For more than forty years, HIV/AIDS has been understood as a paradigmatic public health crisis. The HIV/AIDS crisis generated extraordinary social movement activism and resulted in significant public health reforms. Yet, the dominant narratives of AIDS too often marginalize women’s experiences and obscure how deeply feminist advocacy reshaped not only the law but also the science of AIDS. In Risk and Resistance, Aziza Ahmed offers a powerful corrective to the historical narrative surrounding AIDS while also provoking broader questions about the nature of scientific knowledge itself.
Risk and Resistance is history, theory, and warning. The book is at once a rich archive of feminism and AIDS, a sharp challenge to the myth of science as a purely objective, neutral domain, and a conceptual lens for understanding contemporary public health crises in the MAHA era. Through a meticulously researched genealogy of feminist AIDS activism from the early 1980s through the 2010s, Ahmed shows how feminist social movements reshaped scientific consensus, transformed public health law, and altered the material distribution of life-saving resources.
At its core, the book advances a deceptively simple but profoundly destabilizing claim: law and science are not objective domains that merely respond to disease. Rather, scientific and legal knowledge are co-produced through social struggle, and the “facts” that emerge from this co-production have concrete distributional consequences for who lives and who dies. Feminist AIDS activists, Ahmed shows, recognized that changing the law required redirecting scientific inquiry in new directions—and that changes in both science and law were necessary to redistribute health resources towards women living with HIV.
Feminist Activism and the Production of Scientific Knowledge
Ahmed begins the book with the story of Patricia Nalls and her family, a devastating account that anchors the book’s broader theoretical claims. Nalls, diagnosed with AIDS at a time when women were routinely excluded from clinical trials and diagnostic criteria, survived despite the profound failures of medicine and public health. Nalls survived not because the medical system recognized her needs, but because she mobilized community-based care, advocacy networks, and sheer persistence to secure treatment and benefits in a legal and scientific landscape that largely denied that women could even have AIDS. (Pp. 1–2.) Her story illustrates the book’s central historical theme: the systematic erasure of women from scientific and legal understandings of AIDS, and the life-and-death consequences of that erasure.
The book traces feminist AIDS activism from 1982 through 2013, documenting how women with HIV, feminist health advocates, lawyers, and activist organizations challenged the male-centric scientific framing of the epidemic. Women’s apparent increase in HIV/AIDS numbers was produced by changes in CDC definitions and surveillance practices, driven by feminist advocacy, which corrected systematic undercounting of women. (Pp. 1–3, 52-60.)
One of the book’s most compelling chapters follows the litigation and advocacy efforts that ultimately forced the Centers for Disease Control and Prevention to revise the medical definition of AIDS to include conditions experienced by women, such as gynecological conditions. This was not, Ahmed emphasizes, a case of law belatedly catching up to scientific progress. Instead, feminist legal advocacy actively reshaped medical knowledge itself.
This intervention disrupts a familiar trope in health law and social movement scholarship—that law lags behind science. As Ahmed demonstrates, feminist activists believed precisely the opposite: that litigation, regulatory advocacy, and legal framing could alter scientific knowledge production. Ahmed notes that: “For feminists organizing in the context of AIDS, the belief that law and advocacy can alter science (rather than simply rely on it) is central to the success of redistributional efforts in the context of public health activism.” (P. 34.) For feminists fighting AIDS, destabilizing claims of medical objectivity was essential to expanding eligibility for disability benefits, access to treatment, and recognition within public health institutions.
Law, Science, and Redistribution
Uncovering the story of how feminist health social movement activists changed the scientific and policy response to AIDS is a feat in itself. Yet, Risk and Resistance delves beyond historical recovery. Ahmed uses feminists’ long fight against AIDS as a case study to develop a broader theoretical account of how the fields of science and law co-produce new forms of knowledge and mutually reinforce choices about the distribution of resources. Drawing on science and technology studies and critical legal theory, she challenges the idea that legal regulation and scientific expertise occupy separate domains, with the former simply reliant on the latter. Instead, she adopts the framework of co-production, showing how governance and scientific knowledge mutually constitute one another.
This insight has particular force in public health law. As Ahmed explains, scientific framings of disease risk—such as attributing HIV vulnerability to individual behavior—can obscure structural determinants of health and justify interventions focused on personal responsibility rather than systemic, redistributional reforms such as harm reduction policies or expanding access to care. These scientific narratives, once stabilized through law and policy, legitimate unequal distributions of resources while appearing neutral and inevitable. Ahmed describes this process as a “legal-scientific settlement.” Her definition of this concept is important:
The term legal–scientific settlement describes how the stabilization of particular truth-claims results in new legal and regulatory regimes. I use the term ‘settlement’ to reflect the contingency and possibility for disruption. In these moments of legal–scientific settlement, law and science are coproductive of new facts and new knowledge ecosystems that are then generative of distributional outcomes (Pp. 145-146).
Ahmed’s aim in critically analyzing legal-scientific settlements is not to exacerbate mistrust in science. Rather, Ahmed asks readers to look behind the curtain of how scientific knowledge is produced—or co-produced—through its interaction with legal domains.
One of the book’s most striking contributions is its attention to how claims of scientific objectivity were mobilized during the Reagan era to contract the welfare state. By requiring physicians to validate disability claims, the federal government transformed medical expertise into a gatekeeping mechanism for benefits—rendering science itself a target of feminist activism. Feminist AIDS advocates understood that redistributive justice required contesting not only legal rules, but the epistemic foundations on which those rules rested.
Legal–Scientific Settlements and Contemporary Public Health
Ahmed’s conceptual framework of social contestation leading to “legal-scientific settlements” resonates far beyond AIDS. These settlements describe moments in which particular scientific claims become temporarily stabilized through lawmaking and regulation, generating new regimes of governance and distribution. Crucially, these legal-scientific settlements are contingent and thus remain contestable rather than fixed. The book illuminates how such settlements reflect political and economic choices, not natural facts.
Ahmed’s theorizing provides a remarkably generative tool for analyzing today’s public health conflicts in the MAHA era—whether over vaccine schedules, autism, or gender-affirming care—by exposing how claims of scientific neutrality are forged through law and revealing how law and science co-produce authoritative knowledge. Ahmed draws explicit connections to COVID-19, where scientific claims about risk and mitigation directly shaped the allocation of resources and the acceptance of mass death and disability. Narratives emphasizing personal responsibility, she argues, enabled the state to disclaim obligations to provide care—echoing earlier AIDS-era dynamics that stigmatized marginalized communities.
The book’s closing pages are especially haunting. As Ahmed notes, declarations that COVID-19 now poses a “diminished threat” coexist with the ongoing reality that thousands continue to die each week. These outcomes are not inevitable. They are the product of legal–scientific settlements that distribute vulnerability unevenly across populations. HIV, too, remains an unfinished epidemic—still without a vaccine or cure, still shaped by inequality.
Conclusion
Risk and Resistance makes major contributions to public health law, feminist and social movement theory, science and technology studies, and sociolegal scholarship. By centering feminist AIDS activism, Ahmed not only recovers a crucial history but also provides a toolkit for analyzing contemporary public health debates. The book challenges scholars to take seriously the ways social movements shape scientific knowledge and the ways law and science together legitimate that knowledge—and to confront how appeals to neutrality can entrench inequality.
For legal scholars accustomed to treating science as an external constraint, Ahmed’s account is bracing. It insists that redistribution often requires epistemic struggle, and that the law’s role in stabilizing knowledge carries profound ethical stakes. At a moment when public trust in expertise is failing, and public health crises are pitched battles, Risk and Resistance offers both historical insight and conceptual clarity. It is essential reading for anyone interested in how law, science, and social movements shape who is allowed to survive—and under what conditions.
