Treatment is Prevention

Abstract

The past 15 years have seen the waning of both cultural analysis and activism dedicated to HIV/AIDS prevention, especially in relation to the enduring epidemic in the United States. However, current mutations in the American HIV prevention landscape, driven by the biomedical promise of a ‘Test and Treat’ strategy, are producing potentially destructive outcomes for vulnerable and dispossessed communities, a situation that demands renewed investment from cultural critics. The aim of this article is to mobilize a specific strand of biopolitical theory (Foucault, Agamben, Esposito) to examine recent federally orchestrated prevention measures dedicated to a scale-up and integration of HIV testing, treatment and ‘linkage to care’, in order to move beyond their reductive approach to the preservation of life and advance a more capacious, politically engaged prevention model rooted in communal rather than individual forms of immunity. Based on my ethnographic fieldwork in Baltimore, MD, I attend to ways in which local HIV prevention initiatives are courting the city's precarious Ballroom community – a kinship system of black queer youth structured around competitive dance and performance – in an attempt to materialize their ‘target population’ for testing purposes. Previously neglected by governmental and medical institutions, members of the Ballroom community now find themselves addressed as responsible sexual citizens who are expected to protect their bodies by getting tested and, if tested positive, start treatment. Yet, this emphasis on the medical rights and responsibilities of HIV positive youth threatens to abandon large groups of youth who have managed to stay uninfected. I conclude by locating this problem in the incongruity between the biological life protected by current ‘Test and Treat’ strategies and the forms of life that allow the Ballroom community to persevere under often dire circumstances, constituting an indigenous resource for an alternative take on HIV prevention