Article ID: CBB510383345

Foreskin and the molecular politics of risk (October 2017)

unapi

In this paper, I examine disputes over recent claims that male circumcision reduces HIV risk to suggest a complicated relationship between risk individualization and categorization. Whereas randomized controlled trials (RCTs) conducted in sub-Saharan Africa appear to have provided key evidence for the World Health Organization’s endorsement of male circumcision as an HIV prevention strategy, RCTs alone did not provide evidence for the underlying causal mechanism. For that, medical authorities have turned to histo-immunological studies of the foreskin’s biomolecular vulnerability to HIV, thus molecularizing risk. Some actors used these studies both as a way of shoring up results of RCTs conducted in sub-Saharan Africa and as an important rationale in arguments for making neonatal circumcision more widely available. Others, however, resisted this move to generalize the RCT results to other parts of the world, citing both contextual differences in HIV transmission patterns and conflicting scientific details regarding the biomolecular basis of the foreskin’s susceptibility. Nevertheless, by locating an abstract notion of relative risk in the body itself, I argue that histological studies of foreskin have played a key role in stabilizing male circumcision status as a new risk category, largely independent of a given individual’s risk profile.

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Authors & Contributors
Darby, Robert J. L.
Jenna M. Grant
Şahi̇n, Kaya
Brives, Charlotte
Petty, JuLeigh
Clay Davis
Journals
Social Studies of Science
Journal of the History of Medicine and Allied Sciences
Isis: International Review Devoted to the History of Science and Its Cultural Influences
Canadian Journal of Health History/Revue canadienne d’histoire de la santé
Social History of Medicine
Science, Technology and Human Values
Publishers
University of Chicago Press
Lexington Books
Concepts
Surgery of sex organs; circumcision
Medicine
Clinical trials
Human immunodeficiency viruses (HIV)
Sexuality
Technoscience; science and technology studies
People
FitzGerald, John G.
Voronoff, Serge Avramovitch
Malinowski, Bronislaw
Laqueur, Thomas Walter
Bonaparte, Marie
Time Periods
21st century
20th century, early
Medieval
19th century
20th century, late
Early modern
Places
United States
Europe
Thailand
Cambodia
Uganda
Kenya
Institutions
Johns Hopkins University
Connaught Laboratories (Canada)
University of Toronto
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