Enacting and imagining gay men: the looping effects of behavioural HIV surveillance in Australia

Abstract

The response to HIV in many countries is informed by routine behavioural surveillance of affected populations, yet the impact of this surveillance is rarely considered. In Australia, the Gay Community Periodic Surveys (GCPS) recruit 8000 men each year, surveying sexual practices, drug use and health service utilisation, in line with international guidelines. Using actor–network theory and Ian Hacking’s concept of ‘looping effects’, this article considers how knowledge of gay men is produced by behavioural surveillance, the interdependencies between the surveillance network and its subjects, and the potential for unintended consequences as a result of the mass participation of gay men in the surveillance network. The case of the GCPS is used to show how behavioural surveillance relies on a large, complex assemblage of human and non-human actors, with an emphasis on standardisation and repetition to make its practices durable. The distance of surveillance from gay men’s practices means that the network relies on an imaginary of gay men to create survey tools and to interpret data. This imaginary may be communicated to gay men during their participation in the surveillance, particularly when they are engaging with the surveillance questionnaire. This has the potential to affect their subjectivity and the practices the surveys seek to monitor. Considering the implications of this analysis, it is argued that HIV prevention could be improved if we consider how behavioural surveillance produces knowledge of gay men and the ways in which gay men affect and are affected by surveillance.

Keywords:

• behavioural surveillance
• gay men
• imaginary
• HIV
• looping effects

Acknowledgements

Thanks to the thousands of gay men who participate in the Gay Community Periodic Surveys every year, the AIDS Councils who make recruitment possible, my fellow chief investigators and the health departments who fund the surveys. Asha Persson and two anonymous reviewers provided helpful comments on earlier versions of this article. The National Centre in HIV Social Research is funded by the Australian Government Department of Health and Ageing.