Skip to main content


Log in

African Kaposi’s Sarcoma in the Light of Global AIDS: Antiblackness and Viral Visibility

  • Original Research
  • Published:
Journal of Bioethical Inquiry Aims and scope Submit manuscript


Drawing on the theoretical frameworks of antiblackness and intersectionality and the concept of viral visibility, this essay attends to the considerable archive of research about endemic Kaposi’s sarcoma (KS) in sub-Saharan Africa accrued during the mid-20th century. This body of data was inexplicably overlooked in Western research into KS during the first decade of the AIDS epidemic, during which period European and Mediterranean KS cases were most often cited as precedents despite the volume of African data available. This paper returns to the research on KS conducted in Africa during the colonial and postcolonial period to consider visibility, racial erasure, and discourses of global epidemiology, suggesting that the dynamics of medical research on HIV/AIDS have proceeded according to a tacit paradigm of antiblackness manifest in multiple exclusions of Africa from global health agendas—most recently the exclusion of the region from antiretroviral (ARV) drug therapy during the first decades of the treatment’s availability. During that decade KS all but disappeared among people with access to ARV therapy while KS became even more prevalent in sub-Saharan Africa, escalating along with HIV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. For a critique of therapeutic optimism in the West and in the context of promoting pre-exposure prophylaxis in Africa, see Patton and Kim (2012).

  2. The term “signature condition” appears throughout the history of writing on AIDS/HIV. For an example of its use to describe KS, see “People Dying From a Disease They Didn’t Have: The CDC Revises the Case Definition of AIDS, January 1, 1993” (Body Positive 2001).

  3. We do not have space to describe in detail the complex, changing, and contradictory classification of KS after 1981. On this matter, see the thorough analysis provided in Preda (2005).

  4. On the issue of the appearance of KS in gay men in the 1980s U.S. context, see Altman (1981) and Fannin (1982). On KSHV research and discovery, see Chang et al. (1994) and Altman (1994).

  5. A substantial scholarly literature is devoted to the interpretation of visualization as a means of knowing and experiencing health and illness. See, for example, Cartwright (1995, 2013), Ostherr (2005, 2013), and Serlin (2010).

  6. One system for classifying KS identifies subtypes as classic, endemic or African, immunosuppression- or transplant-associated, and epidemic or AIDS-associated (Wahman et al. 1991; Antman and Chang 2000; Tschachler 2011).

  7. On disruptive negativity, see Michelle Boulous Walker (2002) interpretation of Julia Kristeva’s use of Sigmund Freud’s concept of negation. Walker emphasizes that negation, understood as a semiotic process, is linked to expulsion and rejection and is always embodied. For Kristeva, Walker explains, “negativity (or rejection) is a somatic process which is both heterogeneous to and constitutive of the symbolic” (Walker 2002, 106). The semiotic inhabits language, and is always articulated through the body (Walker 2002). See also Edelman (2004) on disruptive queer negativity.

  8. Mosam et al. state: “[T]he incidence of Kaposi’s sarcoma has increased exponentially with the HIV/AIDS pandemic with a shift in trend demonstrating a dramatic increase in females and occurrence in younger individuals. Kaposi’s sarcoma specific therapy is underutilized due to poor access to highly active antiretroviral therapy and financial constraints in SSA [sub-Saharan Africa]” (Mosam, Aboobaker, and Shaik 2010, 119).


  • Alsop, Z. 2009. Ugandan bill could hamper progress on HIV/AIDS—World Report. The Lancet 374(9707): 2043–2044.

    Article  Google Scholar 

  • Altman, L.K. 1981. Rare cancer seen in 41 homosexuals. The New York Times, July 3. Accessed June 3, 2014.

  • Altman, L.K. 1994. Apparent virus may be a cause of fatal cancer in AIDS patients. The New York Times, December 16. Accessed June 3, 2014.

  • Antman, K.M.D., and Y.M.D. Chang. 2000. Kaposi’s sarcoma. The New England Journal of Medicine 342(14): 1027–1038.

    Article  CAS  PubMed  Google Scholar 

  • Bayer, R., and G.M. Oppenheimer. 2001. AIDS doctors: Voices from the epidemic. Oxford and New York: Oxford University Press.

    Google Scholar 

  • Bayley, A. 1983. Aggressive KS in Zambia. The Lancet 323(8390): 1318–1320.

    Article  Google Scholar 

  • Body Positive. 2001. People dying from a disease they didn’t have: The CDC revises the case definition of AIDS, January 1, 1993. Body Positive, January. Accessed June 3, 2014.

  • Cartwright, L. 1995. Screening the body: Tracing medicine’s visual culture. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Cartwright, L. 2013. How to have social media in an invisible pandemic: Hepatitis C in the time of H1N1. In The international encyclopedia of media studies: Media studies futures, vol. 6, edited by A. Valdivia and K.A. Gates, 215–240. Boston: Wiley Blackwell.

    Google Scholar 

  • Cartwright, L. Forthcoming. Learning from Philadelphia: Retroviral invisibility and the tracing of HIV networks. Journal of Homosexuality.

  • Chang, Y., E. Cesarman, M.S. Pessin, et al. 1994. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi’s sarcoma. Science 266(5192): 1865–1869.

    Article  CAS  PubMed  Google Scholar 

  • Cheney, K. 2012. Locating neocolonialism, “tradition,” and human rights in Uganda’s “gay death penalty.” African Studies Review 55(2): 77–95.

  • Crane, J.T. 2013. Scrambling for Africa: AIDS, expertise, and the rise of American global health science. Ithaca: Cornell University Press.

    Google Scholar 

  • Crenshaw, K. 1991. Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review 43(6): 1241–1299.

    Article  Google Scholar 

  • Davies, J.N.P. 1962. Kaposi’s sarcoma: A re-evaluation based on the disease in Africans. Acta: Unio Internationalis Contra Cancrum 18: 372–375.

    CAS  Google Scholar 

  • Edelman, L. 2004. No future: Queer theory and the death drive. Durham: Duke University Press.

    Book  Google Scholar 

  • Ellis, F.A. 1934. Multiple idiopathic hemorrhagic sarcoma of Kaposi: Report of a case in an American Negro. Archives of Dermatology and Syphilology 30(5): 706–708.

    Article  Google Scholar 

  • Fannin, S. 1982. A cluster of Kaposi’s sarcoma and Pneumocytis carinii pneumonia among homosexual male residents of Los Angeles and Orange counties, California. Morbidity and Mortality Weekly Report 31(23): 305–307. Accessed September 2, 2014.

  • Fanon, F. 1967. Black skins, white masks. New York: Grove.

    Google Scholar 

  • Goffman, E. 1974. Stigma: Notes on the management of spoiled identity. New York: Aronson.

    Google Scholar 

  • Gordon, L. 1999. Bad faith and antiblack racism. Atlantic Highlands, NJ: Humanity Books.

    Google Scholar 

  • Hartman, S.V. 1997. Scenes of subjection: Terror, slavery and self-making in nineteenth century America. New York: Oxford University Press.

    Google Scholar 

  • Hartman, S.V. 2003. The position of the unthought. An interview with Saidiya Hartman conducted by Frank B. Wilderson, III. Qui Parle 13(2): 183–201.

    Google Scholar 

  • Kyomya, M., K.W. Todyrs, and J.J. Amon. 2012. Laws against sodomy and the HIV epidemic in African prisons. The Lancet 380(9839): 310–312.

    Article  Google Scholar 

  • Lee, C.T.T. 2006. Deviant cosmopolitanism: Transgressive globalization and traveling citizenship. Ann Arbor, MI: ProQuest.

    Google Scholar 

  • Loewenthal, L.J.A. 1938. Multiple idiopathic hemorrhagic sarcoma of Kaposi: Report of a fourth case in a full-blooded Negro. Archives of Dermatology and Syphilology 37(6): 972–974.

    Article  Google Scholar 

  • Manalansan, M. 1995. In the shadows of stonewall: Examining gay transnational politics and the diasporic dilemma. GLQ: Journal of Gay and Lesbian Studies 2(4): 425–438.

    Google Scholar 

  • Mayer, K., and M. Mimiaga. 2011. Past as prologue: The refractory and evolving HIV epidemic among men who have sex with men. Clinical Infectious Diseases 52(11): 1371–1373.

    Article  PubMed  Google Scholar 

  • Mbembé, J.A. 2001. On the postcolony. Berkeley: University of California Press.

    Google Scholar 

  • Mosam, A., J. Aboobaker, and F. Shaik. 2010. Kaposi’s sarcoma in sub-Saharan Africa: A current perspective. Current Opinion in Infectious Diseases 23(2): 119–123.

    Article  CAS  PubMed  Google Scholar 

  • Oettle, A.G. 1962. Geographical and racial differences in the frequency of Kaposi’s sarcoma as evidence of environmental or genetic causes. Acta: Unio Internationalis Contra Cancrum 18: 330–363.

    CAS  Google Scholar 

  • Ostherr, K. 2005. Cinematic prophylaxis: Globalization and contagion in the discourse of world health. Durham: Duke University Press.

    Book  Google Scholar 

  • Ostherr, K. 2013. Medical visions: Producing the patient through film, television, and imaging technologies. New York: Oxford University Press.

    Google Scholar 

  • Palmer, P.E.S., and M.M. Reeder. 2001. The imaging of tropical diseases: With epidemiological, pathological, and clinical correlation: Volume 2. Berlin: Springer.

    Google Scholar 

  • Patterson, O. 1982. Slavery and social death. Cambridge: Harvard University Press.

    Google Scholar 

  • Patton, C. 2002. Globalizing AIDS. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Patton, C., and H.J. Kim. 2012. The cost of science: Knowledge and ethics in the HIV pre-exposure prophylaxis trials. Journal of Bioethical Inquiry 9(3): 295–310.

    Article  PubMed  Google Scholar 

  • Persky, B., and J. Lisa. 1944. Multiple idiopathic hemorrhagic sarcoma of Kaposi in a full-blooded negro. Archives of Dermatology and Syphilology 49(4): 270–272.

    Article  Google Scholar 

  • Pinching, A.J. 1986. AIDS and Africa: Lessons for us all. Journal of the Royal Society of Medicine 79(9): 501–503.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Preda, A. 2005. AIDS, rhetoric, and medical knowledge. Cambridge and New York: Cambridge University Press.

    Google Scholar 

  • Rothman, S. 1962. Remarks on sex, age and racial distribution of Kaposi’s sarcoma and on possible pathogenetic factors. Acta: Unio Internationalis Contra Cancrum 18: 326–329.

    Google Scholar 

  • Sasco, A.J., A. Jaquet, E. Boidin, et al. 2010. The challenge of AIDS-related malignancies in sub-Saharan Africa. PLoS ONE 5(1): e8621.

    Article  PubMed Central  PubMed  Google Scholar 

  • Serlin, D., ed. 2010. Imagining illness: Analyzing the visual culture of public health from the nineteenth century to the present. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Serwadda, D., W. Carswell, W.O. Ayuko, W. Wamukota, P. Madda, and R.G. Downing. 1986. Further experience with Kaposi’s sarcoma in Uganda. British Journal of Cancer 53(4): 497–500.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Shiels, R.A. 1986. A history of Kaposi’s sarcoma. Journal of the Royal Society of Medicine 79(9): 532–534.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Tamale, S. 2009. A human rights impact assessment of the Ugandan anti-homosexuality bill 2009. Speech delivered at the Makerere University in Kampala. The Equal Rights Review 4: 49–57.

  • Taylor, J.F., A.C. Templeton, C.L. Vogel, J.L. Ziegler, and S.K. Kyalwazi. 1971. Kaposi’s sarcoma in Uganda. International Journal of Cancer 8(1): 122–135.

    Article  CAS  Google Scholar 

  • Tschachler, E. 2011. Kaposi’s sarcoma. In Sexually transmitted infections and sexually transmitted diseases, edited by G. Gross and S.K. Tyring, 405–410. Berlin and Heidelberg: Springer.

    Chapter  Google Scholar 

  • Wahman, A., S.L. Melnick, F.S. Rhame, and J.D. Potter. 1991. The epidemiology of classic, African, and immunosuppressed Kaposi’s sarcoma. Epidemiologic Reviews 13: 178–199.

    CAS  PubMed  Google Scholar 

  • Walker, M.B. 2002. Philosophy and the maternal body: Reading silence. London and New York: Routledge.

    Google Scholar 

  • Weber, J. 1984. Is AIDS an epidemic form of African Kaposi’s sarcoma? Discussion paper. Journal of the Royal Society of Medicine 77(7): 572–576.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Wilderson III, F.B. 2003. Gramsci’s black Marx: Whither the slave in civil society? Social Identities 9(2): 225–240.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Pawan Singh.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Singh, P., Cartwright, L. & Visperas, C. African Kaposi’s Sarcoma in the Light of Global AIDS: Antiblackness and Viral Visibility. Bioethical Inquiry 11, 467–478 (2014).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: