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Eating Spring Rice

University of California Press

Contents

List of Illustrations..............................................................ixList of Tables.....................................................................xiAcknowledgments....................................................................xiiiNotes on Transliteration...........................................................xixIntroduction The Cultural Politics of AIDS in Postreform China.....................1PART ONE Narratives of the State1. The Aesthetics of Statistics....................................................372. Everyday AIDS Practices: Risky Bodies and Contested Borders.....................75PART TWO Narratives of Jinghong, Sipsongpanna3. Sex Tourism and Performing Ethnicity in Jinghong................................1054. Eating Spring Rice: Transactional Sex in a Beauty Salon.........................1285. A Sexual Hydraulic: Commercial "Sex Workers" and Condoms........................1506. Moral Economies of Sexuality....................................................169Epilogue What Is to Be Done?.......................................................193Notes..............................................................................209References.........................................................................231Index..............................................................................257

Introduction

PATTERN THREE: THE "NEW" ASIAN EPIDEMICS

Despite "the fact that AIDS had appeared simultaneously in disparate cultures and apparently unconnected places around the globe," by the late 1980s, the World Health Organization had carved up the world based on epidemiologic maps of HIV/AIDS (Patton 2002: xi-xii). The pattern of incidence associated with North America and Europe, where cases were concentrated among homosexual men and injection drug users, was called Pattern One. This was followed by African cases, which were initially found among heterosexuals who were noninjection drug users, and labeled Pattern Two. The World Health Organization now warns that Asian AIDS will be the next large epicenter for the pandemic. Epidemiological risk group categories of homosexuals, drug addicts, or heterosexual "sex workers" defined Patterns One and Two, but geography and time define Pattern Three. In moving beyond the narrow nomenclatures that "pattern thinking" leaves us with, the public health world has been slow to explore new infections that lie in countries such as China, places outside the purview of the predominant focus on AIDS in Africa and North America. Yet Asian AIDS cases, predominantly driven by HIV in India, China, Thailand, Cambodia, and Vietnam, are placing Asia firmly on these global maps of disease.

Cindy Patton (2002) notes that pattern thinking emerged out of the Global Program on AIDS (GPA) and its early divisions of the world into six different administrative regions. Within these divisions, developing countries in Asia were strangely aligned with Japan and Australia. The World Health Organization's (WHO's) official story read: "Researchers believe that the virus was present in isolated population groups years before the epidemic began. Then the situation changed: people moved more often and traveled more; they settled in big cities; and lifestyles changed, including patterns of sexual behavior. It became easier for HIV to spread, through sexual intercourse and contaminated blood. As the virus spread, the isolated disease already existing became a new epidemic" (WHO 1989 in Patton 2002: 6061). As Patton so eloquently points out, this common tale meant there was a tension between the actual disease and its translocation. Confusing time and geography, it is a tale about a virus and a description of the particular bodies that might transmit it.

China is facing a revolution in massive population migration from its rural enclaves to its cosmopolitan centers. A mobile force of some 140 million people, roughly 10 percent of the population, migrate both within and across provinces from county towns to large cities such as Chengdu, Beijing, and Shanghai. This mobility has been both theoretically and empirically associated with a rise in urban poverty and crime, risky behaviors, epidemics in drug use and sexually transmitted infections, and now, HIV/AIDS. This book describes how diseases map onto certain places and people more readily than onto others and how HIV/AIDS becomes embedded in political and economic relations, embodied practices, and cultural imaginations. As a disease of postmodernity, HIV/AIDS becomes culturally inhabited at each site where it appears on the map. How representatives of the Chinese state first responded to the epidemic points toward what is particularly unique about the Chinese approach to infectious diseases and what is also shared globally and transnationally.

Yunnan Province was ground zero of the epidemic, where heroin users were first identified as infected in the late 1980s and early 1990s. However-and this is key to the China story-any analysis complicates the singular idea that it was only translocal bodies, and not also government neglect or state-condoned unsafe blood-banking practices, that dispersed Chinese HIV. Therefore, as a quiet and very deadly epidemic was emerging in Henan in the late 1980s and early 1990s in villages where officials were complicit in using local poor peasants as economic canon fodder in blood and plasma collection schemes, the epidemiological emphasis was still on the counties in rural minority Yunnan (Zhang Feng 2004; Chan 2001). Since the first AIDS case was reported in 1985, China has moved into second place for the fastest-growing epidemic in Asia, behind India, and had declared close to one million infections by the end of 2004 (Bloom et al. 2004; Micollier 2004a; Hunter 2005). In contrast, health experts estimate that at least one million poor farmers were infected in these "botched" blood-selling schemes in central China (Reuters 2005).

REMAPPING, RECONFIGURING, AND RETHINKING THE STUDY OF EPIDEMICS

One of the major goals of this book is to approach HIV/AIDS less in terms of a study of a bounded minority prefecture and more in terms of the circulation and movement of conceptualizations of the disease across various boundaries, boundaries that require different kinds of anthropological thinking and methods. This work is not a definitive ethnographic account of the nascent HIV/AIDS epidemic in Yunnan Province, but an investigation into what I call everyday AIDS practices. It begins in the early days of the Chinese epidemic before it was seen as a major public health problem. In the mid-1990s, HIV/AIDS in China was considered a minority problem; minority prefectures in Yunnan revealed the highest number of cases. However, beyond the racial dichotomy of white and nonwhite bodies-or in much of the world, white and black bodies-comes the more nuanced and regionally rooted issue of Han and non-Han bodies. Such ethnic distinctions differentiate an anthropology of epidemiology from cultural studies of disease, straight epidemiology, or a political economy of health. Toward these ends, my lines of inquiry throughout this book demonstrate that understanding transmission of HIV/AIDS requires attention simultaneously to the rise of science and public health...