Modernizing Sexuality : U. S. HIV Prevention in Sub-Saharan Africa

Modernizing Sexuality illustrates how Western idealizations of normative sexuality and the power of modernity come together in U.S. HIV prevention policy in Sub-Saharan Africa. The results are calls for women's "right to say no" to sex and the promotion of "love matches" as the remedy to the"traditional cultural practices" said to put people at risk for HIV. Using the country of Malawi as a case study, Anne W. Esacove draws on narrative theory and a rich set of interview, archival, and ethnographic data to expose the unacknowledged - yet widespread and well-funded - moderniziationproject at the heart of U.S. policy, and to argue that these efforts not only fail to translate into actionable steps for preventing HIV in the widespread, generalized epidemics in Sub-Saharan Africa, but actually exacerbate HIV risk, particularly for women.Moving beyond U.S. policy, Modernizing Sexuality also examines how people targeted by prevention efforts create everyday understandings of HIV risk and prevention. Deploying gossip, information gleaned, and strategically adapted from prevention efforts, and the assumption that sex is essential tolife, Malawians tend to sort potential sexual partners into "tiers of desirability," each with a corresponding HIV-prevention strategy. By illuminating the collective solutions and multiple paths of prevention used by Malawians, the analysis exposes fundamental flaws of U.S. HIV prevention policyand provides direction for potentially more effective strategies.Stepping outside of the normal theoretical and methodological boundaries of HIV scholarship, Esacove raises important questions about lure of the story told through prevention policy, the risks of medicalizing social justice advocacy, and the limits of feminist and sexuality theories for directingprevention efforts, particularly cases when they mirror U.S. policy by erasing corporeal bodies and actual sex acts. Modernizing Sexuality closes with a fascinating alternative narrative to guide HIV prevention that reimagines risk and provides one alternative path for organizing policyefforts.