ABSTRACT
S. Tesh analyzes the competing ideologies which, over the last century, have shaped the agenda for research and practice in medicine and public health. The infectious disease model, implicating human immunodeficiency virus (HIV) as the agent for Acquired Immune Deficiency Syndrome, is the theoretical paradigm that dominates public health research and practice. In eschewing the hypotheses featuring agents other than HIV, medicine and public health may be denying what are said to be the anomalies generated by the, decade long, dominance of the viral model. Additionally, part of the explanation for the hegemony of the HIV theory may lie in the realm of politics. A set of ideas, implicit in much of the foregoing and useful in understanding the politics of paradigm choice, is that of problem “definition” and problem “ownership”. D. Stone states that “in politics, causal theories are neither right nor wrong,” and that “conflicts over causal stories are, therefore, more than empirical claims”.
