In The Borders of AIDS: Race, Quarantine, and Resistance, Karma R. Chávez tells a story of the AIDS epidemic not frequently mentioned in the public discourse that centers on the most privileged victims of HIV/AIDS. Rather than focusing on the white, gay, and middle-class victims, Chávez turns to Black citizens and non-citizens, sex workers, and Haitian migrants to explain the phenomena she calls ‘alienizing logic’ that influenced the treatment of those diagnosed with HIV/AIDS. Alienizing logic “refers to a structure of thinking that insists that some are necessarily members of a community, and some are recognized as not belonging, even if they physically reside there.” The book examines how alienizing logic enacts itself upon immigration status, race, and citizenship as axes of oppression and how the HIV/AIDS pandemic allowed it to take hold in the mainstream. 

The book is split into two parts. Part One, “Alienizing Logic and Structure,” shows how “people with power to frame issues and make decisions utilize disease as an opportunity to enact alienizing logic.” The first chapter provides readers with a history of quarantine in the United States and its transformation from a temporary measure generally associated with goods and services to a tactic deployed in the face of perceived threats from non-white foreigners and so-called sexual deviants. This chapter provides a rich background for how ‘quarantine and ban’ were employed to marginalize the HIV-positive. 

Chapter Two shifts to focus on AIDS and the serious consideration given to quarantining the HIV-positive even once it became clear that the disease was not casually communicable. Although the religious right had every intention of quarantining all AIDS patients and homosexuals, this extreme rhetoric was eventually rejected by the mainstream population; instead, the only legal quarantine of US citizens with AIDS came from laws meant “to isolate individuals with AIDS who refused to alter their risky behavior.” This type of legislation primarily targeted Black sex workers, whom Chávez argues became “an ultimate alien to the state, a fugitive.” Her examples of persecuted sex workers, while visceral and upsetting, powerfully demonstrate how health and labor intersect. 

Chapter Three focuses on the alienizing logic enacted upon migrants and the policy enacted in 1987 that banned HIV-positive migrants from entering the US; this policy was codified into a law that remained in place until 2010. Chávez considers how oppressive institutions used the rhetoric of ‘national common sense’ to define HIV as “grounds for immigration exclusion.” She lays out how even though the rest of the world saw the US as the primary spreader of HIV, the US began requiring HIV testing upon entry to the country. This policy targeted many undocumented immigrants already living in the US who likely contracted the disease while in the United States instead of their country of origin and discouraged them from seeking legalization status.

Most disturbingly, in 1991, the United States held political refugees from Haiti who tested positive for HIV indefinitely at Guantánamo Bay. Chávez illustrates how the anti-Black ‘national common sense’ rhetoric employed to justify this horror showed the US’s real fears about “the potential immigrant of Black Haitian migrants with a deadly disease, without economic security, and some with child.” While she returns to the harsh conditions of these migrants and the activism that attempted to free them in a later chapter, this section argues that the treatment of these migrants shows how ‘national common sense’ is less concerned with factual reality and more so with the “morality of the nation” that affected health and immigration policy rather than the lives of Black migrants and other victims of AIDS. 

Chávez then transitions into Part Two, “Resisting Alienizing Logic,” which documents the ways in which queer AIDS activists fought on behalf of racialized and immigrant Others. Chapter Four, “Boycotts and Protests of the International AIDS Conferences,” focuses specifically on the ways in which the US policy on excluding HIV-positive migrants led to protests of AIDS conferences held in the country, which did not allow HIV-positive travelers to attend. Chávez argues that this moment represents “a key instance of transnational coalition building that resisted the codification of alienating logic.” The AIDS conferences brought the HIV ban to more widespread attention, causing activists to boycott and protest the events, eventually leading to the Boston conference in 1992 being moved to Amsterdam. 

Chapter Five continues the theme of AIDS activists’ contributions to migrant rights, this time focusing on the intersections between queer and Haitian victims of AIDS. Although queer people and Haitians were two of the groups who carried the most AIDS stigma, there was often no true solidarity between them, and queer AIDS activists tended to represent only queer people in their activism. Chávez shows the limited ways in which AIDS media makers fought for the detained Haitian migrants at Guantánamo Bay, including the reporting in the queer paper New York Native on Haitian experiences of AIDS, and AIDS Community TV, which along with ACT UP NY, protested for the release of the Haitian migrants held at Guantánamo.In this instance, AIDS activists “insisted on keeping attention on anti-Black racism and how it intersected with economic and health discrimination,” which was atypical for the mostly white activists. 

Chávez points out the uniqueness of her own work in this chapter, asserting that “Although both Haitians and homosexuals were alienized from the beginning of the AIDS pandemic, virtually no scholarship has considered connections that existed between them, not to mention homosexual Haitians.” One of the book’s greatest strengths is Chávez’s intersectional lens that accounts for all axes of oppression within the context of ban and quarantine, and her insistence on Blackness as a central marker of difference. Although her focus is race and immigration, she also does not lose sight of the ways in which the two interlock with gender, sexuality, and especially sex work. Her conclusion focuses in part on the “power of coalitional gestures” that is thoroughly demonstrated in this chapter. 

Looking back on the history of HIV/AIDS through the lens of race, immigration, and citizenship would have been a relevant project regardless of when it was written, but the book’s 2022 release —three years into another global pandemic— has made these questions all the more applicable to our everyday lives. In the book’s preface, Chávez says it would be “arrogant and silly of [her] to cull too many lessons from this book to help understand the moment we presently live in,” but readers can find those lessons for themselves all the same. There are echoes of the HIV/AIDS crisis all around us, especially in the rhetoric we employ around quarantine, ban, race, immigration, and citizenship. The alienizing logic that Chávez describes is still being utilized by powerful, oppressive institutions that wish to alienize anyone whom they feel is not fit to belong in the nation-state. Chávez’s book gives us a blueprint for how to understand and describe this alienizing logic, and apply it to understanding our past, present, and future.