The emergence of a public third party within the doctor-patient relationship: the HIV epidemic example

The article looks at information regarding treatments gathered from HIV-pos itive patients, within a context that is characterised by the high level of publicity given to therapeutic innovations. It is based upon a questionnai re/interview study of 63 patients encountered in a Paris hospital. The auth ors demonstrate the contrasts between these patients in terms of two main d imensions: the degree of the patients' proximity to specialist knowledge, a nd the level of homogeneousness that the patients attribute to medical know -how. At the point where these two dimensions meet, the article distinguish es between three forms of patient attitude towards treatment: in other word s, three ways of simultaneously positioning oneself with regard to the medi a, associations, doctors and family circules/entourage: resorting to exteri ority, self-integration into biomedical institutions, arranging heterogeneo us players. The article explores the social differences at the root of thes e contrasts, and underlines certain major changes that have taken place dur ing the course of the epidemic.