Anthropology HIV/AIDS
by
Thurka Sangaramoorthy
  • LAST REVIEWED: 13 August 2018
  • LAST MODIFIED: 27 March 2019
  • DOI: 10.1093/obo/9780199766567-0129

Introduction

Acquired immunodeficiency syndrome (AIDS) represents a group of conditions that occur as a result of severe immunosuppression related to human immunodeficiency virus (HIV) infection. HIV/AIDS is an incurable medical condition and a complex global pandemic. Although significant strides have been made in the last thirty years to stem the devastating effects of HIV/AIDS, it continues to be one of the leading causes of infectious disease deaths in the world. HIV/AIDS has claimed more than 35 million lives, and as of 2017, there are approximately 36.9 million people living with HIV/AIDS globally, with a significant majority residing in sub-Saharan Africa. HIV/AIDS is also a social phenomenon that reflects various forms of global inequalities. It runs along the fault lines of society and significantly impacts those who are the most vulnerable. Poverty, gender inequalities, political instability, famine and food insecurity, and inadequate health care standards undergird and continue to drive the epidemic. These issues related to the global inequalities of HIV/AIDS are of central importance to anthropology. Anthropologists have long studied the importance of cultural, social, and structural factors contributing to HIV/AIDS. Since the beginning of the epidemic, anthropologists have contributed to better understandings of cultural beliefs and local practices that place people at risk for HIV/AIDS, advocated for equitable access to care and treatment, and promoted culturally appropriate strategies for prevention. More recently, anthropologists have also critically analyzed the complex relationships of power between global multilateral organizations, influential donors, governments of resource-poor countries, and local communities, and their impact on global HIV/AIDS projects.

Bibliography Indexes

Most anthropological research on HIV/AIDS is not published in books but rather as journal articles. Many anthropologists working on HIV/AIDS publish work in biomedical, public health, and anthropology journals. Indexes such as PubMed, ProQuest, AnthroSource, and Anthropology Plus are comprehensive resources that include these peer-reviewed journal articles.

  • Anthropology Plus.

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    The most comprehensive index for journal articles and books in anthropology, it contains references for articles that appear in over twenty-five hundred journals or edited collections held by the Tozzer Library at Harvard University. Although this database is comprehensive in its coverage of all the key periodicals in anthropology, a major disadvantage is that it does not include abstracts of articles.

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  • AnthroSource.

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    An archive of the journals published by the American Anthropological Association (AAA). It includes more than 250,000 articles, and abstracts of articles are freely available. Full-text articles can be accessed through AAA membership or library Internet gateways.

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  • ProQuest.

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    A database that indexes an extensive number of magazines, newspapers, dissertations, and key scholarly journals in the social sciences, humanities, and the sciences, including many journals that publish anthropological research on HIV/AIDS. It provides full-text of many articles on anthropological research on HIV/AIDS. However, this content can only be accessed with permission, most commonly through library internet gateways.

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  • PubMed.

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    A free database of biomedical and life sciences journal literature maintained by the US National Institutes of Health’s National Library of Medicine. It includes more than 22 million records and about half of these articles have links to full-text. Interdisciplinary biomedical, public health, and anthropology journals that publish anthropological research on HIV/AIDS are indexed here.

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Journals

Many anthropologists publish HIV/AIDS research in medical, public health, and anthropology journals. Articles published in medical and public health journals are mainly those that focus on policy or prevention recommendations or utilize mixed methods or qualitative data collection and analysis methods. These journals often feature papers with multiple authors. Articles published in anthropology journals are more explicitly framed around ethnographic principles and methods, and include more single-authored publications. There are also many instances where anthropologists have written books which expand on their works published in journals.

Medical

Journals devoted to medicine publish on topics of importance to those in the biomedical professions. The Lancet, for instance, focuses on global medicine and the practice of medicine in a variety of settings. The British Medical Journal publishes on issues related to clinical medicine and the social determinants of health. PLoS Medicine features articles that are relevant to both clinical practice and public policy. The International Journal of STD & AIDS and the Journal of Acquired Immune Deficiency Syndromes are much more focused on the study of sexually transmitted disease, with particular attention paid to HIV/AIDS.

Public Health

There are a number of public health journals which publish on relevant topics to those in the various fields of public health that are of interest to anthropologists. The American Journal of Public Health is arguably the most influential journal in public health. Journals such as AIDS and Behavior and Sexually Transmitted Diseases highlight research and commentary on disease-specific issues related to HIV/AIDS and sexually transmitted diseases. Culture, Health & Sexuality, Global Public Health, Sexual Health, and Social Science and Medicine feature more interdisciplinary research topics including those that focus on cultural and social aspects of HIV/AIDS.

Anthropology

Journals in anthropology publish peer-reviewed papers of interest to anthropologists, social scientists, and others who engage in qualitative or ethnographic research and have extended their scope to include broader frameworks. Although journals such as Medical Anthropology Quarterly and Human Organization are key publications of the American Anthropological Association, they increasingly feature interdisciplinary research papers including those from outside of anthropology. Anthropology & Medicine, Culture, Medicine, and Psychiatry, Medical Anthropology, and Medicine Anthropology Theory are highly interdisciplinary journals that feature the work of a diverse array of social scientists, including anthropologists, conducting research at the intersections of biomedicine, health, society, and culture.

Films

There are several films that provide excellent overviews of the HIV/AIDS epidemic. These films are also extremely useful in the classroom as a way to visually narrate the history of HIV/AIDS and daily impact of the disease on people all over the world.

Documentaries

There are many nonfictional accounts of the epidemic that discuss the tumultuous history of HIV/AIDS research and policy and feature stories from people living with the disease. Cran and Barker 2006 is arguably the most comprehensive overview of the HIV/AIDS epidemic. Bilheimer 2003 also provides a thorough account of global HIV/AIDS including its history and its impact. Kennedy 2003, in addition to providing a broad summary of the epidemic, focuses on issues specific to India, Brazil, Thailand, Uganda, and Russia. In addition, Rossetti and d’Adesky 2003 highlights a particular facet of the history of HIV/AIDS, that of treatment activism, and attends to difficult issues around access to lifesaving treatment options for those who are most vulnerable. Focusing on treatment activism in the United States, France 2012 details the rise of the Aids Coalition to Unleash Power (ACT UP) and other AIDS activist groups, and their profound impact on the course of the epidemic. Other documentaries focus on specific populations or specific individual stories. Simone 2012, for instance, centers on the severe inequalities in HIV/AIDS morbidity and mortality facing African Americans in the United States. Ebor 2012 depicts the impact of the epidemic on older adults. Koch 2010 focuses on the epidemic in Washington, DC, portraying how national and local policies do very little to help those most in need, even in one of the most resource-rich countries in the world. Hallacy and Saiyot 2002 features the story of a young girl living in an AIDS hospice in Thailand in order to highlight the growing problem of AIDS orphans around the world. Likewise, Bibby 1998 follows the story of Ken Ward, a Native Canadian, in his quest to publicize and educate native peoples about HIV/AIDS.

  • Bibby, Alan, dir. 1998. The long walk. DVD. Montreal: National Film Board of Canada.

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    This documentary focuses on Ken Ward, the first Native Canadian to publicize his HIV/AIDS diagnosis. It follows his struggle to educate and teach prevention among Native Canadians in a variety of settings such as jails and schools and to combat the isolation, poverty, and stigma that compounds the situation of Native Canadians struggling with HIV/AIDS.

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  • Bilheimer, Robert, dir. 2003. A closer walk. DVD. Santa Monica, CA: Direct Cinema.

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    This documentary discusses a number of issues and features a variety of people impacted by the disease. Using celebrity activists, AIDS orphans, medical and social service providers, government officials, and prominent researchers, the film explores topics like the root causes of HIV/AIDS, the integral relationship between health and human rights, and the need for a universal response to combat HIV/AIDS.

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  • Cran, William, and Greg Barker, dirs. 2006. The age of AIDS. DVD. Arlington, VA: PBS Home Video.

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    Originally broadcast in two parts on 30–31 May 2006 as part of the Frontline television series. A documentary chronicling the twenty-five-year history of HIV/AIDS, this film details the search for the source of AIDS, the conservative political climate which contributed to its spread around the world, and the growing global pressure to adequately finance HIV/AIDS prevention and treatment in the developing world. The future of the epidemic in India and China is also explored.

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  • Ebor, Megan, dir. 2012. Even Me. DVD. Los Angeles: Univ. of California, Los Angeles.

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    Even Me depicts the impact of the HIV/AIDS epidemic on older adult populations, uncovering misconceptions about aging, sexuality, and HIV/AIDS. This documentary focuses on the older adult group that has been identified as an invisible at-risk population.

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  • France, David, dir. 2012. How to Survive a Plague. DVD. New York: Public Square Films.

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    Directed by journalist David France, this documentary focuses on the efforts of activist groups ACT UP and the Treatment Action Group (TAG) in the early years of the HIV/AIDS epidemic in the United States. It follows their struggle for response from the US government and medical establishment in developing effective HIV/AIDS medications.

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  • Hallacy, Jeanne, and Jamlong Saiyot, dirs. 2002. Mercy. DVD. Watertown, MA: Documentary Educational Resources.

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    Focused on a hospice facility in Bangkok, Thailand, that cares for AIDS orphans, this film chronicles the story of a young girl, the loss of her family, and her constant strength and hope. Using the young hospice patients, this documentary explores the growing concern about the future of children who are orphaned by HIV/AIDS and who are themselves grappling with medical and social issues.

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  • Kennedy, Rory, dir. 2003. Pandemic: Facing AIDS. DVD. New York: New Video Group.

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    Originally broadcast as a five-part series on HBO. Details a broad spectrum of issues related to the global HIV/AIDS epidemic by focusing on five individual stories from different parts of the world including India, Brazil, Thailand, Uganda, and Russia.

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  • Koch, Susan, dir. 2010. The Other City. DVD. Cabin John, MD: Cabin Films.

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    Washington, DC, is home to the highest HIV/AIDS rates in the United States, and this documentary provides an intimate look at grassroots activists and those most impacted by the disease as they try to overcome challenges related to lack of resources and the policies that keep these resources from reaching those truly in need.

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  • Rossetti, Ann T., and Anne-Christine d’Adesky, dirs. 2003. Pills, profits, protest: Chronicle of the global AIDS movement. DVD. New York: Action-Life Collective/Outcast Films.

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    This documentary about AIDS treatment activism focuses on drug development and research and health care access globally. Several countries like Brazil are featured for their success in making AIDS treatments available and accessible for everyone. The film ultimately asks whether the global community can afford universal HIV/AIDS treatment, positioning vulnerable populations against multibillion-dollar corporations, drug research operations, and governments.

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  • Simone, Renata, dir. 2012. Endgame: AIDS in black America. DVD. Arlington, VA: PBS Home Video.

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    Originally on 10 July 2012 as part of the Frontline television series. This documentary showcases the acute disparity of HIV/AIDS epidemic in the United States among African Americans. Using personal stories and interviews of HIV-positive African Americans throughout the country and with policymakers, researchers, and activists, this film explores issues of stigma, faith, and legacies of prejudice and discrimination that continue to contribute to the rapid spread of HIV/AIDS in the black community.

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Motion Pictures

There are several fictional accounts that document the reality of the epidemic and those who are impacted by it. Although there was a virtual absence of motion pictures about HIV/AIDS during the early years of the epidemic due to the divisive nature of the topic, Erman 2006, which features a man who discloses his positive HIV status to his family, and Epstein and Friedman 2004, which focuses on people memorialized in the AIDS quilt, were two notable exceptions. Epstein and Friedman 2004 even won an Oscar. Soon thereafter, in the 1990s, movies about HIV/AIDS became less controversial. Demme 2000 and Spottiswoode 2001, for instance, are movies about HIV/AIDS that feature popular actors such as Tom Hanks, Denzel Washington, Matthew Modine, and Alan Alda. In the 2000s, even more feature films were made about HIV/AIDS. Chappell and Peix Eyrolle 2004 explores questions about the methods employed during polio vaccination campaign in Zaire in the late 1950s and its direct contribution to the origin of the HIV virus. Other feature films like Daniels 2010, Murphy 2014, Roodt 2006, Schmitz 2011, and Vallée 2014, which focus on the direct impact of HIV/AIDS on individuals and families, particularly activists and those with HIV, particularly women and children.

  • Chappell, Peter, and Catherine Peix Eyrolle, dirs. 2004. Origins of AIDS. DVD. Toronto: Canadian Broadcasting Corporation.

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    Investigating an extremely controversial hypothesis put forth by journalist Edward Hooper’s book The River, this film explores the possibility of HIV/AIDS as having resulted from a mass vaccination campaign against polio using an experimental polio vaccine and vaccine harvesting methods in Zaire (the Belgian Congo) between 1957 and 1960.

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  • Daniels, Lee, dir. 2010. Precious, 2009. DVD. Santa Monica, CA: Lionsgate.

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    One of the few feature films about HIV/AIDS and its impact on African American women, it tells the horrific story about a teenage girl in Harlem in the late 1980s who is sexually abused by her father and later finds out that she is HIV positive.

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  • Demme, Jonathan, dir. 2000. Philadelphia, 1993. DVD. Culver City, CA: Columbia TriStar Home Video.

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    Based on a real story, this movie focuses on a lawyer who takes legal action against his employer to prove that he was fired as a result of his AIDS diagnosis.

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  • Epstein, Robert, and Jeffrey Friedman, dirs. 2004. Common threads: Stories from the quilt, 1989. DVD. New York: New Yorker Video.

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    The first feature film focused on HIV/AIDS to win an Oscar, it profiles several people memorialized in the AIDS Quilt.

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  • Erman, John, dir. 2006. An early frost, 1985. DVD. New Almaden, CA: Wolfe Video.

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    This made-for-television movie was one of the earliest to address HIV/AIDS directly. It features an attorney who comes out to his parents and reveals that he has AIDS.

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  • Murphy, Ryan, dir. 2014. The Normal Heart. DVD. New York: Home Box Office.

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    The film depicts the rise of the HIV/AIDS crisis in New York City between 1981 and 1984, as seen through the eyes of writer/activist Ned Weeks, the founder of a prominent HIV advocacy group.

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  • Roodt, Darrell, dir. 2006. Yesterday, 2004. DVD. New York: Home Box Office.

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    An Oscar-nominated film, this movie portrays a young Zulu mother who finds out that she is HIV-positive and is determined to stay alive to see her daughter go to school. She cares for her husband as he dies of AIDS despite their banishment from their community. This film touches upon the social, economic, and political determinants of HIV/AIDS.

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  • Schmitz, Oliver, dir. 2011. Life, above all, 2010. DVD. Culver City, CA: Sony Pictures Home Entertainment.

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    This film depicts the struggles of children who are impacted by HIV/AIDS through a story of a twelve-year-old South African girl who struggles to save her family and best friend from prejudiced neighbors.

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  • Spottiswoode, Roger, dir. 2001. And the band played on, 1993. DVD. New York: HBO Video.

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    Adapted from Randy Shilts’s book about the early years of the HIV/AIDS epidemic, this feature film begins in 1981 when researchers stumble onto an unknown disease that is killing homosexual men. It chronicles several related stories including the race between American and French research teams to find the virus and the devastating effects of AIDS on people.

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  • Vallée, Jean-Marc, dir. 2014. Dallas Buyers Club. DVD. Woodlands, TX: Truth Entertainment.

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    Based on a true story, the film follows the journey of Ron Woodrof, a man who contracted AIDS in the late 1980s. In response to the difficulty of obtaining treatment, Woodrof began smuggling unapproved antiretroviral pharmaceuticals into Texas and distributing them.

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Reference Resources

There are a variety of ways to gain important information about HIV/AIDS. Data sources like those from the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization (WHO), the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis, and Malaria, AIDSinfo, the Centers for Disease Control and Prevention (CDC), and the Kaiser Family Foundation (KFF) are excellent places for finding out the latest statistics and reports on HIV/AIDS. Organizations such as the Society for Medical Anthropology (SMA) and the AIDS and Anthropology Research Group (AARG) also provide information on anthropology-related research about HIV/AIDS.

Early Anthropology Studies

Anthropology was unsuccessful at distinguishing itself in its response to the epidemic and, consequently, the prevailing principles determining the management of HIV/AIDS research were established mainly without input from anthropological contributions. The tenets of HIV/AIDS research were conceptualized largely through a biomedical lens, with a focus on the individual, making the development and implementation of a social science research agenda that was equally substantial and effective more difficult. This framework arguably reflected much of the initial anthropological work which, rather than dissecting the study of biomedical construction and contextualizing of HIV/AIDS, sought to provide social and cultural input into established concepts of risk behavior defined solely in terms of sexuality and drug use—and in some cases, even going so far as to detail “exotic” aspects of sexual or ritual behavior in other cultures. Many anthropologists working on the front lines early in the epidemic were mainly those focusing on medical anthropology and sexuality, and working at the intersection of diverse fields of study and settings. Some of the initial works spearheaded by anthropologists have been edited interdisciplinary volumes dedicated to HIV/AIDS research (Feldman and Johnson 1986 and Gorman 1986, both cited under Contributions to Epidemiology; and Herdt, et al. 1991, cited under Questioning Biomedical Paradigms).

Contributions to Epidemiology

Many anthropological contributions during this time focused mainly on contributions to epidemiology. For instance, Coates, et al. 1989 and Des Jarlais, et al. 1986 argued for the importance of measuring risk behaviors. Abramson and Herdt 1990, Bateson and Goldby 1988, Farmer and Kleinman 1989, Feldman and Johnson 1986, and Gorman 1986 concentrated on the social dimensions of disease transmission and prevention, human suffering, and health care delivery. Some research contributions, like those from Des Jarlais, et al. 1986 and Moore and Le Baron 1986 detailed blood and sex rituals as ways to understand the cultural factors contributing to the spread of disease. The principal goal of these early studies, thus, was to play a role in the public health disease prevention and intervention programs designed to minimize behaviors associated with increased risk for HIV infection, and to contribute to the scientific and clinical understanding of the disease.

  • Abramson, P. R., and G. Herdt. 1990. The assessment of sexual practices relevant to the transmission of AIDS: A global perspective. Journal of Sex Research 27:215–232.

    DOI: 10.1080/00224499009551553Save Citation »Export Citation » Share Citation »

    Authors argue that better data on sexual practices will enhance the accuracy of HIV prevalence estimates and promote the World Health Organization’s efforts to gather information on global sexual practices. They provide basic strategies for collecting global data on cross-cultural sexual practices and patterns.

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  • Bateson, Mary Catherine, and Robert Goldby. 1988. Thinking AIDS: The social response to the biological threat. Reading, MA: Addison Wesley.

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    Alternating between examinations of and the social responses to the epidemic, the authors advocate strongly for discussing AIDS pragmatically. They also suggest policy recommendations which for the time would have been considered radical: political rights for gay men and women and legalized shooting galleries for intravenous drug users.

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  • Coates, T. J. R., R. Stall, J. Catania, and S. Kegeles. 1989. Behavioral factors in HIV infection. AIDS 2 Suppl. 1: 239–246.

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    Making the argument that sexual behavioral change is a necessary part of HIV/AIDS prevention and that medical interventions are not enough to stem the epidemic, this article presents a broad overview of the sexual behaviors contributing to the transmission of the virus. It also calls for community-level prevention programs to target at-risk populations not located at the epicenters of the epidemic.

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  • Des Jarlais, Don C., Samuel R. Friedman, and David Strug. 1986. AIDS and needle sharing within the IV-drug use subculture. In The social dimension of AIDS: Method and theory. Edited by D. Feldman and Thomas M. Johnson, 111–126. New York: Praeger.

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    Using interpretations of the meanings of needle sharing as an exotic bonding ritual, this article presents a basic overview of the epidemiology of the epidemic impact on intravenous drug users and outlines the best methods of prevention among this high-risk group.

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  • Farmer, Paul, and Arthur Kleinman. 1989. AIDS and human suffering. Daedelus 118:135–159.

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    This piece uses suffering as a symbolic metaphor for AIDS and focuses on the amplified suffering of individuals and communities that is caused by existing social norms rooted in fear, discrimination, and social inequities.

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  • Feldman, Douglas, and Thomas M. Johnson, eds. 1986. The social dimension of AIDS: Method and theory. New York: Praeger.

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    This collection was written in response to much of the early uncertainty regarding the disease, its transmission, and its effects, and outlines three major areas where research was needed at the time: (1) social epidemiology (2) sociocultural and psychosocial research and (3) prevention-based interventions.

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  • Gorman, E. Michael. 1986. Introduction: Anthropology and AIDS. Medical Anthropology Quarterly 17:31–32.

    DOI: 10.1111/j.1937-6219.1986.tb01011.xSave Citation »Export Citation » Share Citation »

    Based on a special session of the 1984 American Anthropological Association, this collection of papers represents a cross-section of work done by anthropologists in conjunction with medical professionals. Authors discuss issues of concern to anthropologists including stigmatization of at-risk populations, public policy issues, and the intersection between culture and health care service delivery.

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  • Moore, Alexander, and Ronald D. Le Baron. 1986. The case for a Haitian origin of the AIDS epidemic. In The social dimension of AIDS: Method and theory. Edited by D. Feldman and Thomas M. Johnson, 77–94. New York: Praeger.

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    Although there was no evidence that the virus originated in Haiti or that voodoo practices played a role in transmitting HIV, these authors construct a complex web of speculation of the epidemic’s origins in Haiti. This article exemplifies how social scientists were not immune to providing theories that led to further stigmatization of certain groups associated with HIV/AIDS.

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Questioning Biomedical Paradigms

As increasing numbers of anthropologists became involved in both domestic and international HIV/AIDS research, as more information regarding disease etiology and transmission came to light, and as public health programs began to proliferate across diverse sociocultural settings, questions regarding the foundational tenets of research principles and intervention and prevention strategies began to arise. Darrow, et al. 1986, for instance, argued that epidemics were not random biological events, but that they spread along existing fault lines of structural and social inequalities. Patton 1990 deconstructed the powerful ability of science to make and disseminate truth claims about HIV/AIDS, while Gilman 1988, Glick-Schiller 1992, Herdt 1992, and Marshall and Bennett 1990 detailed how scientific paradigms created and sanctioned negative associations between certain groups of people and the disease. Herdt, et al. 1991 and Parker, et al. 1991 provided alternative strategies to HIV/AIDS prevention by calling for interventions that account for both human behavior and sociocultural systems.

  • Darrow, William W., E. Michael Gorman, and Brad P. Glick. 1986. The social origins of AIDS: Social change, sexual behavior, and disease trends. In The social dimension of AIDS: Method and theory. Edited by D. Feldman and T. M. Johnson, 95–110. New York: Praeger.

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    This paper explores why the epidemic has had an impact on seemingly disparate populations including intravenous drug users, hemophiliacs, and homosexual men. It elucidates the point that epidemics do not just happen at random; rather they are biological processes that take place within specific cultural environments and social structures.

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  • Gilman, Sander. 1988. AIDS and syphilis: The iconography of disease. In AIDS: Cultural analysis/cultural activism. Edited by Douglas Crimp, 87–107. Cambridge, MA: Massachusetts Institute of Technology Press.

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    This article presents a detailed historical exploration of the characterization of AIDS as a sexually transmitted disease and its subsequent formulation as an iconic disorder. The author argues that the iconography of AIDS, like syphilis, labels any individual associated with the disease with negative associations related to his or her behaviors and values that may not have any basis in reality.

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  • Glick-Schiller, Nina. 1992. What’s wrong with this picture? The hegemonic construction of culture in AIDS research in the United States. Medical Anthropology Quarterly 6.3: 237–254.

    DOI: 10.1525/maq.1992.6.3.02a00040Save Citation »Export Citation » Share Citation »

    By analyzing the production and rationale of the categorization of “risk” and risk groups and behaviors, this article mainly raises questions regarding the differences between risk group and risk behavior, and the ways in which “subgroup” cultures have been created and validated in biomedical HIV/AIDS discourses.

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  • Herdt, Gilbert. 1992. Introduction. In The time of AIDS: Social analysis, theory, and method. Edited by G. Herdt, 3–26. Newbury Park, CA: SAGE.

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    The main argument is that the dominant biomedical discourses of “subcultures” only serve to reproduce the margin/ mainstream divide, and that this, in turn, makes it difficult to pay attention to the intricacies and complexities of behavior across and within societies and cultures.

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  • Herdt, Gilbert, William Leap, and Melanie Sovine. 1991. Anthropology, sexuality, and AIDS: Introduction. Journal of Sex Research 28.2: 171–187.

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    A special issue featuring theoretical and methodological ethnographic perspectives of sexuality and AIDS, it focuses on social and cultural approaches for the prevention of disease in AIDS research, education, and service provision.

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  • Marshall, Patricia, and Linda A. Bennett. 1990. Anthropological contributions to AIDS research. Medical Anthropology Quarterly 4.1: 3–5.

    DOI: 10.1525/maq.1990.4.1.02a00010Save Citation »Export Citation » Share Citation »

    Encourages anthropologists to focus on risk behaviors rather than risk groups, and to continue to illuminate the limitations of behavioral interventions that focus solely on education or individual psychology.

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  • Parker, Richard, Gilbert Herdt, Manuel Carballo. 1991. Sexual culture, HIV transmission, and AIDS research. Journal of Sex Research 28.1: 77–98.

    DOI: 10.1080/00224499109551596Save Citation »Export Citation » Share Citation »

    Written during a time when there was very little data on human sexuality globally, this article lays out strategies to promote qualitative work on sexual culture. It calls for better understandings of how sexual categories and classification labels, partner relations, sexual practices, and contraceptive use are understood and made meaningful.

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  • Patton, Cindy. 1990. Inventing AIDS. London: Routledge.

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    A groundbreaking book, it focuses on social science scholars’ failure to question how and why biomedical science has become the central tenet of HIV/AIDS knowledge. The author argues that the logic of science itself makes and disseminates truth claims about what counts as “real” and “objective” aspects of the epidemic.

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Cultural Interpretation of Disease

The second decade of the epidemic ushered in many more anthropologists who were involved in the kinds of HIV/AIDS research that posed considerable challenges to established biomedical, epidemiological, and psychological HIV/AIDS approaches. Many anthropologists focused on the interpretation of cultural meanings, as opposed to quantifiable behavioral data, and saw cultural interpretations of sexual behaviors, sexuality, and drug use across and within a variety of settings as vital to the development of more suitable HIV/AIDS intervention and prevention programs. There were several good edited volumes and review articles that attended to the cultural construction of HIV/AIDS and sexuality including those from Herdt and Lindenbaum 1992, Parker 2001, and ten Brummelhuis and Herdt 1995. Some notable individual papers also provided alternative theoretical and methodological frameworks for studying HIV/AIDS stigma (Parker and Aggleton 2003) and marginalized communities such as drug users (Kane and Mason 1992; Page, et al. 1990) and homosexual men (Levine 1992). The directional change toward a more interpretive anthropology of HIV/AIDS was mainly influenced by symbolic interactionism, the postmodern turn in anthropology, women’s studies, and (what was to become) queer studies. These interdisciplinary forces helped to formulate a growing trend of analyzing descriptions of behaviors concerned with local categories of meaning as well as intra-cultural variations.

  • Herdt, Gilbert, and Shirley Lindenbaum, eds. 1992. The time of AIDS: Social analysis, theory, and method. Newbury Park, CA: SAGE.

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    This edited volume provides an excellent introduction to the cultural, political, methodological, and theoretical issues concerning HIV/AIDS. Questions related to the usefulness of culture in the study of HIV/AIDS, the utility of existing biomedical categories, and the ethics involved in applied social science research center authors’ arguments.

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  • Kane, Stephanie, and Theresa Mason. 1992. “IV drug users” and “sex partners”: The limits of epidemiological categories and the ethnography of risk. In The time of AIDS: social analysis, theory, and method. Edited by G. Herdt and Shirley Lindenbaum, 199–224. Newbury Park, CA: SAGE.

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    Focusing on the limits of ethnographic and epidemiological research that advocate for intervention at the level of social groups, the authors advocate for studying risk behaviors of injecting drug users within the context of complex drug distribution systems and the government’s war on drugs which often undermine HIV/AIDS prevention programs.

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  • Levine, Martin P. 1992. The implications of constructionist theory for social research on the AIDS epidemic among gay men. In The time of AIDS: Social analysis, theory, and method. Edited by G. Herdt and Shirley Lindenbaum, 185–198. Newbury Park, CA: SAGE.

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    Providing a broad overview of research on gay men and HIV/AIDS and using the central anthropological concern with meaning, this article explores issues related to the encoding of homosexuality in survey research and proposes a constructivist framework for the study of HIV/AIDS.

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  • Page, Bryan J., Prince C. Smith, and Normie Kane. 1990. Shooting galleries, their proprietors, and implications for prevention of AIDS. Drugs and Society 5.1–2: 69–85.

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    An early study of drug use and HIV/AIDS that explores the numerous and complex variations between the types of drugs utilized and drug networks, it highlights the divergent social relationships among individuals, groups, and institutions.

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  • Parker, Richard. 2001. Sexuality, culture, and power in HIV/AIDS research. Annual Review of Anthropology 30:163–179.

    DOI: 10.1146/annurev.anthro.30.1.163Save Citation »Export Citation » Share Citation »

    An excellent overview of two decades of anthropological research on HIV/AIDS and sexuality. In particular, issues related to the study of the shared character of sexual meanings, the situational contexts in which sexual practices take place, the social scripting of sexual encounters, the meanings of sexual practices, and the multiple existing sexual cultures and subcultures within different societies are highlighted.

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  • Parker, Richard, and Peter Aggleton. 2003. HIV and AIDS-related stigma and discrimination: A conceptual framework and implications for action. Social Science and Medicine 57:13–24.

    DOI: 10.1016/S0277-9536(02)00304-0Save Citation »Export Citation » Share Citation »

    Drawing from Foucault, Bourdieu, and Gramsci, the authors build a conceptual framework for studying HIV/AIDS-associated stigma that extends beyond previous studies of social psychology, anthropology, and sociology. They conceptualize stigma and discrimination as social processes, rather than as things, better understood only in relation to broader notions of power and domination.

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  • ten Brummelhuis, Han, and Gilbert Herdt, eds. 1995. Culture and sexual risk. Sydney, Australia: Gordon and Breach Science.

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    Focusing on the cultural, political, and socioeconomic contexts of sex roles and sexuality, these essays argue that high-risk sexual behavior is embedded in systems of culture and economic exchange and highlight the daily practices of various communities said to be engaged in high-risk sexual behavior throughout the world.

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Political Economy of Health

The second decade of the epidemic also gave rise to anthropological work that focused heavily on structural factors contributing to susceptibilities of HIV/AIDS; Lockhart 2008, Nguyen and Peschard 2003, Schoepf 2001, Setel 1999, and Singer 1998 provide excellent overviews of the political history and economy of HIV/AIDS. Inspired by the budding disciplines of development studies, political economy, postcolonial studies, and ethnic studies, such research strived to show that macro-level factors mediated sociocultural dynamics at the local level. Much of this work on social inequality, power, hegemony, and the political economy of risk was spearheaded by HIV/AIDS research in developing countries and by a growing body of work in the United States that underscored the myriad of social processes that were responsible for higher rates of infection in gay and bisexual men, drug users, women, and babies in communities of color. For instance, Farmer, et al. 1996; Sobo 1995; Susser 2009; and Worth 1990 detail the difficult and destitute circumstances of women in various parts of the world which increase their vulnerability to HIV/AIDS; while Quimby 1992 focuses on the social and structural barriers that contribute to the increased suffering faced by African American communities. This turn continues to offer the potential for generating appropriate change and growth from within communities and groups themselves. Focus on the political economy of HIV/AIDS has generated a move toward a better understanding of the interrelatedness of disease and social transformations not just in terms of risk reduction and disease prevention, but also in the formulation of good health as social, political, and economic equality.

  • Farmer, Paul, Margaret Conners, and Janie Simmons, eds. 1996. Women, poverty, and AIDS: Sex, drugs, and structural violence. Monroe, ME: Common Courage.

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    Focusing on the severe burden that HIV/AIDS has imposed on women, this edited volume presents a wide variety of statistical portrayals coupled with the impact of macro-social forces on women affected by HIV/AIDS. There are several poignant vignettes of individual women from the United States, Haiti, and Africa.

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  • Lockhart, Chris. 2008. The life and death of a street boy in East Africa: Everyday violence in the time of AIDS. Medical Anthropology Quarterly 22.1: 94–115.

    DOI: 10.1111/j.1548-1387.2008.00005.xSave Citation »Export Citation » Share Citation »

    Powerfully written, this article focuses on a life history of a street boy to demonstrate how his experiences and those of others are structured by everyday violence—the interplay between larger socio-structural forces and the everyday lived experiences of individuals.

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  • Nguyen, V. -K., and K. Peschard. 2003. Anthropology, inequality, and disease: A review. Annual Review of Anthropology 32:447–474.

    DOI: 10.1146/annurev.anthro.32.061002.093412Save Citation »Export Citation » Share Citation »

    This review article argues that socioeconomic inequality is highly correlated with poor health outcomes and that illness and suffering cannot be understood outside the context of social hierarchy and structural violence.

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  • Quimby, Ernest. 1992. Anthropological witnessing for African Americans: Power, responsibility, and choice in the age of AIDS. In The time of AIDS: Social analysis, theory, and method. Edited by G. Herdt and Shirley Lindenbaum, 159–184. Newbury Park, CA: SAGE.

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    Chronicles HIV/AIDS in African Americans and social movements in response to the epidemic and argues that many African Americans perceive AIDS as another form of suffering. Main argument is that HIV/AIDS reveals longstanding problems related to unequal, inadequate, or inaccessible services, educational and employment vacuums, structural underdevelopment and dependency, racism, sexism, and homophobia.

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  • Schoepf, Brooke G. 2001. International AIDS research in anthropology: Taking a critical perspective on the crisis. Annual Review of Anthropology 30.1: 335–361.

    DOI: 10.1146/annurev.anthro.30.1.335Save Citation »Export Citation » Share Citation »

    Champions anthropological involvement in research on HIV/AIDS in Africa, and presents a broad overview of work that focuses on the relations between the global political economy and the everyday lives of those impacted by the disease.

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  • Setel, Philip. 1999. Plague of paradoxes: AIDS, culture, and demography in northern Tanzania. Chicago: Univ. of Chicago Press.

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    By carefully tracing the demographic, epidemiological, social, and political history of HIV/AIDS in northern Tanzania, the author argues that the epidemic grew out of conflicting demographic and economic forces that were in place before colonialism. The author also maintains that the economic and geographic routes used to escape harsh working conditions became the exact same pathways to HIV/AIDS risk.

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  • Singer, Merrill, ed. 1998. The political economy of AIDS. Amityville, NY: Baywood.

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    An important overview of early studies of key structural factors that influence the epidemic in a variety of settings and the ensuing response by different groups of communities, including scientists, researchers, and policymakers. The volume covers topics such as the political economy of disease, poverty, racism, gender inequality, and unequal access to quality health care.

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  • Sobo, Elisa. 1995. Choosing unsafe sex: AIDS risk denial among disadvantaged women. Philadelphia: Univ. of Pennsylvania Press.

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    Focusing on inner-city African American women and their continued engagement in unprotected sex despite their extensive knowledge about HIV/AIDS transmission, the author highlights the political and economic context of severe racism, poverty, and discrimination that have a profound impact on how women make choices about safe sex.

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  • Susser, Ida. 2009. AIDS, sex and culture: Global politics and survival in Southern Africa. Oxford: Wiley-Blackwell.

    DOI: 10.1002/9781444306163Save Citation »Export Citation » Share Citation »

    Using the backdrop of Thabo Mbeki’s AIDS denialism, the postapartheid period in South Africa, and the conservative social politics associated with US-based funding, this book provides an overview of how such globalizing forces have contributed to the escalation of gender inequities in southern Africa. It also focuses on how local women play a critical role in stemming the epidemic.

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  • Worth, Dooley. 1990. Minority women and AIDS: Culture, race, and gender. In Culture and AIDS. Edited by D. Feldman, 111–136. New York: Praeger.

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    One of the earliest works on women of color and HIV/AIDS, this piece examines the ways in which gender and sexuality are structural, rather than behavioral, factors that shape the epidemic. The author argues that sexuality and gender cannot be understood outside the context of immigration, colonialism, racism, sexism, and economic and political oppression.

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Knowledge, Power, and Discourse

Beginning around the third decade of the epidemic, many turned to feminist, postcolonial, critical race, and postmodern theories in order to provide analyses focused on the social, economic, and political consequences of the epidemic and the productive and repressive role of governing bodies.

Africa

With a heavy focus on southern Africa, these studies focus on the micro and macro processes of colonialism, nationalism, globalization, and development in Africa and their continued impact on broader logics of power and local experiences of suffering. Studies of HIV in Africa explore a variety of topics including the social and biomedical effects of antiretroviral treatment and other public health interventions (Marsland 2012, Naidu and Khumalo 2016, Prince 2012, Vale and Thabang 2016, Whyte 2014), cultural transformations (Golomski 2018, Smith 2014), and everyday experiences of health professionals (Kwakuya, et al. 2012; Tantchou 2014). Hlabangane 2014 provides a critical examination of anthropological discourses of HIV in Africa, arguing that they often reproduce age-old colonial prejudices.

  • Golomski, Casey. 2018. Funeral culture: AIDS, work, and cultural change in an African kingdom. Bloomington: Indiana Univ. Press.

    DOI: 10.2307/j.ctv1xz10vSave Citation »Export Citation » Share Citation »

    Focused on those who care for the sick and bury the dead in Swaziland, this ethnography illustrates how AIDS has engendered transformations in discourses surrounding value of life, culture, and materiality, ushering in new ways in which people think about and perform funeral customs and practices.

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  • Hlabangane, Nokuthula. 2014. From object to subject: Deconstructing anthropology and HIV/AIDS in South Africa. Critique of Anthropology 34.2: 174–203.

    DOI: 10.1177/0308275X13519274Save Citation »Export Citation » Share Citation »

    Provides a critique of anthropological HIV/AIDS discourse in South Africa, arguing that considering the history and practices of the discipline of anthropology reveals that this discourse often reverts to age-old problematic notions.

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  • Kwakuya, Margaret, Anita Hardon, and Zoe Goldstein. 2012. “The adopted children of ART”: Expert clients and role tensions in ART provision in Uganda. Medical Anthropology 31.2: 149–161.

    DOI: 10.1080/01459740.2011.603399Save Citation »Export Citation » Share Citation »

    This article focuses on the engagement of “expert clients” who assist nurses in managing antiretroviral clinics, provide compassionate care, and possess knowledge of AIDS medicines. Explores the double burden this presents for HIV-positive nurses who must simultaneously negotiate their professional boundaries and keep their status a secret.

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  • Marsland, Rebecca. 2012. (Bio)Sociality and HIV in Tanzania: Finding a living to support a life. Medical Anthropology Quarterly 26.4: 470–485.

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    Explores the conditions of life on antiretroviral therapy in Tanzania, examining the sociality inherent to the biological status of being HIV positive.

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  • Naidu, Maheshvari, and Sinekekwela Khumalo. 2016. I am circumcised so HIV/AIDS can’t touch me!? Young black African university men and narratives of masculinity. Oriental Anthropologist 16.1: 163–181.

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    Examines how the practice of medical male circumcision as an intervention against HIV/AIDS is understood by young black African male university students, showing how misunderstandings of these interventions compound the HIV risk faced by these students and their partners, and how the construction of African masculinity and manhood related to circumcision influence its potential health benefits.

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  • Prince, Ruth. 2012. HIV and the moral economy of survival in an East African city. Medical Anthropology Quarterly 26.4: 534–556.

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    Explores the place of antiretroviral treatment plans within the broader moral economies of the lives of patients in terms of food, hunger, social relationships, and networks of care. Situated in Kenya, the article argues that HIV identities provide ways for people to become visible to the flow of funds and the distribution of goods by NGOs.

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  • Smith, Daniel Jordan. 2014. AIDS doesn’t show its face. Chicago: Univ. of Chicago Press.

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    Explores the ways in which Nigerians view both AIDS and social inequality through a moral lens as ethical failures, drawing out the relationship between these social and medical anxieties.

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  • Tantchou, Josiane. 2014. “Poor working conditions, HIV/AIDS and burnout: A study in Cameroon.” Anthropology in Action 21.3: 31–42.

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    This article traces the existence, extent, and impact of burnout among health workers in a large public hospital in Cameroon. The article argues that burnout was exacerbated by a psychosocial dimension in the care of people with HIV/AIDS.

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  • Vale, Beth, and Mildred Thabang. 2016. Redeeming lost mothers: Adolescent antiretroviral treatment and the making of home in South Africa. Medical Anthropology 35.6: 489–502.

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    Argues that antiretroviral treatment undergone by adolescents in South Africa functions as a means of social repair, signifying the treatment as an enactment of the discipline and care purportedly absent in lost mothers.

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  • Whyte, Susan R., ed. 2014. Second chances: Surviving AIDS in Uganda. Durham, NC: Duke Univ. Press.

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    This collection of essays, by both Western and African scholars, explores the scale-up of antiretroviral treatment in Uganda and how it engendered “second chances” for survivors.

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Asia

These studies carefully attend to the critical impact of various governmental and nongovernmental actors on the local responses to the epidemic as well as the social consequences for specific marginalized populations across the region. Beine 2005 focuses on how prevailing models of HIV/AIDS prevention education are actually counterproductive in Nepal and further stigmatize both people living with HIV/AIDS and health educators. Fordham 2004 and Lyttleton 2000 discuss the limitations of the normative model of the Thai AIDS epidemic. Hyde 2007 provides a comprehensive overview of the politics of HIV/AIDS in China. Boyce 2007 discusses the complex ways in which male desire and sexuality is conceived and experienced in contemporary discourses of HIV prevention in India. Qureshi 2018 explores how global HIV/AIDS policies have had lasting negative impacts on institutions and individuals in Pakistan. Chi, et al. 2011 in Vietnam and van Hollen 2013 in India examine the ways in which HIV positive women experience and make decisions related to pregnancy, birth, and care for children.

  • Beine, David K. 2005. Ensnared by AIDS: Cultural contexts of HIV/AIDS in Nepal. Kathmandu, Nepal: Mandala Book Print.

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    This book presents important arguments regarding how HIV/AIDS donor money plays a critical role in creating short-term solutions to deep-rooted economic and social issues that propel the epidemic. Nongovernmental organizations and other groups, even with donor support, are ultimately ill-equipped to address long-standing issues of poverty, basic health care infrastructure, and food insecurity in Nepal.

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  • Boyce, Paul. 2007. “Conceiving kothis”: Men who have sex with men in India and the cultural subject of HIV prevention. Medical Anthropology 26.2: 175–203.

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    Explores ways in which local, national, and global processes inform contemporary discourses on sexuality between men and the subjectivities of men who have sex with men.

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  • Chi, Bùi Kim, Vibeke Rasch, Nguyễn Thị Thúy Hạnh, and Tine Gammeltoft. 2011. Pregnancy decision-making among HIV positive women in Northern Vietnam: Reconsidering reproductive choice. Anthropology & Medicine 18.3: 315–326.

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    Through deep engagement with HIV positive pregnant women in Vietnam, this article explores the social processes through which they come to make decisions about their pregnancies, whether to terminate or continue them.

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  • Fordham, G. 2004. A new look at Thai AIDS: Perspectives from the margin. Oxford: Berghahn.

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    Arguing against the dominant framework that depicts Thai HIV/AIDS prevention efforts in the 1990s as a success story, the author makes careful analyses of how largely gender and class-based intervention programs, rooted in existing norms of class-based paternalism and morality, were used to control behavior and redraw moral boundaries.

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  • Hyde, Sandra T. 2007. Eating spring rice: The cultural politics of AIDS in southwest China. Berkeley: Univ. of California Press.

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    One of the only ethnographies of HIV/AIDS in China, it provides sociocultural and epidemiological analyses of the politics of HIV/AIDS, with a particular focus on stigma, governance, ethnicity, and sexual behavior.

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  • Lyttleton, C. 2000. Endangered relations: Negotiating sex and AIDS in Thailand. Amsterdam: Harwood Academic.

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    The author examines the Thai government’s response to HIV/AIDS using content analysis to provide a rich account of media messages used by the government to educate the public, and argues that these educational campaigns mainly focused on certain types of immoral behavior, most notably the use of commercial sex workers.

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  • Qureshi, Ayaz. 2018. AIDS in Pakistan: Bureaucracy, public goods and NGOs. Singapore: Palgrave Macmillan.

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    Examines outcomes of HIV prevention policies and efforts in Pakistan, especially as they are translated and received by local actors responding to the evolving HIV/AIDS crisis, emphasizing how the neoliberal contractualization of public services dispossesses the intended local beneficiaries in favor of a few powerful global actors.

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  • van Hollen, Cecilia. Birth in the age of AIDS: Women, reproduction, and HIV/AIDS in India. Stanford, CA: Stanford Univ. Press, 2013.

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    Documents the bleak realities that women living with HIV face during their reproductive years in Tamil Nadu, India, who often have little access to information and treatment and learn of their status upon the death of their husbands. These women face stigma and blame as they experience pregnancy as an HIV-positive widow, and make decisions related to family and children.

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Australia and Melanesia

With few exceptions (Persson 2011; Persson, et al. 2016), much of the anthropological literature on HIV/AIDS in this region focuses on Papua New Guinea on issues related to economic, social, and cultural factors (Butt and Eves 2008, Butt 2013, Herner 2015); gender (Wood 2014); knowledge about HIV (Wardlow 2012); and religious beliefs about HIV (Eves 2012).

  • Butt, Leslie. 2013. Local biologies and HIV/AIDS in Highlands Papua, Indonesia. Culture, Medicine and Psychiatry 37.1: 179–194.

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    Explores the local biologies of HIV infection among indigenous Papuans, showing how fear of stigmatization, regional political conditions, and gaps in care create conditions of evasions of care.

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  • Butt, Leslie, and Richard Eves, eds. 2008. Making sense of AIDS: Culture, sexuality, and power in Melanesia. Honolulu: Univ. of Hawai‘i Press.

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    This collection of studies utilizes a wide variety of methods and approaches to examine the global power relations that frame local articulations of sexuality and culture. It also explores local issues related to HIV/AIDS, particularly how differing groups throughout Melanesia understand and respond to the epidemic and prevention programs.

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  • Eves, Richard. 2012. Resisting global AIDS knowledges: Born-again Christian narratives of the epidemic from Papua New Guinea. Medical Anthropology 31.1: 61–76.

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    Explores local knowledges of AIDS in communities of born-again Christians in Papua New Guinea, discussing how translation and presentation of scientific facts are not sufficient to displace long-held beliefs about HIV and AIDS.

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  • Herner, Susan R. 2015. Breaking silences and upholding confidences: Responding to HIV in the Lihir Islands, Papua New Guinea. Medical Anthropology 34.2: 124–138.

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    Examines the silencing that is characteristic of the response to HIV/AIDS in the Lihir Islands in Papua New Guinea, arguing that the notion of confidentiality especially detracts from efforts to emphasize the serious nature of HIV.

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  • Persson, Asha. 2011. HIV-negativity in serodiscordant relationships: The absence, enactment, and liminality of serostatus identity. Medical Anthropology 30.6: 569–590.

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    Provides a much-needed examination of HIV-negative people who are in intimate relationships with HIV-positive people, a population that continues to remain largely invisible in the HIV/AIDS epidemic, and the ways in which HIV-negative identity is represented and experienced in serodiscordant relationships.

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  • Persson, Asha, Christy E. Newman, Limin Mao, and John de Wit. 2016. On the margins of pharmaceutical citizenship: Not taking HIV medication in the “treatment revolution” era. Medical Anthropology Quarterly 30.3: 359–377.

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    This article explores the implications of the choice of people in resource-rich settings to refuse or delay recommended medication. Drawing from ethnographic research in Australia, it argues that moral and normative expectations in the HIV era of treatment have the power to both demarginalize and marginalize people with HIV.

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  • Wardlow, Holly. 2012. The task of the HIV translator: Transforming global AIDS knowledge in an awareness workshop. Medical Anthropology 31.5: 404–419.

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    Examines the production of new, hybrid knowledges about HIV in the context of HIV and AIDS education programming. This article provides a case study of an awareness workshop in rural Papua New Guinea, which drew from materials provided by national and international organizations but was tailored significantly to the local context.

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  • Wood, Michael. 2014. Great ancestral women: Sexuality, gendered mobility, and HIV among the Bamu and Gogodala of Papua New Guinea. Oceania 84. 2: 185–201.

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    Examines the intersection of gendered mobility, sexuality, and ancestral narratives in Papua New Guinea as these stories are linked to understandings of diseases such as HIV/AIDS. The article argues that the mobility and sexuality of gendered ancestors is crucial to contemporary understandings of the HIV epidemic in Papua New Guinea.

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Latin America and the Caribbean

While HIV is transmitted through personal behaviors (sex, intravenous drug use, breastfeeding; as made evident in Farmer 1992, a seminal work on HIV in Haiti), the epidemic underscores complex historical and international issues in the region, from the economic forces shaping poverty (Padilla 2007) and global health interventions (Romero-Daza, et al. 2013; Singleton 2013) to the cultural beliefs that define difference, morality, and prejudice (Carrillo 2002, Heckert 2018).

  • Carrillo, Hector. 2002. The night is young: Sexuality in Mexico in the time of AIDS. Chicago: Univ. of Chicago Press.

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    Offers a vivid, thorough description of the dynamic relations between culture, sexuality, and gender and the challenges faced by those who work in HIV/AIDS prevention in early-21st-century Mexico.

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  • Farmer, Paul. 1992. AIDS and accusation: Haiti and the geography of blame. Berkeley: Univ. of California Press.

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    This book places the history of AIDS in Haiti and Haiti in AIDS within a larger transnational economic and political framework. It seeks to demonstrate how transnational forces have shaped the epidemiology of AIDS in Haiti and the meanings given to AIDS by Haitian villagers, Haitians living in the United States, US public health officials, and US popular media and opinion.

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  • Heckert, Carina. 2018. Fault lines of care: Gender, HIV, and global health in Bolivia. New Brunswick, NJ: Rutgers Univ. Press.

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    Explores how structural conditions in Bolivia are often used to explain away poor patient outcomes, normalizing the symbolic violence that perpetuates substandard care.

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  • Padilla, Mark. 2007. Caribbean pleasure industry: Tourism, sexuality, and AIDS in the Dominican Republic. Chicago: Univ. of Chicago Press.

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    An excellent investigation of the politics of sexuality and gender situated in colonial history and embedded in the growing Caribbean tourist industry. This book explores the various complex formal and informal exchanges related to pleasure and desire between tourists from richer countries and poor Dominican men.

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  • Romero-Daza, Nancy, Mackenzie Tewell, David Himmelgreen, Oriana Ramirez-Rubio, and Elsa Batres-Boni. 2013. Tourism and HIV: Involving women in the design of educational materials in rural Costa Rica. Anthropology in Action 20.1: 18–30.

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    Discusses a project in which local women from rural Costa Rica were involved in a participatory project to design HIV/AIDS educational materials in a context where tourism has become the predominant economic sector.

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  • Singleton, Benedict Esmond. 2013. “Before HIV you’re a human being”: PLWHA and reproduction in Jamaica. Identities: Global Studies in Culture and Power 20.3: 326–345.

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    This article explores the reproductive health needs of people living with HIV or AIDS in Jamaica, and whether dominant HIV messaging campaigns respond adequately to these needs. The article argues that given the recent paradigm shift from prevention to treatment of HIV, local perceptions of health needs must be acknowledged earlier.

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North America and Europe

Anthropological research of HIV/AIDS in North America and Europe is diverse with many scholars continuing to focus on sexuality, drug use, people living with HIV/AIDS, and gender and race issues. Inspired by recent theoretical turns, a growing number of anthropologists working in these regions are beginning to center on issues related to power, knowledge, and discourse within HIV/AIDS. For example, Treichler 1999 provides invaluable readings of the social history of HIV/AIDS from this region using historical-sociological analyses to highlight the complex issues that blur the boundaries between science and society. Villaamil 2014 explores how discussions around safe sex practices for those living with HIV in Spain reinforces unequal power dynamics between providers and patients. Scholars working in the United States on HIV/AIDS have examined experiences of adolescents (Philbin 2014), black women (Davis 2014, Heath 2016), Native Americans (Gilley and Pfeiffer 2017), Latinos (Servin, et al. 2014), and Haitians (Fouron 2013, Sangaramoorthy 2014, Cormier McSwiggin 2017).

  • Cormier McSwiggin, Chelsea. 2017. Moral adherence: HIV treatment, undetectability, and stigmatized viral loads among Haitians in South Florida. Medical Anthropology 36.8: 714–728.

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    Explores how some Haitians living with HIV in South Florida, through their “undetectable” HIV status, adopt new forms of subjectivity and identity that merge biotechnical categories and moral narratives of responsibility.

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  • Davis, Sarita. 2014. The Sojourner Syndrome: An interpretive framework for understanding poor black women’s HIV risk. Transforming Anthropology 22.2: 121–134.

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    Examines how the intersection of race, class, and gender influence HIV risk among black women in a poor urban community in Atlanta, Georgia. The article uses an interpretive framework called the Sojourner Syndrome to explore how marginalized black women find resilience to HIV risk.

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  • Fouron, Georges E. 2013. Race, blood, disease and citizenship: The making of the Haitian-Americans and the Haitian immigrants into “the others” during the 1980s–1990s AIDS crisis. Identities 20.6: 705–719.

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    Provides a historical overview of how public policy and popular opinions of HIV/AIDS contributed to the acute marginalization of Haitians and Haitian Americans globally and in the United States.

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  • Gilley, Brian J., and Elizabeth J. Pfeiffer. 2017. “White man’s disease”: American Indian AIDS conspiracy theories and the refusal of synthesis. Medicine Anthropology Theory 4.3.

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    Examines American Indian understandings of HIV/AIDS, exploring how their use of nonstandard theories of the origins of AIDS disrupts the AIDS-universalizing project, aligning the epidemic with historical social and medical neglect.

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  • Heath, Corliss D. 2016. Voices from the unheard: Perceptions of HIV among middle class black women in Atlanta. Transforming Anthropology 24.2: 97–115.

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    Examines HIV risk perceptions, knowledges, and sexual behaviors among middle-class black women in Atlanta, Georgia, an understudied group that falls outside of “traditional risk categories,” exploring how race, gender, and class interact to shape HIV risk in this population.

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  • Philbin, Morgan M. 2014. “What I got to go through”: Normalization and HIV-positive adolescents. Medical Anthropology 33.4: 288–302.

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    Examines the lives of HIV-positive adolescents in Baltimore, Maryland, who are at the beginning of a lifelong treatment process, exploring the tensions between their lived experience with HIV as compared to its framing by policymakers and researchers as a normalized chronic disease.

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  • Sangaramoorthy, Thurka. 2014. Treating AIDS: Politics of difference, paradox of prevention. New Brunswick, NJ: Rutgers Univ. Press.

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    Using the deployment and interpretation of AIDS statistical data among Haitians in Miami, this book explores the various levels of surveillance that structure HIV/AIDS prevention programs and highlights how “numerical subjectivities” circulate, how identity and subjectivity become entangled in numerical considerations, and how particular groups of people come to be identified with certain diseases such as HIV/AIDS.

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  • Servin, Argentina E., Fátima A. Muñoz, and María Luisa Zúñiga. 2014. Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border. Culture, Health & Sexuality 16.5: 587–599.

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    Uses a border health perspective to understand barriers to care for Latinos living with HIV in the US-Mexico border region. The article argues that differences and similarities between US and Mexican health-care providers have important implications for cross-border efforts to coordinate health services.

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  • Treichler, Paula. 1999. How to have a theory in an epidemic. Durham, NC: Duke Univ. Press.

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    This book brilliantly combines linguistic discourse analysis with Foucault’s broader historical-sociological view of discursive formations, power, and social and institutional regulation in order to explore the history and controversies surrounding the HIV/AIDS epidemic. The author argues that AIDS is as much about medicine as it is about meanings, definitions, and attributions.

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  • Villaamil, Fernando. 2014. Shared embarrassment: (Not) Talking about sex in HIV-related doctor-patient examinations. Medical Anthropology 33.4: 335–350.

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    Explores how safer sexual practices are promoted in doctor-patient encounters in the context of treatment of HIV in Madrid, Spain. The article argues that silence surrounding sexual matters and the sexuality of people with HIV legitimates the power relationship between doctors and patients around a biomedical narrative of safer sexual practices.

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Future Directions

The turn toward issues of knowledge, power, discourse, and practice has spurred new and exciting directions for the anthropology of HIV/AIDS. These new directions parallel those of the discipline of medical anthropology more broadly where interdisciplinary work is the mainstay of future scholarly work. This innovative work can be found at the nexus of medical anthropology and the fields of public policy, global public health, and science and technology studies.

Public Policy

Although very few anthropologists are trained in public policy, a growing legion of scholars are advocating for anthropologists to study and to participate in public policy issues, not only in terms of policy analysis (Lewellen 2012), but more broadly in investigating and analyzing the governmental decision-making process and its lasting impact on HIV/AIDS and social vulnerability. Biehl 2005, for instance, explores how Brazil’s health and social policies contribute to the increasing number of those who are socially abandoned and left to die. Fassin 2007 similarly argues that the spread of HIV/AIDS in South Africa was spurred by the violence of history under apartheid policies and structures, while Powers 2017 traces more recent public policy development around HIV/AIDS. Owczarzak 2009, meanwhile, discusses the everyday practices of HIV/AIDS prevention that result from the framing of the epidemic as a critical policy issue in postsocialist contexts. Using visual ethnographic methods, Datta 2017 focuses on the implementation of public policy for HIV-positive people with neuropsychiatric comorbidities in rural India. Desclaux 2014 explores the everyday effects of policy changes, including new forms of sociality, brought about by global “informed choice” management approaches, while Rosenthal 2016 examines how a shift in universal access to treatment in Malawi generated new challenges in the country’s health system. O’Daniel 2018 explores health policy changes brought about by national health care reform in the United States and the impact that it has had on women living with HIV and their providers in Indiana. Kenworthy, et al. 2018 argues how discourses signaling the “end of AIDS” are leading to the transformation of global policy around HIV/AIDS in terms of research, funding, and political attention.

  • Biehl, J. 2005. Vita: Life in a zone of social abandonment. Berkeley: Univ. of California Press.

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    Although not directly focused on HIV/AIDS, it examines the practices of health, social, and moral governance that render people socially invisible and physically removed from social life, and explores the ethical responsibility of researchers and society as a whole to such marginalized groups.

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  • Datta, Guarav. 2017. Visual ethnography in an AIDS hospice for the socially abandoned and terminally ill. Visual Anthropology 30.5: 403–411.

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    Explores the effective implementation of public health policy through the lens of hospices for patients with AIDS and neuropsychiatric complications in rural Gujarat, India.

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  • Desclaux, Alice. 2014. After the withdrawal of “informed choice”: The meanings and social effects of mothers’ choice for HIV prevention in Senegal. Anthropology and Medicine 21.2: 113–124.

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    Focuses on the local effects of changes in public health policies through the lens of the withdrawal of the World Health Organization’s “informed choice” approach that provided formula to HIV-positive mothers in Senegal. The article argues that the introduction of “informed choice” as a management imperative was reappropriated locally to create new forms of sociality that could not be easily maintained after the withdrawal of formula.

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  • Fassin, Didier. 2007. When bodies remember: Experiences and politics of AIDS in South Africa. Berkeley: Univ. of California Press.

    DOI: 10.1525/california/9780520244672.001.0001Save Citation »Export Citation » Share Citation »

    Against the backdrop of a transitional postapartheid government in South Africa and the sudden high rates of mortality among young women, the author explores the politics and experiences of HIV/AIDS. The focus is largely on Thabo Mbeki and the political history of HIV/AIDS in South Africa centered on conspiracy theories, national identity, and race relations.

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  • Kenworthy, Nora, Matthew Thomann, and Richard Parker. 2018. From a global crisis to the “end of AIDS”: New epidemics of signification. In Special issue: Critical perspectives on the “end of AIDS.” Edited by Nora Kenworthy, Matthew Thomann, and Richard Parker. Global Public Health 13.8: 960–971.

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    Serving as the introduction to a special issue, this article explores the emerging global policy discourses around the “end of AIDS” and the ways in which global institutions are remaking the epidemic as one that is largely controlled and coming to an end by way of biomedical interventions.

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  • Lewellen, Denver. 2012. Emerging hybrids? Health care policy research in Canada and the United States. Practicing Anthropology 34.2: 13–18.

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    Describes the incorporation of anthropological methods into health-care policy studies focused on HIV, demonstrating the impact of political-economic forces on policy.

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  • O’Daniel, Alyson. 2018. Navigating POWER with HIV/AIDS in Indiana: Poverty and personal responsibility in the era of health care reform. Human Organization 77.2: 102–111.

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    Considers HIV/AIDS care policy in the state of Indiana, examining women’s barriers to health insurance access and considering the shifting of the burden of insurance enrollment to HIV/AIDS care providers. The article concludes with a set of policy recommendations for protecting and enhancing women’s access to care.

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  • Owczarzak, Jill. 2009. Defining HIV risk and determining responsibility in postsocialist Poland. Medical Anthropology Quarterly 23.4: 417–435.

    DOI: 10.1111/j.1548-1387.2009.01071.xSave Citation »Export Citation » Share Citation »

    Argues that the rise in HIV infections and the availability of researchers to conduct projects has made HIV/AIDS a key policy issue in postsocialist countries like Poland, and investigates how HIV/AIDS programs assess and understand HIV risk without considering the broader social, economic, and political issues that contribute to vulnerability.

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  • Powers, Theodore. 2017. Pathways, intersections, and hotspots: Multisited fieldwork and the South African HIV/AIDS policy process. Medicine Anthropology Theory 4.5.

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    Follows the movement of South African HIV/AIDS activists through the process of developing HIV/AIDS policy, using the concepts of pathways, intersections, and hot spots to represent their social and spatial experiences in a unified framework.

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  • Rosenthal, Anat. 2016. “Doing the best we can”: Providing care in a Malawian antiretroviral clinic. Medical Anthropology 35.2: 132–146.

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    Explores how the policy shift toward universal access to antiretroviral treatment in Malawi created new health care delivery challenges, influenced by a global context. The article argues that care should be explored from the perspective of local and international health-care professionals and policymakers, in addition to patients.

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Global Public Health

The subject of global health is gaining importance in both the academy and outside the academy. Many anthropologists continue to examine global health inequalities and the multiple social and structural determinants and consequences of disease and suffering around the world. Hardon and Moyer 2014 and Rhine, et al. 2014 provide overviews of the anthropological scholarship in global health. Anthropologists focusing on HIV/AIDS have questioned the effectiveness of global health prevention efforts in addressing the determinants and consequences of HIV/AIDS. For instance, Benton 2015 explores how HIV exceptionalism unfolded in post–civil war Sierra Leone, and the ways in which this approach led to increased focus on HIV/AIDS at the expense of more urgent health concerns. Miller 2016 similarly examines how increases HIV/AIDS funding in China led to the outsourcing of public health services to NGOs, creating competition among providers. Benton, et al. 2017 and Bernays, et al. 2017 analyze the ways in which global health prevention efforts and institutions moralize the behavior of individuals living with HIV/AIDS. Hirsch, et al. 2010 and Thorton 2008 focus on transformations in sexual networks and cultural meanings of sexuality in the era of HIV/AIDS. Kalofonos 2010 highlights how those living with HIV/AIDS in Mozambique critique the failure of global HIV/AIDS prevention efforts to address persistent problems related to food insecurity. Sangaramoorthy 2018 focuses on HIV chronicity and the ways in which it signals a continuing crisis for many marginalized communities despite global discourses around the “end of AIDS.”

  • Benton, Adia. 2015. HIV exceptionalism: Development through disease in Sierra Leone. Minneapolis: Univ. of Minnesota Press.

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    This book explores how in the wake of its civil war, Sierra Leone repositioned itself as a country suffering from HIV at the expense of other more pressing health concerns in order to benefit from an influx of foreign aid earmarked for HIV/AIDS prevention and care. It explores why HIV exceptionalism continues to guide approaches to the epidemic even in low-prevalence settings.

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  • Benton, Adia, Thurka Sangaramoorthy, and Ippolytos Kalofonos. 2017. Temporality and positive living in the age of HIV/AIDS: A multisited ethnography. Current Anthropology 58.4: 454–476.

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    Focuses on the moralization of the behavior of the individual by global health institutions through a set of moral, physical, and social practices known as “positive living,” and understanding this moralization through temporal rationalities.

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  • Bernays, Sarah, Sara Paparini, Janet Seeley, and Tim Rhodes. 2017. “Not taking it will just be like a sin”: Young people living with HIV and the stigmatization of less-than-perfect adherence to antiretroviral therapy. Medical Anthropology 36.5: 485–499.

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    Analyzes relational dynamics within HIV clinics in the United Kingdom, United States, Ireland, and Uganda, exploring strategies used by young people to maintain their reputation as patients in the face of the moralization of treatment adherence.

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  • Hardon, Anita, and Eileen Moyer. 2014. “Anthropology of AIDS: Modes of engagement.” In Special issue: The normalization of HIV in the age of antiretroviral treatment; Perspectives from everyday practice. Edited by Anita Hardon and Eileen Moyer. Medical Anthropology 33.4: 255–262.

    DOI: 10.1080/01459740.2014.889132Save Citation »Export Citation » Share Citation »

    Introduces a special issue focusing on the normalization of HIV/AIDS and examines the engagement of anthropologists in two eras of the HIV/AIDS epidemic: the prevention era (pre-2000) and the treatment era (post-2000).

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  • Hirsch, Jennifer S., Holly Wardlow, Daniel Jordan Smith, Harriet M. Phinney, Shanti Parikh, and Constance A. Nathanson. 2010. The secret: Love, marriage and HIV. Nashville, TN: Vanderbilt Univ. Press.

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    Highly impressive in its content and scope, this volume compares the meanings of men’s sexual and social lives in Mexico, Nigeria, Papua New Guinea, Uganda, and Vietnam; explores the concept of “sexual geographies,” the economic structures that facilitate HIV/AIDS sexual risk; and presents new ways to understand male desire and its relation to economic and social inequalities.

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  • Kalofonos, Ippolytos. 2010. All I eat are ARVs: The paradox of AIDS treatment interventions in central Mozambique. Medical Anthropology Quarterly 24.3: 363–380.

    DOI: 10.1111/j.1548-1387.2010.01109.xSave Citation »Export Citation » Share Citation »

    Discusses the exponential rise in those who are on antiretrovirals in Mozambique, a country long plagued by political and economic instability and persistent problems related to poverty, and where hunger becomes the means through which people critique the inability of HIV/AIDS prevention efforts to address these underlying issues.

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  • Miller, Casey James. 2016. Dying for money: The effects of global health initiatives on NGOs working with gay men and HIV/AIDS in northwest China. Medical Anthropology Quarterly 30.3: 414–430.

    DOI: 10.1111/maq.12300Save Citation »Export Citation » Share Citation »

    Examines the consequences of global health initiatives working in northwest China, arguing that short-term surges in funding promoted a neoliberal process of outsourcing public health services to NGOs and deliberately encouraged a climate of competition among providers.

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  • Rhine, Kathryn, John M. Janzen, Glenn Adams, and Heather Aldersey, eds. 2014. Medical anthropology in Global Africa. Lawrence: Univ. of Kansas.

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    This edited volume focuses on elaborations of contemporary flows of people, capital, knowledge, and technologies in and out of “Global Africa.” Part 4, Moral Economies, presents several case studies relevant to the anthropology of HIV/AIDS, especially as it relates to global politics, public-private partnerships, and public health.

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  • Sangaramoorthy, Thurka. 2018. Chronicity, crisis, and “the end of AIDS.” Global Public Health 13.8: 982–996.

    DOI: 10.1080/17441692.2018.1423701Save Citation »Export Citation » Share Citation »

    Using both global and local data from the United States, this article traces the logic of HIV chronicity and how it is induced by technological advances in treatment and global financial and political investments, and the ways in which it intensifies long-term uncertainty and prolonged crisis in many marginalized communities.

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  • Thorton, Robert. 2008. Unimagined community: Sex, networks, and AIDS in Uganda and South Africa. Berkeley: Univ. of California Press.

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    Comparing South African and Ugandan sexual networks and family structures, this article argues that changes in HIV/AIDS prevalence has more to do with changes in large-scale sexual networks than the effects of individual behavioral change.

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Science and Technology Studies

A growing number of anthropologists are investigating how biomedicine, science, and technology are produced, understood, and resisted, and drawing attention to the ways in which certain facts and truths about life and labor become stabilized. Research on therapy (Nguyen 2010), pharmaceuticals (Biehl 2009), North-South research collaborations (Crane 2013, Okwaro and Geissler 2015), HIV/AIDS knowledge production (Brives 2016, Munro and Butt 2012, O’Daniel 2014, Peterson and Folayan 2017, Pigg 2001), and techniques of enumeration (Sangaramoorthy and Benton 2012) present exciting new directions located at the intersections of the anthropology of HIV/AIDS and science and technology studies.

  • Biehl, J. 2009. Will to live: AIDS therapies and the politics of survival. Princeton, NJ: Princeton Univ. Press.

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    Argues that public health is being less defined by prevention and clinical care and more through “pharmaceuticalization” or access to treatment, and presents riveting narratives of the neediest and the most marginalized Brazilians affected by AIDS and their engagement in Brazil’s highly regarded antiretroviral treatment policies.

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  • Brives, Charlotte. 2016. Biomedical packages: Adjusting drug, bodies, and environment in a phase III clinical trial. Medicine Anthropology Theory 3.1.

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    Examines experimentation in drug production during clinical trials, exploring how changing the drug simultaneously influences standards for the actions of people, creating a double production of the biomedical technology and its users.

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  • Crane, Johanna Tayloe. 2013. Scrambling for Africa: AIDS, expertise, and the rise of American global health science. Ithaca, NY: Cornell Univ. Press.

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    Charts how during the first decade of the 21st century, Africa went from being a continent excluded from advancements in HIV treatment to an area of central concern, exploring how global health partnerships may benefit from the inequalities they seek to address.

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  • Munro, Jenny, and Leslie Butt. 2012. Compelling evidence: Research methods, HIV/AIDS, and politics in Papua, Indonesia. Asia Pacific Journal of Anthropology 13.4: 334–351.

    DOI: 10.1080/14442213.2012.694467Save Citation »Export Citation » Share Citation »

    Explores how evidence-based public-health methods used in HIV/AIDS research in Papua, Indonesia, attempt to “render technical” the complex realities of living with HIV/AIDS.

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  • Nguyen, V. -K. 2010. The republic of therapy: Triage and sovereignty in West Africa’s time of AIDS. Durham, NC: Duke Univ. Press.

    DOI: 10.1215/9780822393504Save Citation »Export Citation » Share Citation »

    Focuses on the notion of triage where choices are made between who lives and who dies, and links the current epidemic in Abidjan with Ivorian history and the global response to HIV/AIDS in Africa.

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  • O’Daniel, Alyson. 2014. “They read [the truth] in your blood”: African American women and perceptions of HIV health. Medical Anthropology 33.4: 318–334.

    DOI: 10.1080/01459740.2013.808636Save Citation »Export Citation » Share Citation »

    Examines women’s engagement with “blood-work,” exploring how HIV-positive African American women in North Carolina understood laboratory-based knowledge of HIV.

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  • Okwaro, Ferdinand Moyi, and P. Wenzel Geissler. 2015. In/dependent collaborations: Perceptions and experiences of African scientists in transnational HIV research. Medical Anthropology Quarterly 29.4: 492–511.

    DOI: 10.1111/maq.12206Save Citation »Export Citation » Share Citation »

    Examines North-South collaborations in HIV laboratories, focusing on the strategies employed by African scientists in order to collaborate, including sourcing funding, maintaining prospective research populations, and diversifying collaborators.

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  • Peterson, Kristin, and Morenike Folayan. 2017. A research alliance: Tracking the politics of HIV-prevention trials in Africa. Medicine Anthropology Theory 4.2.

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    Explores the politics of alliances between laboratories and HIV-prevention clinical trials of pre-exposure prophylaxis across fields and continents, examining why some of these trials closed prematurely, and analyzing the creation of scientific knowledge.

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  • Pigg, Stacey Leigh. 2001. Languages of sex and AIDS in Nepal: Notes on the social production of commensurability. Cultural Anthropology 16.4: 481–541.

    DOI: 10.1525/can.2001.16.4.481Save Citation »Export Citation » Share Citation »

    This article argues that knowledge about HIV/AIDS came to Nepal from a template of accepted facts, and that this causes a series of complex communicative difficulties for Nepali HIV/AIDS workers as they try to translate these internationally accepted facts into something that fits local life.

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  • Sangaramoorthy, Thurka, and Adia Benton. 2012. Enumeration, identity, and health. Medical Anthropology 31.4: 287–291.

    DOI: 10.1080/01459740.2011.638684Save Citation »Export Citation » Share Citation »

    Introduces a special issue featuring several articles on HIV/AIDS focused on the daily practices of enumeration and its consequences, and examines how governing institutions, social norms, economic structures, and biomedical interventions drive the complex relations between techniques of enumeration, identity, and everyday experience.

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