University of Denver Digital Commons @ DU Electronic Theses and Dissertations Graduate Studies 1-1-2019 Dominating the Disease: A Transnational Feminist Perspective of U.S. Health Coloniality Jessica Ann Johnson University of Denver Follow this and additional works at: https://digitalcommons.du.edu/etd Part of the Critical and Cultural Studies Commons Recommended Citation Johnson, Jessica Ann, "Dominating the Disease: A Transnational Feminist Perspective of U.S. Health Coloniality" (2019). Electronic Theses and Dissertations. 1586. https://digitalcommons.du.edu/etd/1586 This Dissertation is brought to you for free and open access by the Graduate Studies at Digital Commons @ DU. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ DU. For more information, please contact [email protected],[email protected]. Dominating the Disease: A Transnational Feminist Perspective of U.S. Health Coloniality __________ A Dissertation Presented to the Faculty of Social Sciences University of Denver __________ In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy __________ by Jessica A. Johnson June 2019 Advisor: Dr. Bernadette Calafell, PhD ©Copyright by Jessica A. Johnson 2019 All Rights Reserved Author: Jessica A. Johnson Title: Dominating the Disease: A Transnational Feminist Perspective of U.S. Health Coloniality Advisor: Dr. Bernadette Calafell, PhD Degree Date: June 2019 Abstract HIV has been a pandemic since the 1980s with 70 million people infected since the beginning, about 35 million people have died of complications resulting from HIV, and an estimated 36.9 million people living with HIV in 2017 (WHO, “HIV and AIDS”). Many organizations around the world have tried to tackle this issue, however most of these organizations are based in the West or have Western organizations holding the majority of power and control. People in these organizations have the intention of ending the spread of HIV, but they also sometimes spread Western ideology. This work brings together communication scholarship from cultural studies, feminism, rhetoric, and health. Using a transnational feminist rhetorical analysis this project proposes an approach to analyzing international campaigns with a critical perspective to reveal the messages that sustain a Western male hierarchy across the world in the guise of health. This project explores the notion of coloniality in these transnational campaigns and how messages normalize the patriarchy and glorify the West. My framework centers on Chinese and African feminism and coloniality in order to focus on the local perspective in global interactions. Transnationalism and feminism are important issues for health communication that has been largely ignored, even though the savior power disposition that tends to run rhetorically through many health projects easily furthers hierarchies needed for coloniality. ii To explore these issues, this project uses two case studies to show how this occurs not only in US relations with one country, but with many countries. The first case study is a transnational edutainment project between U.S. organizations, the South African ministry of education, using actors from many countries in Africa, and set in three different African countries. The second case study is a transnational campaign that the U.S. created for HIV prevention for pregnant women in China. Both studies show visual and narrative rhetoric that reinforce a (White) western male hierarchy. Keywords: Transnational, Rhetoric, Feminism, Health, Coloniality, HIV, AIDS, Shuga, pregnant women iii Acknowledgements First, thank you to my family for all your love and support during my PhD program. Dad, thank you for always encouraging me to keep going during hard times. I know that you raised me to persevere and I can get through anything. Mom, thank you for always taking a major role in my schooling to keep me accountable. Your toughness pushes me further even when it is hard to hear. Nicole, thank for always being there for me during the emotional parts of my dissertation and life. You are one of the best people I know and truly show unconditional love. Second, thank you to my amazing advisor and committee members for your commitment and all the things you taught me. Bernadette Calafell, you have been an amazing advisor. You pushed me to be a more intersectional feminist and constantly supported me though edits, meetings, and talks. Erin Willer, you share so much of yourself if the classroom and I love our discussions of health and life. Our work together helped me expand to being more community engaged and grew my heart to try to match yours. Christina Foust, you have supported me throughout my time in this program and I have learned so much from your research. Renée Botta, you introduced me to Shuga in your International Health Communication class and were a constant source of encouragement and happiness for me throughout this process. Third, thank you to my great friends Darcy, Tiffany, Robert, Moana, Chris, and Sarah for your love and encouragement that helped push me to write. To all my colleagues, I am indebted to you for your intellectual stimulation. I look forward to many more years together as friends who became family during this process. iv Table of Contents Abstract ............................................................................................................................... ii Acknowledgements ............................................................................................................ iv Table of Contents ................................................................................................................ v Chapter 1: Rationale and Background For the fStudy ......................................................... 1 Rationale .......................................................................................................................... 2 Women and HIV Literature ............................................................................................. 4 The Status of Women with HIV Globally ....................................................................... 7 The Status of Women in China with HIV ..................................................................... 10 The Status of Women in Africa with HIV ..................................................................... 23 The Status of Women in the U.S. with HIV .................................................................. 29 Chapter 2: Review of the literature ................................................................................... 36 Coloniality ..................................................................................................................... 38 Coloniality and Africa ................................................................................................... 45 Coloniality and China .................................................................................................... 49 Coloniality and the US .................................................................................................. 51 Feminism ....................................................................................................................... 53 Transnational Feminism Overview ............................................................................... 57 Feminism and Africa ..................................................................................................... 62 Feminism and China ...................................................................................................... 67 Feminism and the US .................................................................................................... 70 Transnational Feminist Concerns: Health and Sex ....................................................... 78 Chapter 3: Methodology .................................................................................................... 90 Critical Rhetoric ............................................................................................................ 90 The Need for Critical Rhetoric to Turn Towards Transnational Method/Theories ....... 93 Transnational Rhetoric (Critical Rhetorical) Methods for Health Communication Work ....................................................................................................................................... 99 Transnational Feminist Rhetoric ................................................................................. 110 Artifact of Study Justification ..................................................................................... 115 Overview and Impact of Shuga ................................................................................... 115 Impact Beyond The Show ........................................................................................... 122 Overview and Impact of Chinese Campaigns ............................................................. 122 Chapter 4: Case Study Shuga .......................................................................................... 130 Production of Shuga: Local vs (Western) Agency Voices .......................................... 134 Production of Shuga: Commercial/Capitalist Interests ............................................... 139 Representation in Shuga: Christianity ......................................................................... 152 Representation in Shuga: Family Structure ................................................................