title: Reassembling epidemiology: mapping, monitoring and making-up people in the context of HIV prevention in India.
abstract: This paper explores how the Gates-funded HIV Initiative in India, known as Avahan, produces sociality. Drawing upon ethnographic research conducted between 2006 and 2012, we illustrate how epidemiological surveillance procedures, undergirded by contemporary managerial and entrepreneurial logics, entwine with and become transformed by the everyday practices of men who have sex with men (many of whom sell sex). The coevolution of epidemiology and sociality, with respect to these communities, is explored in relation to: 1) how individual identities are reproduced in association with standardized units of space and time; 2) how knowledge of mapping and enumeration data is employed in the making up of group membership boundaries, revealing how collective interests come to cohere around the project of epidemic prevention; and 3) how knowledge of epidemiological surveillance and procedures provides a basis on which groups collectively realize and execute local security strategies. While monitoring and evaluation (M&E) specialists continually track and standardize the identities, behaviours and social spaces of local populations (through various mapping, typologization and random sampling procedures, which treat space and time as predictable variables), community members simultaneously retranslate and reroute these standardizing processes into "the local" through everyday spatial management practices for health protection. These grounded epidemiologies, we argue, point to vital sites in the co-creation of scientific knowledge-where the quotidian practices of sex workers reassemble epidemiology, continually altering the very objects that surveillance experts are tracking. We further argue that attention to these re-workings can help us unravel the tremendous successes that have been claimed under Avahan in terms of HIV infections averted.
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Canada. Electronic address: lorway@cc.umanitoba.ca.
authors.forename: Robert
authors.initials: R
authors.lastname: Lorway
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Canada; Department of Communication, College of Liberal and Fine Arts, University of Texas at San Antonio, United States.
authors.forename: Shamshad
authors.initials: S
authors.lastname: Khan
mesh_terms: D062665:Epidemiological Monitoring; D062305:Geographic Mapping; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D060386:Sex Workers
keywords: Avahan; Bill & Melinda Gates Foundation; Ethnography; Global health; HIV prevention; India