More than five years ago, Sierra Leone emerged from a civil war characterized by widespread sexual violence and massive displacement. A number of social interventions in post-conflict Sierra Leone have an explicit agenda to reconstitute ethical, moral and social order. These interventions, described elsewhere was "technologies of repair," are financed primarily by Western donors and implemented by a host of international, national and local NGOs. Within this context of institutional ethics, self-regulation and moral reconstitution, a variety of institutional actors have designed and implemented HIV prevention, treatment, care and support efforts. Although HIV is epidemiologically insignificant in comparison to other diseases--prevalence is 1.5%--it has captured transnational imaginaries, resulting in disproportionate and separate funding streams In Sierra Leone, the HIV/AIDS is culturally salient, deployed as an idiom for unique suffering among the HIV-positive and a productive site for articulating fantasies about individuals' role in the state's development and the state's capacity to care. Drawing on seventeen months' fieldwork in Freetown, Sierra Leone, my dissertation focuses on how HIV treatment, care and support programs produce and shape novel forms of subjectivity, identity, and exclusion.

In particular, I focus on the relationships between HIV-positive individuals and HIV/AIDS associations, and reflect on medical anthropological inquiries that have located AIDS activism within discussions of citizenship based on biological status. I argue that HIV/AIDS associations are sites of subject-making associated with medical and other resources important to inhabitants of an impoverished, post-conflict state. To gain access to these resources, association members are expected to perform an "impossible" HIV-positive personhood: they must pursue disclosure yet maintain confidentiality; they are urged to perform vulnerability while they also model self-sufficiency. Following Sierra Leone's eleven-year civil war, these "impossible" performances are linked to post-conflict programs aimed at promoting development, reconciliation, and transitional justice among Sierra Leoneans. Ultimately, I argue that given the low prevalence of HIV/AIDS in Sierra Leone, vertically funded and administered HIV/AIDS programs have marginalized the illness from existing systems of care, and reduced the capacity of the government to respond to its other, more pressing problems that also negatively impact health and wellbeing.