Social movement organizing and the politics of emotion from HIV to Covid-19.

The Covid-19 pandemic has seen the rapid growth of collective organizing on the part of patient groups to address scientific and health inequities. This paper considers the emergence of Covid-19 activism as an embodied health movement that draws on and contributes to broader movements for racial, economic and gender justice. Recognizing the central role of emotion in social movements and in the bio-politics of Covid-19, I examine the key presence of the affective domain in social change through three Covid-19 social movement groups. These organizations draw upon anti-racist, feminist, and queer and HIV social movement organizing that position Covid movement building in intersectional histories and futures. I argue that Covid movement activists have built "archives of feeling"-or public cultures of trauma-of commemoration, Covid survivor narratives, and direct action that center affective feelings around grief, representation, and anger, respectively. I suggest that Covid-19 will become a key lens for articulating structural and social inequalities through which broader social movements will leverage their claims for justice-moving towards an integrated social movement. Social movement mobilizing will continue to play a critical role to ensure that the focus in the Covid-19 pandemic shifts from pathogen to society.

Structures of Sexuality: Sexual Stigma, Disclosure, and HIV Risk with Primary Female Partners Among Behaviorally Bisexual Black Men.

HIV continues to disproportionately impact bisexual Black men, as well as their female partners, in the U.S. There is a need to better understand how stigma and disclosure affect sexual risk for men and their female partners. This article describes the relationship between sexual stigma and HIV risk with primary female partners among a sample of 121 behaviorally bisexual Black men of mixed HIV status in the San Francisco Bay Area. Multivariate analyses tested to see if each of three stigma measures (bisexual stigma, internalized homophobia, difficulty with bisexual identity) would have any effect on participants' condom use. Quantitative analyses found that sexual stigma increased men's sexual risk through inhibiting disclosure of their sexual activity with men to their female partners. Men who reported higher levels of bisexual stigma and internalized homophobia reported that it was harder to disclose having sex with men to their primary female partner, which was significantly related to lower levels of condom use. Stigma reduction HIV prevention interventions are needed that address bisexual stigma experienced by Black men. HIV prevention interventions, including stigma reduction programs, must target both men and women to effectively reduce bisexual stigma and address the structural and relationship contexts of HIV.

Reframing masculinity: structural vulnerability and HIV among black men who have sex with men and women.

This paper calls for a critical reframing of masculinity as an intersectional construct in the HIV epidemic and in public health. In-depth qualitative interviews were conducted with a sample of 56 Black men who have sex with men and women in the San Francisco Bay Area. Men described their sexual identities and practices via complex narratives of masculinity that drew on subordinated and resourceful adaptations to the structural effects of racism, economic marginalisation and homophobia. By focusing on men whose experience of masculinity operates outside fixed identity categories, the paper draws attention to the intersectionality that is, by necessity, constitutive of men's lived experiences. Findings suggest the value of an integrative framework for understanding Black masculinities as processes and practices simultaneously informed by structural inequalities (racism, economic marginalisation and/or homophobia, in particular) and cultural meanings of gender. By utilising an intersectional approach, public health and sociology can better understand the concurrent resilience and vulnerability of masculinities, while building an interdisciplinary understanding of the symbolic role of Black masculinities in the USA, as well as a means by which to promote health and well-being in and through these gendered contexts.

Agents of change: peer mentorship as HIV prevention among HIV-positive injection drug users.

This paper presents a qualitative investigation of peer mentoring among HIV seropositive injection drug users in a randomized controlled trial, the INSPIRE study. Qualitative analyses of 68 in-depth open-ended interviews conducted in 2005 in Baltimore, New York, Miami, and San Francisco revealed that these individuals conceptualized themselves as change agents through the identity of peer mentor at the three related domains of individual, interpersonal, and community-level change. Implications for program development and future research of peer mentoring as a mechanism for HIV prevention are discussed. This study was funded by the Centers for Disease Control and Prevention and Health Resources and Services Administration (HRSA).

Dissecting the social body: social inequality through AIDS counter-narratives.

HIV/AIDS conspiracy theories constitute a loosely grouped set of meanings that share the notion of secret collusion among allied parties. This paper traces one woman's etiological narrative of HIV/AIDS. Such embodied experience and cultural understanding when placed against the backdrop of current thinking on the topic in the United States builds a new framework for understanding the emergence and circulation of HIV/AIDS conspiracy theories as "counter-narratives" employed by individuals and publics in the face of the AIDS pandemic. Such counter-narrative creates a rhetorical space for challenges to power through the articulation of oppositional ideas about dominant scientific knowledge. Without a critical exploration of HIV/AIDS conspiracy theories that examines their emergence and effects as a form of discourse circulating in the public domain, public health advocates will not be able to trace and respond to these narratives' impact on HIV prevention efforts or consider their relevance for other emerging infectious diseases.

Managing identity impacts associated with disclosure of HIV status: a qualitative investigation.

Disclosure of HIV status to potential and current sex partners by HIV-positive people (HIVPP) is a complex issue that has received a significant amount of attention. Research has found that disclosure depends upon the evaluation by HIVPP of potential benefits and risks, especially of the risks stemming from the profound social stigma of HIV and AIDS. Drawing on concepts from Goffman's classic stigma theory and Anderson's more recently developed cultural-identity theory of drug abuse, we analyzed data from in-depth, post-intervention qualitative interviews with 116 heterosexually active, HIV-positive injection drug users enrolled in a randomized trial of a behavioral intervention to prevent HIV transmission. We explored how disclosure experiences lead to "identity impacts" defined as: (1) identity challenges (i.e. interactions that challenge an individual's self-concept as a "normal" or non-deviant individual); and (2) identity transformations (i.e. processes whereby an individual comes to embrace a new identity and reject behaviors and values of an old one, resulting in the conscious adoption of a social and/or public identity as an HIV-positive individual). Participants engaged in several strategies to manage the identity impacts associated with disclosure. Implications of these findings for research and prevention programming are discussed.

Acceptability of A-CASI by HIV-positive IDUs in a multisite, randomized, controlled trial of behavioral intervention (INSPIRE).

Audio computer-assisted self-interviewing (A-CASI) is now widely used to gather information from many types of research participants, including injection drug users (IDUs). The purpose of this study was to describe how HIV-positive IDUs participating in an intervention trial viewed A-CASI and to identify the characteristics of participants who held unfavorable attitudes toward A-CASI. Using a sample of participants who completed 12-month assessments (n=821), we found that most (>80%) of the sample held favorable or neutral attitudes toward A-CASI. Approximately 18% said that they would prefer an interview with a person to a computer, 12% said that they did not understand the questions they heard on the computer, and 14% said that the computer made it hard to be open and honest about risk behavior. Multivariate analyses found that participants who were more socially marginalized (with unstable housing and lower sense of empowerment) and had greater physical limitations and lower CD4 cell counts were consistently more likely to report various negative A-CASI attitudes; however, some outcome-specific findings were also noted. Our research supports the feasibility and general acceptability of A-CASI with HIV-positive IDUs, and it suggests further research exploring the associations between A-CASI attitudes and characteristics of disadvantaged populations.

Participants' descriptions of social support within a multisite intervention for HIV-seropositive injection drug users (INSPIRE).

HIV-positive injection drug users (IDUs) are at risk for transmitting HIV to their sex and injection partners, and compared with non-IDUs, they have poorer access to medical care and adherence to antiretroviral therapies. Social support has been linked with decreased injection and sexual risk behaviors and slower disease progression. In this qualitative process evaluation, we explored emotional support (ie, caring, empathy), informational support (ie, information, guidance, feedback), and appraisal support (ie, information for self-evaluation or understanding) received by participants in the Interventions for Seropositive Injectors-Research and Evaluation (INSPIRE) project, a multisite secondary prevention intervention for HIV-positive IDUs. Participants in the intervention and control conditions (N=40) described similar experiences in terms of type, source, and perceived benefits of social support received from the program. Emotional support was received from program staff, other participants, and elements of the intervention. Participants also mentioned social support received from the INSPIRE project in relation to changes they had made in their lives during and after their involvement in the intervention, such as changes in their drug use, sexual practices, and health care utilization.