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56 one day in late December, I made my way to the last HIV/AIDS prevention class of the year at Miami General Hospital. Ricardo Garcia, the education coordinator , introduced the keynote speaker, Steve Taylor, as an HIV/AIDS advocate. The first thing that Steve did was to direct the clients, a majority of whom were African American, to move their chairs to make a circle so that they could talk to each other rather than just to him. Then he asked whether there were issues that people wanted to discuss. Arthur Jones, an older man in the advanced stages of AIDS, indicated that he wanted to talk about the side effects of medications , especially the hallucinatory dreams that he had been having while taking Sustiva. Steve began writing these questions down on the blackboard behind him. Other clients, with an air of confidence now that Arthur had broken the silence, yelled out words and phrases like “dementia,” “mood swings,” and “toxoplasmosis.” Steve was dynamic and confident. With his voice unwaveringly upbeat, he began his discussion by proclaiming loudly that he wanted to “empower” and “self-educate” the participants by telling them about “how HIV worked in the body.” Steve then drew a crude diagram of the HIV virus. In response to the drawings, David Roy, a regular attendee of these classes, raised his hand to ask: “How long does an HIV virus live? What is the life span of the virus?” Steve seemed caught off guard and was hesitantly beginning “You know, I’m not a doctor but . . .” when a social worker in the audience spoke up: “It exists for forty-eight hours, but the replication is so fast that there are always more than there are dying.” As if not to be outdone, Steve added: “That’s what I thought, but I wasn’t sure.” He continued in the same upbeat tone with which he had begun the talk. He asked: “What are the cells that are most affected by the HIV virus?” Byron 3 Treating culture The making of experts and communities TreATIng cuLTure 57 Miller, another regular client who always sat in the front of the class, answered “CD4 cell,” and with a huge grin, Steve thrust his hand into a bowl full of candy and gave some to Byron as a prize for the right answer. Next, he asked the group: “What is the role of the CD4 cell?” People yelled out “fights the virus” and “to protect us.” Steve added: “Just remember to think of it as a general in the army that controls how it is going to fight infections.” Several people received handfuls of candy for their answers. Steve went tirelessly on, as if energized by the wave of “correct” answers. He proceeded to draw and describe the HIV life cycle. He explained that the first part was the attachment of the HIV virus to the cell. He asked a question about the name of the entry fusion drug that stops the receptor from attaching to the CD4 cell. Someone from the back yelled out “T20” and “Fuzeon.” Arthur, who was growing increasingly animated, waved his very thin hands in the air and inquired: “If it stops the virus right there, why don’t they give it to all patients?” Steve again seemed surprised and stood silent for several moments before responding: “I really don’t want to get into it right now because I think it’s a conversation you should have with your health professional, but my opinion, and it’s only my opinion, is that they don’t have enough experience with it and in research, many drugs are tested together, but this has not been done with Fuzeon.” Another question was raised by Vera Thompson, who had been quiet all this time. She asked whether HIV/AIDS research had stopped because it seemed as if all antiretroviral drugs were “masking the disease instead of curing it.” Steve declared that he would “gear [his answer] more toward facts and not opinions , because there have been many strides made in terms of the kinds of drugs coming into the market. People now can take one pill a day, which is really staggering considering that twenty-five years ago people had to take twenty to thirty pills a day.” All of a sudden, Steve’s lecture turned highly technical, and he discussed transcriptases, enzymes, and complex drug combinations rapidly. This seemed to have the effect he wanted; no one asked any...

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