Toward a Virulent Community Literacy: Constellating the Science, Technology, and Medicine of Queer Sexual Health
Toward a Virulent Community Literacy: Constellating the Science, Technology, and Medicine of Queer Sexual Health is a qualitative study (informed by Indigenous and decolonial methodologies) of how queer and trans people of color generate and share knowledge about their sexual health on Twitter with regards to HIV/AIDS. With a Twitter archive of 15,000 discrete tweets built with the keywords “Truvada,” PrEP,” and “HIV,” three datasets were derived comprising general utterances from queer users of color, public health officials using social media for outreach, and organizations sharing research findings. Focusing on the data subset comprising 300 discrete users of color and relevant media (i.e., news articles, public health advertisements, other emergent artifacts from the data), this dissertation recounts three case studies focusing on: the rollout of HIV prevention advertisements within queer-centered media; the patent breaking of Truvada, a once-daily medication for preventing HIV; and the use of social media to take to task bad actors and misinformed healthcare providers.
The data are used as part of an argument that the manner by which medicine and public health interface with queer and trans people of color hinges on ongoing colonization via the medical and outreach practices derived from colonial practices. Moreover, using a theoretical argument derived from Black and Native technology studies (as well as Black Feminist Thought, Anishinaabe cosmology, settler colonial studies, and digital rhetorical theory), the data was reviewed through a protocol for understanding identity construction amid technology use. The results revealed three rhetorical strategies: 1) continuing community-born public health practices created during the HIV/AIDS crisis of the 1980s and 90s by deploying descriptive hashtags to challenge stigma; 2) creating emergent whisper networks for sharing information about dealing with healthcare providers, navigating insurance networks, and communicating the symptoms of taking the medication; and 3) recognizing and countering the complex systems of late capitalist biomedicalization that prioritize profit over life.
To contribute to ongoing commitments within writing and rhetoric studies to create equitable healthcare experiences, an HIV/AIDS health literacy framework follows the data results, which allows for outreach in non-clinical settings through relational design, or a participatory communication design process that incorporates community voices via an attunement to social media such as Twitter. This dissertation contributes to ongoing incursions within technical and professional communication, as well as the rhetoric of health and medicine, to upcycle disciplinary savvy into building better public health and clinical experiences for queer and trans people of color.
Chapter 1: Storying a Virulent Project: Three Threads for Narrative Ignition. In this chapter, I recount three stories that resonate with how digital rhetorical theory, health and medical rhetorics, and technical and professional communication respectively manifested in my experiences with HIV/AIDS-focused public health outreach as a queer Chicano. These stories model the approaches I took to disciplinarily constellating and organizing the dissertation.
Chapter 2: Queer Refusal: Insurgent Paradigms and Methodologizing Amid Settler Colonialism. This chapter outlines an insurgent methodology of refusal, wherein I detail the limitations of Western science and meaning making to advance an Indigenous protocol for thinking relationally about community-born data. I review the protocol for gathering data and organizing them into subsets, as well as the coding schema, to provide an overview of the 300 datapoints used for case studies in Chapter 5.
Chapter 3: The Intersectional Internet as Land: Theorizing Digital Rhetorical Socio-Materiality via Black and Indigenous Studies. This chapter outlines a theoretical intervention in current digital rhetorical theories of identity and technology. In it, I advance a cyborgian method of attuning research projects to the human users of technology and the technological user of the human via Black and Native studies, using this theoretical model to outline my coding protocol regarding the gathered data.
Chapter 4: Unsettling Epistemic Hubris: Rupturing Risk-Informed Health Literacy, Reframing Risky Living. In this chapter, I locate the settler colonial machinations of current public health and biomedical models to prime an epistemic rupturing of risk-informed health literacy. In so doing, I use this approach to outline an interpretive stance for the case studies in the following chapter.
Chapter 5: Blood Cells, Drag Queens, and Digital Faggotry: Three Case Studies (Or Toward a Community-Based Framework of Health Literacy). In this chapter, I review the three case studies I derived from the data analysis, using each to outline key components that together comprise a community-based framework of health literacy. In advancing this model, I argue that this framework serves as a viable tool for understanding how public health officials might more equitably attune outreach to queer and trans communities of color.
Chapter 6: Conclusion: Relational Design and Public Health: Hotwiring Technical and Professional Communication in the Third University. To conclude, I outline a method of hotwiring technical and professional communication practices (namely, user-centered design, communication design, and participatory design) to create equitable experiences for queer and trans people of color. I revise a public health campaign conducted by Gilead in 2019 to correspond to data analysis results, arguing that technical and professional communicators are primed to do this work in healthcare and public health settings.