Treatment ‘cultures’, sexually transmitted infections and the rise of antimicrobial resistance

Author:

Chandra Shiva1ORCID,Broom Alex1,Ridge Damien2ORCID,Peterie Michelle1,Lafferty Lise34,Broom Jennifer56,Kenny Katherine1ORCID,Treloar Carla4,Applegate Tanya3

Affiliation:

1. Sydney Centre for Healthy Societies School of Social and Political Sciences Faculty of Arts and Social Sciences The University of Sydney Sydney New South Wales Australia

2. School of Social Sciences University of Westminster London UK

3. The Kirby Institute UNSW Sydney Sydney New South Wales Australia

4. Centre for Social Research in Health UNSW Sydney Sydney New South Wales Australia

5. School of Medicine and Dentistry (Sunshine Coast Campus) Griffith University Sunshine Coast Queensland Australia

6. Infectious Diseases Service Sunshine Coast Hospital and Health Service Sunshine Coast Queensland Australia

Abstract

AbstractIn this article, we examine the current management of sexually transmitted infections (STIs), in the context of rising antimicrobial resistance (AMR), through the lens of ‘treatment cultures’. Prevailing treatment cultures—including the prominence of syndromic care for STIs—foster certain possibilities and foreclose others, with important consequences for countering AMR. Drawing on qualitative interviews with STI professionals, experts and industry representatives, we unpack these stakeholders’ accounts of STI treatment cultures, drawing out the importance of socio‐historical (i.e. taboo and stigma), political–economic (i.e. perceptions of significance, profit‐making and prioritisation) and subjective (i.e. patient contexts and reflexivity) dimensions therein. In developing this critical account of how treatment cultures are formed, reproduced and indeed resisted, we reveal how such discourses and practices render the reining in of AMR and shifting antibiotic use difficult, and yet, how productive engagement remains key to any proposed solutions. As such, the article contributes to our understanding of AMR as a highly diversified field, through our exploration of the bio‐social dimensions of resistance as they relate to the case of STIs.

Funder

Australian Research Council

Publisher

Wiley

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