**3. Why is a sociological perspective of the HIV pandemic pertinent?**

"Health sociology is no longer, nor should [it] be, the simple contribution of techniques to the health care service but, on the contrary, should mean methodo‐ logical independence [for dealing] with health from an interdisciplinary view‐ point, in which the biomedical aspect is only an additional component, however important it may be".1

Currently, it is widely recognized that the study of HIV constitutes a complex social phenom‐ enon in which there is an interrelation between multiple social, economic, political, cultural and environmental factors in those communities where the pandemic develops and spreads. For instance, although HIV is a chronic disease in some European countries, in some African countries it is a deadly disease. Therefore, insofar as the epidemic influences the lifestyles, practices and subjectivities of a population, it is necessary to study it by utilizing tools that provide a more qualitative and in-depth knowledge of the phenomenon. Consequently, social sciences have begun to study the complex connections established in relation to the HIV phenomenon with the aim of providing knowledge for its understanding and comprehension.

<sup>1</sup> Cited in: Donati P. Sociology of health. Madrid: Díaz de Santos; 1994.

However, despite existing evidence, the epidemiological method has been the benchmark for most of the approaches in the study of issues concerning public health in general and HIV in particular [10]. In this respect, it is worth noting that, currently, the epidemiological method cannot cope with the complexity of the HIV phenomenon on its own. Therefore, there is a need for HIV to be studied by different disciplines in order to address the complexity of the problem. For instance, the positivist method involves the limitation of not being able to grasp the qualitative aspects of health and disease. Thus, neither the subjective aspects of the disease nor the cultural factors influencing the HIV epidemic are present in epidemiological studies. In this sense, there is a need to generate qualitative information to help guide the design of prevention policies, particularly in regions heavily affected by the epidemic, such as African countries.

Social sciences provide a wide range of research theories and methodologies that can be extremely useful for studying HIV in general and in particular, its prevention and treatment. The sociological discipline, insofar as it seeks to explain and understand collective behaviour within a social context, the meanings of actions and the multicausality of phenomena, constitutes an essential tool in the construction of knowledge for an in-depth understanding of the HIV pandemic. Therefore, sociological theories constitute fruitful ground for investi‐ gating health and disease within the current context, as will be discussed throughout this chapter.

Health sociology, as a discipline, is a pertinent tool for the study of HIV. One of the reasons for the emergence of this discipline is the crisis of medicine, not as a science, but as a model of social practice [12]. One of the basic premises on which sociology is based is the need to focus on the analysis of health and not of disease, as opposed to the biomedical model that has primarily focused on disease. Such a fundamental purpose is in accordance with the need for placing greater emphasis on HIV prevention rather than treatment, in order to eradicate the pandemic. Therefore, assumptions that involve focusing on health from a sociological perspective constitute basic assumptions for prevention when applied to the field of HIV [13]:


Below, Table 3 shows some aspects that are likely to be investigated from a sociological perspective:

As will be discussed below, the different theoretical contributions of sociology will enable public health to approach health issues from a wider perspective, providing pertinent tools


**Table 3.** HIV objectives and sociological theories

However, despite existing evidence, the epidemiological method has been the benchmark for most of the approaches in the study of issues concerning public health in general and HIV in particular [10]. In this respect, it is worth noting that, currently, the epidemiological method cannot cope with the complexity of the HIV phenomenon on its own. Therefore, there is a need for HIV to be studied by different disciplines in order to address the complexity of the problem. For instance, the positivist method involves the limitation of not being able to grasp the qualitative aspects of health and disease. Thus, neither the subjective aspects of the disease nor the cultural factors influencing the HIV epidemic are present in epidemiological studies. In this sense, there is a need to generate qualitative information to help guide the design of prevention policies, particularly in regions heavily affected by the epidemic, such as African

32 Trends in Basic and Therapeutic Options in HIV Infection - Towards a Functional Cure

Social sciences provide a wide range of research theories and methodologies that can be extremely useful for studying HIV in general and in particular, its prevention and treatment. The sociological discipline, insofar as it seeks to explain and understand collective behaviour within a social context, the meanings of actions and the multicausality of phenomena, constitutes an essential tool in the construction of knowledge for an in-depth understanding of the HIV pandemic. Therefore, sociological theories constitute fruitful ground for investi‐ gating health and disease within the current context, as will be discussed throughout this

Health sociology, as a discipline, is a pertinent tool for the study of HIV. One of the reasons for the emergence of this discipline is the crisis of medicine, not as a science, but as a model of social practice [12]. One of the basic premises on which sociology is based is the need to focus on the analysis of health and not of disease, as opposed to the biomedical model that has primarily focused on disease. Such a fundamental purpose is in accordance with the need for placing greater emphasis on HIV prevention rather than treatment, in order to eradicate the pandemic. Therefore, assumptions that involve focusing on health from a sociological perspective constitute basic assumptions for prevention when applied to the field of HIV [13]: **•** Preventative action holds keeping people healthy as a central objective and is based on actively guiding willingness and ability, considering health as a process and not as a state; emphasizing the dynamic role of the subject as a pole of active reciprocity in respect of

**•** To expect a permanent engagement with lifestyle changes focused on health, not only on behalf of the individual, but also on behalf of the social and health care system; planning

**•** To expect health to be promoted and safeguarded by all social actors, firstly, by all individ‐ uals, and in all cases, not wholly delegated to specific specialized places and centres.

Below, Table 3 shows some aspects that are likely to be investigated from a sociological

As will be discussed below, the different theoretical contributions of sociology will enable public health to approach health issues from a wider perspective, providing pertinent tools

and programming to prevent the disease both at an individual and collective level.

medical and health care institutions and roles.

countries.

chapter.

perspective:

for designing effective action in the fight against HIV. Additionally, sociology provides a multidimensional perspective for the study of behaviour towards HIV, the social roles that are played in professional-patient interaction, as well as the role of health care institutions and the social networks that influence the prevention of HIV. Finally, theoretical contributions of sociology are also relevant for designing and implementing health promotion programmes in relation to HIV.
