From Blood to Sex: The Impact of Global AIDS Initiatives on Community Organizations in China, 2005-2010

This article examines the ambiguous impact of global AIDS initiatives on local community participation in AIDS intervention by using China as a case. Specifically it focuses on three groups of grassroots organizations working respectively with female sex workers, male gays, and peasants infected through contaminated blood to analyze two questions: how global AIDS initiatives have shaped the goals, strategies, and organizational forms of local community organizations; and how this process has mobilized and demobilized various constituencies along lines of class, gender, and sexuality.

This project utilizes the institutional ethnography method that combines archival research, participant observation, and in-depth interviews. The 1.5-year fieldwork involved global health initiatives especially the Global Fund, Chinese health officials, and grassroots organizations in four provinces.

As revealed by the data, China's grassroots AIDS organizations mostly originated in poor rural areas and were comprised primarily of peasants living with HIV/AIDS. Far from developing autonomously, grassroots organizations were significantly influenced and supported by international advocacy networks. Indeed, this project finds that international engagement transformed the community participation's very configuration and constitution. The leadership of the grassroots organizations shifted from peasants to the gay male community in urban areas. Along the way, other incipient groups– those attempting to organize commercial sex workers for example – were also displaced.

The development of global health governance has opened up participation to a wide range of non-state actors. This project calls attention to whether, how, and with what consequences changes in governing architecture reproduce the inequality of access to global HIV/AIDS initiatives.