Aids prevention,Stigma and migrant status

This article discusses how stigma has been applied to disease and also to foreigners, especially during epidemics. Foreigners, or migrants, fit particularly well into AIDS stigma, being both objects and originators of the generalised reaction: ‘it's somebody else's problem’. Material is presented from a European Community Concerted Action assessing AIDS/HIV prevention which surveyed programmes for short‐ and long‐term guest populations and ethnic minorities in twelve European countries. It is shown how the potential for stigmatisation seriously hindered the establishment of AIDS prevention efforts directed towards migrants. Basic shifts of programme focus which help overcome stigmatisation problems concerning migrants are defined, including: 1) making fine differentiations amongst migrant groups rather than considering ‘migrants’ as a generalised ‘other’, 2) basing programmes on a universal right to know rather than on the notion of risk group, and 3) working in real and effective collaboration with minority communities rather than imposing top down programmes.     

Sexuality,Morality and Lifestyle: The ABC of HIV Prevention Strategies in Rural Papua New Guinea

This article explores the national program for the prevention of the spread of HIV/AIDS in Papua New Guinea and its intersection with the experiences of a rural community in Western Province. The social marketing of HIV/AIDS awareness and prevention has seen an influx of categories and definitions of people, sexual behaviour and HIV/AIDS that have the potential to create confusion, but also spaces in which rural populations can understand and conceptualise AIDS. In the present paper, the preventative program is examined from the perspective of the Gogodala, whose understandings of sickness and prevention are based on an intimate and interactive relationship with the local environment. In this context, ‘lifestyle’ (ela gi) and the maintenance of certain ‘laws’ is the primary method of sickness prevention. I argue that an exploration of the local dynamic between sexuality, morality and lifestyle is vital to the evaluation of the impact of these awareness and prevention programs and the possibilities for future prevention strategies.     

Of desire,the Farang,and textual excursions: Assembling ‘Asian AIDS’

ABSTRACT

This article documents and discusses the neo-orientalist tendencies in the First World's sporadic coverage of ‘Asian AIDS’, with a particular focus on the localized context of Thailand. It takes the problem of ‘Asian AIDS’ as a critical point of articulation between a health crisis and the specific geopolitical movements of capital, tourism, and desire within the processes of globalization. In order to highlight the episodic nature of the First World's narrative about HIV/AIDS in Thailand and to witness the necessarily fragmentary quality of representation in the global sphere involving competing and constantly moving voices, I attempt to enact an imaginary dialogue in the form of what Trinh T. Minh-ha has termed ‘textual excursion’. The purpose of this imaginary dialogue is to elaborate on the various strands of narratives and different levels of discourse (for example, the documentary, the theoretical, the imaginary, the political) that comprise the field of jumbled voices. As the HIV/AIDS pandemic in Pacific and Southeast Asia is taking shape around the configurations of globalist imperatives, it illuminates a dual process: the revitalization of orientalist fantasies in the global sphere and the self-orientalizing tendencies within the Asian world captured by global development. It also illuminates the necessity of addressing the problem of ‘Asian AIDS’ as a migrating vector.     

The US President's Emergency Plan for AIDS Relief

This article analyses the US response under former President George W. Bush to the global HIV/AIDS epidemic at the intersection of neo-conservatism and neo-liberalism, highlighting the various ways their distinct gender logics collide to reproduce masculine privilege and gender inequalities on a global scale. The President's Emergency Plan for AIDS Relief (PEPFAR) is the United States global HIV/AIDS policy and is the largest commitment made by any single nation for an international health project. My analysis is based on PEPFAR's ‘formal’ policy texts, including its authorizing legislation, five-year strategic framework and specific policy directives for recipient organizations. In addition, I examine more ‘informal’ texts like Congressional reports and Presidential speeches delivered by George W. Bush on various occasions. Drawing on a rich body of feminist ethnographic work in the fields of global governance, international political economy, organizational theory and sexuality and masculinity studies, the following article examines the various ways market-based norms and practices can legitimate the moral imperatives of neo-conservatism to promote ‘traditional’ values and institutions in the global South as leading solutions to global problems and insecurities.     

Compelling Evidence: Research Methods,HIV/AIDS,and Politics in Papua,Indonesia

Increasing calls for an evidence-based public health (EBPH) rely on forms of quantitative evidence to decide HIV/AIDS interventions. A major criticism of this method is it downplays the significance of experiential, cultural or political facets of HIV/AIDS. We apply the concept of ‘rendering technical’ to explore the relationship between methods used in HIV/AIDS research in Papua, Indonesia and current socioeconomic conditions. We analysed research methods used in sixty-two HIV/AIDS studies, assessed presentations at an international AIDS conference, and conducted ethnographic research in Papua. Nation-wide EBPH initiatives are implemented in Papua, yet there remains a critical mass of qualitative ethnographic studies carried out by indigenous scholars emphasising experiences of persons and culture, often within a colonial or post-colonial framework. We argue these studies partially counter approaches which render technical complex realities. In political conditions where indigenous minorities suffer inequities, qualitative ethnographic research may yield critical kinds of evidence, potentially contributing to more nuanced decision-making around HIV.     

Social Protection in a Context of HIV/AIDS: A Closer Look at South Africa

Abstract

South Africa is unusual in that it is experiencing high levels of AIDS morbidity and mortality, but is also able to afford a relatively developed system of social assistance. However, HIV/AIDS is affecting poverty in some unique ways and compounding other challenges such as unemployment. Its nature is such that it demands immediate action, balanced with a focus on long-term development. This is requiring a conceptual shift from ‘social security’ to ‘social protection’, since social assistance is not managing to address all dimensions of poverty and is also creating perverse incentives for people not to maximise their health. In South Africa, household studies comprise the most useful evidence to explore the particular challenges posed by HIV/AIDS. They indicate a need to review policies in all the social sectors and to focus on the issue of human capital.     

Dialogue under Occupation

This article critically examines the World Bank's report entitled The Other Half of Gender: Men's Issues in Development published in 2006. The Bank publication covers a range of topics on men and masculinities, and ultimately argues for ‘men-streaming’ development. Using an intersectional analysis, this article expands upon recent feminist scholarship in the field of Men and Development in order to take a closer look at race, culture and representation. In this article, I demonstrate how the World Bank's focus on the social construction of masculinities in the ‘men-streaming’ report places Third World men into a specific realm of visibility that renders them culpable for a wide range of development issues. In representing African men as homogenous, culturally inferior and individually culpable for the HIV/AIDS pandemic, in particular, the Bank's promotes ‘gender-adjustments’, which obscures the Bank's complicity in a variety of development disasters.     

Public spheres,hidden politics and struggles over space: boundaries of public engagement in post‐apartheid South Africa

The development of a public sphere forms a central ingredient in the consolidation of a new political culture following a transition to democracy. The Habermasian idea of the public sphere has been challenged for not taking into account the role of ‘part’ and ‘counter public spheres’, particularly with reference to ‘developing’ societies. ‘Actually existing’ public spheres must therefore be conceptualised within the framework of a broader category of ‘public space’. A national public sphere in South Africa is held back by inequalities of wealth and power. A minority public of privileged consumers has access to a structure of print and electronic media, while the majority population relies on different systems of networking that make up counter publics. After 1994, the public sphere has been influenced by a dominant‐party system, accompanied by a division into formal and informal politics, with formal politics assuming a ritualistic function and ‘Realpolitik’ being played out within the non‐public structures of the dominant party. Meanwhile, critical public debate has had to find its course through varieties of informal politics. The article examines how moral debates around HIV/AIDS and crime in KwaZulu‐Natal have constituted an alternative arena for debate, and how cultural and religious discourses have been the channels of a local public sphere. The article discusses to what extent debates have constituted a local democratic ‘deliberative public sphere’, and looks at the ways in which the local state in the form of the eThekwini Municipality has interacted with local publics since 1994.     

DISEASED PARIAHS AND DIFFICULT PATIENTS

Amongst the diverse resistant strategies that oppose moralistic representations of HIV/AIDS and the stigmatization of people with HIV/AIDS, two modes of resistance frequently intersect within HIV/AIDS narratives: sick role subversions and humour. Sick role subversions in HIV/AIDS narratives form part of a wider shift from an emphasis on the patient as a ‘compliant, passive medical object of care’ towards ‘the sick person as the subject, the active agent of care’ (Kleinman 1988 Kleinman, A. 1988. The Illness Narratives: Suffering, Healing, and the Human Condition, New York: Basic Books.  [Google Scholar], pp. 3–4). The dark, black type of humour so prevalent in the age of AIDS in turn functions as a potentially anti-sentimental, anti-redemptive and anti-moralistic strategy. This essay examines the constructions of these joint resistant strategies in the ‘zine Diseased Pariah News and narratives by Rabih Alameddine, David B. Feinberg, Eric Michaels and Oscar Moore. In DPN, a ‘publication of, by, and for people with HIV disease’ (Shearer 1990 Shearer , T. (1990) ‘Welcome to our brave new world!’ , Diseased Pariah News , no. 1 , pp. 2 . [Google Scholar], p. 1), black HIV/AIDS humour not only functions as a survival tactic and a way to cope with illness but equally aims to reveal failing health care systems, to expose questionable practices of pharmaceutical companies, and to inform and mobilize readers. Alameddine's novel KOOLAIDS employs deflating techniques as part of its anti-redemptive and anti-sentimental aim. Feinberg's Jewish-queer humour is similarly anti-sentimental but his later work reveals the limitations of humour. The connection between humorous and difficult patient modes of resistance is especially noticeable in Michaels’ ‘letters of complaint and revenge’ (1997, p. 34). For both Michaels and Moore, writing in and of itself functions as a sick role subversion, rather than forming a mere portrayal of possible subversions. Moreover, these narratives hope to foster and inspire future modes and practices of resistance.     

WHAT ABOUT THE OLD CULTURAL INTERMEDIARIES? AN HISTORICAL REVIEW OF ADVERTISING PRODUCERS

Critical work on advertising is underscored by a teleological conception of its object. This often emerges in the form of an emphasis on advertising as an evolving, hybrid institutions that increasingly mixes the ‘economic’ with the ‘cultural’. It is in this vein that advertising practitioners have been characterized as ‘new cultural intermediaries’ deploying distinctive aesthetic sensibilities. Similar patterns of knowledge and behaviour, however, can be traced amongst early producers of advertising suggesting a generation of ‘old’ cultural intermediaries. This unexpected phenomenon, it is argued, arises for two reasons. The first is that much critical work addressing the nature of contemporary advertising lacks historical context. The second is that culture and economy are normatively conceptualized as separate spheres. This separation underplays the multiple interconnections between the cultural and the economic in instances of material practice. Accordingly it is proposed that advertising be reformulated as a constituent practice that has historically relied upon the juxtaposition of ‘cultural’ and ‘economic’ knowledges.     

Are service‐delivery NGOs building state capacity in the Global South? Experiences from HIV/AIDS programmes in rural Uganda

Service‐delivery NGOs are often attacked for abandoning the pursuit of ‘alternative development’ in favour of ‘technocratic’ forms of development. Yet some commentators argue that these organizations can have progressive impacts on political forms and processes. We investigate this debate through the lens of state building. Research into The AIDS Support Organisation's (TASO) work with the Ugandan government reveals that its state capacity building effects were both uneven and temporary. Although TASO played important roles in strengthening the bureaucratic ability of targeted hospitals to deliver HIV/AIDS services and increased the state's embeddedness in society in the targeted districts, it was less successful in expanding the infrastructural reach of the state in rural Uganda. We conclude that NGOs need longer time‐frames to achieve state building goals.     

From Health Crisis to Rights Advocacy? HIV/AIDS and Gay Activism in China and Singapore

The relationship between HIV/AIDS and gay activism has been primarily informed by the American experience and understudied in nondemocratic contexts. Drawing upon qualitative research on China and Singapore, we refine understanding of HIV/AIDS’ influence on the development of gay activism under authoritarian conditions, by examining the processes through which activist organizations interact with laws and regulations, political norms, HIV/AIDS funding, and government responses to both HIV/AIDS and collective organizing. We show how HIV/AIDS’ influence plays out in multiple patterns, depending on the strategic responses that gay activists select from a constrained range of options to shape their organizations’ destinies. Therefore, we provide insights for development agencies and international donors into whether and how international assistance intended to encourage activism and wider social change are mediated by political and legal controls on local activism.     

IMPLICATIONS OF INTERNET TECHNOLOGY FOR MEDICAL SOCIOLOGY IN THE NEW MILLENNIUM

This research examines how parental heterosexism—negative attitudes toward homosexuals and homosexuality—and other family characteristics relate to the development of children's attitudes toward people with HIV/AIDS (PWA). Attention is directed to the overall relationship between parents’ and children's attitudes and to the potential mechanisms through which these linkages are manifested. Based on social learning theories of childhood socialization, a range of mechanisms is considered, focusing on heterosexist attitudes in parents and communication with children about AIDS. Findings indicate that parental attitudes concerning homosexuals influence children's attitudes toward PWA, implying that there can be negative as well as positive consequences of parents’ beliefs on children's attitudes. The possibility of negative parental effects on children's prejudices toward PWA suggests that in-school HIV/AIDS education at younger ages is more important than previously thought.     

Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model

HIV/AIDS stigma and homophobia are associated with significant negative health and social outcomes among people living with HIV/AIDS (PLWHA) and those at risk of infection. Interventions to decrease HIV stigma have focused on providing information and education, changing attitudes and values, and increasing contact with people living with HIV/AIDS (PLWHA), activities that act to reduce stereotyped beliefs and prejudice, as well as acts of discrimination. Most anti-homophobia interventions have focused on bullying reduction and have been implemented at the secondary and post-secondary education levels. Few interventions address HIV stigma and homophobia and operate at the community level. Project CHHANGE, Challenge HIV Stigma and Homophobia and Gain Empowerment, was a community-level, multi-component anti-HIV/AIDS stigma and homophobia intervention designed to reduce HIV stigma and homophobia thus increasing access to HIV prevention and treatment access. The theory-based intervention included three primary components: workshops and trainings with local residents, businesses and community-based organizations (CBO); space-based events at a CBO-partner drop-in storefront and “pop-up” street-based events and outreach; and a bus shelter ad campaign. This paper describes the intervention design process, resultant intervention and the study team’s experiences working with the community. We conclude that CHHANGE was feasible and acceptable to the community. Promoting the labeling of gay and/or HIV-related “space” as a non-stigmatized, community resource, as well as providing opportunities for residents to have contact with targeted groups and to understand how HIV stigma and homophobia relate to HIV/AIDS prevalence in their neighborhood may be crucial components of successful anti-stigma and discrimination programming.     

Treatment is Prevention

The past 15 years have seen the waning of both cultural analysis and activism dedicated to HIV/AIDS prevention, especially in relation to the enduring epidemic in the United States. However, current mutations in the American HIV prevention landscape, driven by the biomedical promise of a ‘Test and Treat’ strategy, are producing potentially destructive outcomes for vulnerable and dispossessed communities, a situation that demands renewed investment from cultural critics. The aim of this article is to mobilize a specific strand of biopolitical theory (Foucault, Agamben, Esposito) to examine recent federally orchestrated prevention measures dedicated to a scale-up and integration of HIV testing, treatment and ‘linkage to care’, in order to move beyond their reductive approach to the preservation of life and advance a more capacious, politically engaged prevention model rooted in communal rather than individual forms of immunity. Based on my ethnographic fieldwork in Baltimore, MD, I attend to ways in which local HIV prevention initiatives are courting the city's precarious Ballroom community – a kinship system of black queer youth structured around competitive dance and performance – in an attempt to materialize their ‘target population’ for testing purposes. Previously neglected by governmental and medical institutions, members of the Ballroom community now find themselves addressed as responsible sexual citizens who are expected to protect their bodies by getting tested and, if tested positive, start treatment. Yet, this emphasis on the medical rights and responsibilities of HIV positive youth threatens to abandon large groups of youth who have managed to stay uninfected. I conclude by locating this problem in the incongruity between the biological life protected by current ‘Test and Treat’ strategies and the forms of life that allow the Ballroom community to persevere under often dire circumstances, constituting an indigenous resource for an alternative take on HIV prevention     

Governance for reconstruction in Africa: challenges for policy communities and coalitions

This article seeks to advance analyses and responses to conflict prevention and reconstruction in Africa that go beyond state‐centric perspectives to include a range of non‐state players. Drawing on examples from both Uganda and Canada, it focuses on the activities of NGOs that have ‘partnered’ with state‐based actors in various peacekeeping and peace‐building operations as well as on the increasingly important role played by think‐tanks. The latter have emerged in Africa as major contributors to the proliferating literature on the political economy of violence, an approach that recognizes that African conflict reflects imperatives of production and consumption in relations that juxtapose Africa’s political institutions and cultures with international and global political economies. The article argues that novel forms of ‘security communities’ are emerging from the non‐state/state/international partnerships and coalitions that have developed around contemporary issues like ‘blood’ diamonds, small arms, debt and HIV/AIDS, thus drawing attention to connections between conflict and development.     

The logic of protection: narratives of HIV/AIDS in the UN Security Council

ABSTRACT

When HIV/AIDS was first addressed by the UN Security Council in 2000, it was seen as the culmination of a successful securitization process and a pivotal moment for introducing human security. However, concern for the epidemic was paired with problems in including a nonmilitary issue on the Security Council’s agenda and the fear that peacekeepers were vectors of HIV. Reports of peacekeepers being involved in sexual exploitation and abuse added to these problems. This article aims to understand how gender has informed the efforts to address these issues and to rehabilitate peacekeeping forces and the Security Council from the legitimacy challenges that arose in this context. The article argues that including nonmilitary issues on the Security Council agenda requires adjustment to fit a war/peace logic. Drawing on feminist theories on security and protection, the analysis shows that the security narrative on HIV/AIDS did not form a coherent protection logic until the 2011 reformulation, when HIV/AIDS was constructed as part of the problem of wartime rape. This reformulation is interpreted as an appropriation of gender equality to reproduce a military security doctrine.     

Safer teaching or safer sex? Primary teaching in the age of HIV/AIDS

SUMMARY. Both parents and teachers are concerned about whether and how to talk to young children about HIV/AIDS. Yet despite increasing attention to the relevance of HIV/AIDS for teaching at the secondary school level, little (if any) attention has been paid to the implications of HIV/AIDS for younger children. This paper, which was presented at the 1989 British Psychological Society Education Section Conference, argues that HIV/ AIDS raises important issues in relation to children of primary school age which we cannot afford to ignore. The paper draws on a one year study carried out at Thomas Coram Research Unit (London Institute of Education)     

‘Risky’ representation: the portrayal of women with mobility impairment in twenty-first-century advertising

Representations of disability and gender in advertising have been traditionally confined by narrow ideals surrounding body image. Recently, portrayals of disabled women in advertising have substantially grown in volume and variety. This research applies a feminist disability studies critique to the exploration of women with mobility impairments as ‘risky’ in twenty-first-century advertising. Feminist disability studies recognises culture as a key site in which disabled women have been historically misrepresented. While existing research dominantly focuses on textual analyses of advertisements, this study presents empirical data collected via semi-structured interviews with disabled women. Some women believe that the link between disabled women and riskiness sustains stereotypical attitudes and suggest that women with mobility impairments are included in advertisements as a form of ‘safe quirkiness’. However, others welcome provocative portrayals of women with mobility impairment and suggest that such representations challenge presumptions of disabled women as passive. The results of this research show how disabled women use their life experiences and personal beliefs to explore advertisements that supposedly represent them.     

Vietnamese American sexual behaviors & HIV infection

This brief report presents some preliminary findings of an on‐going ethnosexual field study of Vietnamese American sexual behaviors in Orange County, California, and indicates how they may be related to HIV infection. The primary objective of the study is to gather data on those sexual behaviors having the highest likelihood of transmitting the AIDS virus. The field research data indicate that in the ‘Vietnamese American population, highly acculturated Vietnamese homosexual men, whose partner preference is primarily for Anglo men with whom they play both sexual roles in anal intercourse, appear at present to be at highest risk for HIV infection. Transmission of the AIDS virus within the Vietnamese American population may be facilitated by Vietnamese American men who practice unsafe sex with both Anglo and Vietnamese men. The field research data also indicate that a potential exists for the spread of HIV into the heterosexual population through the sexual activity of Vietnamese men with non‐Vietnamese female prostitutes in California and Mexico, and through the sexual activity of ‘Vietnamese men with Thai and Vietnamese prostitutes in Thailand and Vietnam while on return visits to Southeast Asia.