Abstract
BackgroundCartagena, Colombia’s main port on the Caribbean Coast, reported an HIV incidence of 7.5 per 100,000 inhabitants in 2007 with 90.0% transmission by heterosexual contact and 70 identified as women with a stable partner. Studies across Colombia illustrate that HIV infection relates to social inequalities; most people with HIV live in poverty and have minimal access to health care, education, and secure jobs. The purpose of this article is to analyse the relationship between social inequalities, sexual tourism and HIV infection in Cartagena, Colombia.MethodsData come from a five-year participatory ethnography of HIV in Cartagena in the period 2004–2009, in which 96 citizens (30 of whom were living with HIV) participated in different data collection phases. Techniques included participant observation, in-depth interviews and thematic life histories. Out of this material, we selected three life histories of two women and a man living with HIV that are representative of the ways in which participants expressed how social inequalities make it virtually impossible to engage in safe sex practices.ResultsAt stake is the exchange of condomless sex for goods within the widespread sexual tourism networks that promote an idealisation of dark-skinned men and women as better sexual performers. Our results illustrate the complex interplay of social inequalities based on class, skin colour, gender and sexual orientation. Furthermore, they suggest a synergistic effect between poverty, racialization, and gender inequalities in the historical maintenance of social dynamics for a fruitful growth of a sexual tourism industry that in turn increases vulnerability to HIV infection.ConclusionsAlthough the convergence of social inequalities has been thoroughly reported in the literature on social studies of HIV vulnerability; distinctive dynamics are occurring in Cartagena, including a clear link between the contemporary globalised sexual tourism industries and a racialised social structure - both having historical roots in the colonial past-.
Highlights
Cartagena, Colombia’s main port on the Caribbean Coast, reported an Human Inmunodeficiency Virus (HIV) incidence of 7.5 per 100, 000 inhabitants in 2007 with 90.0% transmission by heterosexual contact and 70 identified as women with a stable partner
The evaluation led to a ‘Local-Scientific diagram’ of social determination of HIV infection [44] that was further discussed by key stakeholders in Cartagena, who identified sexual tourism as one of the most important determinants of the city’s epidemic
Our analytical interpretations relied on concepts from medical Anthropology studies on HIV, sociology, and political economy.This research project was submitted to and approved by Centro de Estudios Socioculturales e Internacionales ethics committee at Los Andes University all research procedures followed ethical norms as laid out in resolution # 8430–1993 by the Colombian Ministry of Health and all participants accepted and signed written informed consents
Summary
Colombia’s main port on the Caribbean Coast, reported an HIV incidence of 7.5 per 100, 000 inhabitants in 2007 with 90.0% transmission by heterosexual contact and 70 identified as women with a stable partner. The purpose of this article is to analyse the relationship between social inequalities, sexual tourism and HIV infection in Cartagena, Colombia. Besides the exploitation of bodies from the global south, the sexual tourism industry exposes local populations to specific diseases or potentiates the relationship between social inequalities, violence and health as seen in the sexual abuse of adults and children [11, 15, 22, 27] and their heightened vulnerability to sexually transmitted infections [12, 16, 28]
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