities pursue particular drug effects to enhance or transform their experience of gender and/or sexuality. Our participants' accounts illuminate how drug consumption materialises in relation to sex, desire and play where it enhances pleasure, facilitates transgression and increases endurance. In the context of gender variance, our findings suggest that drug use can transform gendered experience and enable the expression of non-normative gender identities, in the process challenging gender binarism. By considering the productive role of drugs in enacting queer identities, this article treats drugs as 'technologies of the self' (Foucault 1988) and explores how drug consumption, sex and gender shape each other across a range of settings. We conclude by reflecting on the implications of our findings for research and service provision, and suggest ways of engaging LGBTQ consumers in terms that address their diverse priorities and experiences.
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It is well-established that a high prevalence of substance use is found in lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) populations; a finding that researchers attribute to the stigmatised status of non-normative... more
It is well-established that a high prevalence of substance use is found in lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) populations; a finding that researchers attribute to the stigmatised status of non-normative sexual and gender expression, and the role of illicit drug use in the collective production of socio-sexual pleasures, expressivity and disclosure in LGBTIQ communities. Despite the connections between sexual experimentation and substance use, LGBTIQ consumption practices have rarely received the attention they deserve within the alcohol and other drug (AOD) field. In this paper, we draw on concepts from post-structuralist policy analysis to analyse how AOD consumption among sexual and gender minorities is constituted in the policies of three Australian LGBTIQ health organisations. Following Carol Bacchi's (2009, p. xi) observation that we are "governed through problematisations rather than policies", we consider how substance use in LGBTIQ...
Research Interests: Sociology, Gender Studies, Sexuality, Gender and Sexuality, Drugs and drug culture, and 15 moreDrugs And Alcohol, Health Policy, Medicine, Transgender, Public Policy Analysis, Human Sexuality, Drug Policy, Population, Queer, Lesbian, Normative, WPR approach, Carol Bacchi, Psychology and Cognitive Sciences, and Medical and Health Sciences
Women's "performance and image-enhancing drug consumption" is a growing phenomenon yet remains an under-studied area of research. This essay reviews the existing literature on women's consumption and draws on Fraser's concept of... more
Women's "performance and image-enhancing drug consumption" is a growing phenomenon yet remains an under-studied area of research. This essay reviews the existing literature on women's consumption and draws on Fraser's concept of ontopolitically-oriented research to develop an agenda for future research. Ontopolitically-oriented research applies insights from Science and Technology Studies (STS) to consider the ontological politics of research practices, that is, the realities they enact and foreclose. We argue that the current focus in the existing literature on a limited set of methods and issues risks obscuring the diverse meanings and practices of women's substance consumption for fitness and strength-training, and genders agency in ways that further entrench assumptions of women's vulnerability and passivity. We consider issues pertaining to the nomenclature of performance and image-enhancing drugs, the gendering of agency in formulations of "health" risks and initiation experiences, and the need to understand women's consumption practices in relation to broader cultural changes in health optimization and digital fitness cultures. We argue that ontopolitically-oriented research into women's substance consumption for fitness and strength-training requires greater methodological diversity and attention to the politics of data generation. It should aim to constitute women's experiences through terms, connections and coalitions that expand our understandings of women's agency, and the gendered and social contexts of enhancement practices.
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COVID-19 responses have cast a spotlight on the uneven impacts of public health policy with particular populations or sites targeted for intervention. Perhaps the starkest example in Australia was the ‘hard’ lockdown of nine public... more
COVID-19 responses have cast a spotlight on the uneven impacts of public health policy with particular populations or sites targeted for intervention. Perhaps the starkest example in Australia was the ‘hard’ lockdown of nine public housing complexes in inner-city Melbourne from 4 to 18 July 2020, where residents were fully confined to their homes. These complexes are home to diverse migrant communities and the lockdown drew public criticism for unfairly stigmatising ethnic minorities. This article draws on media articles published during the lockdown and the Victorian Ombudsman’s subsequent investigation to explore the implications of broad, top-down public health measures for culturally and linguistically diverse (CALD) communities. Drawing on Lea’s (2020) conceptualisation of policy ecology, we analyse the lockdown measures and community responses to explore the normative assumptions underpinning health policy mechanisms, constituting ‘target populations’ in narrow, exclusionary terms. We argue that the lockdown measures and use of police as compliance officers positioned tower residents as risky subjects in risky places. Tracing how such subject positions are produced, and resisted at the grassroots level, we highlight how policy instruments are not neutral interventions, but rather instantiate classed and racialised patterns of exclusion, reinforcing pervasive social inequalities in the name of public health.
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Personal narratives of alcohol and other drug addiction circulate widely in popular culture and they also have currency in professional therapeutic settings. Despite this, relatively little research has explored the conventions operating... more
Personal narratives of alcohol and other drug addiction circulate widely in popular culture and they also have currency in professional therapeutic settings. Despite this, relatively little research has explored the conventions operating in these narratives and how they shape people's experiences and identities. While research in this area often proceeds on the premise that addiction biographies are straightforwardly 'true' accounts, in this paper we draw on the insights of critical alcohol and other drug scholarship, and the concept of 'ontological politics' to argue that biographies produce normative ideas about addiction and those said to be experiencing it. Our analysis compares traditional addiction narratives with the biographies we reconstructed from qualitative interviews with 60 people in Australia who describe themselves as having an 'addiction', 'dependence' or drug 'habit'. We track how addiction is variously enacted in these a...
Research Interests: Sociology, Addiction, Drugs And Addiction, Narrative, Politics, and 15 moreQualitative Research, Medicine, Sociology of Health and Illness, Drug Policy, Narration, Humans, Ontological Politics, Female, Male, Normative, Scholarship, Ontological Turn, Science and Technology Studies, Psychology and Cognitive Sciences, and Medical and Health Sciences
Alan Petersen (AP) and Kiran Pienaar (KP): Thank you, David, for agreeing to share your perspectives in this interview. It is a pleasure and honour to have this opportunity to engage with your insights and scholarly contributions on... more
Alan Petersen (AP) and Kiran Pienaar (KP): Thank you, David, for agreeing to share your perspectives in this interview. It is a pleasure and honour to have this opportunity to engage with your insights and scholarly contributions on surveillance medicine and the sociology of diagnosis. Looking back to your early contributions on surveillance medicine, these seem to anticipate recent diagnostic trends. What, if anything, has changed in the interim period?
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Testing—involving the analysis of blood samples or scans, colonoscopies, biopsies, or other procedures—is frequently the front door to healthcare. It often leads to further tests or treatments, perhaps hospitalisation, and sometimes... more
Testing—involving the analysis of blood samples or scans, colonoscopies, biopsies, or other procedures—is frequently the front door to healthcare. It often leads to further tests or treatments, perhaps hospitalisation, and sometimes unwelcome news about one’s future. Consequently, being tested is fraught with meaning and is likely to evoke strong emotional responses in those subject to its regimes, including anxiety, fear and uncertainty. What if the test comes back positive? Should one gain a second opinion? Or confirm the results by undertaking further tests? If it is negative, should one feel relieved and get on with one’s life? While testing promises certainty—providing an objective, unequivocal indicator of an underlying disease or ‘disorder’, or susceptibility to such, and a clear path to treatment and care—it tends to give rise to many uncertainties and questions. In many cases, perhaps most, it calls for further investigation involving a cascade of other tests, which raise t...
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‘Slamsex’ has emerged in gay vernacular in recent years to denote a particular way of taking drugs and a particular kind of sex. Slamming refers in this context to the practice of injecting drugs – typically crystal methamphetamine –... more
‘Slamsex’ has emerged in gay vernacular in recent years to denote a particular way of taking drugs and a particular kind of sex. Slamming refers in this context to the practice of injecting drugs – typically crystal methamphetamine – intravenously. To pair ‘slamming’ with ‘sex’ is to propose that a particular mode of drug administration is constitutive of a particular kind of sex – a relatively novel idea that deserves some unpacking. What does it mean to make a route of drug administration definitional in the delineation of a sexual practice? What does this move reveal about contemporary practices of sex and drug consumption? In this article, we explore these questions with reference to theories of drug effects and practitioners’ accounts of slamsex. We conclude by considering the implications of our analysis for slamsex relations and associated harm reduction measures.
Research Interests: Sociology, Cultural Studies, Gender Studies, Queer Studies, Social Sciences, and 14 moreSexuality, Gay And Lesbian Studies, Drugs and drug culture, Genders and Sexualities, Harm Reduction, Human Sexuality, Injecting Drug Use, Public health systems and services research, Route of Administration, Critical Theories of Drug Use, ChemSex, Sexualities, Methamphetamine Use, and Slamsex
There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation – and not... more
There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation – and not necessarily a problematic one in every instance. Numerous studies have found that infection with HIV and other sexually transmissible infections (STIs) is more likely among gay and men who have sex with men (MSM) who use recreational drugs than those who do not, but the causal nature of these relations is uncertain. Sexualised drug use is associated with a range of other problems, including dependence, mental health issues, accident and overdose. A growing body of work in the Alcohol and Other Drugs (AOD) field demonstrates the action of drugs and their purported effects to be a product of their relations with various other actors, contexts and practices. Given these contingencies, it is impossible to predict the future of drugs or their effect on the ...
Research Interests: Queer Studies, Drugs And Addiction, Gender and Sexuality, Surveillance Studies, Drugs and drug culture, and 15 morePleasure, Risk Taking, Sexual Health, Medicine, Harm Reduction, Antiretroviral Therapy, Smartphones, Men who have Sex with Men, Hiv Aids, Public health systems and services research, Sociology of Drugs and Alcohol, ChemSex, Hookup Culture, Science and Technology Studies, and Medical and Health Sciences
Associated with social and individual harm, loss of control and destructive behaviour, addiction is widely considered to be a major social problem. Most models of addiction, including the influential disease model, rely on the... more
Associated with social and individual harm, loss of control and destructive behaviour, addiction is widely considered to be a major social problem. Most models of addiction, including the influential disease model, rely on the volition/compulsion binary, conceptualising addiction as a disorder of compulsion. In order to interrogate this prevailing view, this article draws on qualitative data from interviews with people who describe themselves as having an alcohol or other drug ‘addiction’, ‘dependence’ or ‘habit’. Applying the concept of ‘diffraction’ elaborated by science studies scholar Karen Barad, we examine the process of ‘addicting’, or the various ways in which addiction is constituted, in accounts of daily life with regular alcohol and other drug use. Our analysis suggests not only that personal accounts of addiction exceed the absolute opposition of volition/compulsion but also that the polarising assumptions of existing addicting discourses produce many of the negative eff...
Research Interests: Critical Theory, Discourse Analysis, Sociology, Addiction, Qualitative Research, and 15 moreHealth, Medicine, Narratives, Humans, Alcoholism, Female, Male, New Materialisms, Middle Aged, Adult, Illness Experience, Critical Addiction Studies, Sociology of Drugs and Alcohol, Substance-Related Disorders, and Science and Technology Studies
Research Interests: Social Change, Public Opinion, South African Politics and Society, Health Policy, Policy Analysis, and 12 moreDrug Policy, Social Stigma, Policy making, South Africa, Humans, Alcohol Drinking, Alcohol and other drugs, Social Marginalization, Elsevier, Substance-Related Disorders, Psychology and Cognitive Sciences, and Medical and Health Sciences
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This article critically analyses biological citizenship in terms of how it instates an ideal human subject drawn expressly from Western liberal discourse. Through an analysis of health promotion booklets directed at people living with HIV... more
This article critically analyses biological citizenship in terms of how it instates an ideal human subject drawn expressly from Western liberal discourse. Through an analysis of health promotion booklets directed at people living with HIV in South Africa, it reveals how regimes of biological citizenship valorise individual responsibility, agency and rationality, all attributes of the human imagined by liberal humanism. Drawing on insights from posthumanist scholarship, I argue that perceived failure to perform these attributes can operate to disqualify certain marginalised HIV-positive subjects from full citizenship. Far from immaterial, attributions of citizenship have material implications for access to human rights, including the right to life-saving treatment. Importantly, they also shape HIV/AIDS, producing two qualitatively different ontologies of disease: (i) a chronic, manageable illness for those who qualify as citizens; and (ii) a life-threatening, debilitating one for those denied full citizenship and who therefore cannot access the rights and rewards attendant on it.
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Within the expansive qualitative literature on alcohol and other drug (AOD) use, knowledge of lived experiences of AOD addiction is limited. Much of the existing scholarship reifies addiction as a calamitous state, and pathologises those... more
Within the expansive qualitative literature on alcohol and other drug (AOD) use, knowledge of lived experiences of AOD addiction is limited. Much of the existing scholarship reifies addiction as a calamitous state, and pathologises those believed to be experiencing it. Such research discounts the many ways people live with regular AOD use and is unable to tell us much about how addiction emerges through, rather than precedes, people’s experiences and understandings of it. This article draws on the theoretical literature on the production of social problems and the concept of “ontological politics” to introduce an innovative approach to understanding lived experiences of AOD addiction. Applying this literature to a critical analysis of personal narratives from two Australian AOD websites, we demonstrate how addiction is conceived narrowly in these narratives as a disorder of compulsion, amenable to treatment. Not only does this conception reproduce unhelpful assumptions about addiction, it also reifies it as a stable, unified entity, the boundaries of which are fixed. Against this familiar account, we conceive addiction as an emergent, fiercely contested phenomenon, constituted in part through the very measures designed to treat it. This shift in focus allows an innovation in engaging with addiction, which is being pursued in a new Australian research project: the development of a public website presenting lived experiences of addiction that will be (1) a means of challenging existing public discourses, and (2) an intervention in the social production of addiction. The article concludes by considering the politics of this approach and how it might reshape addiction.
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The Oprah Winfrey Show is widely recognised as the leading television talk show worldwide (Garson, 2004) and its appeal lies in its exploration of issues which have universal currency, such as relationship problems, gender-based violence... more
The Oprah Winfrey Show is widely recognised as the leading television talk show
worldwide (Garson, 2004) and its appeal lies in its exploration of issues which have universal currency, such as relationship problems, gender-based violence and stories of survival. The Oprah Winfrey Show exploits the television talk show as a forum for public therapy where ordinary people and celebrities alike divulge their problems, successes and the intimate details of their private lives (Marshall, n.d.). In an attempt to understand how Winfrey has blurred the boundaries between public and private to create a modern-day public confessional, this paper explores a recurring theme on the show, the theme of suffering as it is exemplified in discourses used by guests, by Winfrey herself and by viewers. The study uses the APPRAISAL system (Martin & Rose,
2003) to analyse how the attitudinal language of the talk show constructs an identifiable victim whose narrative centres on overcoming suffering. The analysis reveals that expressions of Affect, Judgement and Appreciation are powerful mechanisms for legitimising the identity of the suffering victim. This paper argues that The Oprah Winfrey Show capitalises on the universality of suffering to promote therapeutic self-help for everyone, both ‘suffering victims’ (the guests on the talk show)
and ‘potential victims’ (the viewers).
worldwide (Garson, 2004) and its appeal lies in its exploration of issues which have universal currency, such as relationship problems, gender-based violence and stories of survival. The Oprah Winfrey Show exploits the television talk show as a forum for public therapy where ordinary people and celebrities alike divulge their problems, successes and the intimate details of their private lives (Marshall, n.d.). In an attempt to understand how Winfrey has blurred the boundaries between public and private to create a modern-day public confessional, this paper explores a recurring theme on the show, the theme of suffering as it is exemplified in discourses used by guests, by Winfrey herself and by viewers. The study uses the APPRAISAL system (Martin & Rose,
2003) to analyse how the attitudinal language of the talk show constructs an identifiable victim whose narrative centres on overcoming suffering. The analysis reveals that expressions of Affect, Judgement and Appreciation are powerful mechanisms for legitimising the identity of the suffering victim. This paper argues that The Oprah Winfrey Show capitalises on the universality of suffering to promote therapeutic self-help for everyone, both ‘suffering victims’ (the guests on the talk show)
and ‘potential victims’ (the viewers).
Research Interests: Sociology and Linguistics
Research Interests:
Definitions of addiction have never been more hotly contested. The advance of neuroscientific accounts has not only placed into public awareness a highly controversial explanatory approach, it has also shed new light on the absence of... more
Definitions of addiction have never been more hotly contested. The advance of neuroscientific accounts has not only placed into public awareness a highly controversial explanatory approach, it has also shed new light on the absence of agreement among the many experts who contest it. Proponents argue that calling addiction a 'brain disease' is important because it is destigmatising. Many critics of the neuroscientific approach also agree on this point. Considered from the point of view of the sociology of health and illness, the idea that labelling something a disease will alleviate stigma is a surprising one. Disease, as demonstrated in that field of research, is routinely stigmatised. In this article we take up the issue of stigma as it plays out in relation to addiction, seeking to clarify and challenge the claims made about the progress associated with disease models. To do so, we draw on Erving Goffman's classic work on stigma, reconsidering it in light of more recen...
Research Interests: Neuroscience, Sociology, Addiction, Stigma, Politics, and 15 morePerformativity, Australia, Qualitative Research, Biopower, Medicine, Drug Policy, Social Stigma, Humans, Female, Male, Critical Addiction Studies, Sociology of Drugs and Alcohol, Substance-Related Disorders, Psychology and Cognitive Sciences, and Medical and Health Sciences
Kiran Pienaar (KP) and Alan Petersen (AP): Thank you, Annemarie, for agreeing to share your perspectives in this interview. We are delighted to have this opportunity to engage with your insights and scholarly contributions on the... more
Kiran Pienaar (KP) and Alan Petersen (AP): Thank you, Annemarie, for agreeing to share your perspectives in this interview. We are delighted to have this opportunity to engage with your insights and scholarly contributions on the sociology of diagnosis. In 2011 you co-edited a special issue of Social Science and Medicine entitled ‘Toward a Sociology of Diagnosis’ in which you called for sociologists to pay more attention to medical diagnosis as a central practice and classification tool of medicine. In the introduction, you note that ‘diagnosis has had an absent presence in the sociology of health and illness’ (Jutel & Nettleton, 2011, p. 793). Do you think this is still the case or has the field developed since then to attend more closely to the social issues and processes at work in diagnosis? In your view, does diagnosis merit continued/renewed sociological attention? And if so, why?
The discrimination faced by people understood to have alcohol or other drug addictions has been the subject of extensive research, with many studies documenting experiences of stigma within healthcare services. Building on this... more
The discrimination faced by people understood to have alcohol or other drug addictions has been the subject of extensive research, with many studies documenting experiences of stigma within healthcare services. Building on this literature, we examine the role of stigma in shaping the healthcare expectations of people
seen as affected by alcohol and other drug addictions. Our analysis draws on recent theorisations of stigma as a process of social production to analyse in-depth, qualitative interviews with 20 people who had recently attended an inpatient withdrawal management service. Participants describe as exceptional forms of care that are often taken for granted by other members of the community. We argue that routinised experiences of discrimination work to constitute basic care as exceptional. This finding is significant for two reasons: (1) people who consume alcohol and other drugs often have complex healthcare needs and already encounter obstacles to accessing the care they need, and (2) by positioning people who consume drugs outside the purview of healthcare, this dynamic obstructs their fundamental
right to care. We conclude by reflecting on the implications of these findings for those who are often positioned as not entitled to high quality healthcare.
seen as affected by alcohol and other drug addictions. Our analysis draws on recent theorisations of stigma as a process of social production to analyse in-depth, qualitative interviews with 20 people who had recently attended an inpatient withdrawal management service. Participants describe as exceptional forms of care that are often taken for granted by other members of the community. We argue that routinised experiences of discrimination work to constitute basic care as exceptional. This finding is significant for two reasons: (1) people who consume alcohol and other drugs often have complex healthcare needs and already encounter obstacles to accessing the care they need, and (2) by positioning people who consume drugs outside the purview of healthcare, this dynamic obstructs their fundamental
right to care. We conclude by reflecting on the implications of these findings for those who are often positioned as not entitled to high quality healthcare.
Research Interests:
Diagnosis is pivotal to medicine's epistemic system: it serves to explain individual symptoms, classify them into recognizable conditions and determine their prognosis and treatment. Medical tests, or investigative procedures for... more
Diagnosis is pivotal to medicine's epistemic system: it serves to explain individual symptoms, classify them into recognizable conditions and determine their prognosis and treatment. Medical tests, or investigative procedures for detecting and monitoring disease, play a central role in diagnosis. While testing promises diagnostic certainty or a definitive risk assessment, it often produces uncertainties and new questions which call for yet further tests. In short, testing, regardless of its specific application, is imbued with meaning and emotionally fraught. In this article, we explore individuals' ambivalent experiences of testing as they search for diagnostic certainty, and the anxieties and frustrations of those for whom it remains elusive. Combining insights from sociological work on ambivalence and the biopolitics of health, and drawing on qualitative interviews with Australian healthcare recipients who have undergone testing in the context of clinical practice, we argue that these experiences are explicable in light of the contradictory impulses and tensions associated with what we term ‘bio-subjectification’. We consider the implications of our analysis in light of the development of new tests that produce ever finer delineations between healthy and diseased populations, concluding that their use will likely multiply uncertainties and heighten rather than lessen anxieties.
Research Interests:
Medical testing promises to establish certainty by providing a definitive assessment of risk or diagnosis. But can those who rely on tests to offer advice or make clinical decisions be assured of this certainty? This article examines how... more
Medical testing promises to establish certainty by providing a definitive assessment of risk or diagnosis. But can those who rely on tests to offer advice or make clinical decisions be assured of this certainty? This article examines how Australian health professionals, namely clinicians, microbiologists, specialist physicians and health policymakers, delineate the boundary between certainty and uncertainty in their accounts of medical testing. Applying concepts from science and technology studies, and drawing on qualitative data from a sociological study of testing in Australian healthcare, we consider how professionals ascribe meaning to testing and test results. As we argue, for these health professionals, the ‘evidence’ that testing generates has ambiguous ontological significance: while it promises to provide diagnostic certainty and clear direction for advice or treatment, it also generates uncertainties that may lead to yet further tests. Our analysis leads us to question a key premise of testing, namely that it is possible to establish certainty in medical practice via the measurement of individual health risks and disease markers. Against this dominant view, the responses of the health professionals in our study suggest that uncertainty is intrinsic to testing due to the constantly changing, unstable character of ‘evidence’. We conclude by considering the implications of our analysis in light of healthcare’s increasing reliance on sophisticated technologies of ‘personalised’ testing using genetic information and data analytics.
Research Interests:
Many countries, including Australia, the United Kingdom and the United States have established national screening programs in the effort to advance the early diagnosis of cancers. Australia has population screening programs for breast,... more
Many countries, including Australia, the United Kingdom and the United States have established national screening programs in the effort to advance the early diagnosis of cancers. Australia has population screening programs for breast, bowel and cervical cancers, and this article focuses on breast and cervical cancer screening as the two longest running programs in Australia. While these screening programs are well-established and report relatively high participation rates, the effectiveness of population screening is a contested issue, subject to significant, ongoing debate about its purported benefits (Armstrong, 2019). In this article, we draw on ideas from sociology of science on the construction of scientific facts to analyse how evidentiary claims are presented in policy documents for Australia's breast and cervical cancer screening programs, and the implications for those who are the targets of screening. We explore how screening-related information assumes the status of scientific ‘facts’, and argue that presenting information as neutral and objective obscures the political choices involved in its generation. Importantly, some of the claims presented in the policy documents have a tendency to emphasise the benefits, and minimise the risks and harms of population-based screening. In doing so, we suggest that the current national policies may be contributing to sustaining expectations of screening that are higher than warranted. Higher expectations may bring with them unintended societal and economic costs to the public. We conclude by noting how deeply ingrained socio-cultural meanings of cancer shape public expectations of the protective value of screening, which allows current screening approaches to become further entrenched and resistant to challenge.
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Associated with social and individual harm, loss of control and destructive behaviour, addiction is widely considered to be a major social problem. Most models of addiction, including the influential disease model, rely on the... more
Associated with social and individual harm, loss of control and destructive behaviour, addiction is widely considered to be a major social problem. Most models of addiction, including the influential disease model, rely on the volition/compulsion binary, conceptualising addiction as a disorder of compulsion. In order to interrogate this prevailing view, this article draws on qualitative data from interviews with people who describe themselves as having an alcohol or other drug ‘habit’, ‘dependence’ or ‘addiction’. Applying the concept of ‘diffraction’ elaborated by science studies scholar Karen Barad, we examine the process of ‘addicting’, or the various ways in which addiction is constituted, in accounts of daily life with regular alcohol and other drug use. Our analysis suggests not only that personal accounts of addiction exceed the absolute opposition of volition/compulsion, but also that the polarising assumptions of existing addicting discourses produce many of the negative effects typically attributed to the ‘disease of addiction’.
Research Interests:
Addiction is generally understood to be characterised by a persistent pattern of regular, heavy alcohol and other drug consumption. Current models of addiction tend to locate the causes of these patterns within the body or brain of the... more
Addiction is generally understood to be characterised by a persistent pattern of regular, heavy alcohol and other drug consumption. Current models of addiction tend to locate the causes of these patterns within the body or brain of the individual, sidelining relational and contextual factors. Where space and place are acknowledged as key factors contributing to consumption, they tend to be conceived of as static or fixed, which limits their ability to account for the fluid production and modulation of consumption patterns over time. In this article we query individualised and decontextualised understandings of the causes of consumption patterns through an analysis of accounts of residential relocation from interviews undertaken for a large research project on experiences of addiction in Australia. In conducting our analysis we conceptualise alcohol and other drug consumption patterns using Karen Barad’s notions of intra-action and spatio-temporality, which allow for greater attention to be paid to the spatial and temporal dimensions of the material and social processes involved in generating consumption patterns. Drawing on 60 in-depth interviews conducted with people who self-identified as experiencing an alcohol and other drug addiction, dependence or habit, our analysis focuses on the ways in which participant accounts of moving enacted space and time as significant factors in how patterns of consumption were generated, disrupted and maintained. Our analysis explores how consumption patterns arose within highly localised relations, demonstrating the need for understandings of consumption patterns that acknowledge the indivisibility of space and time in their production. In concluding, we argue for a move away from static conceptions of place towards a more dynamic conception of spatio-temporality, and suggest the need to consider avenues for more effectively integrating place and time into strategies for generating preferred consumption patterns and initiating and sustaining change where desired.
