Opportunistic Infections: The Governance of HIV/AIDS in China.

摘要

This ethnography is an interrogation of HIV testing as an intervention to prevent and control the HIV/AIDS epidemic in China, and the intended and unintended impacts that result from this response. In recent years, sexual transmission has become the leading route of infection for the HIV virus, and the rate of infection among men who have sex with men (MSM) has increased significantly in the country. In response, interventions have turned to scaling up HIV testing among the MSM population, in light of these epidemiological trends. It is in this context that I attend to three main questions in this ethnography: (1) Why MSM? That is, why the focus on MSM in the HIV/AIDS response, and how has this population come to dominate the public (health) imaginary?; (2) Why HIV testing as an intervention, and why is this method presumed to be crucial to containing the spread?; and (3) Why community-based organizations (CBOs), and what role do they play in facilitating testing as part of the overall HIV/AIDS response in China?;Increasingly, the responsibility for HIV testing has shifted away from public health institutions and toward CBOs in mobilizing this intervention among the MSM population. Based on ethnographic research conducted among those involved with HIV testing, either as donors, implementers or beneficiaries, I trace the movement of HIV testing as it circulates through MSM, CBOs, international donors, government institutions, and the market. In doing so, I demonstrate how this intervention enables particular forms of governmentality to emerge from the cultivation of new categories and communities of MSM through which HIV testing is mobilized. It is these very categories of MSM identity that create a new population through which governmentality is evoked, in ways not possible prior to HIV testing as an intervention, but that are central to its success. In attending to these interventions, I am concerned not only with what they do in terms of HIV prevention and control, but also with their unintended impacts in constructing new identity formations and forms of governance, and the implications this has in China and global health writ large.