Putting sexuality (back) into HIV/AIDS: Issues, theory and practice1

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.

Sexualidad, experiencias corporales y género: un estudio etnográfico entre personas viviendo con VIH en el Área Metropolitana de Buenos Aires, Argentina

“…Desde finales de los ochenta las ciencias sociales han avanzado en la necesidad de considerar relacional y contextualmente la sexualidad, incluyendo las configuraciones de género, clase y étnicas en el análisis de las identificaciones, las relaciones y las prácticas sexuales 1,2,3 . En este marco, nuestra investigación aborda la sexualidad como un proceso de construcción a la vez individual y social, que supone una trama de intercambios complejos modelados por relaciones de poder y dispositivos de regulación social.…”

‘It's got to be about enjoying yourself’: young people, sexual pleasure, and sex and relationships education

“…This is evidenced in the Global Programme on AIDS across 14 countries (Boyce et al 2007) that concluded successful programmes are those that stress the creative and pleasurable aspects of sex with open and honest discussion about sex and sexuality being vital. Philpott et al (2006) reported similarly that barriers to pleasure are cited as the main factor in the non-use of condoms and hence stressed that successful condom strategies should no longer focus on the risks to health of sex without condoms and instead stress that condoms can bring pleasure as well as protection.…”

Unintended consequences: evaluating the impact of HIV and AIDS on sexuality research and policy debates

“…While many of these outcomes appear to be unintended consequences of issues that the epidemic has raised, they are nonetheless also clearly shaped by the ways in which we, as researchers, advocates, and policymakers, have responded to these issues -and they can be moved in various directions depending on the nature of our response. Now, more than ever, we may need to fight to find ways of "putting sexuality (back) into HIV/AIDS" 35 , not only to help advance the field of sexuality, but to be sure that we do not witness a major reversal of important accomplishments made during the early decades of our response to the HIV epidemic. …”

“…For some years now, a number of social investigators have raised concerns about a tendency to disregard the bodily experience -the corporeality of sex -in much contemporary HIV-related research 34 . In 2004, at a satellite meeting that was held in conjunction with the International Conference on AIDS in Bangkok, a group of leading social researchers began to call attention to the need to put "sexuality (back) into HIV/AIDS" 35 . I have also written elsewhere of what I fear may be a growing "sanitization" of the field of sexuality research more generally, independent of whether or not it is linked to the investigation of HIV and AIDS, in which our growing concern with issues of social context may inadvertently be drawing attention away from the lived experience of sexual practice in much recent social science research 20 .…”