Recording of "Plenary Session 1 at the Indonesian National AIDS Conference"

I was delighted to be invited to speak at a plenary session of the Indonesian National AIDS Conference, held virtually by PPH UNIKA Atma Jaya.

Further information (Bahasa Indonesia) about the conference is available here: https://pph.atmajaya.ac.id/berita/dokumentasi/pertemuan-nasional-jaringan-penelitian-hiv-indonesia-2021/

Links to open access articles on our research about HIV outreach workers is available here:

• Understanding the challenges faced in community-based outreach programs aimed at men who have sex with men in urban Indonesia (Sexual Health)

• Chasing targets in a pandemic (Global Public Health)

Bahasa Indonesia - Indonesian Essay [Penjangkauan LSL dalam Program HIV selama Pandemi COVID-19: Kerja Esensial]

By Amalia Puri Handayani, Ignatius Praptoraharjo , Sandeep Nanwani, Benjamin Hegarty

Setahun lalu (2020), kami melakukan studi dengan melihat pengalaman salah satu organisasi penjangkauan HIV berbasis komunitas selama awal pandemi COVID-19. Kami menemukan, ketika pandemi, penjangkau diposisikan secara ambigu antara sebagai “pekerja kesehataan” dan “pekerja berbasis komunitas”. Donor internasional lebih menekankan solusi teknis dan farmasi (seperti tes mandiri (self-testing), pengantaran obat, platform daring, dukungan kesehatan mental). Inovasi ditujukan bagi dampingan alih-alih mempertimbangkan kenyataan kerja penjangkau sebagai bagian dari pekerja kesehatan. Peran mereka menjadi lebih luas dalam kesehatan masyarakat selama pandemic. Pada saat yang sama, lembaga donor harus mengikuti kebijakan pemerintah untuk mengurangi kunjungan ke layanan kesehatan ketika pandemi, terlihat dari kebijakan mengurangi biaya transportasi bagi petugas penjangkau. Dengan keterbatasan dukungan finansial dan tanpa perubahan praktik kerja yang substansial, penjangkau sebagai petugas lapangan tidak tinggal diam, apalagi ketika melihat komunitas membutuhkan pertolongan dalam mengakses layanan HIV. Alhasil, penjangkau masuk dalam garda depan yang menghadapi risiko tinggi terpapar COVID-19.

https://pph.atmajaya.ac.id/berita/artikel/penjangkauan-lsl-dalam-program-hiv-selama-pandemi-covid-19-kerja-esensial/

PPH Atma Jaya University Seminar Series - The Cascade of Care as a Data Model

This paper sets up the context in which the Cascade of Care is applied to HIV prevention in the Indonesian context. The Cascade of Care, hence forth referred to as the cascade, is a component of the broader Continuum of Care which is focused on the process from being at risk of HIV through to HIV prevention.  

This paper first outlines the cascade as a data model, which is a core component of providing policy makers and funders a high level picture of progress towards HIV prevention. The paper considers the implications of the 90/90/90 approach to HIV prevention - “90% of all persons living with HIV (PLHIV) are aware of their HIV status, 90% of all people who know their status are receiving antiretroviral therapy (ART), and 90% of those on ART are virally suppressed”. 

The paper then considers two main components required to supply data to the cascade. First, monitoring and evaluation which emphasises that data should be used to drive decisions is examined. Second, surveillance and survey is considered which are the tools by which this data is collected. Throughout the paper, consideration is given to the purpose of the cascade and how the cascade shapes conceptualisation of these key terms. This paper provides a critique of how the cascade provides the appearance of a standard of HIV treatment and the broader implications of this. 

Presentation at AusSTS Workshop in Melbourne - "The Cascade of Care"

With colleagues from the University of Melbourne, Priyanka Pillai and Kristal Spreadborough, I’ll be presenting at the AusSTS workshop in Melbourne held on 24 and 25 June. Details of the workshop are available here: https://scienceandsocietynetwork.deakin.edu.au/call-for-applications-aussts-2021-situated-practice-a-multi-sited-workshop/

The paper is based on some recent work that I’ve been doing as part of an interdisciplinary team about HIV data and its uses in global health, looking at one manifestation - the “cascade of care” (a.k.a. and sometimes overlapping with what is called the continuum of care). I am hoping the workshop can offer an opportunity some emergent themes on governmentality through data in global health regimes, building on my completed book manuscript on the globalisation of concepts for gender and sexual diversity in Indonesia.

The title and abstract is below - if you are in Melbourne, I hope to see you at this fantastic workshop!

Title: Seeing like a cascade - global HIV data and public health governance in Indonesia 

Keywords:  data, public health, HIV, cascade, Indonesia

Abstract: The “cascade of care” is a widely used tool in measuring national and international progress towards HIV testing and treatment goals. Since 2014, these goals have been to achieve 90% of HIV+ people know their status, 90% of people who know their status on treatment, and 90% of people on treatment are virally suppressed. Thus, these targets serve as a catalyst to rapidly and as widely as possible roll out anti-retroviral treatment with the ultimate aim being to end AIDS in the near future. The “cascade” individualises “treatment” and “prevention,” and simplifies the complexities of accessing life-long treatment into a biomedical and pharmaceutical model. Yet a less widely acknowledged aspect of the “cascade” in international HIV programs is the fact that it is accompanied by and indeed necessitates the expansion of systems of collecting, storing and analysing data. We argue that the cascade is not only a method concerned with clinical treatment but has led to the prioritisation of data-driven models which draw “surveillance” (data about the state of the epidemic) together with “monitoring and evaluation” (data about programs). Focusing on SIHA, the Indonesian Ministry of Health Information System for HIV/AIDS developed in 2012, this paper analyses various visualisations of the “cascade” and the data infrastructures that underpin it. We use these visualisations to understand both flows of data in and between actors and the categories that they use in the process. In contextualising how national Indonesian data infrastructures “see like a cascade” we seek to clarify what public health governance does and for whom. 

Authors:

Benjamin Hegarty is an interdisciplinary gender and sexuality studies scholar and McKenzie Fellow at the University of Melbourne.

Priyanka Pillai has a background in bioinformatics and computer science and works as an academic specialist at the University of Melbourne. 

Kristal Spreadborough is a Research Data Specialist at the Melbourne Data Analytics Platform. Kristal’s research interests cut across the fields of data, digital and data ethics, music, psychology and semiotics.

Cultural Studies Association Conference Panel

I am presenting at the Cultural Studies Association (USA) on Saturday 12:00-1:00pm CST, 12 June 2021.

https://docs.google.com/document/d/18HEW_27VDtM16T-CtSQkqi6ZSH8nTQ_nRAT15qp1G8c/edit#

The Force of Images: Digital Media, Bodies, and Data in Southeast Asia

Chair: Benjamin Hegarty, The University of Melbourne

Respondent: Tom Boellstorff, University of California Irvine

Indonesian Youth Protesting for/with Social Media

Annisa Beta, The University of Melbourne

Violent Visibilities: Campus Sexual Misconduct Facilitated by Technology in Singapore

Michelle H. S. Ho, National University of Singapore

The Biosocial Body: Data and Visibility Among MSM in Indonesian HIV Programs

Benjamin Hegarty, The University of Melbourne

This panel considers the force of images in shaping the meanings attached to bodies and embodiment in contemporary Southeast Asia. Throughout the region, political upheaval, contestation and technological developments related to the digital are producing new relationships between bodies and the meanings attached to their representation. In this environment, moral harms are transformed into physiological risk in new ways, resulting in emergent forms of exclusion and claims for inclusion. This is transforming both the possibilities and the modes through which claims to autonomy and representation unfold. In an era of new appropriation and force of images what kinds of political mobilisation are possible? What “boundary objects” act as an interface between them? What new models for critical engagement with “data” as and with visual culture can we consider? And how do these operate in and between Asian contexts with specific political cultures rooted in visual culture and appearances, frequently tied to the body and its appearances?

This panel addresses these questions across two intersecting domains through which to consider the force of images: “social media” and “data.” Investigating the way that images are generating new forms of political investment and engagement tied to the body, each paper offers insights into emergent political investments in Southeast Asia. Michelle Ho’s paper addresses the generative role that “violent visibilities” — encompassing data gathering and their life in social media — have had in creating new possibilities for mobilizing against sexual harassment on Singaporean campuses. Annisa Beta’s paper reflects on the “jocular” use of images on social media by young people — in the form of memes and photographs — as an influential political vocabulary in Indonesia’s fraught postauthoritarian political landscape. Benjamin Hegarty considers the way that data-driven cultures of transparency in global programs for HIV targeting “men wo have sex with men” intersect with extant cultural meanings tied to the body, requiring new forms of discipline.

In each case, digital media and data do not live “outside” of culture or of the realm of the body, but emerges from and through it. By drawing on data that illustrates examples of the “force of images” against broader patterns of social and political change in Southeast Asia, this panel will offer insights into the intersections between digital media, data and the body. Remaining attuned to the cultural meanings of images not as a representation but a force in the world refuses a teleological view of cultures of data and the digital, instead opening new horizons for political mobilization and critique.

Evans Fellow at the University of Cambridge (2021/22)

I was elected as Evans Fellow in the Department of Anthropology at the University of Cambridge for the period of 2021/2022. The Fellowship is funded to anthropologists working in Southeast Asia, and includes a stipend for fieldwork and travel to the University of Cambridge.

The project forms part of ongoing research about the influence of sexual morality on HIV data collection in Indonesia which focuses on the category “MSM” (men who have sex with men). The urgency of this topic lies in recent moves by the Indonesian state to enforce marital heterosexuality and a concurrent push to collect more data about HIV (Human Immunodeficiency Virus). The research contributes to medical anthropology and science and technology studies in focusing its attention to the “infrastructures” through which categories are sustained and made as much as to the subjective life worlds of individuals.

https://www.socanth.cam.ac.uk/about-us/funding/research-funding/evans-fund

Twenty-five years of HIV/AIDS responses in Indonesia

I presented at the ANU Indonesia Study Group at the Australian National University on the history of HIV in Indonesia on 21 April 2021.

Twenty-five years of HIV/AIDS responses in Indonesia

This project draws on material from a National Library of Australia Asia Study Grant-funded project on community memory and epidemiological histories of HIV. It addresses the period from the first official health responses to early cases identified in the 1990s to the present day, when an estimated 640,000 people are living with HIV. It draws on Indonesian-language policy documents, activist accounts, medical surveys, media sources and development archives into conversation with ongoing research on community memories of HIV/AIDS in Indonesia. In particular, I elaborate the political entanglement between HIV/AIDS and political organising among some of the gender and sexual minorities most affected by the epidemic. I argue that the history of HIV/AIDS offers an important lens on broader processes of a discourse of transparency that permeates the era of democratic reform since 1998. In particular, it helps to track the emergence of discourses of morality and their transformation into surveillance from the end of the New Order. Perhaps more importantly, the history of HIV/AIDS in Indonesia – as is the case in other parts of the world – highlights impressive forms of community/government/expert engagement mobilised at the intersection of a concern for public health and human rights.

https://crawford.anu.edu.au/news-events/events/18721/twenty-five-years-hivaids-responses-indonesia

Awarded National Libary of Australia Asia Study Grant

I was awarded a 2021 National Libary of Australia Asia Study grant recipient for a project on Twenty-five years of HIV/AIDS in Indonesia: epidemiological histories and community memories. The project draws on the NLA’s significant Indonesian-language holdings, including policy documents, activist accounts, medical surveys, media sources and archival sources into conversation with an ongoing research project on community memories of HIV/AIDS in Indonesia.

I presented preliminary research that resulted from the fellowship while I was in Canberra at the Australian National University Indonesia Study Group.

https://www.nla.gov.au/asia/grant-recipients/2018-2021