A Conversation with Paul Farmer

TAPS Seminar
Center for AIDS Prevention Studies, March 21, 2000
Hosted by Dan Ciccarone, MD, MPH,
Post-doctoral fellow at CAPS

...PF:...So it's not enough to say, "It's poverty, man."  It is, but 
it's also poverty cheek and jowl by wealth -- or lack of poverty.  In 
other words, the steeper the grade of social inequality, the more 
risk for HIV.  Now, when we started writing about this in the 80's it 
struck people -- I have witnesses in the room -- it struck people as 
peculiar.  In fact, we were talking about -- and this gets back to 
the question about sub groups in San Francisco -- I made this 
hypothesis publicly on a number of occasions.  If you could remove 
gender inequality and social inequality from a sexual relationship, 
you significantly diminish HIV risks.  And of course that hypothesis 
leads to all sorts of social commentary about arrangements and sexual 
union.  Now it doesn't remove HIV risk, but it allows the possibility 
of the introduction of effective preventive techniques that we know 
are virtually 99 per cent effective, and almost 100 per cent 
effective, if they can be used properly.  And the point of my last 
talk here was: but they can't and they aren't and they won't be. The 
technologies that we have are men centered.  They're used by men. 
And the central part of the problem here is gender inequality and 
poverty and social inequality, all three of them conspiring together 
to increase risk....

<http://HIVInSite.ucsf.edu/social/spotlight/2098.4700.html>

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