Fear of Longevity: Everyday Struggles in the Pharmaceutical Age of AIDS, Taiwan

Abstract

Through an ethnographic study of civil society organisations (CSOs) in Taiwan, this research endeavours to explore how Acquired Immunodeficiency Syndrome (AIDS) and biomedical approaches to controlling the epidemic have framed everyday life amongst ganranzhe (HIV infected individuals) and feiganranzhe (HIV uninfected individuals) from tongzhi (Comrades, LGBT populations) communities whose members are labelled as populations at risk. The health regime of the Human Immunodeficiency Virus (HIV)/AIDS in Taiwan, I argue, redistributes state power to local social bodies where the decentralised governance of sexual minorities and social deviants is exercised through compassionate voluntary labour. Moreover, this health regime has escalated and engendered everyday struggles which the affected endure and will continue to confront. In the face of ongoing social and physical suffering amongst vulnerable individuals, living longer is not necessarily the ideal which everyone prioritises in their everyday lives and connections with others. In the early days of AIDS, prior to the availability of triple cocktail therapy in 1997, the diagnosis of disease was an inevitable death sentence. Longevity was desired, but unattainable, by ganranzhe. In contemporary Taiwan, when ganranzhe can access pharmaceuticals which enable a prolonged life with prevention and treatment of HIV-related symptoms, an unexpected fear of longevity has emerged. Living longer, I argue and conclude from stories told by research participants in this study, is not necessarily desirable when the everyday struggles facing ganranzhe are not mitigated, and will continue through that longevity. There is an established scholarly discourse in anthropology and sociology critiquing the impact of global agencies on local responses to HIV/AIDS through their directed provision of funding support. The absence of foreign subsidies to the CSOs in Taiwan society provides a contrasting example of the development and direction of HIV/AIDS programs independent of direct global funding. This thesis argues that the state, even without international monetary aid, has become proficient at drawing on the culture of the tongzhi community to collaborate with CSOs and as a result to productively exercise its power over individuals. CSOs, working with the state, have crafted culturally sensitive programs for AIDS control and prevention which function as less coercive apparatuses to monitor, intervene and govern daily lives amongst the targeted populations. Universal approaches for curtailing the AIDS epidemic are after all not transparent healthcare measures where health amongst individuals of local communities are protected and improved. Global agendas on HIV/AIDS response can generate unforeseen adverse consequences which may burden the already social disadvantaged even further.