Abstract

Much epidemiological research has been conducted on the sexual health of MSM (men who have sex with men) migrating from countries with high levels of institutionalised homophobia to so-called ‘queer hubs’ such as London. However, little work has been done on how the methodology employed by such epidemiological research reinforces an exclusionary and misleading binary between risky, ‘Eastern’ MSM and enlightened, ‘Western’ MSM . Drawing on the ‘Patient Zero’ trope, I argue that sexual health risks which transcend borders are implicitly assumed in much epidemiological research to be distinctly foreign threats to the purity of the homeland. However, growing bodies of literature from both political geographers and philosophers of science on the construction of risk, as well as epidemiological research exploring the specific dynamics of migration (be it international or intranational), illustrate the more complex, chequered nature of sexual behaviours and sexual risk across borders. The conceptual binary currently upheld in epidemiological research and sexual health policy risks letting certain migrants fall through the cracks in sexual health services, while contributing to the stigmatisation and social exclusion of others. It is thus necessary to reformulate our conception of the ‘migrant’ in sexual health policy and epidemiological research in order to capture more precisely what it is about mobile populations that places them at higher sexual risk, and how such factors may affect individuals not typically thought of as migrants. Through an analysis of interviews with sexual health professionals and migrant health organisations, and a rigorous reading of epidemiological research, health policy texts and theoretical literature, I argue for a de-spatialisation of the notion of migration, understanding the migrant as someone who moves between discursive, as well as physical, spaces. Understanding the temporal, as well as spatial, dimensions of migration would vastly improve the validity of epidemiological research on the sexual health of mobile populations.