HIV EXCEPTIONALISM
By Adia Benton
University of Minnesota Press, 2015, 176 pages
Review by Michael Beach
Kabuki Theater?
Benton sums up the heart of her findings as “…the aggregate of HIV programming techniques has given rise to new forms of social relations based on biological status and further entrenched AIDS as having exceptional status” (143). Among many supportive threads of this summation one link to other similar published works is the concern over aid colonialism (139).
A number of behaviors and attitudes link HIV/AIDS development in Sierra Leone to colonial perspectives similar to other forms of global development efforts. In general, infected among the poor are most dependent on the healthcare and food aid offered through sponsored support groups. These programs prescribed patient behaviors based on models used in other parts of Africa for the good of the people. HIV-positive people who have independent means were not subject to the demands of such groups and ultimately received the best care.
For example, patients were often grouped into program-prescribed identities such as “HIV-positive,” “former combatant,” “vulnerable woman,” “bush wife,” and “traumatized” among others (140). Within these roles, infected people are expected to display behaviors which are sometimes contradictory in order to show they are deserving of assistance. How does one demonstrate vulnerability and self-sufficiency at the same time? One should look good to show the effectiveness of treatment. In this case looking good is equated with looking well. At the same time, if one does not seem vulnerable then perception may be that the person does not need the help. The help recipient must then navigate a sort of theater that requires shifting appearance based on circumstances and audience.
Benton points to how the poor must be accountable to development agencies. Metrics such as showing up on time to group events, participating in public events such as marches or parades, making public acknowledgement of their status of being HIV-positive show complicity.
Not only development agencies expect compliance. So does the state. Government leadership want to appear competent to those same development agencies to keep the funding coming in. One approach is an appeal to moral conformance in the most private of human activities. Benton raises the issue of ownership of patient bodies. Clarifying the concept of ‘sexual citizenship’ she notes how the state expects people to abstain or practice ‘safer sex’ in an effort for both care for the state and care of the state. The more extreme version of this argument depicts personal sexuality as a resource of the state (130), the argument being some behaviors lead to the spread of illness and an increased demand on healthcare resources. This seems not unlike how actors’ behavior is prescribed to complete a successful Kabuki performance, but with play directors changing throughout.
By Adia Benton
University of Minnesota Press, 2015, 176 pages
Review by Michael Beach
Kabuki Theater?
Benton sums up the heart of her findings as “…the aggregate of HIV programming techniques has given rise to new forms of social relations based on biological status and further entrenched AIDS as having exceptional status” (143). Among many supportive threads of this summation one link to other similar published works is the concern over aid colonialism (139).
A number of behaviors and attitudes link HIV/AIDS development in Sierra Leone to colonial perspectives similar to other forms of global development efforts. In general, infected among the poor are most dependent on the healthcare and food aid offered through sponsored support groups. These programs prescribed patient behaviors based on models used in other parts of Africa for the good of the people. HIV-positive people who have independent means were not subject to the demands of such groups and ultimately received the best care.
For example, patients were often grouped into program-prescribed identities such as “HIV-positive,” “former combatant,” “vulnerable woman,” “bush wife,” and “traumatized” among others (140). Within these roles, infected people are expected to display behaviors which are sometimes contradictory in order to show they are deserving of assistance. How does one demonstrate vulnerability and self-sufficiency at the same time? One should look good to show the effectiveness of treatment. In this case looking good is equated with looking well. At the same time, if one does not seem vulnerable then perception may be that the person does not need the help. The help recipient must then navigate a sort of theater that requires shifting appearance based on circumstances and audience.
Benton points to how the poor must be accountable to development agencies. Metrics such as showing up on time to group events, participating in public events such as marches or parades, making public acknowledgement of their status of being HIV-positive show complicity.
Not only development agencies expect compliance. So does the state. Government leadership want to appear competent to those same development agencies to keep the funding coming in. One approach is an appeal to moral conformance in the most private of human activities. Benton raises the issue of ownership of patient bodies. Clarifying the concept of ‘sexual citizenship’ she notes how the state expects people to abstain or practice ‘safer sex’ in an effort for both care for the state and care of the state. The more extreme version of this argument depicts personal sexuality as a resource of the state (130), the argument being some behaviors lead to the spread of illness and an increased demand on healthcare resources. This seems not unlike how actors’ behavior is prescribed to complete a successful Kabuki performance, but with play directors changing throughout.
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