4 - Of Remedies and Poisons: Recreational Use of Antiretroviral Drugs in the Social Imagination of South African Carers
African Sociological Review,
Vol. 14 No. 2 (2010): African Sociological Review
Abstract
During an ethnographic study of barriers to, and compliance with, antiretroviral (ARv) treat- ment
in the South Africa’s West Coast region, our team came across a general sense amongst heath careproviders that there was a lively illicit trade in antiretroviral medications. in itself, this is
seen to be a barrier to adherence for many of their patients whose medication is traded to, or
stolen by, drug dealers. independent anecdotal evidence is emerging about this trade, though there has been little hard data verifying the existence of a recreational market for ARvs. While there are rumours that efavirenz (some of whose side effects are hallucinogenic) is being used in the manufacture of crystal methamphetamine (locally ‘tik’), such reports, in themselves, do not seem able to explain the ubiquity (and the confidence) of the belief in this trade amongst the health care providers with whom we have interacted. This paper explores aspects of the off-label trade of ARvs (as we have come to know it) and, as importantly, how rumor and knowledge of this trade has gained increasing currency in the social imagination of health and social care workers. This, we argue, could precipitate a real crisis in the Government’s public rollout programme.
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- Cespedes MS, Aberg JA., 2006 Neuropsychiatric complications of antiretroviral therapy. Drug Safety. 29(10):865-74.
- Christens BD, Hanlin CE, Speer PW., 2007. Getting the social organism thinking: strategy for systems change. American Journal of Community Psychology. 39:229-238
- Derrida,J., 1981. [1970] Plato’s Pharmacy. In Dissemination. [Trans Barbara Johnson].Chicago: Chicago University Press.
- Department of Health., 2010. South African Antiretroviral Treatment Guidelines. Department of Health, Republic of South Africa.
- Hasse B, Günthard HF, Bleiber G, Krause M., 2005.Efavirenz intoxication due to slow hepatic metabolism. Clinical infectious Diseases. 2005 Feb 1:40(3):e22-3.
- Lewin SA, Babigumira SM, Glenton C, Daniels K, Bosch-Capblanch X, van Wyk BE, Odgaard-Jensen J, Johansen M, Aja G, Zwarenstein M & Scheel I., 2010. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD004015. DOI:10.1002/14651858.CD003541.pu b3.
- Lehmann U, Sanders D., 2007. Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Geneva: Evidence and Information for Policy, Department of Human Resources for Health, World Health Organization.
- Lowenhaupt EA, Matson K, Qureishi B, Saitoh A, Pugatch D., 2007. Psychosis in a 12-year-old HIV-positive girl with an increased serum concentration of efavirenz. Clinical infectious Diseases. Nov 15:45(10):e128-30.
- Martin, E. 2006., The pharmaceutical person. Biosocieties 1(3) 273-287.
- Marwaha, A. 2008., Getting high on hiv Drugs in S Africa. BBC News http://news.bbc.co.uk /2/hi/7768059.stm (last accessed September 13th 2010.
- Mdluli, A., Ward. B., & Whitehorn, D., 2010 Whoonga drug spreads rapidly. In The Mercury, June 21st 2010.
- Mills, C. W., 1959. The sociological imagination. New York: Oxford University Press.
- Prince, N., 2008 Children Smoking ARvs. In Cape Argus, May 20th 2010.
- Taylor, C., 2004. Modern Social Imaginaries. Durham & London: Duke University Press. www.statssa.gov.za/keyindicators/QLFS (accessed 11.9.201).
References
Cespedes MS, Aberg JA., 2006 Neuropsychiatric complications of antiretroviral therapy. Drug Safety. 29(10):865-74.
Christens BD, Hanlin CE, Speer PW., 2007. Getting the social organism thinking: strategy for systems change. American Journal of Community Psychology. 39:229-238
Derrida,J., 1981. [1970] Plato’s Pharmacy. In Dissemination. [Trans Barbara Johnson].Chicago: Chicago University Press.
Department of Health., 2010. South African Antiretroviral Treatment Guidelines. Department of Health, Republic of South Africa.
Hasse B, Günthard HF, Bleiber G, Krause M., 2005.Efavirenz intoxication due to slow hepatic metabolism. Clinical infectious Diseases. 2005 Feb 1:40(3):e22-3.
Lewin SA, Babigumira SM, Glenton C, Daniels K, Bosch-Capblanch X, van Wyk BE, Odgaard-Jensen J, Johansen M, Aja G, Zwarenstein M & Scheel I., 2010. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD004015. DOI:10.1002/14651858.CD003541.pu b3.
Lehmann U, Sanders D., 2007. Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Geneva: Evidence and Information for Policy, Department of Human Resources for Health, World Health Organization.
Lowenhaupt EA, Matson K, Qureishi B, Saitoh A, Pugatch D., 2007. Psychosis in a 12-year-old HIV-positive girl with an increased serum concentration of efavirenz. Clinical infectious Diseases. Nov 15:45(10):e128-30.
Martin, E. 2006., The pharmaceutical person. Biosocieties 1(3) 273-287.
Marwaha, A. 2008., Getting high on hiv Drugs in S Africa. BBC News http://news.bbc.co.uk /2/hi/7768059.stm (last accessed September 13th 2010.
Mdluli, A., Ward. B., & Whitehorn, D., 2010 Whoonga drug spreads rapidly. In The Mercury, June 21st 2010.
Mills, C. W., 1959. The sociological imagination. New York: Oxford University Press.
Prince, N., 2008 Children Smoking ARvs. In Cape Argus, May 20th 2010.
Taylor, C., 2004. Modern Social Imaginaries. Durham & London: Duke University Press. www.statssa.gov.za/keyindicators/QLFS (accessed 11.9.201).