Rethinking Decision Making: Contributions from Research on the Health work of People Living with HIV/AIDS.

The emergence of HAART as a standard of care for the treatment of HIV infection has been coupled by growing social scientific interest in the decision-making practices of people living with HIV. Established approaches to decision-making tend to rely on highly rational, individualized conceptions of human action. As such, they fail to fully represent the complexities of how actual people with HIV enter into relation with HAART. In response to this problem, this paper develops an analysis of how people come to take HAART as a social, relational and embodied process. The paper draws on the results of an institutional ethnographic study conducted in and around Toronto, Canada that involved individual and focus group interviews with 79 people living with HIV (57men and 22 women). Drawing on participants? narratives of their "health work" the paper explores two features of the social character of coming to be on HAART. First, it examines the temporal dimensions of coming to take treatment, emphasizing the work people do to ?make? and ?take time? to decide about HAART. Second, it explores how the process of coming to take medications relies on how people actively construct hybrid medico-experiential knowledge about the body and HIV treatment. The paper closes by raising practical implications for supporting the health work of people living with HIV that are suggested by the study?s findings. [ABSTRACT FROM AUTHOR]