HIV Exceptionalism

Development through Disease in Sierra Leone

2015
Author:

Adia Benton

Rachel Carson Prize, Society for the Social Studies of Science

 

Have HIV/AIDS-focused development programs ignored wider health crises in Africa?

In 2002, Sierra Leone emerged from a decade long civil war. Seeking international attention and development aid, its government faced a dilemma. Though devastated by conflict, Sierra Leone had a low prevalence of HIV. However, like most African countries, it stood to benefit from a large influx of foreign funds specifically targeted at HIV/AIDS prevention and care. In HIV Exceptionalism Adia Benton chronicles how Sierra Leone reoriented itself as a country suffering from HIV at the expense of other, more pressing health concerns. 

 

"A keenly observed case study." —Foreign Affairs

In 2002, Sierra Leone emerged from a decade long civil war. Seeking international attention and development aid, its government faced a dilemma. Though devastated by conflict, Sierra Leone had a low prevalence of HIV. However, like most African countries, it stood to benefit from a large influx of foreign funds specifically targeted at HIV/AIDS prevention and care.

What Adia Benton chronicles in this ethnographically rich and often moving book is how one war-ravaged nation reoriented itself as a country suffering from HIV at the expense of other, more pressing health concerns. During her fieldwork in the capital, Freetown, thirty NGOs administered internationally funded programs that included HIV/AIDS prevention and care. Benton probes why HIV exceptionalism—the idea that HIV is an exceptional disease requiring an exceptional response—continues to guide approaches to the epidemic worldwide and especially in Africa, even in low-prevalence settings.

In the fourth decade since the emergence of HIV/AIDS, many today question whether the effort and money spent on this health crisis has helped or exacerbated the problem. HIV Exceptionalism reveals the unanticipated consequences of HIV/AIDS development programs.

Awards

Winner, 2017 Rachel Carson Prize, Society for the Social Studies of Science

Adia Benton is assistant professor of anthropology at Brown University.

A keenly observed case study.

Foreign Affairs

HIV Exceptionalism will be a fine addition to both institutional and personal libraries, offering insights for global health and development scholars, and particularly for HIV/AIDS researchers.

African Studies Review

Through fine-grained accounts describing how individuals navigated new structures, new relationships, and new expectations that came along with being beneficiaries of global HIV funding, Benton reveals that jagged edges and uncomfortable truths about broader global-local health encounters. This book tells a compelling story about an entire society adapting to a sudden infusion of donor money for a disease that, in this particular context, barely existed.

Anthropological Quarterly

Benton recovers numerous silences and opens a conversation foregrounding the unarticulated moral epistemologies people struggle with.

Journal of African History

Benton adeptly dissects the psychological and practical effects of the well-meaning but often overbearing world of development. HIV Exceptionalism is strongly argued and impressively researched.

The Lancet

This book serves as a critical call to those in the public health field to be wary of health programming that so imbalances comprehensive healthcare services in an effort to target a health problem that is perceived as exceptional, emergent and urgent.

Medical Anthropology Quarterly

Contents

Preface
Introduction: HIV Exceptionalism in Sierra Leone: Christiana’s Story
Part I. The Exceptional Life of HIV in Sierra Leone
1. The HIV Industry in Postwar Sierra Leone
2. Exceptional Life, Exceptional Suffering: Enumerating HIV’s Truths
Part II. Becoming HIV-Positive
3. The Imperative to Talk: Disclosure and Its Preoccupations
4. Positive Living: Hierarchies of Visibility, Vulnerability, and Self-Reliance
Part III. HIV and Governance
5. For Love of Country: Model Citizens, Good Governance, and the Nationalization of HIV
Conclusion: The Future of HIV Exceptionalism
Acknowledgments
Notes
Bibliography
Index