In 2010, the government of British Columbia (B.C.) dedicated $48 million to stop the spread of HIV. The STOP HIV/AIDS pilot project promotes the uptake of HIV testing in the general population, and the use of antiretroviral therapy amongst those living with HIV/AIDS. This project operates with the rationale of ‘treatment as prevention’ (TasP), meaning that antiretroviral therapy is beneficial for the person living with HIV/AIDS, and has the secondary benefit of reducing the spread of HIV in the general population. Public health discourses are constructed via particular worldviews and involve the creation and delineation of societal problems. Undertaking a discourse analysis, I identify eight dominant discourses of TasP and STOP HIV/AIDS that include: provincial and international support for TasP and lack of federal leadership in HIV/AIDS; TasP, a ‘paradigm shift’ and a ‘game changer;’ TasP as beneficial to the individual and society; human rights and harm reduction; proof and certainty; failure of current prevention efforts; risk discourses; and, finally, universal treatment. I also identify five alternative discourses: holistic understanding/social determinants of health; stigma and discrimination; rights discourse: GIPA, informed consent and self-determination; coercion/criminalization and alternative risk discourse. Through a lens of governmentality, I explicate two overarching and simultaneous discursive strategies in realizing the objective of decreasing the spread of HIV in B.C. The first strategy acts on individuals living with HIV/AIDS, encouraging individuals to take up antiretroviral therapy. The second strategy acts on the general population, informing the population that HIV is a problem, and that treating people living with HIV/AIDS is the best way to protect society as a whole. There are various techniques within these two strategies. These discursive events have immense consequences for the uptake of health policies and programs by the public. The dominant and alternative discourses of TasP impact HIV policy and practice and specifically the individuals living with HIV and AIDS who are the subjects and targets of these initiatives. / Graduate

Uganda is using a strategy called treatment as prevention where as many individuals as possible that are infected with HIV receive treatment. As a result, the number of newly infected individuals has decreased significantly. However, there is a discussion about a potential problem regarding transmitted drug resistance. This work aims to investigate if this in fact will be a problem in the future, and to estimate the costs for different scenarios. Through developing a population-based mathematical model that describes transmission dynamics of HIV in Uganda, stochastic simulations are made for different conditions. Through analysing our simulations, we can see that Uganda may have to change their approach to HIV treatment. / För att minska smittoriskerna av HIV nyttjar Uganda en strategi som syftar till att behandla så många smittade personer som möjligt. Detta har lett till en signifikant minskning av antalet smittade personer. Det har dock uppstått en diskussion angående om läkemedels-resistent smitta kan komma att utgöra ett problem. Detta arbete syftar till att undersöka om detta kan utgöra ett problem i framtiden samt till att uppskatta de kostnader som kan uppstå i olika typer av scenarion. Under olika förutsättningar genomförs stokastiska simuleringar med hjälp av en matematisk populationsmodell framtagen för att beskriva spridningen av HIV i Uganda. Genom att analysera resultaten från olika simuleringar dras slutsatsen att Uganda kan behöva omvärdera sitt tillvägagångssätt gällande behandling av HIV.