The Aids Pandemic in Latin America

In the last 20 years the growing literature about AIDS in contemporary world history has taken three main forms: as an exercise in re-creating the past for its own sake, indicating how complex are the relations among disease, history, and society; as policy analysis aiming at informing the present with the past; and as narratives aiming at influencing future public health policy. The AIDS Pandemic in Latin America has a little bit of all these and is an important contribution to the quite scarce literature on this current epidemic in the region, especially when compared with the abundance of similar studies for other areas of the world. Shawn Smallman strives to explain how local developments of the AIDS epidemic have been primarily shaped by international factors and issues that marked Latin American politics during the last third of the twentieth century. He focuses his attention on globalization trends, U.S. political intervention, international migrations, war, and the international drug trade. Chapters deal with Brazil and groups of countries — the Caribbean, Mexico and Central America, and Spanish South America — where Smallman tries to prove the key influence of some of these international factors in the making of the local responses to the AIDS epidemic.In the case of Haiti, for example, Smallman discusses the long-held U.S. stereotype that marked the Caribbean island as the possible origin of the AIDS epidemic, the epidemic’s influence in declining tourism, increasing discrimination toward Haitian immigrants in the United States, and the belief in Haiti that the United States created the disease to maintain its power and exterminate the poor. Cuba’s initial policies against AIDS — aggressive cleansing of the blood supply, massive HIV testing, and strict quarantine of HIV-positive individuals — are seen as the Cuban revolutionary state’s attempts to demonstrate the superiority of its public health system over that of the United States, which was much wealthier but less effective. In Brazil, the emphasis is on making anti-retroviral medications universally accessible, a process that entailed both resisting transnational pharmaceutical business pressures and efficiently using the support of state agencies, a local and international network of NGOs, and World Bank financial assistance. In Mexico, Smallman centers his attention on male migrants who spend long and lonely periods doing rural work in the United States, practicing unsafe sex and spreading the disease once back with their families in their hometowns and villages. In Central America, warfare is his main explanation. Thus the alarming statistics of HIV-positive young heterosexuals in Honduras is discussed as a result of the presence of U.S. troops, while in Nicaragua, by contrast, the isolating effects of the Contra War on Nicaraguan society may have significantly limited the impact of the AIDS epidemic.Many of these explanations could be very controversial, especially because local/national factors seem to be somewhat devaluated in comparison to the strong role Small-man gives to the international factors. Combining both is not an easy task. It demands focusing special attention on a very complex locus where the peculiarities of the AIDS crisis could be better explained in each national case. This is something that the book achieves for Brazil and much less so for the Andean region, Cuba, or Honduras. The local level does emerge with all its richness when the author introduces people’s accounts, be they the voices of members of NGOs or governments, activists, or patients. The presentation of the experiences of some of the sick — particularly Brazilian crack addicts, Mexican transgendered prostitutes, and Cuban rockers who intentionally injected themselves with the virus — is particularly eloquent.The book’s introduction offers a sweeping survey of the region, suggesting, on the one hand, the existence of a mosaic of AIDS infections in Latin America and, on the other, a certain Latin American “cultural unity.” However, the case-specific chapters that follow seem to invite the reader to dismiss or at least to accept with enormous caution such ideas of regional cultural unity.With a very engaging narrative that combines personal accounts, anecdotes, statistics, and official and unofficial reports, Smallman’s book is one of the few studies available that deal with the region as a whole. It also articulates a compelling question: why, with the exception of Haiti, Guyana, and perhaps Honduras, has HIV spread so little in Latin America, despite its pervasive poverty, gender inequality, intravenous drug use, hidden male homosexuality, extensive sex trade, and limited public health care?The AIDS Pandemic in Latin America will appeal not only to a broad audience but also to scholars working in the history of AIDS as epidemic, as well as professionals, activists, and policy makers who are dealing with AIDS as history

Coronavirus disease 2019 (COVID-19) · Development economics · Disease · Economic growth · Ethnology · Geography · Globalization · Immigration · Infectious disease (medical specialty) · Latin Americans · Pandemic · Political science · Politics · History · HIV/AIDS Impact and Responses · Law · Medicine