Sex is an important site of social control, adjudication,
and- ultimately -oppression.
Many social movement organizations have focused on sexual
health and do not generally frame their work in terms of social justice or
civil rights.
The failed attempts to
decriminalize HIV in the Virginia legislature, both within and outside the
General Assembly, are both troubling and deserving of critical examination, and
yet they are just pieces of a much larger puzzle comprising legal, social, and
economic systems that do not readily seem to fit together.
Institutional ethnography:
Interrelationships among the General Assembly, Virginia Department of Health,
and community organizations working to repeal the laws criminalizing HIV in the
Commonwealth are each a subject of analysis here…
The Problems of Prospective: “Thinking
Sex”
From the beginning, this issue was not
seen for what it truly was and is: a war on sex.
By
only problematizing HIV, the movement for decriminalization missed
opportunities for determining causality between the effects of such laws and
their impact on the wider whole of society. They failed to consider the true
function of specific language encoded in each law, which I unsuccessfully
attempted to do on occasion when the opportunity arose; and this ultimately
resulted in the failure to decriminalize, with the felony repeal reinstated in
the final moments of the movement.
The historiography of the
legislature, and of society for context, was used to describe the origin off
these laws as a function of HIV-related stigma and fears left over from the
early days of the global pandemic; a perspective, which, pigeonholed their multipurpose
design and the movement for HIV decriminalization in the process.
Hepatitis – control, prisons,
and punishment
Misrepresenting the intentionality
It was never about HIV. It was
about control. The world is waging a war on sex, and the issue of HIV/AIDS-
having claimed millions of lives- created new fears about sex, adding fuel to
long-standing public debates over sexual morality.
(at the same time, social
movements are driven by pharmaceutical industry and the technological
advancements for surveillance are leading an alternative
Social movement organizations
such Positive Women’s Network and Equality Virginia frame their work in terms
of social justice or civil rights, never analyzing and politicizing sex it its
own terms- both within and outside of their analysis of sexuality and gender;
and marks a turn away from the interdisciplinarity of historical movements like
ACT Up, which have typically focused on sexual health. A dichotomy that prefers
itself driving division and interpretive specialization and leaves modern
messaging about sex to the whims of power in the prevailing paradigm; the
structure/agency of which is a blueprint for changing behavior.
Now at the intersection of
culture, health, and sexuality there appears to be only one way to turn
Modern movements are driven
by pharmaceutical industry and the technologies of state surveillance which
monitor them.
Freedom is given only within
the strictest of constraints.
The meaning and materiality of
modern messaging in movements of sex and desire, such as the campaign for “healthy
sexuals” managed by Gilead Sciences, is painfully difficult to contest; as it
relies on mainstream consensus- if not exactly in its favor, at least in
support of the general principles in whose name it fought.
This has had grave
consequences for the autonomy and agency of women, young people, the
disadvantaged, and the vulnerable. It has ruined many, many lives. It has a
particularly violent impact on those who are socially marginalized, socially
stigmatized, or racially marked, or who cherish nonstandard sexual practices.
Sexual freedom has lost significant ground to it- ground that will take a very
long time to recover.
Costly for some, the war on
sex has turned out to be immensely profitable and useful for others- not only
for politicians and academics, therapist and police officers, journalist, and
moral leaders, but also for a multitude of interested parties.
And, as in most wars, fog and
shadows, propaganda and disinformation conceal the contours of events. So, we
need to understand what is going on in order to confront it and challenge it.
And we need to do that now.
Without a coherent analysis of sex and its
relationship to social justice to make sense of how sex is mobilized legally,
politically, and socially, it becomes impossible to think critically about
these cases- and the countless others like them- as a whole.
The world is waging a war on sex and science.
In the context of SB1138
There
is nothing wrong with using legal and moral pressure to reduce the
incidence of sexual assault. However, the war on sex cannot be reduced to an
enlightened effort to prevent and punish sexual harm, though it often
camouflages itself as such. It is a war against sex itself- in many cases,
against sex that does no harm but that arouses disapproval on moral, aesthetic,
political or religious grounds. Those grounds provide an acceptable and
politically palatable cover for a war on the kinds of sex that are disreputable
or that many people already happen to dislike.
In determining the function and intentionality of
Infected Sexual Battery, let me be very clear on this point. There is no
denying that sex can be a vehicle for harm, sometimes very serious harm. It is
not only legitimate but indeed imperative to stop people from using sex to harm
one another. Sexual freedom is not a license to abuse others and abscond
personal responsibility. But preventing sexual battery should not furnish a
pretext for an all-out war on sex that permanently identifies sex itself with
danger and with potential or actual harm. Nor should it provide a justification
for dispensing with all measure and proportion in deterrence and punishment.
The view that sex in itself is bas or harmful is
rarely articulated or argued. But it is powerfully if wordlessly expressed in
the tendency to punish sexual crimes much more harshly than other serious
crimes, even the most destructive and violent crimes. Under that cover, and in
the guide of a campaign for “healthy sexuals,” as it is described by Gilead
Sciences, the war on sex offers a noble cause and an effective rally point for
people located on every part of the political spectrum.
This
was made most evident in the ending moments of the movement for HIV
decriminalization in the specific context of repeal for infected sexual battery
at General Assembly. It unites feminist1 and evangelicals,2 liberals3
and radicals4, politicians5 and activists6,
intellectuals7 and populists8, Left and Right. That is
what makes it so hard to critique and to challenge. But that is also what makes
it so important to address.
The purpose of this report
is to document, to describe, and to oppose the war on sex.
How is it possible, in the
context of such broad and far-reaching progressive reforms, to speak of a war
on sex?
This report does not ignore or attempt to play down these
transformative changes; nor does it aim to demean those working on the issue
and analysis. At the same time, it is possible, in the context of such board
and far-reaching reforms on sexual health and surveillance to end the HIV
epidemic, to speak of a war on sex/identity itself. The progressive
liberalization of sex in the U.S., and in Virginia as it Victorian colonial
antecedent, is not the whole story. And that is the point, to consider
analytic alterity in comparing strategical plans for policy analysis and
advocacy around issues of HIV criminalization, from which a juxtaposition is
used to measure the meaning and materiality of their difference- that is, real
cultural difference and contextuality interpolating the issues of
criminalization, modernization, and repeal.
Think about it in triplicate: There was no debate
over repealing penal codes punishing HIV positive volunteers from donating
blood and minimal discourse on the presence of bodily fluids as justification
for mandating diagnostic HIV and STI screenings; although in deliberation,
forced medicalization for commissioning a crime in the presence of bodily
fluids was centered around the authority of the sheriffs office to oversee the
bodily autonomy and agency of inmates affected by HIV and viral hepatitis- an
issue I am going to address again at another point in this analysis. For two
out of three references in the Code proposed in repeal, there was never an
epidemiologic argument made in support of either law. Instead, concerns over
shifting controls over HIV positive persons for its interpretive status as a
representation of sex outside the boundaries of moral political privilege. That is, the idea of gay sex and the idea of
Black sex are unacceptable and therefore must be prevented and punished.
So long as the felony remains as law, infected sexual
battery no less a source of stigma than before it was amended to the current
form; which is arguably an even greater threat to public health, culture
and sexuality as a open-ended penal prophylactic- the implications of which
have as yet to be explained.
The felony reinstatement by the most progressive body in the
Assembly, as previously stated, were the individuals going out of their way to wage
war against the repeal, continuing a cultural crackdown on sex. This mounting
tendency to treat sex itself as a danger or threat is part of the domain
problematizing sex and an overall intensifying urgency to protect people from
sex; which leads to increasing regulations and criminalization of sex; and the
imposition of ever-narrowing legal and administrative definitions of who is
entitles to engage in sex.**another issue I attended to in the course of this
work that I identified as problematic on the grounds of interpretive violence
risked in taxonomizing transmission practices along the lines of identity
categorization.
The expansion
of the populations whose sexual behavior falls under state or bureaucratic
control is also a part of this project as an issue immediately, and intentionally?
ignored in all initial planning processes within and outside the institutional
debate. Since there is no known example of surveillance technologies being used
to prosecute individuals with HIV under any of the codes in question, its
potentialities were pushed aside as powerless in distilling stigma in law. That
was a mistake.
A striking urgency to keep the felony or kill the bill is
evidence of the disproportional severity of punishments meted out to those who
commit sex offenses, even those for whom there is no contest are subject to
misdemeanor convictions which share a proportional penal power with the same
source of stigma as the felony.
In short, the familiar stores we have been telling ourselves
about the sexual revolution, the rise of sexual permissiveness, the collapse of
traditional sexual morality, the change in sexual attitudes, the progress of
women’s rights and gay rights, the decriminalization of sodomy, and the
legalization of gay marriage have all diverted attention from a less familiar
but equally important story about a new war on sex, a war that in recent years
has intensified in scope and cruelty. One aim of
this project, then, is to tell at least some parts of that neglected story- and
document the increasing restriction and regulation of sex in an era otherwise
characterized by sexual liberalization.
The proliferating restrictions
placed on sex in recent decades should not be seen as mere bumps on the road to
greater sexual tolerance or the last gaps of Victorian prohibitions (as
represented in the origins of this idea in a colonial context of Virginia )residual
formations or dwindling pockets of reaction destined to be swept away by the
rising tide of progress and sexual liberation On the contrary many of these
phenomena represent emergent formations: new development that point to urgent problems
of justice . They demand to be addressed. They call in particular for a
reconsideration not just of specific tactics but also a broad political
strategies on the part of feminists LGBTQ activist another progressive forces
... For sexual freedom is a fundamental an essential freedom and oddly enough
the alternate protector of human privacy vulnerability and autonomy . Moreover
since the criminalizing of sex is entwined with racism sexism social inequality
and homophobia though as I shall explain it is also distinct and independent from
them it demands a coalitional response that can bring together a range of
social movements. All of these developments point to the need for a fresh
historical vision of how we got into our present situation and for an enhanced
understanding of the embattled terrain on which we find ourselves now in the
context of sexual battery and the reinstatement of a felony repeal this must
begin with the complete deconstruction of the domains we see as normal and pre
discursive and development of policy planning efforts and strategies Q describe
the impact and surmise the effects of health related legislation on individuals
affected by the topicality being questioned and at the same time must include
clear concise platform for principled policy program evaluation that assassins
the degree to which actors involved in the advocacy an analytic processes are
understood in the context of their capacity to shape the legislation itself and
in this way we can monitor what ideas and ideals and whose perspectives and
perceptions R penetrating the policy pantheathat in sum is what this paper and
project aims to provide to call attention to the war on facts science and
identity which is to say the interpretive violence inactive by structures and
agencies operating within the cultural domain I have laid out . The manifold
ways in which sexual freedom and sexual expression have in recent years come
under attack from both government and civil society. Stakeholders need to trace
the history of how progressive political movements came to abandon the calls of
human rights pertaining to sex which was made evident in Virginia with the
absence of support from the Commonwealth leading LGBTQ and aids service
organizations whom have historically been involved in processes related to HIV
criminalization and yet despite their continued policy work the shift is now on
trans gender identity and the topicality of trans life rather than an
empowerment effort for ending the epidemic from which these groups emerged . We
also must examine how kinds of sexual conduct as well as kinds of sexually
defined individuals are currently being hemmed in by new sorts of formal
regulation social disqualification policing hyper criminalization and
administrative management and a period of otherwise expanding sexual Liberty
this is what I call a neoliberal penalty which I understand as something quite
precise as a term used to describe a specific form of rationality in which the
penal sphere is pushed outside the political economy and medical legal context
and serves the function of a boundary Sue generes that is the penal section is
marked off from the dominant logic of classical economics as the only states
where order is legitimately enforced by the state to explain as the state
retreats from regulation of the market They can legitimately act that is the
proper sphere of governing so while this project does not discuss in detail the
role of molecular HIV surveillance and new technologies for interceding the
epidemics that issue is nonetheless integrally apart of this and the wider
sexual struggle I have surmised so in the case of saxe this neoliberal penalty
has can duced cue an intensification of criminal and regulatory social control,
evidenced by the felony reinstatementin the medical legal context, and other
programs affecting even widening spheres of human behavior such as the
widespread surveillance of HIV negative individuals for pre exposure
prophylaxis viral load monitoring medical care markers another interpellations
of identity associated with sex as astrategy for categorisation and a taxonomy
of social control. Another critical issue that needs to be made clear for
future work in this area is that there is a meaningless distinction and the
lived experience of incarceration and security azatian that is to say the re
distributive welfare state which once governed through ideals of health well
being and discipline has given way to a punitive neoliberal regime which takes
the crime scene as the basic paradigm of governance and conditions assistance
on very forms of victimization or otherwise subjects benefits to means testing
as opposed to universal entitlement such as in the case of health care as well
as pre exposure prophylaxis and eligibility for Ryan White and aids drug
assistance programs mass incarceration in this context is only one of the
punitive states techniques or technologies of control in their operational
definitions, and what goes on examined is the role of sexual fear and loathing
promoting expansive new extra carceral modes of security another case of the
carceral state itself as the object of critical attention a part of this
project .
So far the war on facts has not
gone entirely unchallenged by activists critics scholars lawyers local
commentators and journalist as I have represented opinions among each of these
groups here in this essay and throughout the course of my project which serves
as both evidence of my analysis and for future work that should be done in the
same way. Anyone who reads the writings assembled here who takes the trouble to
look into the political mobilizations of resistance and critique that they
describe or who perceives the scholarly leads provided by these citations will
recognize how many individuals organizations and political coalitions have
identified an contested the various ways that sex is currently being targeted
for regulation and control it is perhaps symptomatic of the current state of
sexual politics that the war on sex has yet to receive even from feminist and
queer theorists the urgent attention it deserves 3rd you have been defending
sexual freedom along all along would benefit from a wider political critical
and scholarly consensus in their favor as well as from a rigorous and
principled support another purpose of this project accordingly is to underwrite
these efforts to
to provide an example of what a
policy planning project should look …it's only by highlighting the existence of
this issue and by bringing it to the attention of those who might well
challenge it if they actually recognized it extent or the magnitude of the
threat it poses to our sexual freedoms and our individual liberties is truly
what everything I have done here is all about. And I hope the writing is
assembled here provide renewed inspiration for a broad and powerful response to
future policy work related to sex culture and health .
in the specific context of the
2021 General Assembly I have positioned this project to call
for renewed critical analysis of the politics of sex itself which cannot be
reduced to identity . It is a challenge because it calls into question some of
the dominant recent identity based ways of organizing both knowledge and
political movements around sex and sexuality. It is an opportunity because it
offers to bring together, across differences of identity, many distinct
constituencies affected by the politics of sex. In other words , the
inequality is produced by sexual politics are often stratified according to the
same axes of social differences many other kinds of social inequality. Often
but not always as demonstrated by Senate bill 1138 sex as a target of state
power is more than just a vehicle for the consolidation of existing social
hierarchies rather sex understood as a continuum of practices ranging from the
acceptable and approved to the disreputable and disapproved along with the
regulatory categories of persons those practices generate having their own
politics Sue generic this issue should be seen as an axis of social difference
in its own right notwithstanding the governor's Commission on racial equity
notwithstanding equality virginians approach for LGBT equalization
notwithstanding the health department's attempt to modernize it must be
discussed in its own respect as an issue deserving of the full attention and
unique analysis grounded in theories relevant to the topics in question .
In conclusion sexual politics in other words is often a solvent of
identity it can override the divisions among different social groups that
defined themselves by reference to specific identity markers sexual politics
require its own analysis why sex? What is it about sex itself that makes it
such a ready site for social control? And how do we mobilize politically around
it? If this essay does not offer a single answer to that question they provide
a number of salient clues and perhaps increase the pressure on all to find both
theoretical and practical solutions. How is that I drowned
Without any definitive analysis of the implications of the
new bill as signed into law this week I already see a troubling convergence
between the increased governmental regulation of Saxon popular movements that
contain sexual danger the state's new aggressive interest and HIV dovetails
with an extremist an increasingly popular view of HIV infected persons as
dangerous disease carriers who pose a threat to local communities I question
how easy it is for HIV positive people to be assimilated by the public to the
category of sex offender at a cultural level of abstraction people with HIV and
violent sex offenders , encoded in the infected sexual battery law itself,
appear to be completely fungible and popular discourse one standing in for the
other amid call to deprive those with HIV of their civil rights including their
right to privacy critical analysis of the implicate implications of sexually
transmitted infection and criminal transmission of HIV specifically must be
done in the context of the new law and immediately disclosed to the public so
they can protect themselves
The urgency with which
legislatures reinstated the felony for Senate bill 1138 is evidence that
despite the science and social justice issues interpolating this debate it is
already always the topicality of sex that is the prime pot of discussion and
lengthy prison terms or behavior that occasioned no harm to others but that is
associated with socially stigmatized sex far from exceed criminal sentence is
normally handed out for manslaughter in similar contexts 30 years of research
into the sexual dimensions of the HIV aids epidemic have quantified the risky
sexual practices of seemingly every conceivable population at an annual cost of
many millions of dollars but only a small handful of studies have examined the
impact of criminalizing HIV on the epidemic itself and on human rights more
broadly the fact that it is still not possible to determine with any degree of
exactitude the number of HIV positive people who have been incarcerated under
HIV disclosure laws perhaps 1000 perhaps several 1000 is a telling indication
of how little is known about the expanding regulation of sex excessively harsh
or linked the punishment for sex crimes even in some cases for behavior that
caused no injury are not the most terrifying consequences of the war on set
indefinite detention without trial by jury is even more disturbing and this
occurs at the cultural level where the power of stigma shame and self denial in
prisons the individual in an ever expanding psychiatric confinement.
The proliferating
restrictions placed on sex in context of infected sexual battery for STI
exchange, disclosure and its implications on others, PrEP and U=U Risk
Reducation as mediated intimacies, technological novelites to surveil and
interced in the transmission; as well as the linguistic contents and cognitive
structures for thinking about and describing sex as an issue and inquiry.
Analytic
Tools
At the intersection of
bioscience, identity politics, and market economics, pharmaceuticals such as Truvada* (and, now Discovy*) for pre-exposure (HIV)
prophylaxis (PrEP)*
and sophisticated antiretrovirals* (ARVS) used to achieve viral suppression, significantly
reframe cultural ideas about biology, identity, pleasure, and rights. Potential
patients associated with these drugs simultaneously call for and critique
medicalization* as
societies negotiate which aspects of sex, gender, and daily life should be
pharmacologically mediated.
As with Truvada, a single
pill that is a combination of ARVs tenofovir and emtricitabine, approved for
PrEP, drugs that target sexual behavior often arise from accidental discoveries* before going on to
incite major physiological and social changes that both extend and reconfigure
existing cultural logics.
This paper will extend
extant critiques of the medicalization of sexuality and technologies of
mediated intimacies, and present new theories for conceptualizing sex- drugs,
and violence- within the culture associated with conflicts of interest, or with
change and contradiction, into questions of fundamental interests to the
discipline of public health: How do these drugs raise new or illuminate
existing questions of embodiment and ontology? Which forms of inequality are
challenged and which are stabilized via greater access to these
pharmaceuticals? How doe these intersect with other forms of inequality, for
example those based on race, class, serostatus, religion, and rurality? How do
place, environment, and technological mediation matter for these phenomena? As
we move beyond the sex/gender divide, does medicalization of sexuality
reconfigure established (hetero) normative scripts of sexual pleasure and/or
pain? OR do drug interventions into sexual lives compel resistance to not only
the medicalization, but also the normativity attached to pharma interventions?
The political economy
of sexual pleasure** allows us to not only look at pharmaceutical
interventions as normative structures that work within and promote particular
modalities, but also the resistance and alternative sexual identities and
behaviors that emerge in such sexual assemblages. This practicum then aims to
create a conversation about what and how public health can contribute to a
nuanced understanding of these entanglements.
This project is unique.
It examines the role of biomedical technologies on disease prevention in the
specific context of antiretroviral drug treatment interventions for
pre-exposure prophylaxis and untransmittable viremia and surmises its effect on
syndemic incidence of sexually transmitted infection (STI) among the diverse
assemblages entangled in interventions to End the HIV Epidemic.
Few studies have
considered how exposure to pharmaceutical interventions is contributing to
incident STI in minorities at-risk of HIV infection.
Qualitative
methods were primarily used in one aspect of this project and quantitative
measures centered analysis in another. My work on HIV decriminalization
integrated a variety of anthropological research methods and ethnographic
fieldwork strategies for data collection and analysis, with a particular focus
on the intersectionality of culture, health, and sexuality. This perspective on
the issues of criminalization is defined by a general description and locates
the project in a cultural domain that is interpretive and interventional. In
other words, there is no theory/applied divide.
My work in the General
Assembly targeted the sources of stigma in VA Law and the systems of meaning
and materiality interpolating this project as a function of cultural (and
policy) analysis/advocacy – again, the dichotomy is not fundamental. In the
course of this portion of the project, I developed a range of collaborative and
interdisciplinary writing, academic, activist, and artistic projects to address
issues of HIV criminalization, sexual autonomy, surveillance and punishment,
and the construction of knowledge of HIV.
Sources: Terms and
Theories
1.
Truvada
2.
Discovy
3.
Pre-exposure prophylaxis (PrEP)
4.
Antiretrovirals (ARVs)
5.
Medicalization
6.
Extant discoveries (iPrEx)
a. First
human study to determine whether the ARV medication emtricitabine/tenofovir,
sold under the name Truvada among others by Gilead Sciences
7.
Interpretation v. interpolation
These are not abstract
concepts from fields alien to epidemiology. The biomedical conference attended
by DDP leadership last week was centered on desire. Then there it the Healthy
Sexuals campaign from years ago, and the new “sexual health” paradigm being
promoted by …. Instead of passively promulgating these paradigms of
prevention, perhaps public health leadership should properly position social
theory at the epicenter of epistemology
Surv. Is the CONSCIENCE
- Pre-exposure prophylaxis (PrEP)
is a daily course of antiretroviral drugs (ARVs) taken by HIV-negative
people to protect themselves from infection.
- While PrEP can
provide very effective protection against HIV, it does not provide
protection against other sexually transmitted infections (STIs) and
blood-borne illnesses such as Hepatitis C, syphilis, and gonorrhoea.
- As of 2019,
Truvada, a single pill that is a combination of ARVs tenofovir and
emtricitabine, is approved for use as PrEP.
- For people facing
limited options to protect themselves against HIV or for those who can’t
or don’t want to use a condom, PrEP allows them to discreetly take control
of their HIV risk.16
·
Medicalization
·
contradictions that are associated with
conflicts of interest within the culture, or with change
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