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This paper takes as starting point research conducted in Durban, South Africa to unravel the complexities of care ethics in the context of humanitarian aid. It investigates how the gendering of care shapes humanitarian aid in the context of the HIV/AIDS epidemics in Africa constructing an image of “virile” and “violent” African masculinity. Humanitarian organizations construct imagined relations of caring invoking notions of a shared humanity as informing the imperative to facilitate change. This paper draws on varied examples of research and NGO activity to illustrate how these relations of care are gendered. Humanitarian interventions which invoke universalizing conceptions of need could instead draw on feminist care ethics that seeks to balance rights, justice and care in ways that attend to the webs of relationships through which specific lived realities are shaped. Essentialising, feminized discourses on care result in a skewed analysis of international crises that invariably invoke women (and children) as victims in need of care and, at best, ignore the lived experiences of men, and at worst, cast men as virile and violent vectors of disease and social disorder.

Although South Africa's total fertility rate is one of the lowest in sub-Saharan Africa, high rates of early childbearing remain a concern. Most teenage pregnancies occur among poor black and coloured South Africans. The majority of these pregnancies are said to be unwanted and unplanned and the teenager's relationships, unstable. Becoming a mother during one's teenage years is perceived to be socially, economically and physically deleterious for the teenager and her baby. This paper presents ethnographic data collected over a five-year period in the South African township of Nyanga East in the Western Cape. It draws attention to the circumstances that surround teenage pregnancy and discusses reactions to teenage pregnancies in this community. Findings highlight that despite the negative perception of teenage pregnancy within the township, particular social and cultural circumstances provided fertile ground for its occurrence. Furthermore, the paper argues that in this particular community the management of a teenage pregnancy played a functional and critical role in maintaining and reproducing social norms and ideals regarding intergenerational relationships, which ultimately ensured that the rates of early childbearing remained high.

HIV prevention discourses concern lives, the protection of bodily rights and people's active involvement in the policies and programmes that affect them. HIV prevention discourses also create lives, relying upon the deployment of normative sexual identities at the same time as they invite complex and fluid youth identities to embody the norms of prevention. This paper examines a particular HIV prevention text that is available to teachers in the Western Cape province of South Africa to support the implementation of the national Life Orientation programme. Rather than considering this text as a neutral 'scaffold' upon which teachers and students add cultural meanings, it is important to interrogate the ways in which texts rely upon and reiterate particular discursive constructions of the youth sexual subject. This paper argues that the text deploys a particular discursive framework in order to construct a 'normal' (and hetero) sexuality that validates, rather than questions, social constructions of masculine privilege within heterosexuality. This is achieved through the deployment of a scientific expertise of sexuality; the mobilisation of a valued hetero/homosexual binary to create a 'safe' heterosexuality; the normalisation of bourgeois sexuality through the ideology of marriage; and the naturalisation of heterosexual masculine and feminine identities.

Engaging men in work towards gender equality is a critical aspect of gender and development. However, there are few documented grassroots-level approaches to undertaking such work. This paper argues that context specific stresses on local constructions of masculinity, such as unemployment, poverty and high HIV prevalence, may provide useful entry points for work with men towards gender equality. While these stresses may act to undermine men's ability to 'achieve' the requirements of traditional constructions of masculinity, particularly the role of men as providers, they simultaneously create spaces for change. In this research, land-use provided a basis from which to engage with a group of older men (45-75 years) around a range of issues, including HIV and AIDS and health. Increases in levels of communication around HIV, household resources and health are used as indicative of the men's moves towards gender-equal behaviour. The paper argues that this was achieved by supporting positive aspects of traditional masculine identities, particularly the role of men as breadwinners, in a social and economic context where these roles are threatened or placed under pressure, while simultaneously working around 'sensitive' issues.

Sex-selective abortion is the major direct cause of the severe imbalance in the sex ratio at birth - contributing to the phenomenon of over 100 million 'missing' females worldwide and 40 million in China alone. Internationally as well as in China, moral condemnation and legal prohibition constitute the mainstream and official position on sex-selective abortion. This paper characterises the dominant Chinese approach to the issue as state-centred and coercion-oriented. Drawing upon case study material, the paper discusses eight major problems arising from coercive state intervention in sex-selective abortion: neglect of reproductive liberty and reproductive rights; the hidden dangers of state power; inconsistency with existing abortion policies; practical ineffectiveness; underestimating the costs and resistance involved; simplifying and misrepresenting the key issues; the lack of sufficient public discussion; and ignoring the moral and political principles established by traditional Chinese thought. To avoid a solution that is worse than the problem itself, alternative social programmes that are focused on women, community-oriented and voluntary in nature need to be developed.

Group sex has consistently been identified as one of a group of risk behaviours among gay men associated with HIV seroconversion. This paper presents a detailed description of how gender, and specifically masculinity, operates as an aspect of the discourse of gay men's group sex. The findings presented in this paper are one part of a multi-aspected discourse analysis through which we are aiming to develop an account of the discourse of gay men's group sex as it was produced in a series of qualitative interviews conducted with gay men who participate in group sex. The interviews were conducted as part of the Three or More Study (TOMS), a larger project that involved a substantial quantitative component. The overarching intent of the discourse analysis is to provide as comprehensive a mapping as possible of this discursive terrain to facilitate the targeted development of HIV and sexual health educational initiatives. The discourse of gay men's group sex reproduces some key formations of masculinity within discourses of gender, which present specific challenges for HIV prevention education. These challenges are outlined at the conclusion of this paper.

Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non-professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population.

Over the course of the past three decades, there has been a significant increase of research on the social and cultural dimensions of sexuality. This paper reviews three major phases in the development of this work. In the first phase, work focusing on the social construction of sexual experience developed an important critique of the biomedical and sexological approaches that had dominated the field over much of the twentieth century. In the second phase, increasingly detailed studies of sexual life were developed which highlighted the cross-cultural diversity of sexual cultures, sexual identities and sexual communities. In the most recent phase, there has been a growing recognition of the complex relationship between culture and power, and increasing attention to the political and economic dimensions of sexuality. In spite of the significant conceptual and methodological advances that have taken place over time, however, it is also possible to identify a number of important questions that have not yet been adequately addressed and that may have been precluded by some of the perspectives that have come to dominate the field. The paper ends by focusing on the silences and invisibilities that continue to characterize this field of research and the challenges that must still be confronted in seeking to expand our understanding of these issues.

Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicized as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them.

This paper explores the manifestation of HIV-related stigma in seven- and eight-year-old white South African children's responses to HIV and AIDS. Drawing from elements of ethnographic and interview data, it shows how young children's responses to HIV and AIDS are inscribed within popular accounts of contagion and articulate gendered, sexual, raced and classed discourses in South Africa. Rejecting static accounts of stigma, the paper shows how children resist and confirm power inequalities involving intense self-regulation as well as inscribing within discourses of care and concern for others infected with HIV and AIDS. The findings have implications for scaling up educational efforts to address awareness of HIV and AIDS and stigma, but also to build on positive insights that young children demonstrate with regard to the disease.

This paper describes how South African soldiers draw on notions of gender, sexuality and morality in their constructions of identity and heterosexual sexuality. Popular discourses around HIV and AIDS in South Africa and elsewhere have highlighted the centrality of notions of morality, many of them problematic, in the response to the epidemic. In Southern Africa, the centrality of heterosexuality to HIV transmission has triggered a focus on morality in sexuality, including calls for abstinence or, in married relationships, monogamy. This paper discusses the findings of a research study that explored male soldiers' constructions of masculinity, sexuality and risky sexual practices. Discourses that emerged reflected dominant attitudes regarding men and women's sexual rights and, in particular, the moralisation of women's sexuality.

Women in Viet Nam have long had to face various sexual and reproductive health problems, ranging from abortion to reproductive tract infections (RTIs) and sexual coercion. These issues have increasingly been addressed by scholars in the fields of public health and social sciences through sexual and reproductive health research and in other ways. Despite this, there remains a lack of in-depth information on attitudes and practices regarding sex and sexuality of Vietnamese women today. This paper in part responds to the knowledge gap by reporting on findings from qualitative research on sexual attitudes and practices among rural married women in a Northern rural community, measured against the broader social and cultural context. Twenty-five women in total were interviewed; and two focus group discussions were conducted. The findings show that women generally believe that men are (or should be) the initiators in sexual relations. Many women feel reluctant to refuse sex to their husbands or communicate openly about sex and sexuality. However, this paper also demonstrates that women are not totally passive in sexual relations. Women in this study used a range of strategies to negotiate their sexual life, and sometimes 'silence' is used as a form of agency in order to maintain harmony and happiness within the family.

While Australian Aboriginal conceptions of health have been described as holistic and collective, contemporary approaches to health services and health research are often premised on the rational, reflexive subject of neoliberal discourse. This paper considers how neoliberal conceptions of health and subjectivity arose and were negotiated in the context of a qualitative research project on Aboriginal experiences of HIV in Western Australia. Questions about 'coping', 'future' and 'life changes' stood out in the interview transcripts as examples of neoliberal discourse. This paper explores the reflexive, contextual and deflective responses to these questions and suggests they demonstrate how neoliberal discourse can produce the impression that 'everything is okay' despite the difficult social and economic conditions of everyday life experienced by many Aboriginal people. Aboriginal people with a chronic and serious infectious disease such as HIV may utilise the language of self-management and responsibility when talking about HIV with a non-Aboriginal researcher for pragmatic and utilitarian reasons. In this way, the responses of the Aboriginal participants in this study provide a valuable opportunity for exploring new approaches to both research methodology and health service delivery.

This paper presents interview data and media analysis on the gay male community in the USA. It describes how sexual objectification is more than the outcome of racism in the gay male community. Sexual objectification of gay men of colour in the USA produces a white sexual community. Ideologies of inclusivity and non-discrimination blind white gay men to the harmful effects of sexual objectification. Moreover, discussing negative effects of objectification is met with considerable resistance. The experiences of African American men, described in this paper, show the pervasiveness of sexual objectification. The sexual objectification of men of colour forces them to play specific roles in sexual encounters that are not necessarily of their own choosing.

Because of the multiple stigma attached to HIV/AIDS, disclosure of HIV-positive serostatus is a considerable social risk for those who disclose. While HIV/AIDS-related stigma affects all HIV-positive people, for people from minority cultures additional cultural factors may play a significant role in self-disclosure. This paper draws on data from semi-structured, in-depth interviews with HIV-positive people from minority cultures in Sydney. Disclosure decisions were influenced by gender, sexual orientation, as well as cultural background. Gay men drew on both collectivist and individualist notions of interdependence and self-reliance in different socio-cultural contexts. This enabled them to accommodate the imperative to maintain harmony with the family and meet their individual needs for support. Heterosexual men who had disclosed voluntarily or involuntarily experienced discrimination and avoidance, and interdependence with family and ethnic community was disrupted. Heterosexual women disclosed to no one outside the health care system and were anxious to avoid any disclosure in the future. For all participants, voluntary and involuntary disclosure caused potential and actual disruption of relationships with their families and ethnic communities. The paper concludes by arguing for an ecological perspective of health in which decisions are not located in rational decision making alone but in the broader context of family and community.

The HIV epidemic has had a profound impact on people's everyday life in most African societies. A large proportion of all new HIV infections involves young people between 15 and 25 years. The objective of this paper is to explore local moral worlds of young people in Bobo-Dioulasso, Burkina Faso, and discuss how the HIVS epidemic affects their reflections on their everyday life and their perceptions of sexual relationships. Based on anthropological fieldwork, including focus-group discussions, in-depth interviews and participant observation, a total of 57 young people between 15 and 25 years were followed over a 3-month period. Using the notion of 'lifestyle', the paper shows how structural factors of unemployment and poverty paired with global discourse on AIDS present the young people with frustrations and quandaries in relation to their hopes and images of love, faithfulness and modern living. The data shows that the HIV epidemic contributes to and accelerates their feeling of living in a risk society and of being at risk. In order to cope with these uncertainties and contingencies, local discourses of trust and fidelity become extremely important and to most young people HIV prevention is synonymous with finding a faithful partner and/or using condoms.

Vasectomy is considered a permanent form of contraception for men that can help reduce reproductive inequality. Its underutilisation in the context of the threats it may pose to perceptions of traditional masculinity has been closely investigated, but the lived experience of the procedure itself has been largely overlooked. This paper examines the experience of having a vasectomy in Israel, focusing on the recommended form of anaesthesia. Drawing on 15 semi-structured interviews with Israeli men who have experienced vasectomy, we found that the choice of anaesthesia has a significant impact on the meaning and experience of vasectomy. Unlike the widespread use of local anaesthesia during vasectomy in other countries, vasectomy in Israel is performed almost exclusively under twilight sedation administered intravenously. Based on our findings, we argue that framing vasectomy as an operation that requires sedation is related to views of masculinity and reproduction. Our data suggest that vasectomy in Israel is constituted as a potentially traumatic event, and anaesthesia is employed to protect patients from feelings of embarrassment and discomfort. We conclude that the prevailing method of sedation perpetuates the silencing and marginalisation of vasectomy as a contraceptive method, and consequently, its very limited accessibility in Israel.

Interactive community-based theatre is used to engage with audience members and allow for free exchange of ideas relevant to context. It aims to bring about a new understanding of an issue while challenging people's attitudes and perceptions. Its application within the field of sexual and reproductive health has been limited, particularly in low and middle-income contexts. This paper presents the rationale for a research-arts partnership in Jordan and describes the process and some lessons learned from the development and country-wide performances of a research-informed interactive play. The play

This paper examines the shifting nature of contemporary epidemiological classifications in the HIV/ AIDS epidemic. It first looks at assumptions that guide a discourse of vulnerability and circulate around risk categories. It then examines the underlying emphasis in public health on the popular frame of “vulnerable women” who acquire HIV through heterosexual transmission. Drawing on work on gender, sexuality, and intersectionality, the paper asks why a discourse of vulnerability is infused into discussions of heterosexually-active women's HIV risks but not those pertaining to heterosexually-active men's. The paper then moves to current surveillance categories that are hierarchically and differentially applied to women's and men's risks in the HIV epidemic. Here, the focus is on the way in which contemporary classifications allow for the emergence of the vulnerable heterosexually-active woman while simultaneously constituting lack of fathomability concerning bisexual and lesbian transmission risk. Lastly, theories of intersectionality, are used to examine current research on woman-to-woman transmission, and to suggest future more productive options.

The expanding AIDS epidemic in Mozambique is fuelled principally by heterosexual transmission, with young people identified as a key group for prevention efforts. However, little is known about the sexual behaviour of young people in Mozambique and the protective practices they adopt. This paper seeks to identify the contexts and rules governing sexual risk-taking among young people in Maputo. In doing so, the paper affirms the importance of context in understanding risk practices, but highlights the fluidity of practice as an important limitation for the use of contextual analysis in prevention interventions. By focusing on one innovation, the saca cena one-night stand, this paper shows how a subgroup of young people in Maputo has redefined a "risky" sexual practice to include exclusive condom use. As a risk context, the saca cena dictates a set of implicit rules emphasizing anonymity, discretion, verbal and non-verbal cues, and for a set of select innovators, condom use. The saca cena challenges the hegemonic gender roles found among many young people in Maputo of male dominance through sexual conquest and female acquiescence. Instead, the practice allows young people to be both adventurous and responsible. The discourse demonstrates how sexual identities have been redefined to combine risk reduction with sexual experimentation and the satiation of desire.

Egger and Harcourt have formulated their response to my paper with regard to apparent 'conclusions concerning the impact of the law on the policing of prostitution and the structure and size of the sex industry' in New South Wales (NSW). It is with some difficulty that I respond to their criticisms, as my original article was neither concerned with the 'size' or 'structure' of the sex industry in NSW: at least, not in the narrow and positivistic sense the authors would indicate. Put simply, the paper was not concerned with measurement or producing specific 'facts' about the sex industry. To challenge the validity of my statements because I have not attempted to comprehend the 'structure and size' of the sex industry demonstrates a crude misunderstanding of the core thrust of the paper, which was framed according to a 'problem analysis' approach, as opposed to 'problem solving' approach (see Schneider 1985). In fact, the paper was concerned with documenting how the sex industry is governed and the relationship between regulation and public perceptions of the sex industry. That said, there seems to be little of value in engaging the authors in an unnecessary polemical exercise by systematically addressing each of the points they have raised. To do so would only further remove the paper from its original context, which the authors have either deliberately ignored or failed to comprehend. It would be more constructive to restate and further clarify the objectives of the original paper with some reference to recent events in NSW, while urging readers to carefully re-read the paper with reference to the response.

This paper describes findings from fieldwork conducted among Pitjantjatjara tribespeople of Central Australia between 1989 and 1997. The study examined the impact of a distinctive gender system and practices of masculinity, particularly sexual and ritual practices, on the risk of contracting sexually transmissible infections and other blood-borne diseases. The research was designed as an ethnography of masculinity, conducted via participant observation, life history interviews, ritual analysis, and critical reflection on the work of early ethnographers. The paper presents selected field data, examined in the light of early twentieth century anthropological description of Pitjantjatjara sexuality. It identifies a systematic deflection of male same-sex attraction away from possible resolution through sexual practices between men. Key components of this deflection are the ritual construction of a culturally distinctive masculinity, the inextricable linkage between masculinity rites and the system for arrangi...

Recent research indicates that risk perceptions are shaped by social and cultural factors, and therefore it is important to study the cultural aspects of sexual risk understandings. This paper reports on a pilot study using consensus analysis to study the content and distribution of knowledge of sexual risk among a small sample of college students at a private university in western New York. Twenty men and 20 women were surveyed. The results of the subsequent consensus analysis suggest that the men, the women, and all the respondents combined share a model of what constitutes risky sex. The women showed a greater level of consensus and average competence than men. There were important differences between men and women in some aspects of the content of knowledge. In particular, men perceived sexual desire as more likely to prevent the practice of safe sex, whereas women saw alcohol in that role. One issue raised in this paper is the problematic assumption that culture as knowledge determines behaviour. Une...

This paper argues that the relationship between homophobia and HIV/AIDS is not as direct as is often assumed. This argument is pursued through an examination of the situation of gay men in Australia, a country where the HIV epidemic is largely confined to gay men, and Bangladesh, a country and culture where sex between men does not conform to categories of human sexuality privileged in Western theory. Both of these countries reveal something different about cultures of sex between men, which provides a counterpoint to the often compelling and usually pervasive accounts of HIV-related discrimination that are derived particularly from North America. The paper concludes with a plea that as efforts are geared up to fight the HIV pandemic in Asia and the Pacific, researchers, planners and practitioners become more critical of the conceptual tools they rely on in thinking about HIV/AIDS and human sexual activity, so that it is possible to mobilize (and do less damage to) local cultures of sexuality.

This paper examines the gendered nature of desire in a North Balinese rural village adjacent to a tourist resort. It poses the theoretical question of what happens when a culture's dominant belief systems fail to accommodate desire. Observing that male promiscuity is indulged and naturalized in this community, the paper argues that women's desire is channelled narrowly into achieving and retaining a spouse. Women who admit of desire outside these cultural constraints may be subject to episodes of 'hysteria'. Hysterical illness is read herein as a displacement of desire onto the body such that the body becomes 'the place'-as a site of illness-where desire may reside. Although the resort to hysteria may provide temporary emotional release for women's frustrated affect, it does not fundamentally transform the gendered relations of desire. Curiously, neither does it appear to exacerbate the inequalities they sustain, implying that in North Bali (hysterical) illness may serve as a legitimate avenue for the expression of desires that are otherwise culturally-proscribed.

This paper argues for a holistic approach to improving the sexual health of young people, effecting change at cultural, socioeconomic, and service organization levels. Such an approach necessitates close partnership working. The paper draws mainly upon the results of an in-depth case study of the process of developing an integrated approach to sexual health in East Yorkshire, England. Findings indicate that partnership working is severely curtailed by cultural barriers between different stakeholders when operating under their traditional roles, even when all are working towards a common goal. By contrast, when encountered common tasks are new, cultural barriers do not appear to matter and cultural diversity becomes a positive factor. There is a need to re-orientate practices according to a more integrated discourse of sexual health, utilizing in full the contribution each relevant stakeholder can make.

Recent advances in treatment have improved the health of many people living with HIV/AIDS. The research described in this paper shows that the changing context of care is also impacting significantly on people who provide services. In this paper, we explore both perspectives by comparing recent service provider data with that derived from research involving people living with HIV/AIDS. We explore four themes: (1) hope and optimism; (2) changing context, roles and identities; (3) changing relationships; and (4) quality of life. Treatment advances and a new focus on living has altered the context of working with people living with HIV/AIDS and challenges health professionals to find new meanings and relationships within that context. Study findings have implications for the wider health care context and the changing roles and power balances within this arena.

Abortion decision making by rural villagers in Thailand must be understood within its broader economic, social and ideological context. Abortion laws are highly restrictive in Thailand, yet abortions remain common. This paper examines rural villagers' normative constructions of the act of abortion and the 'socially embedded morality' they bring to discussions about abortion. The paper is based upon seven focus group discussions with women and men and long-term ethnographic fieldwork in rural north-east Thailand. Vignettes based upon real stories of women stimulated detailed discussion in the focus groups of the circumstances under which abortion is acceptable. The paper first discusses the social construction of abortion in Thailand, definitions of abortion as Buddhist sin and ethnomedical categorizations of the foetus. Then it describes the major themes that emerged from focus group discussions and interviews on abortion decision making. The material conditions of women and men's lives, changing construc...

This paper describes the experiences of a hitherto invisible and possibly increasing population in England, namely young homeless lesbian, gay and bisexual people. It draws on preliminary findings from research into transitions for young lesbian, gay and bisexual people that took homelessness as one theoretically informed focus. The paper explores two main questions. Firstly, how far and in what ways does sexuality play a role in a housing crisis? Secondly, why have the experiences of young people who may be questioning their sexuality been neglected in service provision and in the mainstream literature on leaving home and homelessness? Qualitative and quantitative evidence is brought together to suggest that a sizeable proportion of young homeless people may be lesbian, gay and bisexual, and that issues of sexuality have had an important bearing on their circumstances. At a time when it may be easier than before for a person to come out at a younger age, the risks associated with constructing identity an...

This paper brings into question conceptualizations of community, specifically those that have been termed 'communities of shared interest and circumstance'. To do this, it explores the ways that people with haemophilia and their families experience and constitute community. Drawing on empirical data from semi-structured interviews and participation in joint activities, this paper details and describes the nature of the Australian haemophilia community. In doing this it addresses the role that advances in medical technologies and blood borne viruses, such as HIV, play in the production and maintenance of this community. Findings suggest that the haemophilia community is one steeped in historical intrafamilial genealogies and a network of other families, interfamilial, that pre-existed HIV and other blood borne viruses. As such, it is a more complex community than the term 'communities of shared interest and circumstances' suggests and has the potential to provide much to public health partnerships, which r...

This paper presents an analysis of the 'meanings' of sexuality, reproduction and contraception among the men of a rural community in Central Mexico (Ocuituco). The study is based on 74 in-depth interviews conducted between 1988 and 1992 with women, men and key informants (physicians, midwives and teachers) of the community. Interview data was analysed from a qualitative and contextual perspective. Findings suggest that men from this community conceive of male sexuality as a natural force that is difficult to control. This belief makes them permanently suspicious about the fidelity of their wives and the paternity of their own children. It also accounts for the fact that contraceptive use is experienced with ambivalence, in as much as it holds the potential to relieve the economic burden of the family, which is deemed an advantage, but it also promotes the sexual freedom of the women, which is perceived as a risk. This paper concludes by showing the possibilities of generalizing research of this kind and i...

Over the past four decades, two forms of lesbian community have come gradually into existence in Taiwan: The T-Po community which revolves around butch-femme distinctions, and the feminist lesbian community which advocates women's liberation through same-sex practises. This paper examines the ways in which each community has come into formation. It highlights how, via a process of 'domestic colonialism', the feminist lesbian community has appropriated many of the gender and sexual roles performed by the T-Po community so as to establish a global and progressive 'queer' identity. The paper end by exploring a number of issues that remain problematic in Taiwan's feminist lesbian discourse today. These include notions of social class and the relevance of concepts of globalization for an understanding of contemporary lesbian identities and practises.

This paper offers a review of the ways in which the Thai print media presents images of transgendered and/or homosexual identities or what may be termed 'gendered/transgendered sexualities'. The author argues that the varied, and at times contradictory, images of gendered sexualities used by the print media can be understood as discursive devices in broader social debates within Thai society. The paper reviews three cases recently covered by the Thai print media: The emergence of lesbian/gay youth cultures (tom-dee, gay); the Rajaphat College ban on transgendered/gay students; and sex crime cases in which the defendant is labelled as 'Tuy' or a type of homosexual male. These three cases offered particular representations of gendered sexualities that can only properly be understood within the social-political context of modern day Thailand. In particular, they operate as a kind of Thai 'Orientalism', or cultural critique, which contrasts sharply with the ironic silence of the media towards high profile ind...

This paper reflects on recent research on Thai discourses of gender and eroticism in order to problematize some of the universalist assumptions that have dominated discussion of the international proliferation of forms of erotic diversity. By mapping the proliferation of Thai gender/sex categories from the 1960s to the 1980s, the paper shows that Thai homoeroticisms are not converging towards Western models and points to the cultural limits of Foucauldian-modelled histories of sexuality. In particular, it demonstrates the inability of Foucauldian history of sexuality, and queer theoretical approaches drawing on Foucault, to account for shifts in Thai discourses in which gender and sexuality do not exist as distinct categories. Only when current feminist theories of gender and queer theories of sexuality are integrated so as to offer a unified account of the eroticization of gender, and the gendering of eroticism, will Western theoretical models be capable of mapping shifts in non-Western patterns of eroti...

The research on male homosexuality and alternative sexual cultures among Latin American men is one of the richest sources of data and cross-cultural analysis on sexuality, sexual identities and sexual communities anywhere in the world. New research includes not only an ongoing concern to describe the distinct contours of different social and cultural constructions of sexual identity (a concern that has been evident in this field for 3 decades), but also a concern to describe the complex process of social, cultural, economic and political change taking place in sexual cultures throughout the region. Numerous papers now document the dilemmas confronted--and the creative solutions that have been invented--by Latino American men in response to the HIV/AIDS epidemic, and the emerging struggles for sexual rights and sexual-determination that can now be seen emerging in major urban centers throughout the region. These papers demonstrate the limitations of the dominant North American models of behavior change in response to AIDS by carefully uncovering the culturally articulated worlds of intimacy and desire that such models ignore, pointing the way toward a culturally constituted prevention practice as the only possible route to health promotion--possibly among all marginalized and vulnerable populations.

In this paper, we explore the relationship between "viral load" as a virological, immunological, epidemiological and social category and how it links the four decades-long global HIV pandemic to the ongoing response to COVID-19. We argue, metaphorically, that the response to SARS-CoV-2 contains 'genetic' material from HIV, which has (as a result of the digital age which reproduces error-filled data at incredible speed) mutated and is being transmitted into the social and political body. Using sexual health and substance use as focal points, we turn to Deleuzoguattarian theoretical insights about the assemblage of desire, affect and material factors that produce epidemics. Contrasting historical and contemporary scenes and issues, we explore the complex assemblage created by viral loads, medical and public health protocols, conceptions of risk, responsibility and fear that connect both pandemics. Finally, we consider the goal of viral eradication and related militaristic metaphors, alongside the increasing convergence of medicine, public health, the law and corporate interests, and contrast this with community responses that engage with what it means to be living and dying in viral times.

Pre-exposure prophylaxis (PrEP), a daily oral pill for HIV prevention demonstrated to be effective for adults, was recently approved by the US Food and Drug Administration for use with young people weighing at least 35 kilograms. Given that young people aged 13-19 years account for a disproportionate share of new US HIV infections, PrEP presents an important opportunity. There has been limited effort, however, to increase PrEP awareness and uptake among young people. While prior work has identified barriers young people face in getting PrEP, effective strategies for overcoming these barriers have not yet been identified. This paper presents results from interviews with 15-19 year old gay and bisexual young men about their knowledge and perceptions of PrEP, and the barriers they perceive. Results suggest that participants were aware of PrEP but confused by the details of insurance coverage and out-of-pocket costs. Participants also felt parents and providers would not be knowledgeable or supportive, and were reluctant to share their own use of PrEP on social media. Suggested next steps include online parent and provider education, systemic health care reform to streamline and simplify access to preventative care and awareness campaigns that meet youth where they are on popular platforms.

Young women are increasingly engaging with digital sexual media, yet discussion of female desire remains absent or is vilified. This paper examines young women's online sexual expression, as seen through the eyes of both young men and young women. Based on small friendship group interviews conducted with 106 12-16-year-old young women and men in Aotearoa New Zealand, I analysed perceptions of young women's sexual expression. Framed through patriarchal ideals and underpinned by competitive masculinity, young women's sexuality and opportunities for sexual expression were policed and regulated. Young women were expected to be passive yet digitally heterosexy, but not slutty. Perceptions of young women's sexual expression continue to be framed within silencing and absent pleasure discourses, which ultimately compromises both young men and women's development of sexual subjectivities.

Using crip theory, specifically Barounis' formulation of antiprophylactic citizenship, Piepzna-Samarasinha's conceptualisation of care work, and Shotwell's calls against purity, this paper analyses the making of the film HIV in the Rust Belt during the COVID-19 crisis. HIV in the Rust Belt (directed by Holly Hey) documents some of the experiences of local HIV survivors. During the course of filming, however, a story emerged about the importance of an AIDS facility, David's House Compassion, which had served as a hospice and a resource centre between 1988 to 2003. When COVID-19 arrived in the USA, we were mid-way through filming. Doing this work during the COVID-19 pandemic opened up a host of questions about the porousness of bodies as well as the slippage of time and stigma between the two pandemics. As we continued filming, we were made more aware that the story of David's House Compassion could be just as much as story of COVID-19, representative of antiprophylactic citizenship, an idea of belonging that comes from an openness and vulnerability that only sickness can offer.

This paper focuses on rural aspects of sexual and reproductive health and sexuality. Disadvantage of access to practitioners with expertise in sexual and reproductive health and sexuality is compounded for rural residents. Retaining and supporting the rural sexual and reproductive health workforce is important in addressing sexual health inequities and promoting the sexual and reproductive rights of rural residents. However, little is known about the role-related challenges encountered by rurally-based sexual and reproductive health practitioners. We draw on 15 qualitative interviews with general practitioners and nurses with recognised expertise in sexual and reproductive health working in three rural regions of Victoria, Australia. Findings highlight the precarious state of sexual and reproductive health delivery in rural contexts and draw attention to the unsustainability of current systems for providing access to care in rural settings. Problems stem from cultural processes and assumptions within the health sector. Adapting organisational cultures and how sexual and reproductive health is structured within the health system are critical to improving access for rural residents. Our findings have relevance for other high-income, Eurocentric and metrocentric countries with public health systems and similar geographies.

Young women in Uganda are at risk of negative sexual and reproductive health outcomes, in part because of sex with older men. Theoretically grounded in the concept of liminality, this paper examines perceived markers of adolescent girls' suitability for sexual activity. In 2014, we conducted 19 focus group discussions and 44 in-depth interviews in two communities in Uganda. Interviews were conducted using a semi-structured tool, audio-recorded and transcribed verbatim. Interviews examined markers of transition between childhood, adolescence and adulthood and how these were seen as relating to girls' perceived readiness for sex. Analysis was thematic. Pre-liminal status was most often accorded to childhood. Sex with a child was strongly condemned. Physical changes during puberty and children's increasing responsibility, autonomy and awakening sexuality reflected a liminal stage during which girls and young women were not necessarily seen as children and were increasingly described as suitable for sex. Being over 18, leaving home, and occupying 'adult' spaces reflected post-liminal status and perceived appropriateness for sexual activity including for girls under the age of 18. Interventions that seek to prevent early sexual debut and sexual activity with older men have the potential to reduce sexual and reproductive health risks.

There has been little exploration of the social and emotional wellbeing of young Indigenous populations who identify as gender and sexuality diverse. Given the vulnerability of this cohort in settler colonial societies such as Australia, Canada and the USA, wider investigation is called for in order to respond to their needs and aspirations. Using a scoping review, this paper maps existing research on the intersections of youth, gender and sexuality diversity, Indigeneity and wellbeing. The evidence points to the importance of historical and contemporary experiences tied to colonisation and intergenerational trauma. For young Indigenous gender and sexuality diverse peoples, heteronormative colonial value systems converge to produce environments characterised by racism, phobia and marginalisation. The evidence base includes deficit models based on trauma and negative outcomes. However, there is also an emerging body of research highlighting the resistance and resilience of Indigenous gender and sexuality diverse youth.

Treatment as Prevention is a key biopolitical intervention on the HIV epidemic but relies on individual adherence to antiretroviral treatment in order to have an effect on the population as a whole. Informed by a discussion of biopower, this paper analyses the complex relationships between discourses of competent authorities and modes of subjectification through a qualitative analysis of findings from 5 years of fieldwork associated with the action-research project Yantzin: Women HIV Peer Advisors in Mexico. It looks at the production of subjects of adherence, whereby peer advisors emerge as key agents at the interface between scientific and experiential knowledge. Contradictorily, the desire to live becomes feasible only by engaging with these biopolitical interventions. We discuss how peer advisors twist these technologies in such a way that they provide not only operations of power but also courses of action for desire. Through embodied mediation strategies that critique obedience to medical prescription and translate scientific information into bodily and emotionally shared experiences, peer advisors' work goes beyond the behavioural rationality of biomedical models offering embodied proof for other women that, even when living with HIV, a project of happiness is possible.

Drawing on ethnographic research, this paper explores self-understandings among same-sex attracted men in Harare along with the local terms such men use to refer to themselves as well as their adoption and modification of globally circulating sexual identity labels. All study participants related to some of the labels that are prominent in the present-day, western-inspired global discourse on same-sex relations. However, they were rarely understood in the exact same way that is represented as typical in the 'west', indicating that when understandings and labels travel, they are not simply copied and pasted into new contexts. In Harare, being gay was closely interwoven with considerations about one's gendered self, and many same-sex relations were gender-structured. At the same time, this characteristic appeared to be a matter of emerging dispute, as it was sternly criticised by some. The history of political homophobia in Zimbabwe shone through in many stories and could be identified in some of the local terms used to refer to gay people, some of which had been invented to conceal from outsiders what they laid bare for insiders, and others of which had sting and mocked those in power for ideas and rhetoric perceived to be misguided or bizarre.

Gender norms serve to normalise gender inequalities and constrain girls' agency. This paper examines how girls' agency, along a continuum, is influenced by the interplay between constraining and enabling influences in the girls' environments. We analyse data from a qualitative study nested within a cluster randomised evaluation of Samata, a multi-layered programme supporting adolescent girls to stay in school and delay marriage in Karnataka, South India. Specifically, we compare agency among 22 girls from intervention communities and 9 girls in control communities using data from the final round of interviews in a qualitative cohort. Using the concept of 'thin' and 'thick' agency on a continuum, we identified shocks like mothers' death or illness, poverty stress, gender norms and poor school performance as thinning influences. Good school examination results; norms in support of education; established educational aspirations; supportive parents, siblings and teachers; and strategic government and Samata resources enabled thicker agency. The intervention programme's effect increased in parallel to the gradient from thin to thicker agency among girls in progressively supportive family contexts. Engagement with the programme was however selective; families adhering to harmful gender norms were not receptive to outreach. In line with diffusion theory, late adopters required additional peer encouragement to change norms.

In the past several decades, conflicting discourses have coexisted in the field of intersex studies, including the pathologising discourse of the biomedical disciplines and the affirmative, subjective psychosocial discourse of people born with intersex bodies and their advocates. Intersex activists call for a positive discourse on intersex bodies and a humanistic healthcare approach that accepts and protects intersex bodily autonomy to replace continuing harmful, traumatic treatments aimed at normalising variations of sex characteristics (VSC). Our awareness of the biomedical discursive dominance prompted us to initiate Inter-Care and Awareness, an intercultural German-Israeli action research project. This paper introduces the project and explores intercultural approaches to psychosocial intersex care using an action research framework. We describe how the project's goals, processes and outcomes created educational material on intersex which uses positive language, explores intersex in the Jewish tradition, improves the support offered to parents of intersex children, and examines cross-cultural differences that arose in the encounters between the Israeli and German participants. The analysis points to sociocultural themes that reflect intersex people's current status in Israel and Germany. Implications regarding the implementation of similar projects in other countries are discussed.

This paper examines women's movement between sex work and intimate economies, with a specific focus on how non-Chinese women in Hong Kong leverage intimacy as a means of managing legal and socio-economic precarity within various institutional and individual constraints. To capture the diversity of women's experiences, we use the term 'intimate-material exchanges' to broadly refer to compensation or material support provided in exchange for sexually intimate relations. We ground our analysis of the interactional processes involved in intimate-material exchanges in 39 interviews with ethnically non-Chinese women and men in Hong Kong. For the women in this study, intimate-material exchanges were shaped by migration and distinguished by pragmatism, strategy and intentionality that involved adapting, improvising and experimenting with sexual scripts in an ambiguous legal space in order to derive maximum material benefit. We conclude with a discussion of the implications of migration and intimate-material exchanges for sex worker rights.

The 2006 Yogyakarta Principles apply human rights law in relation to sexual orientation and gender identity. Created outside the UN system, their aim was to promote good practices in protecting the rights of LGBT and intersex people. They were ineffective in protecting the rights of intersex people, including due to an inappropriate framing around 'sexual orientation' and 'gender identity'. In the same year, a group of clinicians published a 'consensus statement' reframing intersex traits as 'disorders of sex development', entrenching medical authority over intersex bodies. It was not until 2015 that the first country (Malta) sought to enact protections of rights to bodily integrity and physical autonomy and freedom from discrimination, associated with a new attribute of 'sex characteristics'. In 2017, an update to the Yogyakarta Principles known as the Yogyakarta Principles plus 10 incorporated the new attribute and recognised rights to bodily integrity, truth and legal recognition. These principles have direct relevance to the human rights situation of intersex people. This paper addresses reasons why the earlier Yogyakarta Principles were ineffective and presents the goals of the update process, inviting adoption of a new attribute of sex characteristics and new principles relevant to intersex populations, advocates and policymakers.

This paper describes a study that examined the challenges faced by Vietnamese ethnic minority girls regarding their sexual and reproductive health. The study employed photovoice, a research method which treats photographs and the accompanying stories provided by participants as qualitative data. Twenty-six (26) minority ethnic girls took photographs of aspects of their lives as a way of documenting the challenges, difficulties and barriers that they faced in looking after their sexual and reproductive health. Findings indicated limited access to sexual health knowledge, the exclusion of young people from mainly adult-focused sexual and reproductive health services in minority ethnic communities and the prevalence of cultural beliefs and practices that negatively affected young people’s sexual and reproductive health. The intersection of ethnicity, age and gender places Vietnamese ethnic minority girls at risk, as everyday practices informed by culture and tradition curtail their access to the limited sexual and reproductive health information and services available in their communities. Understanding these challenges is needed in developing appropriate policies, programmes and services aimed at enhancing the sexual and reproductive health of this segment of the population. Refereed/Peer-reviewed

Teenage pregnancy can have adverse social and health outcomes, and rates are high in Flint, Michigan as compared to the rest of the state and the USA. It is important to understand contributing factors to adolescent pregnancy to be able to better address this issue. This study examined qualitative data from interviews with 100 community members who participated in the Flint Women's Study, a study designed to better understand the hopes, dreams and needs of women in Flint, and their suggestions for how to address identified needs. Using a Community Based Participatory Approach, data were collected and analysed by a team of community members and academic researchers. The paper focuses on the theme of family planning among young women which included attitudes about contraception, sexuality education and bio-medical and structural barriers to accessing reproductive health. Community members emphasised the need for increased access to comprehensive contraception options, improved sexuality education in schools and from health care providers, and ultimately valuing young women.