Expanding in tandem with the political, economic and cultural trends associated with “neoliberalism”, the AIDS epidemic has grown into a global pandemic, producing new political subjectivities and socio-cultural processes alongside the historically informed discourses of death, disease, and suffering with which it is oft accompanied. Examining the socio-cultural manifestations of the AIDS epidemic in it geographical areas of highest prevalence, South Asia and Southern Africa, this analysis will consider the ways in which discourse, institutions, and political subjectivities produce uneven social outcomes. This session seeks to investigate the complex and divergent ways in which the AIDS pandemic and its responses have built upon existing modalities of social inequality in different cultural contexts to (re)produce social stratification, with an emphasis on the disparities produced along the lines of race, gender, and sexuality.

Critical to these questions and the inquires which will arise out of their investigation, is attention to the axes around which the AIDS epidemic produces inequality. Examined cross-culturally, women of color with lesser material means have been isolated to bear the brunt of the pandemic through political processes at an inordinate rate. This session contends that rather than merely revealing the gendered social calculus of governing, these trends are productive; of the AIDS pandemic, the institutions created to manage infected publics, and of the emerging identities which often serve as the primary mechanism for grounding critical analysis of an abstract and global process.

This inquiry takes seriously the tension between cognitive and materialist approaches in the study of socio-cultural phenomena and the production of knowledge. As such panel participants will explore the “ground truths” of local AIDS activism, the historical roots of contemporary subjectivities, and the theoretical tools through which these processes are analyzed, understood, and translated to an academic audience. This panel asks how “local” socio-political subjectivities and practices transform existing modes of governance? What are the limitations of conceptual schemas currently utilized to contextualize these rapidly shifting identities and practices, and what are the ways that a critical research agenda can offer a critical contribution to ongoing debates within and between the publics with which academic research is concerned?

Growing out of the social and material inequalities that are productive of unequal relations of power constructed upon culturally specific notions of gender, race, and sexuality, this session will explore the cross-cultural dimensions of “local” shifts in politics and identity in order to critically explore the productive tension immanent in current academic debates.

Over the last two decades, diverse forms of ‘revivalist Christianity’, variably termed Pentecostal-Charismatic and evangelical Christianity, have swept across Southern Africa, where an increasing majority of national populations claims Pentecostal-Charismatic (PCC) or African Independent Church (AIC) ties and the numbers of local congregations have grown exponentially. An expanding body of anthropological work has endeavored to explain this rapid church growth in different ways; in terms of the mass impact of economic inequality and insecurity, exacerbated by neoliberal and structural adjustment policies, on impoverished communities and the consequential turn towards alternative institutions; and of globalizing media that have extended the reach of proselytizers and exposed local populations to grand narratives of personal material prosperity. Through this notion of the ‘end times’, Pentecostal eschatology provides a language and narrative that infuses local suffering with new meaning. Yet alongside concerns over foreign faith-based policies as neocolonial attempts to control the reproductive and sexual lives of ‘poor people’ in ‘poor countries’, and of local charlatanism, is evidence of the structural, psychosocial, and material support that churches often provide disenfranchised groups. Importantly for women, participation in local congregations may provide new and vital forms of sociality and mutual social support that attempt to respond to survival needs in remote rural areas and in dangerous, septic peri-urban slums and shanty towns.

Despite these seismic shifts, there is curiously little in the literature about a more urgent dimension of church expansion in southern Africa. Its spectacular growth parallels the ascendance of southern Africa as the global epicenter of the AIDS pandemic, where antenatal prevalence rates range from 16% in Mozambique to 42% in Swaziland. UN estimates suggest that faith-based organizations provide an estimated 30-50% of HIV/AIDS services in developing countries. The clearly vital roles of religious institutions, which are diverse in mission, funding, size, organizational structure, and practices, in the context of AIDS/TB, malaria, and poverty have received little attention from anthropologists and public health researchers and remain poorly problematized; eclipsed, in part, by debates over the President’s Emergency Plan for AIDS Relief (PEPFAR) and a singular and reductive focus on abstinence programs. Indeed, the bulk of research to date has come from scholars of religion and theology in Africa who have productively conceptualized that dynamic nexus of religion, politics, poverty, and health in terms of “religious health assets.” Recently, some medical anthropologists have also begun to explore ho revivalist Christian forms are shaping local and global discourses of AIDS and stigma, influencing HIV-relations health practices among members, including HIV testing and treatment uptake/adherence, providing care and support to those who are HIV-positive, and potentially influencing other HIV-related behaviors. Drawing on recent fieldwork in Swaziland, Zimbabwe, and Mozambique, the papers in this panel explore the situated intersections of poverty, religion, and HIV/AIDS and the implications for these underexamined processes in reconceptualizing anthropological frameworks of public health policy and praxis, medical anthropology, and postcolonial Christianity in Africa.

Three decades after the spotty appearance of the First AIDS cases in sub-Saharan Africa, AIDS has become interwoven with the fabric of everyday life. Scholarly examinations of the implications of AIDS must break free from the constraints of public health frameworks that contain theory practice to the realm of prevention and risk—a domain where various individual, cultural, political, and economic “factors” are viewed as shaping vulnerability to HIV infection. Limiting our understanding of AIDS to such factors of disease transmission elides the profound effect that AIDS has had upon social life itself. Amid the complex entanglements of competing expert and medical discourses that characterizes the response to the AIDS epidemic, how do many sub-Saharan Africans experience AIDS as they struggle to make meaning and to locate avenues through which to pursue livelihood strategies?

We might invoke Durkheim to suggest that the pervasiveness of AIDS has begun to work as social fact. AIDS animates ways of acting, thinking, and feeling that exist outside the consciousness of the individual and it is endued with a compelling and coercive power to reorganize social relations and structures. In other words, AIDS as a social fact provides the force for a diverse array of social actors to assert political agendas, malign or exalt particular lifestyles, and propagate moral narratives. It is within this crowded discursive terrain that we begin to understand the fuller gravity of the AIDS epidemic as reconstituting identities, reorganizing gendered power relations, and altering notions of cultural authenticity and belonging. Moreover, it is at this complex intersection that we document the ways in which people are beginning to reconstitute livelihood strategies and forge new moral narratives around social organization(s).

A team of prominent anthropologists specializing in HIV/AIDS policy will review the Obama Administration’s first 400 days in office to assess what has been accomplished in this area both domestically and internationally. We will focus on HIV/AIDS policy in the areas of HIV prevention, AIDS care and treatment, vaccine and microbicide development, and HIV/AIDS stigma reduction. We will assess the impact on men who have sex with men, injecting drug users, the homeless, African Americans, sex workers, and other populations at high risk for HIV/AIDS. We will also look at the status of the President’s Emergency Plan for AIDS Relief (PEPFAR), and to what extent it is reaching its stated goals.

Medical anthropologists recognize that research to address sexual risk (such as non-condom use with partner/s of unknown STI/HIV status) and other risk behaviors that increase vulnerability to STI/HIV much encompass the gender, socioeconomic, cultural, and political contexts that shape perceptions of risk and influence patterns of risk behavior. Drawing on research in Costa Rica, Kenya, Mexico, the US, Zambia, and Zimbabwe, we explore the diversity of risk perceptions, behaviors, and vulnerabilities that can expose diverse populations to STI and HIV acquisition and the ways that STI/HIV prevention efforts can be informed and improved through anthropologically sound research.

This session presents preliminary findings of aids2031, a United Nations funded project whose mission is to assess the past 25 years of AIDS policies and programs, examining the successes and shortcoming of the first years of the fight against AIDS, and to generate new approaches to ensure greater success by 2031. In this panel we offer three community views of the global fight against AIDS based on community dialogues held in 2008 with sex workers, youth, other vulnerable populations, and AIDS service providers in Ghana, Senegal, and Worcester, MA. In addition to sharing the perspectives of often silences and silent groups, the papers highlight emerging community partnerships in each location and their attempts to initiate new strategies for HIV/AIDS prevention.

Around the globe, locations where high-risk sexual behaviors are initiated (i.e., high risk venues) differ according to such factors as urban versus rural setting. However high-risk venues share many similarities such as being publicly shared spaces where individuals congregate to socialize, engage in alcohol and/or substance abuse, and meet potential sexual partners. Triangulated and mixed methods are used to explore sexual risk behaviors in the context of environmental, individual, and community involvement during an HIV clinical trial in Botswana, sex workers in Dubai and Mexico, adolescents in Trinidad and Tobago, and college women and homeless women in the US.

For many women around the world the greatest risk of contracting HIV comes through having sexual intercourse with their husband. This session presents findings from a multi-country comparative ethnographic study focusing on the connection between men’s extramarital sexual relationships and women’s exposure to HIV. A considerable body of scholarship has criticized the narrow constructions of problems and solutions common in public health literature and programs. Such critiques emphasize the importance of accounting for political-economic structures and forces in shaping human behavior and affecting health outcomes. Demonstrating how these structural forces actually manifest themselves in everyday action of ordinary people remains, however, and under-theorized endeavor. These papers draw on extended anthropological fieldwork in Mexico, Nigeria, Papua New Guinea, and Uganda, explaining the theoretical advantages of a comparative approach and developing the key concepts of extramarital opportunity structures, sexual geographies and social risk to situate and analyze marital and extramarital relationships in the context of gender and its associated inequalities. The papers offer a multidimensional framework that illuminates the socially pragmatic concerns that motivate people’s behavior. Each paper addresses one of the key conceptual contributions of the project, using ethnographic evidence to explicate the study’s theoretical innovations.

Composed of members of the AIDS and Anthropology Research Group (AARG), this panel considers intersections between different kinds of HIV prevention strategies and particular risk practices in Africa. AIDS research in the human sciences has produced accounts of the social bases of sex and sexuality, as well as of sexual practices understood to be 'risky'. As well, debates over the efficacy of different prevention strategies have changed over time, but anthropological research has consistently had an increased presence and importance within these evaluations. This panel explores some of the work of members of the AARG who conduct their research in Sub-Saharan Africa. The panel considers the connections and disjunctures between their research findings, in the wider context of the conference's celebration of interdisciplinarity within medical anthropology, and in terms of the broader impact of HIV prevention and risk reduction strategies.

With growing efforts to expand access to HIV/AUDS prevention and treatment programs there continues to be need for local, contextualized data upon which to build such programs. Anthropologists have long argued for the need to understand both cultural context and structural factors as a means to better understand the patterns of disease. In this session, presenters describe research in Asia and Africa which identifies specific elements of local culture, including gender relations, care giving roles and expectations, community practices, and religion which offer means to weave HIV prevention and treatment into existing social fabrics. In doing so, the panel argues, HIV/AIDS programs will be more easily “taken up” by local populations. Additionally, authors demonstrate the role of ongoing structural factors, such as poverty and weak health care delivery systems, in threatening the long term success of current programs for prevention and treatment. By highlighting the interaction of cultural context with structural factors, this panel seeks to identify new pathways forward in the global HIV/AIDS struggle.

Four papers will be presented with the context of HIV/AIDS stigma, resistance, and prevention. The first presentation turns to understanding how racial disparities in infection and the transition to post-AIDS converge in the lives of older HIV-positive people. The role of stigma is examined in the illness narratives of older HIV-positive minority men. The second paper addresses the emergence of two opposing ideologies in the US—the Religious Right and the gay/queer rights movement. This presentation focuses on John Lauritsen’s persistent rejection of the HIV thesis, two fictions by the African-American fantasy writer Samuel L. and alternatives to views found in Diseased Pariah News and Infected Faggot Perspectives. The third paper compares the experiences of a small cohort of poor, HIV positive mothers with medical care and treatment in Brazil and the United States in order to understand how these prevention efforts might be made more effective. It argues that stronger social and institutional network, as well as the Universal HIV treatment program, provided Brazilian women with forms of support that were absent in the experiences of their US counterparts. The final paper argues that the HIV virus is fraught with a standpoint of reductionism that simplifies HIV transmission and prevention and builds upon the foundation of negative stereotypes within the purview of American popular culture. Therefore, the stigmatized social construction of Black women with HIV/AIDS further complicates African American women’s efforts to empower themselves with HIV/AIDS prevention, care, and treatment.