Precarity and the HIV/AIDS pandemic in the Caribbean: Structural stigma, constitutionality, legality in development practice

ABSTRACT

The social stigma of sexual immorality is inscripted in constitutions, laws, and statutes in the Caribbean and justified and legitimated through references to Christian doxa. This induces forms of structural stigma through policies and practices of governance. I employ country comparisons to demonstrate the critical effect on rates of HIV/AIDS of structural stigma induced by these inscriptions in Caribbean countries. By comparing rates of HIV/AIDS across selected countries, I analyse the differing patterns of structural stigma against the latter’s relationship with structural vulnerabilities associated with poverty, underdevelopment, government incapacities, and population flows. I conclude that significant reductions in rates of prevalence can be achieved when social stigma is minimised or meliorated through effective government action or through the influence of external actors, even in the presence of other forms of structural vulnerabilities. The intensity of population flows into a country can also act independently to increase rates of prevalence, even in the face of reductions in structural stigma related to sexual immorality.

KEYWORDS:

• Documentary practice
• stigma
• precarity
• poverty

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1 In 2017, for example, 289 West Indian pastors wrote a letter of ‘grave concern’ to President Donald Trump, protesting what they saw as policies of the United States to coerce their countries ‘into accepting a mistaken version of marriage’ in their ‘promotion of same sex marriage’ and of ‘LGBT and intersex rights’ (Washington Blade, 2017).

2 For a discussion of this relationship among colonialism, religion, social stigma and HIV/AIDS in the Caribbean see (Varas-Diaz et al., 2010).

3 I use structural vulnerability following Quesada et al. (2011, p. 340) who define it

as a positionality that imposes physical and emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of class-based economic exploitation and cultural, gender/sexual, and racialized discrimination, as well as complementary processes of depreciated subjectivity formation.

4 By ‘instrument effects’ I mean the far-reaching effects of institutional or bureaucratic practice for communities. These effects relate to the ‘documentary bases’ that inform the practice of ordering and directing relations among groups (see Escobar (2012, pp. 107–109) discussing Smith (1984)).

5 see, for example the Schedule of the Saint Vincent and the Grenadines Constitution (The Government of Saint Vincent and the Grenadines, 1979).

6 A working group organized by ARC International (ARC International, 2011), in representations to the government of St. Vincent and the Grenadines in an effort ‘to address discrimination based on sexual discrimination and gender identity’, identified these two sections of the Criminal Code as particularly egregious for its effects on stigmatization. The report, in calling for the repeal of both, also pointed out that ‘prosecution of public indecency is not limited to homosexual acts but also relates to heterosexual acts between consenting adults’.

7 Authors of a study of HIV in Puerto Rico (Varas-Diaz et al., 2010) made a connection between religious derived stigma and HIV infection, particularly ‘homosexual men’ rendered vulnerable through their violation of the heteronormativity inscribed by religion into the sexual practice of the nuclear family.

8 All subsequent references to prevalence rates refer to adults between 15 and 49.

9 Subordinated locations, cultural depreciation, and legal persecution have been linked by Queseda et al. (Quesada et al., 2011) to intensified precarity in their study of Latino migrant laborers in the U.S.

10 By exception I refer to choices and orientations among regimes and governing institutions to ‘give value or deny value’ to identified categories of people whose members are, as a result, either denied access to rights and protection or are exempted from constitutional and legal prescriptions. This is taken primarily from Aihwa Ong’s work on neoliberalism. Specifically, it refers to the practice of governing authorities to deny segments of the population access to the rights and benefits that they deserve as citizens. It also refers to the exemption of the powerful and privilege from legality and the rule of law (Ong, 2006). In this case, they are also exempted from the negative consequences of stigmatized behaviour and from its punishments, formal or informal, legal or otherwise.

11 The vulnerability of Bahamainian workers relate to their subordinate location in the global economy and cultural subordination as objects of exoticitized desire. Similar forms of vulnerabilities to ill health were noted by Quesada et al. (2011) among Latino immigrants to the United States linked to their subordinate position and by documentary practices of illegality.

12 See Baptiste (2014) for the strategies and influence of the evangelical Christian right on homophobic policies adopted by African governments.

13 The figures for Cuba and Haiti are taken from United Nations Development Programme (2016, pp. 248–251).

14 See, for example (Albo, 2018; World Health Organization, 2016).