Impure Science: AIDS, Activism, and the Politics of Knowledge
In the short, turbulent history of AIDS research and treatment, the boundaries between scientist insiders and lay outsiders have been crisscrossed to a degree never before seen in medical history. Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles."
Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH–sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties.
Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists.
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Analyzing AIDS Controversies
The Plan of the Book
Some Intellectual Debts
THE POLITICS OF CAUSATION
THE NATURE OF A NEW THREAT
Lifestyle vs Virus 19821983
POINTS OF DEPARTURE
Clinical Trials Take Center Stage 19861987
DRUGS INTO BODIES
A KnowledgeEmpowered Movement A LAB OF ONES OWN
THE CRITIQUE OF PURE SCIENCE
Activism and the Manufacture of Knowledge 19891991
DILEMMAS AND DIVISIONS IN SCIENCE AND POLITICS
Inside and Outside the System
The Triumph of Retrovirology 19821984
HIV AND THE CONSOLIDATION OF CERTAINTY
HIV as Obligatory Passage Point
REOPENING THE CAUSATION CONTROVERSY
RED FLAGS AT THE ACADEMY
THE DEBATE THAT WOULDNT DIE
Whither the Controversy? 19921993
Causation and Credibility
THE POLITICS OF TREATMENT
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ACTG AIDS activism AIDS activists AIDS Drug AIDS movement AIDS patients AIDS research AIDS Treatment AIDS virus Altman analysis Anthony Fauci antibodies antiviral approval April argued biomedical cancer causation controversy cause of AIDS Celia Farber cells clinical trials conference credibility David debate disease dissenters doctors Donald Abrams England Journal etiology expertise experts Fauci Gallo gay communities Gina Kolata groups hemophilia HIV infection homosexual HTLV HTLV-III immune system Immunodeficiency interview by author issue Kaposi's sarcoma knowledge Koch's postulates lesbian mainstream Mark Harrington Martin Delaney ment Montagnier NIAID opportunistic infections participants percent Peter Duesberg placebo political Press Project Inform question quote retrovirus risk Robert Gallo role San Francisco Science scientists sexual social movements Sonnabend strategies surrogate marker syndrome T-cell tape recording theory therapy tion treatment activists Univ unqualified reference viral virus viruses York Native Zidovudine