'Rugged Vaginas' and 'Vulnerable Rectums': The Sexual Identity, Epidemiology, and Law of the Global HIV Epidemic

Abstract

AIDS remains amongst the leading causes of death globally. Identity is the primary mode of understanding HIV and organizing in response to the HIV epidemic. In this article, I examine how epidemiology and human rights activism co-produce ideas of identity and risk. I call this the “identity/risk narrative”: the commonsense understanding about an identity group’s HIV risk. For example, epidemiology offers the biological narrative of risk: anal sex and the weak rectal lining make men who have sex with men more vulnerable to HIV; while the fragility of a woman’s vaginal wall provides a biological foundation for women’s vulnerability. These biological narratives underpin rights-claiming in international human rights institutions: many women’s rights activists and gay rights activists rely on these biological ideas of risk to define their groups and demand legal and policy change. The corresponding legal projects emanate from identity driven projects.

While acknowledging identity’s potential as an organizational force, this Article argues that we must critically interrogate our reliance on identity politics in building movements to respond to the HIV epidemic. Through telling the history of gender organizing in the context of the international HIV epidemic and international human rights law, this article encourages HIV-movement lawyers and activists to remain vigilant about the downsides of identity politics so that we can remain responsive to the most marginalized communities. In other words, we must be attuned to the downsides of identity politics, even as it may feel like a necessary mode of activist engagement, in order to protect people and issues that are left out of identity-based movements and strengthen the response to HIV and AIDS.

I conclude this article by offering strategies to minimize the downsides of identity-based legal advocacy through shifting the mode of legal advocacy around HIV. By remaining vigilant about destabilizing identity, taking a consequentialist approach, and remaining focused on the background rules, advocacy can remain agile and responsive to the impact of HIV.