Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China

Heroin. AIDS. Migration. Development programs. Gender roles. In Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China, Shao-hua Liu examines each of these issues and how they relate to Nuoso youth. An anthropological researcher, the author delves into how China’s evolution from the traditional to the modern intersects with drug use, disease, and development. The book focuses on the Nuoso, a poor and marginalized group in southwest China that has been disproportionately affected by the drug trade and HIV/AIDS.

The author does a commendable job of stressing the interconnected nature of migration, gender, drug use, and political economies. While these issues are naturally linked, too many authors focus on one of these aspects while ignoring the myriad forces that shape cultures and communities. Passage to Manhood features a fresh approach to understanding why heroin use and HIV took over the Nuoso to such a great extent. The author presents an answer that relies on the intersection of marginalization, stigmatization, modernization, and power dynamics within communities.

The author’s honest approach to gender stood out in the book. Instead of making sweeping generalizations about gender politics among the Nuoso, the author explains how she approached the subject and details the difficulties she had using male translators to interview women.

Acknowledging that her access to information was limited, the author conveys the basic framework of what she found. While drug use and HIV/AIDS shaped the entire community in some way, it affected men and women differently. The author explains that young men were first drawn to heroin because it was fashionable and demonstrated a particular social status. Drug use overlapped with the definition of masculinity among the Nuoso, which was based on a desire for adventure and mobility. The gender hierarchy, which placed women subordinate to men, played out in heroin politics: Women encountered the drug trade through small dealings and followed their husbands or partners, who were responsible for the larger trades.

The author is careful to note that gender dynamics not only shaped the details of the drug trade among the Nuoso, but also determined the effectiveness of state-managed intervention programs to combat drug use and HIV/AIDS. In a careful dissection of the failures of these intervention programs, the author examines how the program administrators viewed cultural taboos about sex as barriers to their work. Instead of acknowledging the fluidity of cultural norms, state-managed interventions overlooked honest sex education and contributed to misinformation about HIV/AIDS. By ignoring the unique cultural context of the Nuoso and using global AIDS messages from elsewhere, the architects of these programs inadvertently instilled a stigma about AIDS where one previously did not exist. This case study presents a sobering lesson for those working on global AIDS prevention programs; such interventions must be designed as a cooperative exercise between local groups and the program implementers, not cookie-cutter programs delivered from above.

It is difficult to pluck one nugget of information from the author’s interconnected web, but perhaps the greatest take away from the book is that AIDS and drug use do not exist in a vacuum. Gender politics, economics, migration, and urbanization each exact pressure on people’s actions and perceptions. A thorough understanding of drug use and HIV/AIDS within a community must begin with an expansive interpretation of how individuals, families, and societies grapple with these ever-changing forces.

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