Modernizing Sexuality

Modernizing Sexuality illustrates how Western idealizations of normative sexuality and the power of modernity come together in U.S. HIV prevention policy in Sub-Saharan Africa. The results are calls for women's "right to say no " to sex and the promotion of "love matches " as the remedy to the "traditional cultural practices " said to put people at risk for HIV. Using the country of Malawi as a case study, Anne W. Esacove draws on narrative theory and arich set of interview, archival, and ethnographic data to expose the unacknowledged - yet widespread and well-funded - moderniziation project at the heart of U.S. policy, and to argue that these efforts not only fail to translate into actionable steps for preventing HIV in the widespread, generalized epidemicsin Sub-Saharan Africa, but actually exacerbate HIV risk, particularly for women.Moving beyond U.S. policy, Modernizing Sexuality also examines how people targeted by prevention efforts create everyday understandings of HIV risk and prevention. Deploying gossip, information gleaned, and strategically adapted from prevention efforts, and the assumption that sex is essential to life, Malawians tend to sort potential sexual partners into "tiers of desirability, " each with a corresponding HIV-prevention strategy. By illuminating the collective solutions and multiplepaths of prevention used by Malawians, the analysis exposes fundamental flaws of U.S. HIV prevention policy and provides direction for potentially more effective strategies.Stepping outside of the normal theoretical and methodological boundaries of HIV scholarship, Esacove raises important questions about lure of the story told through prevention policy, the risks of medicalizing social justice advocacy, and the limits of feminist and sexuality theories for directing prevention efforts, particularly cases when they mirror U.S. policy by erasing corporeal bodies and actual sex acts. Modernizing Sexuality closes with a fascinating alternative narrative toguide HIV prevention that reimagines risk and provides one alternative path for organizing policy efforts.

"Esacove has amassed a treasure trove of data from international and domestic policy discussions to local conversations, turning Modernizing Sexuality into an immensely stimulating book." --Joanna Watkins, Senior Public Sector Specialist, The World Bank"This is an outstanding contribution to the social science of sexuality and a piercing analysis of moralism hidden in global health work." --Jennifer Hirsch, Professor and Deputy Chair for Doctoral Studies, Department of Sociomedical Sciences, Columbia University"This extraordinary book offers a compelling critique of U.S. policy to tackle HIV in Africa. It highlights an intensely moralistic agenda in efforts to modernize sexuality through outsider led but locally delivered forms of bureaucratic control. A real eye-opener on what has happened in recent years and why such efforts are doomed to fail. --Peter Aggleton, Scientia Professor, Centre for Social Research in Health, UNSW Australia"Esacove's book reveals how interpretations of gender, external and internal discourses of modernity, and discord between risk perception and prescriptive solution combine to fundamentally challenge the efficacy of public health interventions designed to stem the spread of HIV." --Rachel Sullivan Robinson, Associate Professor, Department of Sociology, American University"Overall, perhaps the lasting and most important contribution of Esacove's work is to illustrate the power of stories to direct billions of U.S. dollars to determine what interventions are carried out, and ultimately whether those interventions are set up for success or failure. This book's significance and innovation earn it a place on the bookshelves of scholars of HIV/AIDS, gender, health policy, African studies, and culture." --American Journal of Sociology

Anne W. Esacove, Associate Director of the Alice Paul Center for Research on Gender, Sexuality, and Women at the University of Pennsylvania, is motivated by questions that arose during her public health training and years of working to promote sexual and reproductive health. In addition to U.S. global HIV-prevention policy, her research has challenged intentionality-based behavioral models of sexual decision-making, explicated the social movementframing and counterframing of "partial-birth" abortion, and explored the circumstances that lead women to use emergency contraception. Her current research examines the burgeoning natural death movement in the United States.