AIDS first manifested itself in the early 1980s as an apparent
“gay disease.” Cases soon appeared outside the industrialized
west and among other communities. Given HIV's modes of transmission,
sex workers, drug injectors, and those who engaged in unprotected
nonmonogamous sex were at higher risk, and the political economy of the
virus was such that communities on domestic as well as international
margins had the highest prevalence. Governments were slow to respond
seriously. In their place, segments of the gay and lesbian community
united by the late 1980s to educate, protect, and care for themselves,
even in countries in which cases of homosexual transmission comprise a
relatively small proportion of infections. At times, governments'
abdication of responsibility left those nongovernmental organizations
(NGOs) less closely-scrutinized than others—most notable where
associational life is generally subject to illiberal
controls—leaving them relatively free to advance explicit or
implicit community-building among their marginalized constituencies.
Though governments and media gained interest as heterosexual transmission
rates rose, both still neglected the highest-risk groups. Importantly, the
perspectives, perceived constituencies, and approaches of
HIV/AIDS-related NGOs may diverge sharply from those of public health
authorities, with unambiguous consequences in terms of the relative
empowerment, receptivity to messages, and, ultimately, behaviors of target
communities.Meredith L. Weiss is a Research
Fellow at East-West Center Washington ([email protected]).
Preliminary research for this project was supported by a DePaul University
faculty research grant.