Evelyne Micollier

Alternative medicines for AIDS in resource-poor settings: Insights from exploratory anthropological studies in Asia and Africa

The emergence of alternative medicines for AIDS in Asia and Africa was discussed at a satellite symposium and the parallel session on alternative and traditional treatments of the AIDSImpact meeting, held in Marseille, in July 2007. These medicines are heterogeneous, both in their presentation and in their geographic and cultural origin. The sessions focused on the role of these medications in selected resource poor settings in Africa and Asia now that access to anti-retroviral therapy is increasing. The aims of the sessions were to (1) identify the actors involved in the diffusion of these alternative medicines for HIV/AIDS, (2) explore uses and forms, and the way these medicines are given legitimacy, (3) reflect on underlying processes of globalisation and cultural differentiation, and (4) define priority questions for future research in this area. This article presents the insights generated at the meeting, illustrated with some findings from the case studies (Uganda, Senegal, Benin, Burkina Faso, China and Indonesia) that were presented. These case studies reveal the wide range of actors who are involved in the marketing and supply of alternative medicines. Regulatory mechanisms are weak. The efficacy claims of alternative medicines often reinforce a biomedical paradigm for HIV/AIDS, and fit with a healthy living ideology promoted by AIDS care programs and support groups. The AIDSImpact session concluded that more interdisciplinary research is needed on the experience of people living with HIV/AIDS with these alternative medicines, and on the ways in which these products interact (or not) with anti-retroviral therapy at pharmacological as well as psychosocial levels.

Exploring the intersections of transnationalism, sexuality and HIV risk

In the context of international migration, transnationalism, defined as ‘the processes by which immigrants forge and sustain multi-stranded social relations that link together their societies of origin and settlement’, has important implications for sexuality and HIV-related risk (Basch, Glick Schiller, and Blanc 1994, 6). The concept of transnationalism draws attention to two key features of immigrants’ transnational lives: (1) the cross-border linkages or networks of relationships created by transnational flows of people, goods, ideas, values and so on; and (2) the simultaneous engagement of individuals with two nation states, made increasingly possible by technological advance (e.g., the Internet, air travel, satellite technology and the mobile phone) (Levitt and Glick Schiller 2004; Mazzucato 2010; Tsuda 2012). Migrants’ dual engagement in sending and receiving countries , and simultaneous embeddedness in more than one society, may also be viewed as defining characteristics of transnationalism (Levitt and Jaworsky 2007; Tsuda 2012). Transnationalism challenges state-centric thinking about international migration as consisting solely of movement from one country to another, or as an event that ends with migrants’ settlement in the host country. Through a transnational lens, international migration is best understood as a lifelong process that involves complex interactions between migrants, second-generation family members and those left behind. This process evokes a linkage or a network of relationships that spans two or more nation-states, often over more than one generation (Lunt 2009). Unlike traditional methodological nationalism, ‘methodological transnationalism’ creates vantage points that recognise ‘the processes, ties and links between people, places, and institutions that routinely cut across nation states’ (Yeates 2008, 22). Furthermore, transnational thinking and living challenge the nation-bounded concept of societies and carries the potential to overcome the dichotomy between the global and the local, while recognising cross-border connections in a globalising world (Amelina et al. 2012). A cross-border approach thus makes it possible to understand sexuality and HIV risk in the context of international migration from a broader transnational perspective. This perspective, in turn, allows us to better contextualise the research focus by encompassing mobility, crossor beyond-border social relations, hybrid cultural assemblages and transnational narratives. It also supports public health approaches and government policy options concerning HIV prevention, taking into consideration the often complex transnational contexts that international migrants navigate. Although the notion of transnationalism has been widely explored in immigration studies since the 1990s, its implications for health research, and specifically research into HIV-related risk, have been largely overlooked. Most studies have examined HIV-related risk to immigrants in their host countries. In doing so, popular discourse has ignored the simultaneous influence of the home country context (which is not limited to its culture) on immigrants’ risk perceptions, risk exposure and risk responses. These perceptions of risk, influenced by multiple and sometimes contradictory discourses and sources, in turn, have important but seldom specified implications for access to and practices for HIV prevention. Traditional assimilation models assume a linear transition from an ‘old’ culture to a ‘new’ one in the host country. In contrast, key assumptions in a globalisation model include the possibility

Femininities on transnational journeys and sexual health risk: experiences of Chinese immigrant women in Canada

Abstract Negotiations at work in a globalising China in regard to femininity, sexuality, and family relationships have been well documented from the 1990s. Nonetheless less is known about them in a transnational context, and femininities are far less explored than masculinities. Drawing on interview data from a larger research study of transnationalism and gendered HIV vulnerability, this article investigates the intersection of femininity, sexuality and sexual health risk through Chinese immigrant women’s narratives about their experiences in Canada. It examines to what extent these intimate negotiations within China are re-enacted through Chinese immigrant women’s transnational experiences in Canada. These women live ‘in-between’ China and Canada in terms of identity, space and time with their cross-cultural connections unveiling both virtual and actual relations. Gender norms and roles, intimate and sexual experience, and family relations are realigned in the transnational lives of these women and are impacted by both their home and host societies, as well as their past and present experience in China. Used in the article as a concept and an analytical lens, gender is acknowledged as a key organising principle in post-immigration individual and social experience.

Gestion de l’épidémie et usages de la médecine chinoise

Dans le contexte d’une reponse sociale et medicale des autorites chinoises face au SIDA, la politique d’extension du traitement a tous les patients qui en ont besoin a terme, revele des «caracteristiques chinoises » qui rejoignent des preoccupations internationales en matiere d’usage des medecines alternatives et complementaires. L’une d’entre elles concerne l’utilisation de la medecine chinoise traditionnelle (MCT) principalement en traitement combine (biomedecine et medecine chinoise) dans un systeme de sante publique ou elle tient une place relativement importante comparee aux autres modeles de systemes de sante qui existent dans le monde. Mon article porte sur l’integration de la MCT dans les therapies et les recherches sur le VIH/ SIDA.