INTRODUCTION Côte-d’Ivoire and Triage in the Time of AIDS

In 1994, two years after he found out he was HIV positive, a young Abidjan law student named Dominique Esmel founded one of the first groups of people living with HIV in Africa, Light for AIdS. “We chose that name because we felt we were living in darkness,” Dominique told me; “we wanted to come out of the shadows of our isolation and live in the light of solidarity.” At the time, AIdS was already the leading cause of death in many parts of the continent, including in Côte-d’Ivoire’s bustling port metropolis, Abidjan.1 Few knew, or had been told, of their diagnosis— not that it would have made much difference then. HIV testing wasn’t readily available, and health care workers were reluctant to disclose a “hopeless” diagnosis. When Dominique “came out” publicly with his HIV diagnosis, the focus of the struggle against the epidemic in Africa had begun to shift away from epidemiological surveillance and public awareness campaigns aimed at increasing condom use. Worried that the campaigns weren’t working, international agencies bemoaned what they called a “culture of denial.” They emphasized the need to “put a face” to the disease. The number of Africans getting tested for HIV must increase, they insisted. More individuals like Dominique would need to “come out” publicly about being HIV positive. I first began to work in West Africa the same year Dominique testified. I remember first hearing about a mysterious and terrifying new epidemic, reported in gay men in 1982, in my first year of university.