Mobility, Risks And Vulnerability Anthropological Mapping Of AIDS Risk And Vunerability Around The Construction Of A Highway In Western Yunnan

This research attempts to provide a thorough understanding of the relationship between domestic population mobility in China and the spread of the HIV/AIDS epidemic, as well as to explore ways of combining biomedical and anthropological perspectives to dissect and analyze HIV/AIDS prevention issues. To achieve that, multi-sited ethnographic work on HIV/AIDS risks were done at and around the construction site of a highway in western Yunnan, southwest China. Using combined qualitative and quantitative methods, the HIV risk among construction laborers, commercial sex workers and local villagers are investigated in their contextual political, economic, cultural relationships, from which the whole picture of population mobility and HIV risk associated with the road construction is presented.The main findings of this research reveal there are two sorts of HIV risk related the population mobility triggered by the road construction project. The more explicit risk is commercial sex between construction labors and sex workers. After the inception of the road construction project, the number of entertainment venues and commercial sex workers increased dramatically. Many of them, have been following the infrastructure construction for a long time, traveling from one project to another, because construction labors who are predominantly male and mainly living separately from their home or fixed sexual partners are important potential clients to the commercial sex service industry. Actually, there are self-reported commercial sex acts from generally every occupation groups among the male construction labors working at this highway. Meanwhile most of them tend to underestimate the HIV/AIDS risk in their surroundings. The other sort of risk is more implicit, the communication and reproduction of HIV/AIDS risks between construction labors and local villagers; it is less visible and more likely to be neglected. This Highway construction site goes through a variety of communities in western Yunnan that are heterogeneous in terms of culture and environment, and in the degree of local development. By doing field work in three chosen villages—Huihuan, Mangdan, Majiazhai—along the road construction site, the author finds that each of them has idiosyncratic HIV/AIDS epidemics and risks resulting from differences in environment, culture, and mode of livelihood. Because of its poverty caused by low agricultural capacity, the HIV/AIDS risks in Huihuan are related to villagers'tradition of seasonal migratory work in the high-epidemic area at the Sino-Burma border and a special form of cross-border marriage that imports possibly-infected"Burma brides"to the village. While, in Mangdan a village with well developed tropical agriculture, the HIV/AIDS is mainly associated with the high tolerance to pre- and extra-marital sex in its"transformed Dai ethnic culture". Influenced by its close proximity to the city center, as well as its diverse and highly-developed non-agricultural economy, the HIV/AIDS risk in Majiazhai is mainly involved with organized labor export to developed eastern cities in China. Since the highway construction began, villagers from these three communities have been respectively interacting with the increasing commercial sex workers and construction labors in their own ways. On one hand, these interactions carry on the original HIV/AIDS risks of each village. On the other hand, the commercial sex workers, construction labors and villagers are more or less connected into a social network of sex by all kinds of multi-partner sex practices between either two groups of them, in which their risks are delivered, communicated and overlapped to reproduce various new risks that never before existed.Meanwhile, this research discovers that facing the aforementioned explicit and implicit HIV/AIDS risk, construction labors are not homogeneous. Taking the explicit risk as an example, different occupation groups of construction labors vary in terms of risk behavior and HIV/AIDS knowledge. Though un-skilled workers—the largest as well as the most marginal and disadvantageous component of the construction labors—have the least HIV/AIDS knowledge, they do not actively engage in commercial sex. Skilled workers know a little more HIV/AIDS but also engage in a little more commercial sex. However, the most powerful and advantageous groups—such as inspectors and project management staff—have the most adequate HIV/AIDS knowledge, a large portion of them have been involved in commercial sex consumption relating to bribery and corruption. Foremen and drivers are the occupational groups with most commercial sex behavior, but they have relatively less HIV/AIDS knowledge, due to the traits of their jobs.In conclusion, this research portrays a range of relationships between HIV/AIDS risks and population mobility associated with a highway construction project from perspectives of multiple stakeholders. Proceeding from the major findings, the author claims that it is not population mobility that causes HIV/AIDS risks. However, when poverty, social inequality, unbalanced power relations, or some particular culture norms happen in a context of migration, they may become the social root of HIV/AIDS risks in various forms. Nevertheless, population mobility is not the real cause itself.Based on the main findings and conclusions, the last part of the dissertation critically discusses and develops some theoretical models found in the literature. Firstly, for the prevalent"K-A-P"model, the tendency is to neglect political, economic, social, cultural and other external factors that contribute to shaping HIV/AIDS risk. In addition to the individual rationality, this negligence seems to be a vital flaw preventing a holistic view of HIV/AIDS risk. Secondly, as to the political-economy theory of medical anthropology, the results of this research suggest that the dichotomy of"the marginal"and"the central"can be adjusted to different scales. In a macro system, such as the world system, the marginal are more likely to be harmed by the HIV/AIDS epidemic, according to previous literature. However, in a micro-context, such as the construction site of a highway, the most powerful occupation groups are at higher risk because their commercial sex behavior associated with power abuse and corruption. Meanwhile the most marginal group of un-skilled workers are prevented from engaging in commercial sex by their lack of consuming capacity, due to their disadvantageous economic status. Thus, the marginal may not be at the highest risk in this micro-context. Thirdly, the newly emergent interdisciplinary theoretical models, such the as"HIV/AIDS vulnerability"model, are confusing and ambiguous in that they try to subsume two distinct concepts under one name. This research is an empirical study to distinguish these two concepts: the behavioral risk related to potential HIV/AIDS infection, and the lack of ability to exert self-protection against HIV/AIDS epidemic. Recognizing this distinction will help to comprehensively analyze the characteristics of an individual or a group when he/they face the HIV/AIDS epidemic, according to which more specific intervention can be developed to address these two aspects. Additionally, distinguishing these two concepts can be a fundamental precondition to further interdisciplinary cooperation between the humanities, social science and biomedicine in the arena of HIV/AIDS prevention research and practices.Finally, the author summarizes and discusses methodological issues based on this multi-sited ethnographic work. Multi-sited ethnography has its unique strength in unfold the narratives among multiple sites/groups /communities which are all connected by HIV/AIDS risks. Nevertheless, some aspects of it, such as its evaluation system and techniques to deal with shifting perspectives and changing roles between multiple conflicting groups/sites, are to be further developed and improved by future research forays.