These two books belong to a series published by the Center for the Study of Sexualities at National Central University, Taiwan. They are products of conferences on cultural critiques on HIV/AIDS in 2012 and 2013. Both are comprised of original articles by local scholars and translated articles by experts from Canada (Cindy Patton) and Australia (Kane Race), along with transcripts of workshop discussions. Editor Hans Tao-Ming Huang claims that these are the first books on cultural studies of HIV/AIDS in Taiwan. To address locally distinctive ideas pertaining to the East Asian Science, Technology and Society community, this review particularly foregrounds the articles and discussions by local scholars and participants while treating translated articles as background for comparison.
The first book, AIDS Governance and Local Actions, contains two articles by Huang, two translated articles by Patton, a long response, and an account of a discussion panel. It concentrates on HIV-related organizations and the mainstreaming of HIV/AIDS prevention before and after the advent of highly active antiretroviral treatment (HAART), the so-called AIDS cocktail therapy, in 1996. The first article by Huang addresses the period before HAART, which was marked and illustrated by the autobiography of Han Sen (a pseudonym). This article describes the formation of a new moral order centered on safe sex, which banned all kinds of risky sex, for the sake of public health. The article also analyzes the ways in which people with HIV/AIDS and those who sympathized with them organized and developed a politics of grievance against social stigmatization through quilt weaving and narrative making, among many other actions.
Huang’s second article examines the strategies of a number of HIV/AIDS organizations in the post-HAART period, among them the Taiwan AIDS Foundation (台灣紅絲帶基金會). Huang observes that these organizations, although established to cooperate with the government and offer assistance to people with HIV/AIDS, aggravated the culture of moralizing sex and stigmatizing sero-positiveness. Their endeavors, such as propagandizing through peer educators, expansion of HIV screening, and promotion of healthy behaviors, enhanced constrained sexual morality by resorting to education of sentiment and deployment of homonormativity. Huang’s article in the second book adds to this emphasis by criticizing the case-manager system for people with HIV/AIDS. By reviewing the documents from various organizations, including the Center for Disease Control, he contends that this individual-based system of case management is a form of state surveillance that does not resort to downright coercion but to camouflaged coaxing nevertheless. Moreover, this “HIV case-management care industry” was embraced and constituted by many hospitals and nongovernmental organizations (NGOs). The cooptation of the government and NGOs contributed to a new moral authoritarian regime that emphasizes the ideal of a positive carrier—“positive” in this context referring to both the individual’s sero-status and his or her conformity to this moral regime. Echoing Huang’s criticism of this reinforced homonormativity, Yung-Ching Chang contributes an article that analyzes the homonormativity exemplified by polarized representations of gay people: gay people are portrayed as good if they show a positive and bright attitude; by contrast, they are framed as bad if they transgress the social and behavioral boundaries that protect the majority from HIV/AIDS.
These articles are critical and even suspicious of governmental policies and programs that claim to contain the social, health, and personal impacts of HIV/AIDS. According to their authors, the development of Taiwan’s policy on HIV/AIDS prevention has been entangled with stigmatization and suppression despite the provision of free antiretroviral medications and the revision of laws to codify HIV prevention ideals while protecting human rights. However, these articles present a rather one-sided perspective: HIV/AIDS governance, however revised and renewed, is nothing but old wine in a new bottle, re-presenting a persistent prejudiced view of HIV/AIDS. This accusation perhaps fits the perceptions of some, as shown in the discussion in these two books. However, given the progress of medical treatment for HIV/AIDS and the social movements and organizations that have advocated the rights of people with HIV/AIDS, readers like me cannot help but wonder how this moralizing, stigmatizing, and suffocating bigotry about sexual practices, infectious illness, and desirable behavior have managed to resist change for the past three decades. The authors do not seem to provide an answer to this question.
The translated articles and interviews are obviously important references and sources of inspiration for these local scholars. These pieces address the works of an emerging global regime of HIV/AIDS governance that articulates disease prevention for the public and intimate relationships for the individual. In their depictions, this regime displaces the focus of health intervention from the sociopolitical entanglements of sex and HIV/AIDS to personal behavior and biomedical possibilities. Subjectivity and collectivity that should have been present in the public endeavor to contain rather than stigmatize people with HIV/AIDS are thus left out in a regime informed by neoliberalism and neomoralism. Overall, the articles in these two volumes collectively demonstrate a cultural criticism of health governance around HIV/AIDS, sex, and morality in Taiwan and beyond.
Given the closely woven critiques shown by these articles, the discussion parts in these books are highly eye-catching, because the remarks therein insightfully question the issues that these articles fail to address but which underlie the concerns of those on the front line. The people who ask questions or make comments include HIV/AIDS case managers, NGO workers, HIV-positive drug users, and even the author of the book himself (“Han Sen”). They suggest that the importance of personal experience and practice should not be neglected if the analysis is to go beyond criticism of existing institutions. Similarly, these HIV/AIDS practitioners and writers ask questions regarding themselves. One telling moment is when Han Sen raises a question in response to Huang’s first article: “Then, how do you see the current Han Sen, Chang Wei, or Wu Ying-Jung?” to which Huang answers, “I cannot answer this question immediately.” (Han Sen and Chang Wei are two pseudonyms of Wu Ying-Jung.)
In the end, we have no idea how this sexual ideology (or moral authoritarianism, or surveillance regime, depending on the context of the articles) is enacted in everyday encounters. Words and texts are powerful indeed, but only when actions and interactions are involved. Unfortunately, as they are based on analysis of existing discourses, criticisms addressed in these articles appear somewhat adrift.
As the first work in cultural studies on HIV/AIDS governance in Taiwan, these books have certainly set a good example for how to examine the ways in which HIV/AIDS has been implicated culturally, socially, and politically in Taiwan. HIV/AIDS governance is a topic that I firmly believe awaits in-depth research and criticism. A good start needs more follow-up.