HIV/AIDS and stigma in Kerala, India: The 'wretched new class of untouchables'

This project explores the social meaning and context of HIV/AIDS in contemporary Kerala, India. It seeks to develop a nuanced social understanding of the disease as it is manifest in the lived experience of Keralites. Such an understanding is derived from field work performed in 2007 and 2008 in Kerala, the center piece of which is open-ended interviews of HIV patients and their families. Nine life histories of HIV patients were central to this analysis. Unsurprisingly, the interviews confirm the existence of an intense, pervasive and multi-faceted HIV stigma in Kerala.;In ascertaining the social and economic context of the disease in the Keralan setting, the project examines the role that dominant structures of inequality---especially class and familial inequality---play in facilitating HIV and HIV stigma. Class and familial inequality determine the mechanism of HIV transmission in a high number of cases. Class inequality in the state produces a certain kind of labor migration that exposes migrants and their families to a risk of HIV acquisition. It then figures critically in the capacity of persons with HIV to obtain treatment and to do so without exposing the fact of their condition. Familial inequality, especially marital inequality, represents an important variable in the transmission of the disease---persons of higher family status tend to pass the disease to persons of lower familial status. Familial inequality also determines the experience of persons who contracted the disease. Widows especially tend to suffer serious economic and social deprivations following acquisition of the disease.;In an effort to determine the social meaning of the disease, the project also examines the role of Brahmanic ideology, especially the ideology underlying caste structures and gender relations, in assigning social meaning to the disease. Brahmanic ideology places profound emphasis on the dichotomy between pollution and purity. The same dichotomy appears to frame attitudes toward HIV. Persons with HIV, like persons of lower caste in traditional Brahmanic systems in the region, are subjected to touch aversion, regimes of commensality and marital exclusion. They are also described by HIV-negative persons as immoral and impure. The Brahmanic conceptions of gender and reproduction also contribute to the stigmatization of HIV positive persons. Drawing on the insights of Mary Douglas, Michael Foucault and Pierre Bourdieu, the dissertation argues that stigmatization of persons with HIV represents a response to disorder within the systems of Brahmanic order, including dissolution of occupational hierarchy and rigid structures of family life.