HIV Exceptionalism by Adia Benton

Author:Adia Benton [Benton, Adia]
Language: eng
Format: epub
Tags: SOC002010 Social Science / Anthropology / Cultural
ISBN: 9780816692422
Publisher: University of Minnesota Press
Published: 2015-02-11T16:00:00+00:00

By not disclosing to some, fully responsibilized individuals have simultaneously protected themselves from retribution and rejection and chosen to relieve others from the burden of their HIV disease. In the situations where they learn to manage disclosure narratives—content, audience, and audience response—HIV-positive people must actively negotiate their revelation with the knowledge that they will always be judged by the fact that they, seemingly unprovoked, revealed information about themselves. In these scenarios, the responsibilities for managing others’ responses to the illness, for protecting others from infection, and for transferring caregiving responsibilities to others are all carried by the HIV-positive person.

In this chapter, I have described how a moral discourse surrounding disclosure—defined as a dual preoccupation with disclosure as catharsis, redemption, and self-love, and with secrecy as guilt, shame, and fear—is crucial to understanding how disclosure functions in HIV programs. This dual preoccupation operates alongside a moral logic of responsibilization, which, in this context, refers to a process by which individuals learn and inform others about their biomedical condition, assume risks associated with the condition, and become prudent and rational citizens to avoid burdening others. Bureaucratic and therapeutic practice in clinical care, as well as adult education techniques like skits, role-play, and facilitated discussions on the topic of disclosure, enable and guide this process of responsibilization. Specifically, in clinical encounters and support groups, HIV-positive individuals learn why they should disclose, the appropriate ways to do so, and the best ways to manage outcomes of disclosure.

While responsibilization is actively pursued and even embraced by HIV-positive people through idioms of love, protection, and commitment, it also poses existential, juridical, and interpersonal predicaments for many of them. How do they manage knowledge about themselves in a cultural milieu where concealment and silence can be moral markers, post-conflict programmatic imperatives to talk prevail, and economic advancement through disclosure is a promising possibility? Responsibilization through disclosure—although posed as a virtue and readily embraced—has its limits. It overemphasizes the individualized and disease-centered nature of risk calculations, foreclosing critical reevaluation of the cathartic role of HIV disclosure and the shame of secrets. Such inattention to the multiple and overlapping loci, interpretations, and layers of risk, disclosure, and secrecy obscures the role that HIV programs play in actively shaping the risks, burdens, and opportunities presented by disclosure.

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