Paul Boyce

Putting sexuality (back) into HIV/AIDS: issues, theory and practice.

Abstract After more than twenty years of programming and activism aimed at stemming the sexual transmission of HIV (and addressing the needs of those most vulnerable to infection) the HIV/AIDS epidemic continues to grow worldwide. Taking up this concern, this paper argues that one of the reasons why HIV prevention has had limited success is because of inadequate conceptualization of human sexuality in such work. Giving sexuality a more prominent position in responses to the epidemic raises a range of issues, including theorization of gender, understanding of sexual subjectivity, the significance of pleasure (or lack of pleasure) in sexual decision-making, and conceptualization of sexual behaviour and culture. Taking these themes forward entails asking significant questions about the underlying paradigmatic and methodological commitments of mainstream HIV/AIDS research, especially the tendency to reproduce accounts of human sexuality as if it were a measurable form of conduct only. Advocating new approaches that take the meaning and symbolic value of sexualities into account complicates established orthodoxies in the field whilst offering potential for more effective HIV prevention strategies.

'Conceiving kothis': men who have sex with men in India and the cultural subject of HIV prevention.

HIV prevention with men who have sex with men in India has, in large part, been premised on the reification of “cultural categories”—kothi being among the most popularized terms in this context, broadly designating men who have a feminine sense of self and who enact “passive” sexual roles. Countering prevailing research trends, this article explores ways in which local, national, and global processes inform contemporary kothi sexual subjectivities—disrupting simplistic perspectives on the cultural coherence of the category. Derivative uses of anthropological knowledge in public health and activist milieux are seen to have propounded limited representations of men who have sex with men in India. Drawing on ethnographic research in Calcutta, conceptualization of time in ethnography is examined and a critique of positivist epistemologies is put forward as a basis for advancing more conceptually cogent and effective HIV prevention research and programming strategies, especially those that aim to address sexuality between men.

moral ambivalence and irregular practices: contextualizing male-to-male sexualities in Calcutta/India

Male-to-male sexuality in India has been described as both heavily stigmatized and implicitly tolerated. This paper examines these apparently contradictory attitudes, arguing that they reflect broader moral ambivalence about homosexuality in Indian culture and society. While the effects of homophobia in India are very real, simultaneous social latitude allows for relatively un-scrutinized same-sex sexual contact. The paper explores this scenario as a post-colonial legacy and considers the consequences for contemporary sexual subjectivity, particularly in respect of irregular responses to emerging gay identities and socially ambiguous male-to-male sexualities. Conceiving of men who have sex with men as subject to both prejudice and tolerance raises complex questions for HIV/AIDS related policy, programming and activism. The paper argues that understanding male-to-male sexualities in India as practiced within a climate of ambiguous moral censure offers critical insights for the future promotion of health.

Rights and representations: querying the male-to-male sexual subject in India.

Same-sex sexualities in India have been portrayed in research and activism as socially marginal and minoritarian. Whilst proceeding from a commitment to the political utility of such a view, this paper questions such a standpoint. Drawing on ethnographic research conducted in different sites, the paper considers male-to-male sexualities as enacted and implicated in the production of ostensibly heteronormative spaces. This, in turn, raises questions about the representation of the queer or same-sex sexual subject in law and HIV prevention, especially in the context of post-colonial perspectives on sexuality.

Contextual influences on condom use among men who have sex with men in India: subjectivities, practices and risks.

Quantitative studies among men who have sex with men in India have shown high levels of unprotected anal sex. However, there is little information about the contexts in which such men may not use condoms. Relevant information on these contexts can assist in designing HIV prevention programmes to remove barriers to consistent condom use. As part of a larger study on sexual and social networks, we explored the contexts in which men who have sex with men did not use condoms, with a focus on personal, interpersonal and structural levels of experience. Data indicate the importance of understanding the different contexts that lead to unprotected sex but also reveal that the concept ‘context’ itself as a complex variable to consider in research of this kind, as research subjects interpret their social worlds and sexual risks in subtle and varied ways. Based on this viewpoint we make recommendations regarding HIV prevention.

Young Gay Men and HIV/AIDS: Towards a contextual understanding of sexual risk

Recent research in the USA, some European countries and Australia points to an increase in rates of HIV and other sexually transmitted infections amongst young gay men. Urgent action needs to be taken to meet the health promotion needs of those who are most vulnerable. HIV/AIDS awareness and sexual health promotion strategies aimed at young gay men have frequently focused on problems and needs. In contrast, the strengths and capacities of young gay men have largely been ignored. With these issues in mind, the research described here sought to explore the HIV/AIDS awareness and prevention needs of young gay men within the context of the other issues in their lives. As part of a larger research project focusing on gay and bisexual mens HIV primary prevention needs, data was collected from 77 self identified gay and bisexual men under the age of 25 living in the Greater London area. Through a participatory workshop format, both written and oral accounts were generated. Data were analysed thematically so as to identify recurrent issues and concerns. Findings illustrate the strengths of young gay men in coping with a range of challenging life and relationship issues, including those related to HIV. The capacity of young gay men to identify their own sexual health education needs is emphasised and processes through which such stated needs may be incorporated into HIV prevention and sexual health promotion strategies are discussed.

Do you feel somewhere in light that your body has no existence? Photographic research with transgendered people and men who have sex with men in West Bengal, India

This article explores the terrains within which day-to-day sexualness and subjectivity are conceived, experienced and imagined visually. Photographic research conducted with people of transgender and men who have sex with men in West Bengal, India, explored sexualities as phenomenologically apprehended. This, in turn, offers some critical insights into the representation of male-to-male and trans-sexualities within HIV prevention work and within analysis of social change in India.

Desirable rights: same-sex sexual subjectivities, socio-economic transformations, global flows and boundaries – in India and beyond

Sexual rights are increasingly and unevenly advanced internationally as constitutive of progressive legal possibilities for same-sex desiring subjects. Legislative progress in this area has taken place in the context of recognition of same-sex sexual subjects within the globalising flow of neo-liberal political-economic ideologies in some parts of the word, and resurgent homophobia as a countervailing trend elsewhere (or indeed even within the same context). Ambivalent responses to sexual rights praxis in peoples day-to-day lives indicate complex relationships between sexual subjectivity, economy, law, the state, and peoples most intimate aspirations. Rights on grounds of same-sex sexualities may or may not be perceived as universally desirable, even among those people who might otherwise be imagined as their beneficiaries. Given this, the relationship between sexual subjectivities, political economies, and rights must be understood in terms of multifaceted refractions, attending to generative and curtailing possibilities – imagined in peoples differing responses to free-market capital, legislation, and possibilities for livelihood. These issues are explored in respect of ethnographic work in West Bengal, India, with a particular focus on male-bodied subjects who evince both masculine and feminine subjectivities, and in respect of recent contestations in law, polity, and sexual rights praxis.

Sexuality and health in Vietnam--new directions. Introduction.

Research on sexuality in Vietnam has expanded greatly over the course of the last decade. This has been associated with a high rate of economic growth and market liberalization (Doi Moi), which has been a critical influence on individual aspirations for intimate and sexual relationships. In urban areas such as Hanoi and Ho Chi Minh City, the links between sexual life and ‘traditional’ and familial expectations have gradually loosened. Similar changes are occurring elsewhere in Vietnam. In a recently published book, Khuat Thu Hong (2009) and colleagues have written about these changes:

Transgender-inclusive sanitation: insights from South Asia

This paper provides insights from initiatives to include transgender people in sanitation programming in South Asia. Three case studies of recent actions to make sanitation inclusive for transgender people (in India and Nepal) are presented, accompanied by reflections and recommendations to guide future practice. Practitioners are recommended to: engage with transgender people as partners at all stages of an initiative; recognize that the language of gender identity is not fixed, varying across cultures and between generations; and acknowledge that transgender people are not a single homogeneous group but rather have diverse identities, histories, and priorities. The case studies aim to raise awareness of the diversity of transgender identities, exploring the needs and aspirations of transgender women, transgender men, and third gender people in South Asia.