Abstract
Abstract Drawing on the framework of transnational materiality (Gille 2014), a conceptual contribution from the Framing the Global project, this article examines how HIV testing and counselling services became a site of political contestation in Taiwan since expanding service delivery was proposed as a response to the HIV epidemic by global health institutions in the 2000s. This global scheme, the study argues, not only reshaped the organization and practices of HIV service delivery, but also generated vulnerability as these practices connected to HIV-positive people’s lives were largely governed by global models and national programs that may not fully reflect local concerns. In response, local NGO workers politicize service delivery in part by transnationally adopting and promoting practices that attend more carefully to localized forms of vulnerability. Using qualitative data collected in Taiwan, the analysis reveals a grounded politics of HIV service delivery that highlights the materialization of vulnerability and its management.
Highlights
HIV politics has been a central concern for global scholars since the outbreak of the HIV epidemic
non-governmental organizations (NGOs) were well aware of some ethical principles and practices of HIV services validated by global actors, which could be seen in their 2008 protest press release: “the necessity of HIV preand post-test counselling is well documented in United Nations’ International Guidelines on HIV/AIDS and Human Rights” (PRAA 2008)
As illustrated in this study, the material practices of HIV service delivery are rarely just locally determined, but instead are often informed by models of health care delivery proposed by global health institutions
Summary
HIV politics has been a central concern for global scholars since the outbreak of the HIV epidemic. Even in the absence of a direct institutional force, social life could be altered by transnational power and politics when such a politics becomes materialized in the substances and practices that constitute social life, which Gille calls the materialization of politics This framework is useful in analyzing the material practices of HIV service delivery in Taiwan, since HIV service programs and practices in Taiwan are often influenced by actors beyond the national border. Decoteau (2013) illustrates the ways in which HIV biomedicine constitutes new technologies of the self that privatize blame and patient responsibility in South Africa These studies illuminate how HIV treatment is embedded in larger national, transnational, and colonial webs. The aim is to scrutinize how politics are implicated in the practices of HIV testing and related service delivery, that is, how the materiality of service delivery is simultaneously associated with clients’ potential vulnerability and with providers’ efforts to reduce and navigate clients’ vulnerability
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