Viral Frictions

Global Health and the Persistence of HIV Stigma in Kenya

EL I ZABETH J. PFE I FFER

“Through engaging storytelling and careful analysis, Viral Frictions examines the persistence of stigma surrounding AIDS in Kenya. Tracing the intersection of multiple axes of inequality and illuminating the complicity of global actors, Elizabeth Pfeiffer provides a new and insightful perspective on an enduring problem. Further, her rich ethnography takes a Rift Valley ‘truck stop’—stereotypically reduced to a risk site—and reveals a vibrant community.”

—Daniel Jordan Smith, author of AIDS Doesn’t Show Its Face: Inequality, Morality, and Social Change in Nigeria

“An exquisite ethnography of the complex social frictions arising from decades of HIV interventions, and more recent efforts to ‘end AIDS,’ in Kenya. Deftly interweaving history, theory, and ethnographic stories, Viral Frictions offers a humane and carefully wrought reminder that HIV stigma persists in social relations even as the virus becomes increasingly ‘undetectable’ in bodies due to biomedical treatment.”

—Nora Kenworthy, author of Mistreated: The Political Consequences of the Fight Against AIDS in Lesotho

Viral Frictions takes the reader along a trail of intersecting narratives to uncover how and why it is that HIV-related stigma persists in the age of treatment. Pfeiffer convincingly argues that stigma is a socially constructed process co-produced at the nexus of local, national, and global relationships and storytelling about and practices associated with HIV. Based on a decade of eldwork in one highway trading center in Kenya, Viral Frictions offers compelling stories of stigma and discrimination as a lens for understanding broader social processes, the complexities of globalization and health, and their profound impact on the everyday social lives and relationships of people living through the ongoing HIV epidemic in sub-Saharan Africa. This highly engaging book is ideal reading for those interested in teaching and learning about intersectionality, as Pfeiffer meticulously demonstrates how HIV stigma interacts with issues of treatment, race, ethnicity, class, gender, sexuality, social change, and international aid systems.

ELIZABETH J. PFEIFFER is an assistant professor of anthropology at Rhode Island College in Providence.

Medical Anthropology

Viral Frictions

Global Health and the Persistence of HIV Stigma in Kenya

Elizabeth J. Pfei er

Table of Contents

Acronyms and Abbreviations

List of Figures

Series Foreword by Lenore Manderson

Preface

Introduction

Chapter 1 Uneven Anthropological and Epidemiological Stories in Historical HIV Context

Chapter 2 HIV and Legacies of Racism, Political Violence, and Ethnic Con ict

Chapter 3 Stigma and the Cultural Politics of Uncertainty

Chapter 4 Economic Inequalities, Social Change, and the Politics of Gender and Sexuality

Chapter 5 (Re)Imagining Stigma at the Intersection of HIV and Mental Health Statuses

Chapter 6 HIV and the (Re)Making of Moral Personhood

Conclusion

Acknowledgments

References Index

May 2022

Health and Medicine • Anthropology