ORCID Profile
0000-0003-4770-7882
Current Organisation
Deakin University
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Publisher: Elsevier BV
Date: 06-2023
Publisher: Wiley
Date: 08-2023
Abstract: 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.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.SOCSCIMED.2019.05.020
Abstract: 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.
Publisher: Informa UK Limited
Date: 16-11-2017
Publisher: Informa UK Limited
Date: 10-08-2020
Publisher: Wiley
Date: 29-10-2022
Abstract: Diagnosis is pivotal to medicine's epistemic system: it serves to explain in idual 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 in iduals' 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.
Publisher: SAGE Publications
Date: 17-01-2021
Abstract: ‘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 meth hetamine – 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.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.DRUGPO.2017.05.024
Abstract: 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 in idual, 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 in idualised 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 in isibility 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.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH16080
Abstract: 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 sexual health of gay and MSM with any degree of certainty. This article outlines some of the conditions most likely to mediate such futures in the medium term. Public funding for lesbian, gay, bisexual, transgender and queer drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.
Publisher: Springer Science and Business Media LLC
Date: 12-08-2015
DOI: 10.1057/STH.2015.26
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.DRUGPO.2015.12.013
Abstract: The strong symbolic value of illicit drug use makes it a contested issue, which attracts mixed public opinion, intense media attention and close political scrutiny. This means that the formulation of plausible, authoritative policies governing illicit drugs must navigate fraught political terrain. In a country like South Africa with its long unique history of institutionalised oppression of the black majority, the issues confronting drug policy are particularly complex and the need for carefully formulated policy responses especially urgent. Yet despite this, the area of drug policy development in South Africa has received little scholarly attention to date. This paper explores the complexities of policymaking in the South African context by drawing on feminist scholar Carol Bacchi's poststructuralist approach to policy analysis, which focuses on how policy helps to produce the problems it purports to solve. Taking as its empirical focus, South Africa's current drug policy, the third National Drug Master Plan (NDMP), 2013-2017, the paper analyses how the policy constitutes the 'problem of alcohol and other drugs' (AODs). We identify three central policy proposals through which specific problematisations emerge: (1) the proposal that drug use is a global issue requiring a coordinated policy response, (2) appeals to evidence-based policy proposals and (3) the proposal that AOD 'use' and 'abuse' be treated interchangeably. We suggest that these proposals reveal a tendency towards inflating the 'problem of AODs' and thus work to justify punitive policy measures. In an effort to explore the implications of particular problematisations for effecting social change, we clarify the ways in which the policy may work to undermine the interests of those it seeks to aid by reinforcing stigma and marginalisation.
Publisher: SAGE Publications
Date: 09-02-2023
DOI: 10.1177/00914509231154938
Abstract: 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 erse 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 ersity 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.
Publisher: Springer International Publishing
Date: 2020
Publisher: Informa UK Limited
Date: 29-10-0002
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.DRUGPO.2018.01.008
Abstract: 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 populations has been formulated as a policy problem requiring intervention. Doing so allows us to identify the normative assumptions about minority sexual and gender identities that underpin dominant problematisations of LGBTIQ substance use. These include: a) high rates of AOD use in LGBTIQ populations constitute problems in and of themselves, regardless of in idual patterns of use b) LGBTIQ people are a vulnerable population with specialised needs and c) sexualised drug use is associated with "disinhibition" and a range of risks (including HIV transmission, drug dependence and mental health issues). Addressing the implications of these assumptions for how LGBTIQ communities are governed, we suggest that problematisation is an embodied, situated process, and that there is much to be gained by reframing dominant problematisations of AOD consumption so that this process is better informed by the inventive practices of LGBTIQ consumers themselves.
Publisher: Springer Science and Business Media LLC
Date: 19-12-2015
DOI: 10.1007/S10912-015-9369-X
Abstract: While it is well-established that poverty and disease are intimately connected, the nature of this connection and the role of poverty in disease causation remains contested in scientific and social studies of disease. Using the case of HIV/AIDS in South Africa and drawing on a theoretically grounded analysis, this paper reconceptualises disease and poverty as ontologically entangled. In the context of the South African HIV epidemic, this rethinking of the poverty-disease dynamic enables an account of how social forces such as poverty become embodied in the very substance of disease to produce ontologies of HIV/AIDS unique to South Africa.
Publisher: Informa UK Limited
Date: 02-08-2021
Publisher: Informa UK Limited
Date: 06-05-2015
Publisher: SAGE Publications
Date: 21-04-2021
DOI: 10.1177/10497323211003543
Abstract: 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 implications of our analysis for the provision of online sexual health information.
Publisher: SAGE Publications
Date: 03-2021
Abstract: 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?
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.DRUGPO.2017.05.011
Abstract: 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 accounts and comment on the effects of particular enactments. By attending to the ways in which people cope, even thrive, with the kind of consumption that would attract a diagnosis of addiction or dependence, the biographies we produced disrupt the classic narrative of increasing drug use, decline and eventual collapse. Doing so allows for consideration of the benefits of consumption, as well as the ways that people carefully regulate it to minimise harms. It also constitutes in iduals as active in managing consumption-an important move that challenges dominant understandings of addiction as a disorder of compulsivity. We conclude by considering the implications of our attempt to provide an alternative range of narratives, which resonate with people's erse experiences.
Publisher: SAGE Publications
Date: 03-2021
Abstract: 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?
Publisher: Informa UK Limited
Date: 12-2008
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.DRUGPO.2017.01.013
Abstract: Critical analyses of drug use and 'addiction' have identified a series of binary oppositions between addiction and free will, independence, self-control, responsibility, productivity and autonomy. This critical work has also examined how science, policy and popular discourses frequently characterise addiction as antithetical to health and well-being. Furthermore, those diagnosed with addiction are often understood as indifferent to health and well-being, or as lacking the knowledge or desire required to maintain them. In this article, we draw on data from 60 qualitative interviews with people who self-identify as living with an 'addiction', 'dependence' or 'habit', to argue that the binary opposition between addiction and health struggles to attend to their rich and varied health perspectives and experiences. We explore three themes in the interview data: reinscribing the binary opposition between addiction and health/well-being strategies for maintaining health and well-being alongside addiction and alcohol and other drug consumption as aiding health and well-being. Perhaps because addiction and health have been so thoroughly understood as antithetical, such perspectives and experiences have received surprisingly little research and policy attention. Yet they offer fertile ground for rethinking the strengths and capacities of those who self-identity as living with an addiction, dependence or habit, as well as untapped resources for responding to the harm sometimes associated with alcohol and other drug use.
Publisher: SAGE Publications
Date: 03-02-2021
Publisher: SAGE Publications
Date: 18-03-2021
Abstract: 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 in idual 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.
Publisher: Informa UK Limited
Date: 09-07-2021
Publisher: Elsevier BV
Date: 04-2020
Publisher: Springer Science and Business Media LLC
Date: 19-03-2014
DOI: 10.1057/STH.2014.1
Start Date: 2018
End Date: 2019
Funder: Monash University
View Funded ActivityStart Date: 2022
End Date: 2022
Funder: Deakin University
View Funded ActivityStart Date: 2017
End Date: 2021
Funder: Australian Research Council
View Funded Activity