Matthew Gutmann in his book Fixing Men: Sex, Birth Control, and AIDS in Mexico provides some startling facts on AIDS and describes how various forces play a part in its unheeded spread in the Oaxaca state of Mexico, and perhaps the world as a whole. Various forces in the form of cultural misperceptions, global institutions, the economic and political policies of Mexico, the lack of men’s participation in reproductive health, and the health behaviors of men play a part in the spread of this highly contagious and deadly disease. According to Gutmann (2007), these cultural misperceptions of Mexicans toward other Mexicans, the role of global institutions, as well as Mexico’s own political and economic policies, and the behavior of Mexican men allow the spread of AIDS to become a genocide engineered against the poverty stricken people of Mexico.
In the Oaxaca state of Mexico there is a cultural misperception that takes it for granted that men are sexual animals with very limited self control. In his meetings with doctors at a local health clinic, the medical professionals relate to Gutmann (2007) that migrant men acquire AIDS from their homosexual activity in the United States (p.3). When Gutmann (2007) questions one medical professional about this belief he is told, “that’s what Mexican men do: they have sex with other men” (p. 3). Gutmann (2007) also states that there is a “widespread belief that men have stronger sexual drives than women” which perhaps leads them to engage in more at risk behaviors which puts them in the position of acquiring HIV (p. 202). Gilmore (n.d) states in his study of machismo in Spain, that the three ideals of Spanish masculinity is “virility, valor, and virtue” (Brettell and Sargent, 2009, p. 198). While the valor and virtue of Spanish of masculinity may not be so clearly defined in Spanish culture, the urge to prove one’s virility is encouraged in Spanish culture by the stigmatization of a man being labeled a “flojo” or someone that is “flaccid”, “weak”, “soft”, or “who can’t get it up” (Brettell and Sargent, 2009, p. 199). Perhaps this cultural misperception of Mexican men being sexually out of control is actually a result of a culture that encourages men to be sexually proactive as a means of proving their masculinity?
Global institutions play an important role in the fight against AIDS in not only Mexico but the entire world. Gutmann (2007) states “the pharmaceutical companies, government health institutions, the Catholic church, and the planned parenthood federations” among other global “influences” effect the sexual and reproductive health practices made by the typical Mexican, whether this is known or not (p. 202). In the governments of the first world there have been measures put into place to “balance the need for social regulation of the population with the rights of parents and of individual women to control their own fertility” to deal with the epidemics of sexually transmitted diseases like syphilis and HIV (Weeks, Brettell and Sargent, 2009, p. 377). As our first world governments and global organizations are “more concerned with the threat of overpopulation in the Third World”, they create policies which are designed to limit negative sexual activity that encourages the spread of sexually transmitted diseases, especially in the homosexual sector where HIV shows its most prevalent growth (Brettell and Sargent, 2009, p. 378). As the source of much aid to the Third World, these global institutions export their polices to poorer countries to regulate the spread of AIDS by using their influence in shaping and developing sexual and reproductive policies of the countries that they give financial and material assistance to.
Mexican economics and politics play an important role in the spread of AIDS in Mexico. “In the 1970’s and 1980’s health care coverage” saw an increased trend which tried to expand and spread services more evenly throughout Mexico (Gutmann, 2007, p. 24). In the late 1990’s though this trend began to diminish and reverse as health care was “shifted away from public to private institutions” (Gutmann, 2007, p. 25). Gutmann (2007) states, “as a result of neoliberal economic reforms, health care spaces, like clinics and hospitals, that had been touted as public became increasingly inaccessible to those without the personal funds to pay for health services” (p. 25). In regards to AIDS and its treatment, Mexico, according to Gutmann (2007), “pays whatever the drug companies demand” rather than negotiating with pharmaceutical companies for lower cost medications that can be used to help the most people as possible (p. 46). This results in what Gutmann (2007) states is “only a fraction of people who need” AIDS medication “are able to receive them”, and that Mexicans are not made aware of existing AIDS clinics, nor encouraged to seek out AIDS testing (p. 48). The economic and political policies of Mexico play a major factor in the spread of AIDS in the Mexican population.
The cultural permission for Mexican men not to participate in reproductive health adds to the spread of AIDS in Mexico. Gutmann (2007) asks “how is culture inscribed on male bodies through beliefs and practices associated with their sexuality?” (p. 5). Before the invention of the birth control pill, Gutmann (2007) states, the only options that men had in preventing a woman’s pregnancy was “slipping on a condom prior to sexual intercourse or, more often, withdrawing from the woman prior to ejaculating: coitus interruptus” (p. 11). With the invention of the birth control pill men could now be free to “enjoy sex”, as well as women, without the fear of becoming trapped in a “chronic round of pregnancy and childbirth” (Gutmann, 2007, p. 11). The past few decades of advances in reproductive health have displaced men from reproductive health and focused primarily on the female due to what was seen as an “urgent need” to focus on woman’s biological and reproductive role as mother (Gutmann, 2007, p. 12). Gutmann (2007) states that for men “there was no parallel or complementary demand in men’s health” and in “government and nongovernmental institutions, men were in effect excluded from participation in many health and development programs” (p. 12). By officially omitting men from advances in reproductive health, men are further removed from practices that could hinder the spread of HIV and AIDS.
The health behavior of Mexican men contributes as an additional factor in the spread of HIV and AIDS. Since health care is often prohibitively expensive to the citizen of Mexico, men search out alternative means to modern health care. Gutmann (2007) speaks about Mexicans taking “Cocos a la Viagra” which are nothing more than “coconuts mixed with octopus and shrimp” to cure their erectile dysfunction (p. 194). Gutmann (2007) talks about citizens going to “boticarios” or community pharmacies that sell all kinds of concoctions for all kinds of illnesses, rather than pursuing modern and proven methods yet expensive treatments for their ailments (p. 174). Gutmann (2007) relates the experience of dirt poor migrant workers who live in such dismal and unsanitary conditions, conditions which often cause “chronic stomach pains and diarrhea” (p. 52). These men “sought to relieve these symptoms by injecting themselves with vitamins and antibiotics”, often times using syringes that were unsterilized and shared (Gutmann, 2007, p. 52). Due to the prohibitive cost of health care in Mexico, men are often forced to seek out alternative means to health problems, rather than modern medicine which could determine whether they are carriers of the HIV/AIDS virus.
In his book Fixing Men: Sex, Birth Control, and AIDS in Mexico, Matthew Gutmann provides some startling facts on AIDS and how cultural beliefs about sex and gender determine how AIDS is dealt with in Mexico, rather than from a true scientific exploration of the subject. Gutmann describes how the patriarchal hegemony is maintained in Mexico by the social constructionism in the form of global institutions that distance men from their sexual and reproductive health, while placing the responsibility for these concerns solely on women. Due to the need for cheap labor in the United States, Mexican men cross the border every day in search of work that they cannot find at home, enduring stresses and pressures that they naturally seek to relieve through the means they have available, but these men are somehow and in some way acquiring the HIV virus in the United States. And because it is believed that these men are homosexuals in a society that is homophobic, these migrant workers return to their country with a highly contagious disease for which they will likely spread before they themselves die a horrible death, solely for the sin of being poor in a world that needs their cheap labor to build other people’s wealth.
References
Gilmore, D.D. (2009). My Encounter with Machismo in Spain. In C.B. Brettell & C.F.
Sargent, (Eds.), Gender in Cross-Cultural Perspective 5th ed. (pp. 196-210).
Upper Saddle River, N.J: Pearson/Prentice Hall.
Gutmann, M. (2007) Fixing Men: Sex, Birth Control, and AIDS in Mexico. Berkeley and
Los Angeles, C.A: University of California Press.
Weeks, J. (2003). An Unfinished Revolution: Sexuality in the 20th Century. In LaFont, S.
(Ed). Constructing Sexualities: Readings in Sexuality, Gender, and Culture (pp. 376-386). Upper Saddle River, N.J: Prentice Hall.
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