front cover of African Intimacies
African Intimacies
Race, Homosexuality, and Globalization
Neville Hoad
University of Minnesota Press, 2007
There have been few book-length engagements with the question of sexuality in Africa, let alone African homosexuality. African Intimacies simultaneously responds to the public debate on the “Africanness” of homosexuality and interrogates the meaningfulness of the terms “sexuality” and “homosexuality” outside Euro-American discourse. Speculating on cultural practices interpreted by missionaries as sodomy and resistance to colonialism, Neville Hoad begins by analyzing the 1886 Bugandan martyrs incident—the execution of thirty men in the royal court. Then, in a series of close readings, he addresses questions of race, sex, and globalization in the 1965 Wole Soyinka novel The Interpreters, examines the emblematic 1998 Lambeth conference of Anglican bishops, considers the imperial legacy in depictions of the HIV/AIDS crisis, and reveals how South African writer Phaswane Mpe’s contemporary novel Welcome to Our Hillbrow problematizes notions of African identity and cosmopolitanism.Hoad’s assessment of the historical valence of homosexuality in Africa shows how the category has served a key role in a larger story, one in which sexuality has been made in line with a vision of white Western truth, limiting an understanding of intimacy that could imagine an African universalism.Neville Hoad is assistant professor of English at the University of Texas, Austin.
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Commodities of Care
The Business of HIV Testing in China
Elsa L. Fan
University of Minnesota Press, 2021

How global health practices can end up reorganizing practices of care for the people and communities they seek to serve 

Commodities of Care examines the unanticipated effects of global health interventions, ideas, and practices as they unfold in communities of men who have sex with men (MSM) in China. Targeted for the scaling-up of HIV testing, Elsa L. Fan examines how the impact of this initiative has transformed these men from subjects of care into commodities of care: through the use of performance-based financing tied to HIV testing, MSM have become a source of economic and political capital. 

In ethnographic detail, Fan shows how this particular program, ushered in by global health donors, became the prevailing strategy to control the epidemic in China in the late 2000s. Fan examines the implementation of MSM testing and its effects among these men, arguing that the intervention produced new markets of men, driven by the push to meet testing metrics. 

Fan shows how men who have sex with men in China came to see themselves as part of a global “MSM” category, adopting new selfhoods and socialities inextricably tied to HIV and to testing. Wider trends in global health programming have shaped national public health responses in China and, this book reveals, have radically altered the ways health, disease, and care are addressed. 

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Cooking Data
Culture and Politics in an African Research World
Cal (Crystal) Biruk
Duke University Press, 2018
In Cooking Data Crystal Biruk offers an ethnographic account of research into the demographics of HIV and AIDS in Malawi to rethink the production of quantitative health data. While research practices are often understood within a clean/dirty binary, Biruk shows that data are never clean; rather, they are always “cooked” during their production and inevitably entangled with the lives of those who produce them. Examining how the relationships among fieldworkers, supervisors, respondents, and foreign demographers shape data, Biruk examines the ways in which units of information—such as survey questions and numbers written onto questionnaires by fieldworkers—acquire value as statistics that go on to shape national AIDS policy. Her approach illustrates how on-the-ground dynamics and research cultures mediate the production of global health statistics in ways that impact local economies and formulations of power and expertise.
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Criminalized Lives
HIV and Legal Violence
Alexander McClelland
Rutgers University Press, 2024
Canada has been known as a hot spot for HIV criminalization where the act of not disclosing one’s HIV-positive status to sex partners has historically been regarded as a serious criminal offence. Criminalized Lives describes how this approach has disproportionately harmed the poor, Black and Indigenous people, gay men, and women in Canada. In this book, people who have been criminally accused of not disclosing their HIV-positive status, detail the many complexities of disclosure, and the violence that results from being criminalized. 
 
Accompanied by portraits from artist Eric Kostiuk Williams, the profiles examine whether the criminal legal system is really prepared to handle the nuances and ethical dilemmas faced everyday by people living with HIV. By offering personal stories of people who have faced criminalization first-hand, Alexander McClelland questions common assumptions about HIV, the role of punishment, and the violence that results from the criminal legal system’s legacy of categorizing people as either victims or perpetrators. 
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Fault Lines of Care
Gender, HIV, and Global Health in Bolivia
Heckert, Carina
Rutgers University Press, 2018
The HIV epidemic in Bolivia has received little attention on a global scale in light of the country’s low HIV prevalence rate. However, by profiling the largest city in this land-locked Latin American country, Carina Heckert shows how global health-funded HIV care programs at times clash with local realities, which can have catastrophic effects for people living with HIV who must rely on global health resources to survive. These ethnographic insights, as a result, can be applied to AIDS programs across the globe.
 
In Fault Lines of Care, Heckert provides a detailed examination of the effects of global health and governmental policy decisions on the everyday lives of people living with HIV in Santa Cruz. She focuses on the gendered dynamics that play a role in the development and implementation of HIV care programs and shows how decisions made from above impact what happens on the ground.  
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Health Dimensions of Sex and Reproduction
The Global Burden of Sexually Transmitted Diseases, HIV, Maternal Conditions, Perinatal Disorders, and Congenital Anomalies
Christopher J. L. Murray
Harvard University Press, 1998

From the health risks of sexual activity to those of pregnancy, abortion, and childbirth, reproduction constitutes enormous risks to a woman’s health. Ill-health conditions related to sex and reproduction account for 25 percent of the global disease burden in adult women. In sub-Saharan Africa, they account for over 40 percent. The catastrophic effects of reproductive ill-health, however, are not limited to women; for infants and adult men, they inflict 25 percent and 1 percent respectively of the global burden.

This volume offers comprehensive data and detailed discussions of the epidemiologies of three sexually transmitted diseases, HIV, and five specific maternal conditions, as well as those of congenital anomalies and perinatal conditions. Projections of the HIV epidemic are provided: by 2020 HIV is projected to double to 2.5 percent of the global disease burden.

Health Dimensions of Sex and Reproduction will serve as a comprehensive reference for epidemiologists, public health specialists, practitioners and advocates of STD and HIV prevention, and reproductive and neonatal health.

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Heterosexual Africa?
The History of an Idea from the Age of Exploration to the Age of AIDS
Marc Epprecht
Ohio University Press, 2008

Heterosexual Africa? The History of an Idea from the Age of Exploration to the Age of AIDS builds from Marc Epprecht’s previous book, Hungochani (which focuses explicitly on same-sex desire in southern Africa), to explore the historical processes by which a singular, heterosexual identity for Africa was constructed—by anthropologists, ethnopsychologists, colonial officials, African elites, and most recently, health care workers seeking to address the HIV/AIDS pandemic. This is an eloquently written, accessible book, based on a rich and diverse range of sources, that will find enthusiastic audiences in classrooms and in the general public.

Epprecht argues that Africans, just like people all over the world, have always had a range of sexualities and sexual identities. Over the course of the last two centuries, however, African societies south of the Sahara have come to be viewed as singularly heterosexual. Epprecht carefully traces the many routes by which this singularity, this heteronormativity, became a dominant culture. In telling a fascinating story that will surely generate lively debate, Epprecht makes his project speak to a range of literatures—queer theory, the new imperial history, African social history, queer and women’s studies, and biomedical literature on the HIV/AIDS pandemic. He does this with a light enough hand that his story is not bogged down by endless references to particular debates.

Heterosexual Africa? aims to understand an enduring stereotype about Africa and Africans. It asks how Africa came to be defined as a “homosexual-free zone” during the colonial era, and how this idea not only survived the transition to independence but flourished under conditions of globalization and early panicky responses to HIV/AIDS.

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The Histories of HIVs
The Emergence of the Multiple Viruses That Caused the AIDS Epidemics
William H. Schneider
Ohio University Press, 2021

This new collection of essays on HIV viruses spans disciplines to topple popular narratives about the origins of the AIDS pandemic and the impact of the disease on public health policy.

With a death toll in the tens of millions, the AIDS pandemic was one of the worst medical disasters of the past century. The disease was identified in 1981, at the height of miraculous postwar medical achievements, including effective antibiotics, breakthrough advances in heart surgery and transplantations, and cheap, safe vaccines—smallpox had been eradicated just a few years earlier. Arriving as they did during this era of confidence in modern medicine, the HIV epidemics shook the public’s faith in health science. Despite subsequent success in identifying, testing, and treating AIDS, the emergence of epidemics and outbreaks of Ebola, Zika, and the novel coronaviruses (SARS and COVID-19) are stark reminders that such confidence in modern medicine is not likely to be restored until the emergence of these viruses is better understood.

This collection combines the work of major social science and humanities scholars with that of virologists and epidemiologists to provide a broader understanding of the historical, social, and cultural circumstances that produced the pandemic. The authors argue that the emergence of the HIV viruses and their epidemic spread were not the result of a random mutation but rather broader new influences whose impact depended upon a combination of specific circumstances at different places and times. The viruses emerged and were transmitted according to population movement and urbanization, changes in sexual relations, new medical procedures, and war. In this way, the AIDS pandemic was not a chance natural occurrence, but a human-made disaster.

Essays by: Ernest M. Drucker, Tamara Giles-Vernick, Ch. Didier Gondola, Guillaume Lachenal, Amandine Lauro, Preston A. Marx, Stephanie Rupp, François Simon, Jorge Varanda

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A Pill for Promiscuity
Gay Sex in an Age of Pharmaceuticals
Andrew R. Spieldenner
Rutgers University Press, 2023
For a generation of gay men who came of age in the 1980s and 1990s, becoming sexually active meant confronting the dangers of catching and transmitting HIV. In the 21st century, however, the development of viral suppression treatments and preventative pills such as PrEP and nPEP has massively reduced the risk of acquiring HIV. Yet some of the stigma around gay male promiscuity and bareback sex has remained, inhibiting open dialogues about sexual desire, risk, and pleasure. 
 
A Pill for Promiscuity brings together academics, artists, and activists—from different generations, countries, ethnic backgrounds, and HIV statuses—to reflect on how gay sex has changed in a post-PrEP era. Some offer personal perspectives on the value of promiscuity and the sexual communities it fosters, while others critique unequal access to PrEP and the increased role Big Pharma now plays in gay life. With a diverse group of contributors that includes novelist Andrew Holleran, trans scholar Lore/tta LeMaster, cartoonist Steve MacIsaac, and pornographic film director Mister Pam, this book asks provocative questions about how we might reimagine queer sex and sexuality in the 21st century. 
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Prevention
Gender, Sexuality, HIV, and the Media in Côte d'Ivoire
Christine Cynn
The Ohio State University Press, 2018
Approximately 70% of the global total of people living with HIV/AIDS in 2016 were in sub-Saharan Africa. After delayed governmental responses, the media has been consistently deployed as an essential tool for prevention. But HIV prevention campaigns reflect multiple conflicting and shifting agendas that encompass far more than the imparting of information about how to limit the spread of the virus. In Prevention: Gender, Sexuality, HIV, and the Media in Côte d’Ivoire, Christine Cynn draws from postcolonial, queer, and feminist film and media studies to critique global HIV prevention efforts and how they attempt to reshape gendered sexualities and notions of family in line with the rationality of neoliberalism.
More specifically, Cynn argues that through the bolstering of normative conceptions of gendered sexualities and families, HIV prevention media campaigns seek to actively create proper subjects, a goal corresponding with nation-building projects and reproducing their terms of belonging. During periods of increasingly virulent political and economic struggles in Côte d’Ivoire, such HIV prevention messages have lent support to lender- and state-mandated structural adjustment policies and to the exclusionary logic that casts some—such as those suffering from AIDS-related illnesses, those labeled as “homosexual,” sex workers, intravenous drug users, and the HIV-positive child—as implicitly unassimilable to the community and nation. Deeply interdisciplinary, Prevention brings to light new forms of exclusion and expands scholarship on gender and sexual normativities as it intersects with that on public health, neoliberalism, and film and media.
 
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The Republic of Therapy
Triage and Sovereignty in West Africa’s Time of AIDS
Vinh-Kim Nguyen
Duke University Press, 2010
The Republic of Therapy tells the story of the global response to the HIV epidemic from the perspective of community organizers, activists, and people living with HIV in West Africa. Drawing on his experiences as a physician and anthropologist in Burkina Faso and Côte d’Ivoire, Vinh-Kim Nguyen focuses on the period between 1994, when effective antiretroviral treatments for HIV were discovered, and 2000, when the global health community acknowledged a right to treatment, making the drugs more available. During the intervening years, when antiretrovirals were scarce in Africa, triage decisions were made determining who would receive lifesaving treatment. Nguyen explains how those decisions altered social relations in West Africa. In 1994, anxious to “break the silence” and “put a face to the epidemic,” international agencies unwittingly created a market in which stories about being HIV positive could be bartered for access to limited medical resources. Being able to talk about oneself became a matter of life or death. Tracing the cultural and political logic of triage back to colonial classification systems, Nguyen shows how it persists in contemporary attempts to design, fund, and implement mass treatment programs in the developing world. He argues that as an enactment of decisions about who may live, triage constitutes a partial, mobile form of sovereignty: what might be called therapeutic sovereignty.
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Risky Rhetoric
AIDS and the Cultural Practices of HIV Testing
J. Blake Scott
Southern Illinois University Press, 2003

Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing is the first book-length study of the rhetoric inherent in and surrounding HIV testing. In addition to providing a history of HIV testing in the United States from 1985 to the present, J. Blake Scott explains how faulty arguments about testing’s power and effects have promoted unresponsive and even dangerous testing practices for so-called healthy subjects as well as those deemed risky.A new afterword to the paperback edition discusses changes in testing technology, treatments, and public health responses in the last ten years. The ultimate goal of Risky Rhetoric is to offer strategies to policy makers, HIV educators and test counselors, and other rhetors for developing more responsive and egalitarian testing-related rhetorics and practices.

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Speech and Song at the Margins of Global Health
Zulu Tradition, HIV Stigma, and AIDS Activism in South Africa
Steven P. Black
Rutgers University Press, 2019
Speech and Song at the Margins of Global Health tells the story of a unique Zulu gospel choir comprised of people living with HIV in South Africa, and how they maintained healthy, productive lives amid globalized inequality, international aid, and the stigma that often comes with having HIV. By singing, joking, and narrating about HIV in Zulu, the performers in the choir were able to engage with international audiences, connect with global health professionals, and also maintain traditional familial respect through the prism of performance. The focus on gospel singing in the narrative provides a holistic viewpoint on life with HIV in the later years of the pandemic, and the author’s musical engagement led to fieldwork in participants’ homes and communities, including the larger stigmatized community of infected individuals. This viewpoint suggests overlooked ways that aid recipients contribute to global health in support, counseling, and activism, as the performers set up instruments, waited around in hotel lobbies, and struck up conversations with passersby and audience members. The story of the choir reveals the complexity and inequities of global health interventions, but also the positive impact of those interventions in the crafting of community.
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Viral Frictions
Global Health and the Persistence of HIV Stigma in Kenya
Elizabeth J. Pfeiffer
Rutgers University Press, 2022
Viral Frictions takes the reader along a trail of intersecting narratives to uncover how and why it is that HIV-related stigma persists in the age of treatment. Pfeiffer convincingly argues that stigma is a socially constructed process co-produced at the nexus of local, national, and global relationships and storytelling about and practices associated with HIV. Based on a decade of fieldwork in one highway trading center in Kenya, Viral Frictions offers compelling stories of stigma and discrimination as a lens for understanding broader social processes, the complexities of globalization and health, and their profound impact on the everyday social lives and relationships of people living through the ongoing HIV epidemic in sub-Saharan Africa. This highly engaging book is ideal reading for those interested in teaching and learning about intersectionality, as Pfeiffer meticulously demonstrates how HIV stigma interacts with issues of treatment, race, ethnicity, class, gender, sexuality, social change, and international aid systems.
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Whose Agency
The Politics and Practice of Kenya's HIV-Prevention NGOs
Megan Hershey
University of Wisconsin Press, 2019
Nongovernmental organizations (NGOs) are ubiquitous in the Global South. Often international in origin, many attempt to assist local efforts to improve the lives of people often living in or near poverty. Yet their external origins often cloud their ability to impact health or quality of life, regardless of whether volunteers are local or foreign.
By focusing on one particular type of NGO—those organized to help prevent the spread and transmission of HIV in Kenya—Megan Hershey interrogates the ways these organizations achieve (or fail to achieve) their planned outcomes. Along the way, she examines the slippery slope that is often used to define “success” based on meeting donor-set goals versus locally identified needs. She also explores the complex network of bureaucratic requirements at both the national and local levels that affect the delicate relationships NGOs have with the state. Drawing on extensive, original quantitative and qualitative research, Whose Agency serves as a much-needed case study for understanding the strengths and shortcomings of participatory development and community engagement.
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