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In my PhD dissertation, I show that HIV-positive heterosexual men and heroin users are often forced to bear the intensity of HIV and opioid addiction, respectively, in silence and without institutionalized care. I argue that the absence of support for these groups and the political blindness towards the suffering of these invisible populations makes their chronic diseases fatal. I show that Colombian HIV prevention and treatment policies, known for their inclusiveness of diverse gender dynamics, have systematically excluded heterosexual men from prevention and healthcare, most profoundly impacting men living in poverty. I examine how heterosexual men find out about their HIV diagnosis, how they understand it, and how they cope with it. I highlight the struggles that heterosexual men must undergo to access support and medical networks, as well as the complicated role of HIV in romantic and family relationships. I also show how the neoliberal fragmentation and privatization of the Colombian healthcare system, as well as the centralization of HIV clinics in cities, magnifies the negative experiences of men living in poverty in urban and rural areas of Colombia. My dissertation also explores the effects of the rapidly growing heroin epidemic in Colombia, a “risk group” for HIV and Hepatitis C infection, through the experiences, photographs, and narratives of heroin users in the first state-run methadone clinic in the southwest of Colombia. I explain how inter-American shifts in the legal and illegal opioid markets have resulted in the production and marketing of heroin within Colombia, sparking an unprecedented national epidemic with nearly non-existent public policies to deal with the issue. Moreover, my research shows that HIV and heroin addiction can sometimes can become experiences of self-reflection that promote positive changes. These reflections with positive outcomes are typically the product of the labor of men in conjunction with partners, family members, frie

La violencia del proceso privatizador evidencia una combinación de mecanismos materiales y simbólicos de disciplina y punición de los procesos sociales que insisten en la defensa de lo público. Estos mecanismos favorecen la acumulación flexible mediante la destrucción de las vidas individuales, sociales y políticas que representan las/os trabajadoras/es, a tal punto que adquieren la forma de tortura, cuando las atacan activamente, y de autodestrucción, cuando se implantan intangiblemente como dispositivos que socavan su bienestar. El presente artículo trata el caso de las/os trabajadoras/es del Instituto Materno Infantil (imi) de Bogotá (Colombia), quienes desde el año 2004 enfrentan la privatización del hospital y la liquidación injusta de sus contratos. Para tal análisis, se propone la etnografía dialéctica, con el fin de comprender las articulaciones locales y globales de los procesos de acumulación y destrucción capitalista en relación con identificaciones políticas y construcciones particulares de subjetividades.

La violencia del proceso privatizador evidencia una combinación de mecanismos materiales y simbólicos de disciplina y punición de los procesos sociales que insisten en la defensa de lo público. Estos mecanismos favorecen la acumulación flexible mediante la destrucción de las vidas individuales, sociales y políticas que representan las/os trabajadoras/es, a tal punto que adquieren la forma de tortura, cuando las atacan activamente, y de autodestrucción, cuando se implantan intangiblemente como dispositivos que socavan su bienestar. El presente artículo trata el caso de las/os trabajadoras/es del Instituto Materno Infantil (imi) de Bogotá (Colombia), quienes desde el año 2004 enfrentan la privatización del hospital y la liquidación injusta de sus contratos. Para tal análisis, se propone la etnografía dialéctica, con el fin de comprender las articulaciones locales y globales de los procesos de acumulación y destrucción capitalista en relación con identificaciones políticas y construcciones particulares de subjetividades., Since 2004, workers of the Instituto Materno Infantil (imi) have been facing the privatization of the hospital and the unjust termination of their contracts. The article proposes dialectic ethnography as a way of understanding the local and global articulation between capitalist processes of accumulation and destruction, and political identification and specific construction of subjectivities. The violence of the privatization process displays a combination of material and symbolic mechanisms aimed at punishing and disciplining the social processes that adamantly defend the public domain. These mechanisms promote flexible accumulation through the destruction of the individual, social and political lives of the workers. Such mechanisms acquire the form of torture when they actively attack the workers and of self-destruction when they are implanted intangibly as dispositives that consume the well-being of the workers.