The primacy of politics

Abstract

The strongest community-based AIDS organizations were initially established in northern Europe, North America, and Australasia where politically-organized gay communities, which were first affected by HIV/AIDS, had political and economic resources. In countries where AIDS is not as clearly linked to specific communities, mainly in Africa and the Caribbean, the shape of HIV support organizations is very different, with much of the leadership coming from preexisting grassroots organizations not based in any particular community. Even more significant than the epidemiology of the pandemic may be the extent of political space conferred to nongovernmental organizations (NGO), which in many parts of the world are regarded with great suspicion by governments. AIDS-related organizations face considerable governmental obstacles in many countries due to a governmental desire to control all aspects of public health, governmental hostility to any attempts to create groups outside of the direct control of the state, religious opposition to discussing AIDS, and/or antipathy between NGOs and government. The paper discusses community-based AIDS organizations in Western countries, community organizing in Southeast Asia, AIDS in Asia/Pacific, and the importance of community-based organizing.