Resisting Public Health Surveillance: Anonymous HIV Testing and the Imperative of Health
Bibliographic record
Abstract
To date, there has been little research published about public health surveillance and HIV testing/prevention. Accordingly, an exploratory project was undertaken, involving a detailed review of local public health law, and the distribution of surveys about self-reported STI testing/diagnosis, HIV testing practices, and sexual behaviours among gay, bisexual, and other men who have sex with men. A review of the public health law indicated that, in the local context, there is a pervasive public health surveillance apparatus that requires mandatory reporting of identified communicable diseases, including HIV. Results of the survey indicated that individuals who reported a preference for, or use of, anonymous HIV testing were more likely to have reported having (a) been tested for, and diagnosed with, STIs, (b) a self-reported history of anal sex, (c) more sexual partners, and (d) been aware of criminal prosecutions against people living with HIV for not disclosing their HIV status. At first glance, it appeared as though anonymous HIV testing represented a form of resistance to public health surveillance; a strategy by which individuals who are likely to test positive for HIV circumvent surveillance. However, when these results were examined using Lupton’s “Imperative of Health” framework, it became clear that one must appreciate the two-pronged nature of anonymous HIV testing. On the one hand, knowing one’s HIV status can be beneficial; for example, it corresponds with decreased HIV transmission and improved quantity / quality of life for people living with HIV. On the other hand, anonymous testing represents a complicit acceptance of the imperative of health, and an internalization of public health surveillance. From this perspective, true resistance to public health surveillance would manifest as an absolute rejection of HIV testing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.081 | 0.079 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.007 | 0.076 |
| Scholarly communication | 0.013 | 0.021 |
| Open science | 0.002 | 0.011 |
| Research integrity | 0.010 | 0.012 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".