University of Kentucky UKnowledge University of Kentucky Doctoral Dissertations Graduate School 2007 MAPPING HIV PREVENTION IN POLAND: CONTESTED CITIZENSHIP AND THE STRUGGLES FOR HEALTH AFTER SOCIALISM Jill Teresa Owczarzak University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Owczarzak, Jill Teresa, "MAPPING HIV PREVENTION IN POLAND: CONTESTED CITIZENSHIP AND THE STRUGGLES FOR HEALTH AFTER SOCIALISM" (2007). University of Kentucky Doctoral Dissertations. 515. https://uknowledge.uky.edu/gradschool_diss/515 This Dissertation is brought to you for free and open access by the Graduate School at UKnowledge. It has been accepted for inclusion in University of Kentucky Doctoral Dissertations by an authorized administrator of UKnowledge. For more information, please contact [email protected]. ABSTRACT OF DISSERTATION Jill Teresa Owczarzak The Graduate School University of Kentucky 2007 MAPPING HIV PREVENTION IN POLAND: CONTESTED CITIZENSHIP AND THE STRUGGLES FOR HEALTH AFTER SOCIALISM _________________________________ ABSTRACT OF DISSERTATION __________________________________ A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Arts and Sciences at the University of Kentucky By Jill Teresa Owczarzak Lexington, Kentucky Director: Dr. Mary K. Anglin, Professor of Anthropology Lexington, Kentucky 2007 Copyright © Jill Teresa Owczarzak 2007 ABSTRACT OF DISSERTATION MAPPING HIV PREVENTION IN POLAND: CONTESTED CITIZENSHIP AND THE STRUGGLES FOR HEALTH AFTER SOCIALISM This ethnographic dissertation research project examines HIV prevention programs in Warsaw, Poland to explore the concurrent processes of democratization and privatization as Poland begins European Union accession. As inherently political public health interventions, HIV prevention programs provoke discussions of risk and responsibility, and visions of the moral social order. Therefore, they can be used to understand the ways in which politically and socially marginalized populations invoke claims to citizenship status through attention to health issues. From an epidemiological perspective, HIV/AIDS arrived in Poland relatively late (1985) and never reached the anticipated “epidemic” levels. In the 1980s, drawing attention to the potential threat of AIDS served as a forum through which the perceived failures of the socialist government could be publicly addressed. In the 1990s calls for improved access to AIDS information suggested that to be “democratic” meant to have open and easy access to scientific information, and debate surrounding the establishment of AIDS care facilities suggested that to be European was to be “tolerant.” However, issues of information and tolerance were problematic in reference to homosexuality. Prior to the advent of AIDS in Poland, socialist gender and sexual ideologies converged with Catholic notions of proper morality to marginalize and pathologize homosexuality. Nascent gay organizations saw the potential of HIV prevention as a way to justify the value of such organizations for the greater good of society. The possibility of controlling and participating in the task of HIV prevention presented an alternative to state- sponsored surveillance under the guise of HIV prevention and encouraged public dialogue about the issues gays face in their daily lives. Whereas the national HIV prevention agenda focuses on risks as equally distributed across Polish society, a central component of the HIV prevention programs within Polish gay rights and drug abuse prevention organizations is “harm reduction.” As practiced by Polish gay organizations, a harm reduction philosophy draws attention to heterogeneity within gays and challenges the construction of them as a coherent risk group. These programs deemphasize sexuality in favor of a wider constellation of factors that contribute to finding oneself in situations that can lead to risky behavior. KEYWORDS: HIV prevention, Postsocialism, Citizenship, Poland, Gender/Sexuality Jill Owczarzak May 20, 2007 MAPPING HIV PREVENTION IN POLAND: CONTESTED CITIZENSHIP AND THE STRUGGLES FOR HEALTH AFTER SOCIALISM By Jill Teresa Owczarzak Mary K. Anglin Director of Dissertation Lisa Cliggett Director of Graduate Studies May 20, 2007 RULES FOR THE USE OF DISSERTATIONS Unpublished dissertations submitted for the Doctor’s degree and deposited in the University of Kentucky Library are as a rule open for inspection, but are to be used only with due regard to the rights of the authors. Bibliographical references may be noted, but quotations or summaries of parts may be published only with the permission of the author, and with the usual scholarly acknowledgments. Extensive copying or publication of the dissertation in whole or in art also requires the consent of the Dean of the Graduate School of the University of Kentucky. A library that borrows this dissertation for use by its patrons is expected to secure the signature of each user. Name Date ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ DISSERTATION Jill Teresa Owczarzak The Graduate School University of Kentucky 2007 MAPPING HIV PREVENTION IN POLAND: CONTESTED CITIZENSHIP AND THE STRUGGLES FOR HEALTH AFTER SOCIALISM _________________________________ DISSERTATION __________________________________ A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Arts and Sciences at the University of Kentucky By Jill Teresa Owczarzak Lexington, Kentucky Director: Dr. Mary K. Anglin, Professor of Anthropology Lexington, Kentucky 2007 Copyright © Jill Teresa Owczarzak 2007 TABLE OF CONTENTS Introduction........................................................................................................................................ 1 Chapter One: Theoretical Perspectives on Citizenship, the State, and Gender Interrogating HIV and its prevention................................................................................ 14 Theories of citizenship and the state ................................................................................. 16 States, citizens, and power.................................................................................... 16 Neoliberal governance and postsocialism........................................................... 20 Citizenship and biopolitics................................................................................... 23 Gender and sexuality in socialist and postsocialist contexts ........................................... 26 Gender and socialism............................................................................................ 27 Gender ideology and politics in postsocialism.................................................... 31 Adding sexuality................................................................................................... 33 Chapter Two: Linking it Together: HIV Prevention as a Site for Anthropology HIV prevention, harm/risk reduction, citizenship............................................................ 37 Harm reduction..................................................................................................... 40 Risk messages ....................................................................................................... 44 Researching HIV prevention in the Polish context.......................................................... 48 Chapter Three: On Fieldwork and Methods Introduction......................................................................................................................... 57 The role of the Catholic Church in Polish politics and society ....................................... 61 Before World War One: the Church and building the Polish nation................. 62 Socialist Poland and state opposition................................................................... 64 Postsocialism, democracy, and authority ............................................................ 66 Researching HIV prevention and the Catholic Church...................................... 68 The “public” and the “private”.......................................................................................... 72 Social circles, private life, and surviving socialism............................................ 73 The public and private as spheres of activism .................................................... 76 States, citizens, and civil society ....................................................................................... 81 Redefining civil society........................................................................................ 87 Methods