Sister cities and easy passage: HIV, mobility and economies of desire in a Thai/Lao border zone

Abstract

It is recognised that people movement can increase potential risk of HIV transmission. In recent years, mobile populations moving across national borders have become a focus for HIV/AIDS prevention campaigns. These programs generally target border ‘‘hot zones’’ that produce high levels of HIV vulnerability due to the degree of mobility and the risk behaviours fostered by these marginal environments. However, high degrees of movement and social exploitation need not be the only criteria for borders to exacerbate HIV vulnerability. The types of social interactions promoted by mobility take many forms. In this paper we consider a border zone between Thailand and Laos to show that the links between movement and HIV vulnerability are not confined to stereotypical instances of coercion and exploitation. Rather we demonstrate that HIV risk in this area is a product of both a sense of community and a sense of difference that together foster a range of interactions based on mobility back and forth across the border. As HIV/AIDS prevention programs increasingly control forms of sexual interaction, the border provides a practical and symbolic opportunity to establish new forms of sexual relationship falling outside these constraints. This tendency to move outside bounds is not limited to border areas but has implications for prevention programs everywhere.

Introduction

It is now well over ten years since the Thai government began its wholehearted response to the dire prescription that HIV and AIDS forecast both for this country and the region as a whole. Since then AIDS has become an ever-present nightmare facing people throughout Southeast Asia. And yet, after years of programming, it is clearer than ever that alleviating the impact of HIV/AIDS still remains a highly politicized project full of contradictions and complex issues of identity and responsibility. Recognizing that the obstacles HIV interventions confront are not limited to encapsulated nation/states, these days the focus of many foreign funded initiatives, is on border regions and mobile populations particularly in Asia, home to nearly half the world's population. Borders are often considered magnet areas that heighten HIV vulnerability largely through the social disruption brought about by movement across national boundaries (Decosas et al., 1995; Shtarkshall & Soskolne, 2000). This social unease fosters a variable set of relationships incorporating issues of fear, deportation, violence, exploitation and language difficulty. Uneven power relations and transience can encourage drug abuse and sexual subcultures, which increase vulnerability to HIV in border regions (Porter & Bennoun, 1997).

Like many countries in regions where HIV is rampant, Thailand offers classic examples of these border dynamics: Burmese fishermen in Ranong and brothel workers at key Cambodian/Thai crossing points are commonly depicted in reports as high risk mobile populations with attendant high levels of HIV infection (see, for example, Caouette et al. (1999a), Chantanavich et al. (1999b); Caouette et al., 1999). In this article, we consider tensions provoked by geographic and social proximity to a Thai/Lao border that are of a different order and less obvious HIV severity than these above scenarios. While borders are typically peripheral zones that embrace marginal populations, a study of the dynamics of HIV spread in these regions also sheds light on the complicated ways that people respond to disease transmission and modes of regulation wherever they are. Skeldon (2000) has emphasised recently that it is not mobility per se that should concern us most but rather the specific practices and interactions of people in zones where population movement occurs in its various forms. By focussing more closely on behaviour we see that HIV vulnerability and mobility is not limited to specific groups or specific locales. As Skeldon notes: “While the existing cross-border studies have generated a wealth of valuable information, the impression given is of isolated “hot spots” whereas the border towns are integral links in broader systems of regional mobility.” (2000, p. 12) Although our intention is to highlight issues that make HIV/AIDS prevention consistently problematic at this particular border site, the way border zones act as a crucible for the interplay of psychological, social and economic forces allows us to identify trends that have relevance in other parts of the region as well.¹ While there was some opportunity for interviews with Lao informants, the bulk of our research was conducted on the Thai side of the border. We thus present a picture largely based on the Thai perspective.