‘I am a culprit’: neoliberal public health discourses versus social risks for HIV within marriages in Kenya

ABSTRACT

Rates of HIV within marriages in Kenya remain high. While critical public health scholars have argued that socio-structural contexts shape HIV vulnerability, public health emphasizes neoliberal health management approaches that prioritize individual responsibility to avoid HIV risks. This article examines Kenya’s marital fidelity campaign as a manifestation of neoliberal health governance techniques. It considers the sexual morality of the campaign including how the campaign frames extramarital risks and gender relations in marriage. Further, using ethnographic data from a cash-cropping community in rural Kenya, the article examines how participants’ conceptions of marriage as a gendered site shape their everyday moral/rational reasoning that challenges public health’s neoliberal logic of risk and responsibility. Participants deploy the social risk concept to show how they engage in reasoning that is informed by their social and material context. The article argues that public health should consider how the gendered social organization of marriages within specific political-economic contexts shapes HIV vulnerabilities as an alternative to neoliberal governmentality.

KEYWORDS:

• HIV
• gender
• extramarital sex
• public health
• neoliberalism
• governmentality
• social risk

Disclosure statement

No potential conflict of interest was reported by the author(s).