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  • Occupational Hazards: Sex, Business, and HIV in Post-Mao China by Elanah Uretsky
  • Priscilla Song
Elanah Uretsky, Occupational Hazards: Sex, Business, and HIV in Post-Mao China. Stanford: Stanford University Press, 2016. 262 pp.

Elanah Uretsky's potent ethnography demonstrates how China's burgeoning HIV/AIDs epidemic is intimately related to the everyday practices of Chinese government officials and businessmen. Her unflinching analysis and clear prose shine the spotlight on these elite men, challenging public health scholars and policymakers to rethink conventional understandings of risk and vulnerability in order to mount an effective campaign to address sexually transmitted infections in China. As a socio-cultural anthropologist based at George Washington University's Milken Institute School of Public Health, Uretsky offers a powerful counterpoint to dominant global health paradigms through detailed fieldwork in southwest China. Public health work on HIV/AIDS typically focuses on groups marginalized by inequalities of wealth, gender, race, and sexuality. But as Uretsky points out, zeroing in on these populations as the predominant loci of vulnerability to HIV infection runs the danger of further stigmatizing these groups. In a classic case of "studying up" (Nader 1972), Uretsky leverages an ethnographic perspective to demonstrate how "quest[s] for professional success" (5) by elite Chinese men are fueling China's HIV/AIDS epidemic. Overlooked because of their power and wealth, these "mobile men with money" (Uretsky 2008) constitute a hidden "at-risk" population missed in standard interventions focusing on marginalized groups.

The analytical power of Uretsky's erudite scholarship lies in her ability to bring a rich body of social science scholarship on Chinese state–society relations into conversation with key debates in medical anthropology and public health. Building on the work of China experts in the fields [End Page 329] of anthropology (Fei 1992, Yang 1994, Yan 1996, Osburg 2013), sociology (Walder 1986, Wank 1999), and political science (Tsai 2007), Uretsky demonstrates the sociopolitical logic underpinning what is typically framed in the public health sector as individual risk and behavior. She focuses in particular on how two classic concepts in sinology—guanxi and yingchou—have fueled China's HIV epidemic. Through detailed ethnographic description, Uretsky illustrates how aspiring Chinese bureaucrats and businessmen establish guanxi (a system of relationships built upon trust and reciprocity) through social practices of yingchou (shared rituals of eating, drinking, smoking, and entertainment). Although yingchou practices have deep roots in the socialization of China's literati class during the imperial era, Uretsky demonstrates how these ritualized forms of male-centered entertainment have flourished in the post-Mao era. Under the uncertainties of market socialism, these guanxi relationships between businessmen and local government officials enhance access to state-controlled resources and protect mutual business interests. These practices also provide fertile ground for the circulation of STIs.

Uretsky divides her book into two parts. She devotes the bulk of her analysis (Chapters 1–4) to detailing the culture of elite masculinity in post-Mao China. Paying close attention to elite men's lived experiences, Uretsky unveils the inner workings of business networking rituals, the centrality of homosocial relationships, and the competing cultural scripts organizing men's sexual experiences. While readers focused on public health concerns may find themselves impatiently wondering how this all connects with China's HIV/AIDS epidemic, China scholars and sociocultural anthropologists will delight in her thick descriptions of Chinese feasting and drinking practices, the vivid stories of how her informants constructed their masculinity in the realms of family and workplace, and her cultural deconstructions of off-color "yellow jokes" featuring politicized sexual innuendo circulating as anonymous text messages. Uretsky more than satisfies her public health readership in the remaining third of her book, which analyzes the effects of these elite masculine practices on China's burgeoning HIV epidemic. These final two chapters anchor her preceding analysis of yingchou and elite masculinity to more explicit public health concerns.

Uretsky's book makes the provocative claim that drinking, smoking, banqueting, and sexual entertaining are not recreational activities for elite men in China, but instead constitute a form of work that ultimately jeopardizes their health and well-being. Her analysis of yingchou practices [End Page 330] redefines conventional gender and class framings of sex...

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