The political economy of HIV prevention in Ghana: peer education, queer social reproductive labor, and the global development industry

Abstract

ABSTRACT Peer education has become an increasingly popular mode of community-level human immunodeficiency virus (HIV) prevention around the globe. In Ghana, networks of volunteer peer educators are mobilized by non-governmental organizations (NGOs) to conduct sexual health outreach among populations disproportionately affected by HIV, including men who have sex with men (MSM). In development discourse, peer education is typically rationalized in terms of its cost efficiency and “community empowerment” objectives. This article explores whether these initiatives are indeed “empowering” for the working-class men who work as MSM peer educators in the Ghanaian capital, Accra, as well as their broader impact on queer political organizing. Empirically, the article draws on ethnographic research conducted between 2013 and 2014, including participant observation in an HIV/MSM NGO, group and life story interviews with peer educators, and semi-structured interviews with key civil society actors involved in HIV/MSM and wider lesbian, gay, bisexual, trans, and intersex (LGBTI) rights work in Ghana. The article conceptualizes peer education as a form of social reproductive labor that is systematically devalued and frequently invisibilized within the global capitalist economy. It further argues that, contrary to the intervention’s core “empowerment” aims, peer education in Ghana places a disproportionate burden of responsibility on queer working-class men in dealing with the HIV epidemic, increases peer educators’ risk of homophobic violence and abuse, and engenders division between working-class queer communities and the civil society organizations that are supposed to represent them.