Academic journal article International Journal of Men's Health

Entrepreneurial Masculinity, Health, and the State in Post-Socialist China

Academic journal article International Journal of Men's Health

Entrepreneurial Masculinity, Health, and the State in Post-Socialist China

Article excerpt

Drawing on the author's three years' ethnographic research of karaoke bar hostesses and male clients in the Chinese urban sex industry, this paper argues that men's health practices are impacted by the practices of entrepreneurial masculinity and the development of social relationships with the state. In addressing the ways in which men's health practices are impacted by social factors rather than individual factors, this research has significant implications for HIV intervention programs, which should be devised to alter men's health practice through breaking the association of condoms with authoritarian, top-down, and coercive family planning programs and changing peer culture, peer behaviors, and peer worldviews in men's workplaces including companies and government offices in China.

Keywords: masculinity, sex industry, state power, health, China


In addressing the epidemic of AIDS, the current dominant biomedical model in public health explains health as stemming from individually chosen lifestyles. Epidemiologists focus on individual health behavior, apply value-neutral objectivity, and rely heavily on surveys as their primary method of scientific study (Bastos, 1999; Frankenberg, 1994; Hunt, 1996; Mann, 1996; Schoepf, 2001, p. 339). In so doing, they reduce "understanding human health to the quantification and recording of information regarding individuals within populations" (Lupton, cited in Robertson, 2009, p. 5). Following the rational choice model, public health studies assume that people engage in dangerous behaviors because they fail to recognize the risk or underestimate the risk involved in such behavior. It is assumed that if individuals are informed of these risks, they will recalculate and abstain from such behavior.

In general, epidemiological studies on health behaviors tend to focus on surveys of risk-related behaviors. Previous studies on health behaviors and STD/HIV in China have collected quantifiable data on numbers of sexual partners, the frequency of different sexual practices, previous experiences with other STDs, and other similar issues related to HIV infection (Cheng, 2002; Cui, 2001; Gu, 1993; Ma, 2002; S.P. Lau, 2001; T.H. Lau, Siah, & Zhang, 2002; Liu, 1998; Pisani, 2000; Rogers. 2002; Singh, 1995; Van den Hoek, 2001 ;Wang, 2001 a&b; Wu, 2002; Zhang, 2002; Zheng, 2001). The underlying assumption was that individual behaviors would change with knowledge. There was a concerted effort to develop and employ medical technologies such as screening to eliminate risks by "changing behaviors or lifestyles that are perceived to cause illnesses within body systems" (Robertson, 2009, p. 5).

Public health literature in general exhibits three major characteristics: First, it follows a methodology centered on the investigation and analysis of "problem populations." Second, it uses a "rational-choice" model of human behavior that attributes high-risk behavior to inadequate knowledge. Third, it is based on survey results from questionnaire responses.

This paper contends that this dominant biomedical approach dismisses the fact that health behaviors are related to social conditions and shaped by cultural systems and therefore is "unable to deal concretely with the lived social realities" (Mann, 1996, p. 3; Parker, 2001). Eschewing the dominant biomedical model widely employed in public health, this article adopts a more complex, socially structured view of human behavior (see also Bolton & Singer, 1992; Carrier, 1989; Flowers, 1988; Herdt & Boxer, 1991; Obbo, 1995; Parker, 1987, 1988). I argue that the intricate relationship between the state and male clients and the meanings of the entrepreneurial masculinity are critical to understanding many male consumers' decision-making about condom use and hence the social dimension of HIV/AIDS (de Zalduondo & Bernard, 1995; Farmer, 1992; Gupta, 1993; Micollier, 2004; Parker, 1991; Schoepf, 1992; Sobo, 1993, 1995a & b, 1998). …

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