As global health institutions and aid donors expanded HIV treatment throughout Africa, they rapidly ""scaled up"" programs, projects, and organizations meant to address HIV and AIDS. Yet these efforts did not simply have biological effects: in addition to extending lives and preventing further infections, treatment scale-up initiated remarkable political and social shifts. In Lesotho, which has the world's second highest HIV prevalence, HIV treatment has had unintentional but pervasive political costs, distancing citizens from the government, fostering distrust of health programs, and disrupting the social contract. Based on ethnographic observation between 2008 and 2014, this book chillingly anticipates the political violence and instability that swept through Lesotho in 2014. This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.

As global health institutions and aid donors expanded HIV treatment throughout Africa, they rapidly ""scaled up"" programs, projects, and organizations meant to address HIV and AIDS. Yet these efforts did not simply have biological effects: in addition to extending lives and preventing further infections, treatment scale-up initiated remarkable political and social shifts. In Lesotho, which has the world's second highest HIV prevalence, HIV treatment has had unintentional but pervasive political costs, distancing citizens from the government, fostering distrust of health programs, and disrupting the social contract. Based on ethnographic observation between 2008 and 2014, this book chillingly anticipates the political violence and instability that swept through Lesotho in 2014. This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.

Telling the story of a clinical trial testing an innovative gel designed to prevent women from contracting HIV, Negotiating Pharmaceutical Uncertainty provides new insight into the complex and contradictory relationship between medical researchers and their subjects. Although clinical trials attempt to control and monitor participants' bodies, Saethre and Stadler argue that the inherent uncertainty of medical testing can create unanticipated opportunities for women to exercise control over their health, sexuality, and social relationships. Combining a critical analysis of the social production of biomedical knowledge and technologies with a detailed ethnography of the lives of female South African trial participants, this book brings to light issues of economic insecurity, racial disparities, and spiritual insecurities of Johannesburg's townships. Built on a series of tales ranging from strategy sessions at the National Institutes of Health to witchcraft accusations against the trial, Negotiating Pharmaceutical Uncertainty illuminates the everyday social lives of clinical trials. As embedded anthropologists, Saethre and Stadler provide a unique and nuanced perspective of the reality of a clinical trial that is often hidden from view.