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Health and HIV

Health and HIV


Heteronormativity prevents access to decent health care for many people. Work on HIV has sometimes challenged heteronormativity particularly when it has been led by trans women, men who have sex with men (MSM) and sex workers, all of whom are vulnerable to HIV infection. It has provided entry points for discussions about the policies and politics that help shape the ways in which society constructs gender and sexual orders. Whilst many people are understandably uncomfortable with using a biomedical or disease framing to talk about gender and sexuality, work on HIV has provided an opportunity to help understand other ways to have sex, have relationships and live our lives.

Conversely, HIV policy and practice has rewarded conforming behaviour and punished those who deviate from the norm. For example, the US President’s Emergency Plan for AIDS Relief (PEPFAR) stipulated that grantees explicitly opposed sex work and that they did not provide or advocate for safe abortion services. Grantees who were unwilling to accept these conditionalities often lost their funding. Furthermore PEPFAR ushered in an era of abstinence-only education for young people which was contrary to the evidence base.

Feminists’ advocacy for comprehensive sexual and reproductive health and rights policy and programming has helped reshape the way that women’s health was viewed. It has often challenged harmful norms around the role of women and led to a reprioritising of their wellbeing in global health agendas. Yet all too often the women’s health agenda has reduced women to their role as mother and failed to adequately challenge the social norms related to gender which make women vulnerable to ill health.

Same sex desiring women and trans, gender queer and intersex people can struggle to access the healthcare that they need and they are rarely prioritised in development interventions (except in relation to trans women and HIV). Few doctors and health care programmers are trained on trans issues during their formal education and most reflect the values of their communities in their practice. In some settings self-treatment with hormones is common which can lead to complications associated with mis-dosing and unsafe injection practices. In other cases trans people may resort to informal and private health care providers, for treatments to modify their bodies, at considerable cost with variable outcomes. Intersex people may be assigned a gender at birth and their genitals and hormones may be altered without their consent.

(Image credits: Amber de Bruin/ Flickr under Creative Commons License)

Repoliticizing sexual and reproductive health and rights: Report of a global meeting, Langkawi, Malaysia, 3–6 August 2010
reproductive health matters / Reproductive Health Matters 2010
This meeting was held as a result of concerns that the sexual and reproductive health agenda has been becoming more conservative. Key messages from the meeting include: The Millennium Development Goals (M...
The Right to Health and Sexuality
A. Khanna / Centre for Enquiry Into Health and Allied Themes 2007
Recent years of activism around health have brought about a conceptualisation of the relationship between health and various social, economic, political and cultural factors. Unfortunately, for the large part, the politics of sex and ...