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Maxwell School
Maxwell / Moynihan / South Asia Center

Gender, Sexuality, and Health Conference in the Globalized World

Abstracts

HIV/AIDS, Gender, and Sexuality in a Globalized World- September 27- 28, 2007.

Roger Hallas, Assistant Professor of English and Textual Studies, Syracuse University
From Photojournalism to Visual Activism: Reframing HIV/AIDS in the Work of Gideon Mendel.”
This paper examines how the recent work of acclaimed South African photographer Gideon Mendel offers new models for representing HIV/AIDS within local and global publics. Having dedicated the past decade of his career to documenting the AIDS pandemic and poverty in sub-Saharan Africa (paying particular attention to the experience of women), Mendel has developed an aesthetically and politically innovative set of projects that not only challenge the prevailing aesthetics of pity in the photojournalistic representation of contemporary Africa, but also demonstrate a profound flexibility with regards to the new media ecology.  It is in his innovative engagement with new media that Mendel produces opportunities to empower those living with HIV/AIDS in the Global South

FRIDAY: 09.28.2007

Judith Auerbach, Deputy Executive Director for Science and Public Policy, San Francisco AIDS Foundation. (Abstract will be added later)

Anastasia J Gage, Associate Professor, Department of International Health and Development, Tulane University.
"
Child Marriage, Gender Relations and HIV/AIDS in Ethiopia"
Child marriage is a common practice in Ethiopia.  According to the 2005 Demographic and Health Survey, 13% of 15-19 year-old girls first married before their fifteen birthday, while among those aged 20-24, nearly half first married before the age of 18 (CSA and ORC Macro, 2005).  A study by the National Committee on Traditional Practices of Ethiopia showed that girls as young as age eight were forced into arranged marriages and in some instances were even promised in marriage at birth (NCTPE, 2003). Using data from the 2005 Ethiopia DHS, this presentation highlights how child marriage increases girls’ vulnerability to HIV/AIDS in Ethiopia.  The study examines the linkages between child marriage and young women’s control over resources, participation in decision making, and ability to negotiate safer sexual relationships. The relationship between child marriage and HIV knowledge, attitudes, behavior, and prevalence among young women is also explored.


Carrie Foote-Ardah, Associate Professor, Department of Sociology, Indiana University-Purdue University of Indianapolis
"Fertility Desires and HIV Risk in the US and Kenya"  
The AIDS epidemic in sub-Saharan Africa has driven down the fertility rates of HIV-infected men and women. Until recently, fertility trends among HIV infected individuals were similar in developed countries such as the U.S. and Great Britain. HIV treatment (Antiretroviral Therapy or ART), however, is now widely available in developed countries and mother-to-child transmission is as low as 2% in these areas.  As a result, HIV positive parenting is on the rise.  ART programs, implemented in global partnerships spanning the developed and less developed world, are currently treating thousands of afflicted in areas such as Kenya.  As HIV treatments become more widely available in these areas, HIV infected men and women there may also increasingly desire children.  The increasing desire to have children, however, may pose challenging public health concerns in these nations.  Reproductive medical assistance and techniques to reduce HIV transmission risks, available in the U.S. and other developed areas, remain largely inaccessible in sub-Saharan Africa.  Furthermore, information about inexpensive strategies to reduce transmission likelihoods that couples can take into their own hands remains virtually non-existent in the sub-Saharan African HIV and reproduction discourse.  Despite these global public health concerns, very little research has examined the fertility desires and corresponding risk taking behaviors of HIV-infected men and women. This session discusses these issues as they relate to the U.S. and Kenya. The critical importance of enhancing the reproductive choices of both HIV infected men and women is stressed as a key ingredient in reducing HIV-related stigma and, by extension, HIV transmission risks.

Lesley Doyal, Professor of Health and Social Care, School for Policy Studies, University of Bristol
"Gender and Sexuality in the shaping of experiences of HIV/AIDS among African migrants in London"
There is an urgent need for more qualitative studies of individuals living with HIV/AIDS. Thus far, researchers have concentrated mainly on issues relating to prevention while life after infection has been relatively neglected.  The development of more effective therapies has made HIV/AIDS a chronic disease for some and the implications of this need further exploration. But the vast majority of those infected are not able to gain access to drugs or other care. This highlights the massive global inequalities that exist not just in patterns of infection but also in daily life with the disease.  It is here that the gap in research is most obvious. This presentation will illustrate the diversity of life with HIV as reflected in a project just completed among Black African migrants in London. Of course these men and women have much better life chances than their compatriots back in Africa. However they face particular challenges as migrants of African origin in a country that is not ‘home’ and most cannot return to Africa without risking their lives. The overall project consisted of three separate studies focussing on heterosexual women, heterosexual men and gay/ bisexual men. There were obviously similarities in the experiences of daily life for each group but there were also marked differences. For heterosexual women the main tensions to be managed were between their HIV status and their motherhood, for heterosexual men, the management of their (African ) masculinity and their illness was paramount while  for gay/bisexual men their sexual identity often posed a significant obstacle in managing their relationships with other people (especially their families) and with potential support services. The theoretical and policy implications of this diversity are explored through the general framework of intersectionality.
    

Mark Padilla, Assistant Professor, Department of Health Behavior and Health Education, School of Public Health, University of Michigan
"Tourism, Stigma and HIV Risk: How Responses to Global "Perversion" shape Local Vulnerability"
The Dominican Republic, as with many Caribbean countries, has undergone large-scale social and political-economic transformation as a consequence of the dramatic expansion of the country’s tourism and sex industries since the 1970s.  In this context, media and popular discourse has focused on particular dimensions of these changes as expressions of the country’s purported “degeneration” and moral decline.  Male sex workers and their exchanges with foreign gay men have come to occupy a central place in social anxieties about the “invasion” of foreign vices due to the country’s dependence on tourism, and pronouncements by the Catholic Church and leading public figures suggest that deep-seated anxieties about broad structural transformations have contributed to an historically and culturally particular expression of “border anxiety.”  Drawing on the author’s long-term ethnographic research among informal tourism workers in the Dominican Republic, this paper examines discourses of invasion that circulate in Dominican popular culture about the “perverse” influences of the tourism industry on local expressions of sexuality, and explores how these discourses and experiences of social stigma shape men's patterns of sexual risk.  Incorporating an analysis of ethnographic data and in-depth interviews with 72 men with a history of sexual-economic exchanges with foreigners in two Dominican cities, the author offers a framework for understanding the intersections of large-scale political-economic transformations, social stigma, and HIV-related vulnerability in a specific Caribbean context.  It is argued that this analysis has implications for scientific understandings of the influence of the spread of tourism on local patterns of marginalization and HIV risk.

Robin Root, Assistant Professor, Department of Sociology and Anthropology, Baruch College, City University of New York
"From Condom's to the Koran: Risk Assemblages on Malaysia's Assemble Lines"
Drawing on ethnographic research in the export processing zones of Malaysia in the mid-1990s, the paper presented here examines how factory women’s HIV risk narratives hinged on the interpretive idiom of self-control in social and work settings marked by numerous risks. Above all, women desired multiple risk knowledges, both biomedical and moralistic, so that they could “control themselves by themselves” and avoid “putting a price on themselves,” a project of reflexive self-shaping mediated by the discordant discourses of industrialization and Islamicization that shaped how risk was named, enacted, engendered, and experienced.


Sandra Teresa Hyde, Assistant Professor, Departments of Anthropology and Social Studies of Medicine, McGill University
"
Smoldering Embers and the Rise of a Gendered Epidemic"
Renowned Chinese Sociologist Pan Suiming argues that both sexually transmitted infections (STIs) and prostitution were eradicated by Communist government health teams in the early 1950s, although small “smoldering embers” never went out.  The current exponential increase in sexually transmitted infections and in particular HIV is due in part to these embers and the massive changes in the cultural, social, and economic landscape. China is in the midst of capitalist revolutionary changes in terms of individual behavior change and the exponential increase in sexually transmitted infections where the list of casualties increases daily.  While divorce rates and increasing STIs are merely two symptoms of a Chinese public that no longer adheres to a Maoist regime of sexual conservatism, they also point toward the influence of market practices and the consumption of sex.  This paper focuses on the dilemmas faced when relying on flawed epidemiological surveillance data on China’s ethnic minority populations and their rates of HIV. It then shifts to an ethnographic gaze on a small tourist town in Sipsongpanna Tai-Lüe Autonomous Prefecture in southern Yunnan, as an example of how sex tourism and the post-socialist drive for consumption relates to the fourth wave of the HIV epidemic.

Geeta Rao Gupta, President, International Center for Research on Women, Washington DC. (Abstract to be added later)

David Marshall, Director and Producer, Post Central, Rochester, New York
"Autumn's Harvest: America, Migrants,AIDS"
There are undeniable links between poverty, social inequality, discrimination, and HIV/AIDS.  Although data are limited, rates of HIV infection among the migrant farm worker population are estimated to be 10-20 times higher than among the U.S population as a whole.  Autumn’s Harvest is a documentary film that focuses on the confluence of three factors: a historically invisible and legally subjugated migrant worker population; a shift from a predominantly Southern, African American migrant population to a socially, culturally, and linguistically isolated workforce from Mexico and Central America; and HIV.  Weaving various histories and biography to raise awareness about migrant farm workers and HIV in America, Autumn’s Harvest focuses on the life and circumstances of Douglas, an African American man who has been a farm worker since the age of nine and was diagnosed with HIV in the 1990s.

                     

Health Care in Transition in South Asia-September 28-29, 2007

Geeta Rao Gupta, President, International Center for Research on Women, Washington, D.C. (Abstract to be added later)

SATURDAY: 09.29.2007

Jennifer Hyndman, Professor, Department of Geography, Syracuse University
"Santé/Sanity: Creating Security in Post-tsunami Sri Lanka"
Social relations, including gender, are destabilized by conflict and disaster. In Sri Lanka, a country at war on and off for more than two decades, the social impact of the 2004 tsunami cannot be divorced from the pre-existing landscape with its layers of conflict, nationalism, and economic disparities.  This paper explores the ways in which the tsunami changed people’s relations of home, family, and security for those who lost a spouse. Interviews with 40 widows and widowers along the east coast of Sri Lanka in February 2006 suggest that the tsunami not only reorganized gender relations among specific ethnonational groups, but also created conditions of insecurity and trauma that changed the meaning of ‘widow.’ A feminist approach to understanding the power relations that shape these transformations is advocated in the wake of the tsunami.

Sajeda Amin, Senior Associate, The Population Council, New York
"The Privatization of Family Planning in Bangladesh"
Since 1975, family planning services have been distributed in Bangladesh through a subsidized commercial initiative called social marketing. Social marketing of contraception is done by a private company, the Social Marketing Company (SMC), that began as a project funded by USAID to distribute pills and condoms was supplied to SMC free of cost.  In the early years, about one third of the cost of contraception was recovered by charging user fees (Ciskewski and Harvey, 1995).  Despite difficulties of cost recovery and high price sensitivity,  social marketing has  since become the delivery mechanism of  choice of multi-laterals such as UNICEF, UNDP and DFID, for distribution of  health products and services such as oral rehydration solutions and STD/HIV  treatments. SMC sells  a range of branded oral contraceptives and condoms, markets aggressively through an extensive media campaign and distributes through regular pharmacies and shops as well as through a network of franchised kiosks. SMC brands cost more than the government brands but less than the products sold by local pharmaceutical companies.   The Demographic and Health Surveys  conducted with regularity in Bangladesh documents the rising influence of social marketing—between 1993-94 and 2004, the use of social marketing brands of oral contraception rose from 14 % percent to 40%. Social marketing brands account for 60% of all condom sales (Bangladesh Demographic and Health Surveys, 2004). This paper explores the idea of social marketing through an in-depth analysis as practiced by the SMC in Bangladesh. The paper explores the welfare and efficiency implications of through analysis of DHS data on brand choice. By exploring the determinants of brand choice a