Matthew Thomann | University of Maryland, College Park (original) (raw)

Papers by Matthew Thomann

Research paper thumbnail of The precarity of mobile loan debt and repayment among female sex workers in Nairobi, Kenya: Implications for sexual health

Research paper thumbnail of An urgent call to include men who have sex with men in the HPV immunisation programme in Kenya

Research paper thumbnail of Understanding Racial Inequities in the Implementation of Harm Reduction Strategies

American Journal of Public Health, 2022

Objectives. To elucidate a structurally oriented theoretical framework that considers legacies of... more Objectives. To elucidate a structurally oriented theoretical framework that considers legacies of racism, trauma, and social exclusion and to interrogate the “unmet obligations” of the institutionalization of the
harm reduction infrastructure to provide equitable protections to Black and Latinx people who use drugs (PWUD) in Maryland.
Methods. In 2019, we conducted a rapid ethnographic assessment of and qualitative interviews with PWUD (n 5 72) and stakeholders (n 5 85) in 5 Maryland counties. We assessed PWUD’s experiences, service gaps in as well as barriers and facilitators to accessing services, and the potential to expand harm reduction programs.
Results. The unmet obligations we found included enforcement and punitive governance of syringes, naloxone, and other drug use equipment; racism and racialization, social exclusion, and legacies of trauma; and differential implications of harm reduction for populations experiencing racialized criminalization.
Conclusions. The implementation of harm reduction policies are a first step, but assessment of structural dynamics are needed for diverse communities with unique histories. This research illuminates
a key paradox: progressive policy is implemented, yet the overdose crisis escalates in communities where various forms of racialized exclusions are firmly entrenched.

Research paper thumbnail of Understanding socio-sexual networks: Critical consideration for HIVST intervention planning among men who have sex with men in Kenya

BMC Public Health, 2022

Background: HIV self-testing (HIVST) has emerged as a way of reaching individuals who may be less... more Background: HIV self-testing (HIVST) has emerged as a way of reaching individuals who may be less likely to access testing, including men who have sex with men (MSM). Understanding the social networks of MSM is key to tailoring interventions, such as HIVST, for particular locations.
Methods: We undertook a socio-sexual network study to characterize and identify patterns of connection among MSM and inform an HIVST intervention in three sites in Kenya. Community researchers in each site selected eight seeds to complete a demographic form and network surveys for 15 each of their sexual and social network members. Seeds recruited three respondents, including two regular service users and one MSM who was “unreached” by the program, who then each identifed three respondents, resulting with data on 290 individuals.
Results: Findings illustrate the interconnectedness of community-based organization (CBO) members and nonmembers. In networks where a majority of members had a CBO membership, members had better contacts with programs and were more likely to have accessed health services. Larger networks had more HIV testing and seeds with frequent testing had a positive influence on their network members also being tested frequently. HIVST was tried in very few networks. Almost all network members were willing to use HIVST.
Conclusion: Willingness to use HIVST was nearly universal and points to the importance of networks for reaching individuals not enrolled in programs. Network analysis can help in understanding which type of networks had higher testing and how network-based approaches can be useful to promote HIVST in certain contexts.

Research paper thumbnail of Remaking the Technosubject: Kenyan Men Contextualizing HIV Self-Testing Technologies

Medical Anthropology, 2022

The Kenyan government offers free HIV self-testing kits to men who have sex with men. The value o... more The Kenyan government offers free HIV self-testing kits to men who have sex with men. The value of self-testing is based on the imaginary of an autonomous technosubject empowered to independently control testing services, thereby “freed,” through technology, from the social conditions that might inhibit health services utilization. Following a community-centered collaborative approach, community researchers interviewed their peers who examined and reacted to the technology. Participants reframed the technosubject as intertwined with the social world and the testing kit itself as an object that exerts agency and possesses affective potential. Attending to these socio-material relationalities offers insights into program planning.

Research paper thumbnail of “Heavy Drinking” and HIV Vulnerability Among African Male Sex Workers: Narratives from a Community-Based Participatory Study in Nairobi, Kenya

Male Same-Sex Sexuality and HIV in Africa

Research paper thumbnail of 'The only safe way to find a partner': rethinking sex and risk online in Abidjan, Côte d'Ivoire

Critical Public Health, 2020

Research paper thumbnail of Making up MSM: Circulations, becomings, and doings in global health

Medicine, Anthropology, Theory, 2019

How does an epidemiological category such as 'MSM' circulate across global health contexts? In wh... more How does an epidemiological category such as 'MSM' circulate across global health contexts? In what ways is this label implicated in and productive of global health knowledgemaking practices? The papers in this special section take up these questions by showing how the MSM category, across an array of social, cultural, and political backdrops, comes into existence as a 'category, thing, technology' (see Biruk, this issue), and especially as a vital or doing thing (see Boyce and Cataldo, this issue; Lorway, this issue). Rather than reiterate the already well-documented and important scholarly work detailing the (mis)uses of this category in global public health1a critique that stresses the erasure of lived realities that should be recognized to better understand people and promote sexual healththe contributions to this special section focus on the more 'ontological' materiality of 'MSM' and the work it does as it travels. That is to say, what comes of 'MSM' being in the world; and how does 'MSM' in turn call for new kinds of becomings? In short, our starting point for this special section extends beyond what MSM does not do, and instead emphasizes what it has done and can do. These contributions, then, examine the ontology of the term 'MSM': what it does and what it becomes in the concrete world of health and development interventions.

Research paper thumbnail of Crafting a 'critically-applied' PrEP collaboration in Memphis

Research paper thumbnail of 'On December 1, 2015, sex changes. Forever': Pre-exposure prophylaxis and the pharmaceuticalisation of the neoliberal sexual subject

Global Public Health, 2018

Research paper thumbnail of From a global crisis to the 'end of AIDS': New epidemics of signification

Global Public Health, 2018

In the past decade, discourses about AIDS have taken a remarkable, and largely unquestioned, turn... more In the past decade, discourses about AIDS have taken a remarkable, and largely unquestioned, turn. Whereas mobilisations for treatment scale-up during the 2000s were premised on perceptions of an 'epidemic out of control', we have repeatedly been informed in more recent years that an end to AIDS is immanent. This new discourse and its resulting policies are motivated by post-recession financial pressures, a changing field of global institutions, and shifting health and development priorities. These shifts also reflect a biomedical triumphalism in HIV prevention and treatment, whereby shorter term, privatised, technological, and 'costeffective' interventions are promoted over long-term support for antiretroviral treatment. To explore these changes, we utilise Treichler's [(1987). How to have theory in an epidemic: Cultural chronicles of AIDS. Durham, NC: Duke University Press] view of AIDS as an 'epidemic of signification' to develop a review of 'End of AIDS' discourses in recent years. We use this review to investigate the political and philanthropic interests served by efforts to rebrand and re-signify the epidemic. We also hold up these discourses against the realities of treatment access in resource-poor countries, where 'Ending AIDS' has not heralded the end of an epidemic per se, but rather the end of external support for treatment programmes, highlighting new difficulties for sustaining treatment in this new era of the epidemic.

Research paper thumbnail of Parents’ Perspectives About Adolescent Boys’ Involvement in Biomedical HIV Prevention Research

Archives of Sexual Behavior, 2018

Research on the use of pre-exposure prophylaxis (PrEP) among adolescents at high risk for HIV is ... more Research on the use of pre-exposure prophylaxis (PrEP) among adolescents at high risk for HIV is urgently needed, and parents’ perspectives on these studies are essential for guiding the responsible conduct of adolescent PrEP research. We conducted interviews with 30 parents of adolescent boys (50% known/presumed heterosexual; 50% sexual minority) to understand their views of research risks and benefits and parental permission regarding their sons’ involvement in a hypothetical PrEP adherence trial. Parents identified several health and educational benefits of the study, and expressed that waiving parental permission would overcome barriers to accessing PrEP, particularly for youth who may benefit most. Among their concerns were medication nonadherence and risk compensation. Parents provided suggestions to facilitate informed, rational, and voluntary participation decisions and protect youth’s safety if parental permission was waived. These findings can inform ways to increase parental trust in PrEP research and create adequate protections for adolescent participants.

Research paper thumbnail of Barriers and Facilitators to Seeking HIV Services in Chicago among Young Men who have Sex with Men: Perspectives of HIV Service Providers

AIDS Patient Care and STIs, 2018

Research paper thumbnail of 'WTF is PrEP?': attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City

Culture, Health, & Sexuality , 2017

Research paper thumbnail of Violence, Exclusion and Resilience among Ivoirian Travestis.

Critical African Studies, 2017

Among sexual and gender minorities in Côte d'Ivoire, travestis are defined as individuals born an... more Among sexual and gender minorities in Côte d'Ivoire, travestis are defined as individuals born anatomically male who live as women on a full-or part-time basis. Travestis encounter harsher stigmatization and violence than sexual minorities whose gender normativity allows them to avoid unwanted attention. Moreover, they have traditionally been underserved by Ivoirian sexual minority rights groups, who have worked to distance themselves from travestis, framing them as recklessly indiscreet. In this paper, we examine the extent to which travestis' isolation has lessened in the wake of the post-election violence that followed Côte d'Ivoire's 2010 presidential election. We trace how Ivoirian travestis became increasingly vulnerable following the installation of a new national army that proved more hostile to them. And we show how, as a result of anti-travesti abuses committed by the army, nontravesti sexual minority activists became increasingly aware of the plight of travestis, and took steps to include them in their programming. These activists may have also been motivated by an increasing interest in transgender issues on the part of international donors. Finally, we explore the extent to which emerging human rights and HIV/AIDS programming has resulted in newly embodied positions for travestis as they confront identifications reflecting Western trans-spectrum identities.

Research paper thumbnail of HIV Vulnerability and the Erasure of Sexual and Gender Diversity in Abidjan, Cote d'Ivoire.

Global Public Health , 2016

In the fight against concentrated HIV epidemics, men who have sex with men (MSM) are often framed... more In the fight against concentrated HIV epidemics, men who have sex with men (MSM) are often framed as a homogeneous population, with little attention paid to sexual and gender diversity and its impact on HIV vulnerability. This article draws on ethnographic research conducted in Abidjan, Côte d’Ivoire among les branchés – a local term encompassing several categories of same-sex desire and practice. In the context of increased HIV prevention programming targeting Ivoirian sexual and gender minorities, such diversity is effectively erased. This obfuscation of difference has particularly negative impacts for travestis, who may be at higher risk for HIV infection, though research and prevention efforts in which they are grouped with “MSM” render them underrepresented and make their vulnerability difficult to quantify. Branchés whose class and/or ethnic backgrounds compound their stigmatized status as sexual and gender minorities also bear the burden of this exclusion. Furthermore, some branchés deploy “MSM” as a form of self-identification, further complicating who such categories represent. By highlighting the ways in which constructions of gender and sexuality within HIV/AIDS programming obscure complex social realities, I aim to reorient thinking around the development of purposeful HIV programming that engages the complexity of sexual and gender minority experience.

Research paper thumbnail of Zones of Difference, Boundaries of Belonging: Moral Geography and Community Mapping in Abidjan, Côte d’Ivoire.

Journal of Homosexuality, 2016

In Abidjan, Côte d’Ivoire, 18% of men who have sex with men (MSM) are HIV positive. This article ... more In Abidjan, Côte d’Ivoire, 18% of men who have sex with men (MSM) are HIV positive. This article is based on ethnographic research conducted among HIV peer educators and activists in Abidjan and examines their narratives and hand-drawn maps of city space. I draw on a methodological process of map-making to examine research participants’ evaluations of neighborhoods and link these evaluations to debates over national and cultural belonging in Côte d’Ivoire. I suggest a moral geography emerges from the maps and narratives and ask what the bioethical implications of moral geography are in the context of service delivery and activism among sexual minorities.

Research paper thumbnail of Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men

Introduction: Free or low-cost HIV testing, condoms, and lubricants are foundational HIV preventi... more Introduction: Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. Methods: The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n 03857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. Results: About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR 00.57, 95% CI 00.33, 0.98) and condom-compatible lubricants (OR 00.54, 95% CI00.30, 0.98). Conclusions: This first look at access to HIV prevention services for trans MSM globally found that most reported inadequate access to basic prevention services and that they were less likely than cisgender MSM to have access to HIV testing and lubricants. Results indicate the need to enhance access to basic HIV prevention services for trans MSM, including MSM-specific services.

Research paper thumbnail of Gender and Sexual Diversity Organizing in Africa, In "Understanding Southern Social Movements." Routledge Press

The chapter shows how studying African gender and sexual diversity movements allows scholars to r... more The chapter shows how studying African gender and sexual diversity movements allows scholars to reorient “northern” social movement theorizing in three ways. First, these movements challenge the distinction between “politics” and “culture.” Second, African gender and sexual diversity movements face complicated dilemmas related to the transnational patronage and funding. Third, African gender and sexual diversity movements disrupt the notion that queer movements are “identity movements,” an argument that overlooks gender and sexual diversity organizations’ survival efforts. This chapter constitutes one of the first essays synthesizing the lessons from African gender and sexual diversity movements for social movement theorizing.

Research paper thumbnail of HIV Treatment Cascades that Leak: Correlates of Drop-Off from the HIV Care Continuum among Men Who Have Sex with Men Worldwide. Journal of AIDS and Clinical Research

The health and prevention benefits of antiretroviral therapies (ART), delivered as part of compre... more The health and prevention benefits of antiretroviral therapies (ART), delivered as part of comprehensive HIV care programs remain unrealized for men who have sex with men (MSM). This multilevel study explores the correlates of drop-off from the HIV care continuum in an international study of MSM, taking into account individual and regional differences in access to and utilization of care.

Research paper thumbnail of The precarity of mobile loan debt and repayment among female sex workers in Nairobi, Kenya: Implications for sexual health

Research paper thumbnail of An urgent call to include men who have sex with men in the HPV immunisation programme in Kenya

Research paper thumbnail of Understanding Racial Inequities in the Implementation of Harm Reduction Strategies

American Journal of Public Health, 2022

Objectives. To elucidate a structurally oriented theoretical framework that considers legacies of... more Objectives. To elucidate a structurally oriented theoretical framework that considers legacies of racism, trauma, and social exclusion and to interrogate the “unmet obligations” of the institutionalization of the
harm reduction infrastructure to provide equitable protections to Black and Latinx people who use drugs (PWUD) in Maryland.
Methods. In 2019, we conducted a rapid ethnographic assessment of and qualitative interviews with PWUD (n 5 72) and stakeholders (n 5 85) in 5 Maryland counties. We assessed PWUD’s experiences, service gaps in as well as barriers and facilitators to accessing services, and the potential to expand harm reduction programs.
Results. The unmet obligations we found included enforcement and punitive governance of syringes, naloxone, and other drug use equipment; racism and racialization, social exclusion, and legacies of trauma; and differential implications of harm reduction for populations experiencing racialized criminalization.
Conclusions. The implementation of harm reduction policies are a first step, but assessment of structural dynamics are needed for diverse communities with unique histories. This research illuminates
a key paradox: progressive policy is implemented, yet the overdose crisis escalates in communities where various forms of racialized exclusions are firmly entrenched.

Research paper thumbnail of Understanding socio-sexual networks: Critical consideration for HIVST intervention planning among men who have sex with men in Kenya

BMC Public Health, 2022

Background: HIV self-testing (HIVST) has emerged as a way of reaching individuals who may be less... more Background: HIV self-testing (HIVST) has emerged as a way of reaching individuals who may be less likely to access testing, including men who have sex with men (MSM). Understanding the social networks of MSM is key to tailoring interventions, such as HIVST, for particular locations.
Methods: We undertook a socio-sexual network study to characterize and identify patterns of connection among MSM and inform an HIVST intervention in three sites in Kenya. Community researchers in each site selected eight seeds to complete a demographic form and network surveys for 15 each of their sexual and social network members. Seeds recruited three respondents, including two regular service users and one MSM who was “unreached” by the program, who then each identifed three respondents, resulting with data on 290 individuals.
Results: Findings illustrate the interconnectedness of community-based organization (CBO) members and nonmembers. In networks where a majority of members had a CBO membership, members had better contacts with programs and were more likely to have accessed health services. Larger networks had more HIV testing and seeds with frequent testing had a positive influence on their network members also being tested frequently. HIVST was tried in very few networks. Almost all network members were willing to use HIVST.
Conclusion: Willingness to use HIVST was nearly universal and points to the importance of networks for reaching individuals not enrolled in programs. Network analysis can help in understanding which type of networks had higher testing and how network-based approaches can be useful to promote HIVST in certain contexts.

Research paper thumbnail of Remaking the Technosubject: Kenyan Men Contextualizing HIV Self-Testing Technologies

Medical Anthropology, 2022

The Kenyan government offers free HIV self-testing kits to men who have sex with men. The value o... more The Kenyan government offers free HIV self-testing kits to men who have sex with men. The value of self-testing is based on the imaginary of an autonomous technosubject empowered to independently control testing services, thereby “freed,” through technology, from the social conditions that might inhibit health services utilization. Following a community-centered collaborative approach, community researchers interviewed their peers who examined and reacted to the technology. Participants reframed the technosubject as intertwined with the social world and the testing kit itself as an object that exerts agency and possesses affective potential. Attending to these socio-material relationalities offers insights into program planning.

Research paper thumbnail of “Heavy Drinking” and HIV Vulnerability Among African Male Sex Workers: Narratives from a Community-Based Participatory Study in Nairobi, Kenya

Male Same-Sex Sexuality and HIV in Africa

Research paper thumbnail of 'The only safe way to find a partner': rethinking sex and risk online in Abidjan, Côte d'Ivoire

Critical Public Health, 2020

Research paper thumbnail of Making up MSM: Circulations, becomings, and doings in global health

Medicine, Anthropology, Theory, 2019

How does an epidemiological category such as 'MSM' circulate across global health contexts? In wh... more How does an epidemiological category such as 'MSM' circulate across global health contexts? In what ways is this label implicated in and productive of global health knowledgemaking practices? The papers in this special section take up these questions by showing how the MSM category, across an array of social, cultural, and political backdrops, comes into existence as a 'category, thing, technology' (see Biruk, this issue), and especially as a vital or doing thing (see Boyce and Cataldo, this issue; Lorway, this issue). Rather than reiterate the already well-documented and important scholarly work detailing the (mis)uses of this category in global public health1a critique that stresses the erasure of lived realities that should be recognized to better understand people and promote sexual healththe contributions to this special section focus on the more 'ontological' materiality of 'MSM' and the work it does as it travels. That is to say, what comes of 'MSM' being in the world; and how does 'MSM' in turn call for new kinds of becomings? In short, our starting point for this special section extends beyond what MSM does not do, and instead emphasizes what it has done and can do. These contributions, then, examine the ontology of the term 'MSM': what it does and what it becomes in the concrete world of health and development interventions.

Research paper thumbnail of Crafting a 'critically-applied' PrEP collaboration in Memphis

Research paper thumbnail of 'On December 1, 2015, sex changes. Forever': Pre-exposure prophylaxis and the pharmaceuticalisation of the neoliberal sexual subject

Global Public Health, 2018

Research paper thumbnail of From a global crisis to the 'end of AIDS': New epidemics of signification

Global Public Health, 2018

In the past decade, discourses about AIDS have taken a remarkable, and largely unquestioned, turn... more In the past decade, discourses about AIDS have taken a remarkable, and largely unquestioned, turn. Whereas mobilisations for treatment scale-up during the 2000s were premised on perceptions of an 'epidemic out of control', we have repeatedly been informed in more recent years that an end to AIDS is immanent. This new discourse and its resulting policies are motivated by post-recession financial pressures, a changing field of global institutions, and shifting health and development priorities. These shifts also reflect a biomedical triumphalism in HIV prevention and treatment, whereby shorter term, privatised, technological, and 'costeffective' interventions are promoted over long-term support for antiretroviral treatment. To explore these changes, we utilise Treichler's [(1987). How to have theory in an epidemic: Cultural chronicles of AIDS. Durham, NC: Duke University Press] view of AIDS as an 'epidemic of signification' to develop a review of 'End of AIDS' discourses in recent years. We use this review to investigate the political and philanthropic interests served by efforts to rebrand and re-signify the epidemic. We also hold up these discourses against the realities of treatment access in resource-poor countries, where 'Ending AIDS' has not heralded the end of an epidemic per se, but rather the end of external support for treatment programmes, highlighting new difficulties for sustaining treatment in this new era of the epidemic.

Research paper thumbnail of Parents’ Perspectives About Adolescent Boys’ Involvement in Biomedical HIV Prevention Research

Archives of Sexual Behavior, 2018

Research on the use of pre-exposure prophylaxis (PrEP) among adolescents at high risk for HIV is ... more Research on the use of pre-exposure prophylaxis (PrEP) among adolescents at high risk for HIV is urgently needed, and parents’ perspectives on these studies are essential for guiding the responsible conduct of adolescent PrEP research. We conducted interviews with 30 parents of adolescent boys (50% known/presumed heterosexual; 50% sexual minority) to understand their views of research risks and benefits and parental permission regarding their sons’ involvement in a hypothetical PrEP adherence trial. Parents identified several health and educational benefits of the study, and expressed that waiving parental permission would overcome barriers to accessing PrEP, particularly for youth who may benefit most. Among their concerns were medication nonadherence and risk compensation. Parents provided suggestions to facilitate informed, rational, and voluntary participation decisions and protect youth’s safety if parental permission was waived. These findings can inform ways to increase parental trust in PrEP research and create adequate protections for adolescent participants.

Research paper thumbnail of Barriers and Facilitators to Seeking HIV Services in Chicago among Young Men who have Sex with Men: Perspectives of HIV Service Providers

AIDS Patient Care and STIs, 2018

Research paper thumbnail of 'WTF is PrEP?': attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City

Culture, Health, & Sexuality , 2017

Research paper thumbnail of Violence, Exclusion and Resilience among Ivoirian Travestis.

Critical African Studies, 2017

Among sexual and gender minorities in Côte d'Ivoire, travestis are defined as individuals born an... more Among sexual and gender minorities in Côte d'Ivoire, travestis are defined as individuals born anatomically male who live as women on a full-or part-time basis. Travestis encounter harsher stigmatization and violence than sexual minorities whose gender normativity allows them to avoid unwanted attention. Moreover, they have traditionally been underserved by Ivoirian sexual minority rights groups, who have worked to distance themselves from travestis, framing them as recklessly indiscreet. In this paper, we examine the extent to which travestis' isolation has lessened in the wake of the post-election violence that followed Côte d'Ivoire's 2010 presidential election. We trace how Ivoirian travestis became increasingly vulnerable following the installation of a new national army that proved more hostile to them. And we show how, as a result of anti-travesti abuses committed by the army, nontravesti sexual minority activists became increasingly aware of the plight of travestis, and took steps to include them in their programming. These activists may have also been motivated by an increasing interest in transgender issues on the part of international donors. Finally, we explore the extent to which emerging human rights and HIV/AIDS programming has resulted in newly embodied positions for travestis as they confront identifications reflecting Western trans-spectrum identities.

Research paper thumbnail of HIV Vulnerability and the Erasure of Sexual and Gender Diversity in Abidjan, Cote d'Ivoire.

Global Public Health , 2016

In the fight against concentrated HIV epidemics, men who have sex with men (MSM) are often framed... more In the fight against concentrated HIV epidemics, men who have sex with men (MSM) are often framed as a homogeneous population, with little attention paid to sexual and gender diversity and its impact on HIV vulnerability. This article draws on ethnographic research conducted in Abidjan, Côte d’Ivoire among les branchés – a local term encompassing several categories of same-sex desire and practice. In the context of increased HIV prevention programming targeting Ivoirian sexual and gender minorities, such diversity is effectively erased. This obfuscation of difference has particularly negative impacts for travestis, who may be at higher risk for HIV infection, though research and prevention efforts in which they are grouped with “MSM” render them underrepresented and make their vulnerability difficult to quantify. Branchés whose class and/or ethnic backgrounds compound their stigmatized status as sexual and gender minorities also bear the burden of this exclusion. Furthermore, some branchés deploy “MSM” as a form of self-identification, further complicating who such categories represent. By highlighting the ways in which constructions of gender and sexuality within HIV/AIDS programming obscure complex social realities, I aim to reorient thinking around the development of purposeful HIV programming that engages the complexity of sexual and gender minority experience.

Research paper thumbnail of Zones of Difference, Boundaries of Belonging: Moral Geography and Community Mapping in Abidjan, Côte d’Ivoire.

Journal of Homosexuality, 2016

In Abidjan, Côte d’Ivoire, 18% of men who have sex with men (MSM) are HIV positive. This article ... more In Abidjan, Côte d’Ivoire, 18% of men who have sex with men (MSM) are HIV positive. This article is based on ethnographic research conducted among HIV peer educators and activists in Abidjan and examines their narratives and hand-drawn maps of city space. I draw on a methodological process of map-making to examine research participants’ evaluations of neighborhoods and link these evaluations to debates over national and cultural belonging in Côte d’Ivoire. I suggest a moral geography emerges from the maps and narratives and ask what the bioethical implications of moral geography are in the context of service delivery and activism among sexual minorities.

Research paper thumbnail of Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men

Introduction: Free or low-cost HIV testing, condoms, and lubricants are foundational HIV preventi... more Introduction: Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. Methods: The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n 03857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. Results: About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR 00.57, 95% CI 00.33, 0.98) and condom-compatible lubricants (OR 00.54, 95% CI00.30, 0.98). Conclusions: This first look at access to HIV prevention services for trans MSM globally found that most reported inadequate access to basic prevention services and that they were less likely than cisgender MSM to have access to HIV testing and lubricants. Results indicate the need to enhance access to basic HIV prevention services for trans MSM, including MSM-specific services.

Research paper thumbnail of Gender and Sexual Diversity Organizing in Africa, In "Understanding Southern Social Movements." Routledge Press

The chapter shows how studying African gender and sexual diversity movements allows scholars to r... more The chapter shows how studying African gender and sexual diversity movements allows scholars to reorient “northern” social movement theorizing in three ways. First, these movements challenge the distinction between “politics” and “culture.” Second, African gender and sexual diversity movements face complicated dilemmas related to the transnational patronage and funding. Third, African gender and sexual diversity movements disrupt the notion that queer movements are “identity movements,” an argument that overlooks gender and sexual diversity organizations’ survival efforts. This chapter constitutes one of the first essays synthesizing the lessons from African gender and sexual diversity movements for social movement theorizing.

Research paper thumbnail of HIV Treatment Cascades that Leak: Correlates of Drop-Off from the HIV Care Continuum among Men Who Have Sex with Men Worldwide. Journal of AIDS and Clinical Research

The health and prevention benefits of antiretroviral therapies (ART), delivered as part of compre... more The health and prevention benefits of antiretroviral therapies (ART), delivered as part of comprehensive HIV care programs remain unrealized for men who have sex with men (MSM). This multilevel study explores the correlates of drop-off from the HIV care continuum in an international study of MSM, taking into account individual and regional differences in access to and utilization of care.

Research paper thumbnail of Book Review: Kenyan, Christian, Queer: Religion, LGBT Activism, and Arts of Resistance in Africa by Adriaan Van Klinken

Journal of Modern African Studies, 2020

Research paper thumbnail of Book Review: Out in Africa: LGBT Organizing in Namibia and South Africa by Ashley Currier, African Studies Quarterly

Research paper thumbnail of Book Review Tacit Subjects: Belonging and Same-Sex Desire among Dominican Immigrant Men by Carlos U. Decena, Journal of Homosexuality

Journal of Homosexuality, 2011

Research paper thumbnail of Book Review: Maskulinitas: Culture, Gender and Politics in Indonesia by Marshall Clark, Gender and Society

Research paper thumbnail of Applied Anthropology

This graduate-level course draws on a broad range of approaches to the practice and theories of a... more This graduate-level course draws on a broad range of approaches to the practice and theories of applied anthropology to explore its evolving relationship with the discipline and other systems of power. It focuses on the application of anthropological knowledge to relevant human problems, including social inequality, environmental justice, and health disparities. We will consider the legacies of applied anthropology, from its inception as a 'handmaiden' to colonial systems to its radical and justice-oriented traditions of public, engaged, and abolitionist approaches (among others). It explicitly seeks to deconstruct dominant frames of knowledge production in the discipline by decentering whiteness, hetero/homo/cisnormativity, and other perspectives that have historically been dominant in anthropology and academia as a whole. The course explores the ethics and methods used by anthropologists engaged in contemporary struggles, moving beyond the ethical imperative to "do no harm" in order to center reflexivity, representational politics, and solidarity with the ultimate goal of helping students to develop an informed approach and mindset to their program of research as graduate students and beyond.

Research paper thumbnail of Method and Theory in Anthropology and Global Health

This course advances understanding of the complex interplay of the social dimensions of global he... more This course advances understanding of the complex interplay of the social dimensions of global health from the perspective of medical anthropology. We will critically consider the theoretical and methodological question of how one approaches illness, healing, and medicine as an object of ethnographic study. Through lectures and readings, you will refine and enhance your understanding of the global assemblages that both produce and alleviate human suffering in order to develop insights about the field of medical anthropology and the methods of ethnography. PREREQUISITES You will get the most out of this course if you have a beginning level understanding of the anthropology of global health, preferably through courses such as ANTH265 and ANTH210. If you have never taken a global health or medical anthropology course before, you may need to spend a little more time actively engaging with class materials and discussions.

Research paper thumbnail of Advanced Studies in Global Health

This upper-level course will extend your understandings of the anthropology of global health, par... more This upper-level course will extend your understandings of the anthropology of global health, particularly the shifting health conditions facing global populations today and the science being made around them. You will critically examine key issues in global health, with an emphasis on the theories, concepts, and methods of anthropology. Readings will cover a range of anthropological approaches, health problems, and world regions and will encompass the cultural histories of key global institutions, material practices, and "magic bullet" technologies. The overall purpose of the course is to expand your critical understanding of the social, market, environmental, and biotechnological dimensions of health problems worldwide, as well as the political and ethical questions raised by how these are addressed on a global scale. We will focus on case studies, especially in the form of ethnographies, to examine these entangled issues in depth. PREREQUISITES You will get the most out of this course if you have a beginning level understanding of the anthropology of global health, preferably through courses such as ANTH265, ANTH210, and ANTH310. If you have never taken a global health or medical anthropology course before, you may need to spend a little more time actively engaging with class materials and discussions.

Research paper thumbnail of Critically Applied Medical Anthropology

This course provides an overview of critically applied medical anthropology – the examination of ... more This course provides an overview of critically applied medical anthropology – the examination of the social origins of vulnerability, the role of structures of power in its social reproduction, and critical praxis in responding to it. We will explore the major theoretical lenses within medical anthropology with a particular focus on how medical anthropologists theorize the relationship between culture, structural violence, and health. We will consider its position within the broader discipline, with a particular focus on debates over its applied dimensions and radical alternatives related to those dimensions. In this course, you will gain ways to utilize ethnographic, anthropological, and qualitative data in health-related fields including advocacy and organizing, program evaluation and needs assessments, and health care delivery. You will gain critical skills in evaluating the adequacy and validity of formulations about “culture” and “tradition” in health programs and research, examine emic perceptions of disease, and consider the ways in which western science and biomedicine are themselves cultural constructs. You will become familiar with a range of work on culture and health, domestically and internationally. You will acquire skills in utilizing data about culture and health at macro- and micro- levels.

Research paper thumbnail of Medical Anthropology

This course provides students with an introduction to the sub discipline of medical anthropology ... more This course provides students with an introduction to the sub discipline of medical anthropology through studies on the meaning and experience of health, illness, disease, suffering, disability, healing, and death. The aim of the course is to familiarize students with social methods in critical medical practice, as well as with the critique of power hierarchies within such practices that scholars have mounted from within anthropology and related disciplines. Course materials will consider research on illness and healing, risk and vulnerability, biomedicine, structural violence, death and dying, and health inequalities (among others). Through an examination of anthropological scholarship, students will be introduced to intersectional analyses of disease and healing as social processes that reveal social inequalities. Students will learn to engage in critical analysis of the relationship between social inequalities and medicine, systems of healing, and experiences of illness, disease, and death. Students will be able to identify and compare different views of disease and healing within social pluralities, human groups, and social classes. Students will also have the opportunity to reflect on scholarly work about health ideologies as tied to state formations and biopolitical strategies. Finally, the course takes into account ‘alternative’ health care systems and knowledges, as well as patient and clinician activist histories.

Research paper thumbnail of Africa in Global Context

ANSO103 Overview: This course is designed to introduce students to the diversity of peoples on th... more ANSO103 Overview: This course is designed to introduce students to the diversity of peoples on the continent of Africa and the ways that groups of people negotiate their identities and roles in the ever-shifting contexts of culture change and globalization. We will begin with a critical examination of the ways that Africa and African peoples have been and continue to be represented in the global North and discuss what those representations mean for our own understandings and assumptions. We will then spend the bulk of the term working to understand the complexity of contemporary issues facing African peoples. Through lectures, readings, discussions and analyses of the news, students will grapple with the historical, cultural and political-economic nature of specific contemporary issues. It is hoped that students will come away from this course with an appreciation for the richness and diversity of the continent, a critical analysis of the neoliberal political-economic structures governing national and international policy, and a heightened ability to sort through the versions of Africa which we encounter here, in Africa, or via other people's accounts.

Research paper thumbnail of States, Bodies, and Epidemics

ANSO320 Overview: This upper-level course will examine epidemic events as particularly instructiv... more ANSO320 Overview: This upper-level course will examine epidemic events as particularly instructive conjunctions of state formations, bodily regimes, and global medical governmentality. Students will become familiarized with major anthropological and sociological works on contagion and disease management. Particular attention will be paid to the ways in which epidemics threaten notions of national integrity or 'wholeness,' especially through the 21st century frame of 'national security'. Transnational flows and the movement of persons and things across national and regional contexts is highlighted by such insecurities, and this course will look at the racializing, gendered, and classed tropes that inform discourse on national security, migration, integrity, as well as both the real and perceived threats posed by emergent or potential outbreaks and epidemics. This course will provide students with the opportunity to reflect on the historical and philosophical genealogy of social and state responses to epidemics, the politicized representations (visual, written, media, etc.) of such epidemics and of state responses to epidemics, as well as familiarize students with key works in theories of the state, theories of the body and embodiment, and social analyses of communicable disease events through the framework of critical medical and political anthropology.

Research paper thumbnail of Medicine and Society

ANSO210 Overview: This course provides students with an introduction to the sub disciplines of me... more ANSO210 Overview: This course provides students with an introduction to the sub disciplines of medical anthropology and medical sociology through studies on the meaning of illness and health. The aim of the course is to familiarize students with social methods in critical medical practice; as well as with the critique of power hierarchies within such practices that scholars have mounted from within anthropology and sociology. Course materials will consider qualitative research on healing and illness. Students will be introduced to the intersectional analysis of disease and healing as social processes through the examination of anthropological and sociological knowledge about illness and health. Students will learn to engage in critical analysis of the relationship between society and medicine, systems of healing, and understandings of illness, disease, and death. Students will be able to identify and compare different views of disease and healing within social pluralities, human groups, and social classes. Students will also have the opportunity to reflect on scholarly work about health ideologies as tied to state formations and biopolitical strategies. Finally, the course takes into account 'alternative' health care systems and knowledges, as well as patient and clinician activist histories. This course has a prerequisite of ANSO 103 or CGHL 120. Course Objectives: • Students will develop a working knowledge of core anthropological and sociological terms, concepts, and major debates in the fields of medical anthropology and sociology. • Understand the importance and multiple spheres of cultural meaning that are part of the experience of illness and access to health, as well as the relationships between the individual, social groups, and institutions. • Analyze social inequality in institutional and structural (rather than solely interpersonal or individualized) terms and relate social inequities to medicine and health. • Develop a working understanding of the social scientific research process within the medical fields and enhance appreciation for the extent and significance of historical and contemporary worldwide cultural diversity with regards to notions of disease, illness, health, and healing.