UCSF

This dissertation is an ethnographic and epidemiological investigation of HIV/AIDS treatment and prevention. This research focuses on South Florida, and explores how global health and policy frameworks of HIV/AIDS affect the health and well being of transnational immigrants such as Haitians. It traces the circulation of knowledge about HIV/AIDS prevention from sites of surveillance and regulation to various clinics and hospitals to the social worlds of Haitian immigrants. Interviews with HIV/AIDS experts and public officials, as well as Haitian clients, demonstrate that global technicalities of disease prevention are inherently linked to individual practices and local politics of difference.

Specifically, this project explores how the politics of difference permeates HIV/AIDS prevention in the United States. As discussions of the biological basis of race continue to gain traction in light of recent demographic changes and advances in genetic research, this research documents how medical, epidemiological, and social constructions of HIV/AIDS risk fuse notions of pathology with racial and cultural differences. It reveals that notions of individual responsibility in HIV/AIDS risk management often become inseparable from notions of racial, ethnic, and immigrant identities. It argues that HIV/AIDS surveillance practices help to reinforce categories of individual and collective difference, and sustain race and ethnicity as risk factors for HIV/AIDS. In addition, this project highlights the specific problems facing diverse immigrant and ethnic populations, and reveals that Haitians strategically identify with various institutions and diseases in order to access critical resources. Here, it illustrates that public understandings of health interventions are complex, and as a result, translations of HIV/AIDS prevention do not occur smoothly or as planned in Haitian communities. Finally, it argues for a re-envisioning of health disparities to emphasize their productive capacity in generating subjectivities, domestic and global policies, and scholarly research initiatives. This research posits that disparities in health, as realized in the socio-political and scientific realms in which they are engaged, are being made into everyday social instruments of action for securing funding, gaining political power, and obtaining forms of welfare benefits.