From “Fangzhi” to “Fangzhi”: The Logic of Prevention in AIDS Policies and Everyday Lives of Gay and MSM Communities in China

Abstract

This thesis examines how epidemic governance and queer subjectivities intersect in contemporary China, focusing on the historical development and everyday effects of the country’s “prevention-first” HIV/AIDS intervention policy. It combines socio-historical analysis of epidemic control policies with ethnographic research on how these policies shape the lives of gay and MSM (men who have sex with men) individuals, a population that is both central to state intervention and sociopolitical imaginations of the epidemic but marginalized in everyday life.This study asks three key questions: (1) What historical, sociopolitical, and cultural conditions and contingencies have shaped China’s “prevention-first” approach to AIDS intervention? (2) How do state-led HIV/AIDS policies impact the organizing efforts and lived experiences of gay and MSM individuals? (3) How do these individuals navigate the contradictions of surveillance, pathologization, and empowerment under AIDS intervention policies and politics? Using textual and discourse analysis alongside ethnographic fieldwork—including participant observation and targeted interviews in a gay and MSM community-based organization in Xi’an—this thesis makes two main arguments. First, it traces the changes and continuities of China’s HIV/AIDS policies over the past three decades, showing how both the centering of gay and MSM population in the politics of epidemic visibility and the making of “prevention-first” approach involve historical contingencies and local contexts. Second, this project argues that the pervasive logic of prevention extends beyond the domains of state public health and official sociopolitical narratives. It has become embedded in the mundane operations of the organization and the everyday lived experiences of gay and MSM community members through a range of disciplinary, campaign, and advocacy techniques. Prevention, in this sense, is not merely a public health measure but a structuring force that materializes through multiple channels, reinforcing itself as a central framework for shaping the actions, belonging, desires and anxieties of gay and MSM individuals around the organization-centered community. By examining the entanglement of bio/necropolitics, epidemic governance, citizenship and queer organizing and sociality, this thesis explores how prevention-first operates as both a regulatory tool and an everyday reality, reshaping the ways queer communities experience health governance in contemporary China.