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7 - Anthropological reflections on HIV prevention strategies: the case for targeting London's backrooms

Published online by Cambridge University Press:  14 January 2010

Melissa Parker
Affiliation:
Director of the International Medical Anthropology Programme, Brunel University in London
George Ellison
Affiliation:
South Bank University, London
Melissa Parker
Affiliation:
Brunel University
Catherine Campbell
Affiliation:
London School of Economics and Political Science
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Summary

Introduction

Eight years ago the anthropologist Ralph Bolton (1995: 289) wrote: ‘Prevention efforts have enjoyed limited success – behaviours have changed to some degree in some places, but no thanks to our research’. Unfortunately, these words still hold true today. This chapter explores some of the reasons why anthropologists have struggled to contribute to public health programmes seeking to prevent the transmission of HIV. In particular, it shows that there has been a long-standing resistance to working within public health programmes that ‘target’ epidemiologically-defined groups of people (such as men who have sex with other men, intravenous drug users, sex workers) and risky behaviours (such as unprotected anal intercourse, unprotected vaginal intercourse). They have chosen, instead, to investigate HIV in the context of social, cultural, political and economic aspects of daily life; and to write about how HIV and AIDS relate to particular social settings, moral codes, political and economic relationships. Ideas about structural violence and processes of disempowerment have played a central role in this work; and research undertaken by applied anthropologists seeking to promote behavioural change by targeting high risk groups has typically been regarded as rather naive and not ‘real’ anthropology.

This chapter suggests that it is a matter of some urgency that mainstream anthropologists revise their views. It is no longer enough to describe and analyse what is happening or to empathise with those affected by the pandemic.

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Publisher: Cambridge University Press
Print publication year: 2003

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References

Altman, D. (1986). AIDS and the New Puritanism. London: Pluto
Barnet, T. and Whiteside, A. (2002). AIDS in the Twenty-First Century. Disease and Globalization. Hampshire: Palgrave MacmillanCrossRef
Bolton, R. (1992). HIV and promiscuity: muddles in the models. Medical Anthropology 14: 145–223CrossRefGoogle ScholarPubMed
Bolton, R. (1995). Rethinking anthropology: the study of AIDS. In Culture and Sexual Risk, ed. Ht. Brummelhus and G. Herdt, pp. 285–313. Amsterdam: Gordon and Breach
Bond, G., Kreniske, J., Susser, I. and Vincent, J. (1997). The anthropology of AIDS. In AIDS in Africa and the Caribbean, ed. G. Bond, J. Kreniske, I. Susser, and J. Vincent, pp. 3–9. Boulder: Westview
Brandt, A. (1988). AIDS and metaphor: toward the social meaning of epidemic disease. Social Research 55 (3): 413–432Google ScholarPubMed
Brandt, A. (1987). No Magic Bullet: A Social History of Venereal Disease in the United States since 1880. Expanded edition. New York: Oxford University Press
Bwayo, J. J., Plummer, F. A. and Omari, A. M. (1994). Human immunodeficiency virus infection in long distance truck drivers in East Africa. Archives of Internal Medicine 154: 1391–1396CrossRefGoogle ScholarPubMed
Campbell, C. (2003). ‘Letting them die’? Why HIV Prevention Programmes Often Fail. Oxford: James Currey
Davies, P., Hickson, F., Weatherburn, P. and Hunt, A. (1993). Sex, Gay Men and AIDS. London: Taylor and Francis
Day, S. (1988). Prostitute women and AIDS: anthropology. AIDS 2: 421–428CrossRefGoogle ScholarPubMed
Ellen, J. M., Hessol, N. A., Kohn, R. P. and Bolan, G. A. (1997). An investigation of geographic clustering of repeat cases of gonorrhoea and chlamydial infection in San Francisco, 1989–1993. Journal of Infectious Diseases 175 (6): 1519–1522CrossRefGoogle Scholar
Estebanez, P., Zunzunegui, M. V., Aguilar, M. D.et al. (1998). A demographic and health survey of Spanish female sex workers: HIV prevalence and associated risk factors. Journal of Biosocial Science 30: 365–379CrossRefGoogle ScholarPubMed
Farmer, P. (1992). AIDS and Accusation: Haiti and the Geography of Blame. Berkeley/Los Angeles: University of California Press
Farmer, P. (1995). Culture, poverty and the dynamics of HIV transmission in rural Haiti. In Culture and Sexual Risk: Anthropological Perspectives on AIDS, ed. Ht. Brummelhus and G. Herdt, pp. 3–28. Amsterdam: Gordon and Breach
Farmer, P. (1999). Infections and Inequalities: The Modern Plagues. Berkeley: University of California Press
Fee, E. and Fox, D. (eds) (1989). AIDS: The Burden of History. Berkeley: University of California Press
Glick Schiller, N., Crystal, S. and Lewellen, D. (1994). Risky business: the cultural construction of AIDS risk groups. Social Science and Medicine 38 (10): 1337–1346CrossRefGoogle Scholar
Gunn, R. A., Fitzgerald, S. and Aral, S. O. (2000). Sexually transmitted disease clinic clients at risk for subsequent gonorrhoea and chlamydia infections: possible “core” transmitters. Sexually Transmitted Diseases 27: 343–349CrossRefGoogle ScholarPubMed
Holmes, K. K., Johnson, D. W., Kvale, P. A.et al. (1996). Impact of a gonorrhea control program, including selective mass treatment, in female sex workers. Journal of Infectious Diseases 174: S230–S239CrossRefGoogle ScholarPubMed
Kane, S. and Mason, T. (1992). ‘IV drug users’ and ‘sex partners’: the limits of epidemiological categories and the ethnography of risk. In The Time of AIDS: Social Analysis, Theory and Method, ed. G. Herdt and S. Lindenbaum, pp. 199–222. London: Sage Publications
Keogh, P. and Wetherburn, P. (2000). Tales from the backroom: anonymous sex and HIV risk in London's commercial gay sex venues. Venereology 13: 150–155Google Scholar
Kilmarx, P., Limpakarnjanarat, K., Mastro, T. D.et al. (1998). HIV-1 seroconversion in a prospective study of female sex workers in northern Thailand: continued high incidence among brothel-based women. AIDS 12: 1889–1898CrossRefGoogle Scholar
Kreiss, J. K., Koech, D., Plummer, F. A.et al. (1986). AIDS virus infection in Nairobi prostitutes: extension of the epidemic to East Africa. New England Journal of Medicine 314: 414–418CrossRefGoogle Scholar
Manjunath, J. V., Thappa, D. M. and Jaisankar, T. J. (2002). Sexually transmitted diseases and sexual lifestyles of long-distance truck drivers: a clinico-epidemiologic study in South India. International Journal of STD and AIDS 13: 612–617CrossRefGoogle ScholarPubMed
Moses, S., Plummer, F. A. and Ngugi, E. (1991). Controlling HIV in Africa: effectiveness and cost of an intervention in a high-frequency STD transmitter core group. AIDS 5: 407–411CrossRefGoogle Scholar
Obbo, C. (1993). HIV transmission through social and geographic networks in Uganda. Social Science and Medicine 36: 949–955CrossRefGoogle ScholarPubMed
Oppenheimer, G. M. (1992). Causes, cases and cohorts: the role of epidemiology in the historical construction of AIDS. In AIDS: The Making of a Chronic Disease, ed. E. Fee and D. Fox, pp. 49–83. Berkeley: University of California Press
Parker, M. (1992). Re-assessing disability: the impact of S.mansoni on female activity patterns in Gezira Province, Sudan. Social Science and Medicine 35: 877–890CrossRefGoogle ScholarPubMed
Parker, M. (1996). Re-thinking female circumcision. Africa 65: 506–523CrossRefGoogle Scholar
Parker, M. (1998). Sex in Backrooms: Issues and Dilemmas for Health Practitioners. Report London: Health Education Authority
Parker, M. (1999a). HIV transmission in urban environments: London and beyond. In Human Biology in Industrialised Countries, ed. L. Schell and S. Ulijaszek, pp. 280–308. Cambridge: Cambridge University Press
Parker, M. (1999b). Female circumcision and cultures of sexuality. In Culture and Global Change, ed. T. Skelton and T. Allen, pp. 201–211. London: Routledge
Parker, M. (2001). Stuck in GUM: life in a clap clinic. In Inside Organisations, ed. D. Gellner and E. Hirsch, pp. 137–155. Oxford: Berg Press
Parker, M., Ward, H. and Day, S. (1998). Sexual networks and the transmission of HIV in London. Journal of Biosocial Science 30: 60–83CrossRefGoogle Scholar
Plummer, F. A., Nagelkerke, N. J. D., Moses, S., Ndinya-Achola, J. O., Bwayo, J. and Ngugi, E. (1991). The importance of core groups in the epidemiology and control of HIV-1 infection. AIDS 5: S169–S176Google ScholarPubMed
Public Health Laboratory Service (PHLS) (2002). HIV and AIDS in the UK: An Epidemiological Review. London: Communicable Disease Surveillance Centre
Ramjee, G., Karim, S. S. and Sturm, A. W. (1998). Sexually transmitted infections among sex workers in Kwazulu-Natal, South Africa. Sexually Transmitted Diseases 25: 346–349CrossRefGoogle ScholarPubMed
Rothenberg, R., Kimbrough, L., Lewis-Hardy, R.et al. (2000). Social network methods for endemic foci of syphilis. Sexually Transmitted Diseases 27: 12–18CrossRefGoogle ScholarPubMed
Schoepf, B. (1992). Women at risk. Case studies from Zaire. In The Time of AIDS: Social Analysis, Theory and Method, ed. G. Herdt, and S. Lindenbaum, pp. 259–286. London: Sage Publications
Schoepf, B. (1995). Culture, sex research and AIDS prevention in Africa. In Culture and Sexual Risk: Anthropological Perspectives on AIDS, ed. Ht. Brummelhuis. and G. Herdt, pp. 29–51. Amsterdam: Gordon Breach
Schilts, R. (1987). And the Band Played On: People, Politics and the AIDS Crisis. London: Penguin
Singer, M. (1998). The Political Economy of AIDS. Amityville, NY: Baywood
Singh, Y. N. and Malaviya, A. N. (1994). Long distance truck drivers in India: HIV infections and their possible role in disseminating HIV into rural areas. International Journal of STD and AIDS 5: 5137–5138CrossRefGoogle ScholarPubMed
Sontag, S. (1977). Illness as Metaphor. New York: Farrar, Strauss and Giroux
Spina, M., Mancuso, S., Sinicco, A.et al. (1998). Human immunodeficiency virus seroprevalence and condom use among female sex workers in Italy. Sexually Transmitted Diseases 25: 451–454CrossRefGoogle ScholarPubMed
Steen, R., Vuylsteke, B., DeCoito, T.et al. (2000). Evidence of declining STD prevalence in a South African mining community following a core group intervention. Sexually Transmitted Diseases 27: 1–8CrossRefGoogle Scholar
Ward, H., Day, S. and Weber, J. (1999). Risky business: health and safety in the sex industry over a 9 year period. Sexually Transmitted Infections 75: 340–343CrossRefGoogle Scholar
Yorke, J. A., Hethcote, H. W. and Nold, A. (1978). Dynamics and control of the transmission of gonorrhoea. Sexually Transmitted Diseases 5: 51–56CrossRefGoogle Scholar
Young, A. (1996). The Harmony of Illusions: The Social Construction of Post-Traumatic Stress Disorder. Princeton, NJ: Princeton University Press

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