The HIV/AIDS epidemic has affected some communities more than others. African Americans and HIV/AIDS: Understanding and Addressing the Epidemic, edited by Donna Hubbard McCree, Kenneth Terrill Jones, and Ann O’Leary, discusses the health disparity between the white and black communities and the psychosocial variables and contextual factors that may affect prevention efforts. In 1993, in response to the AIDS epidemic, James Jones updated his well-known Bad Blood: The Tuskegee Syphilis Experiment to include a chapter on AIDS, in which he noted that Tuskegee was the “historical lens” through which blacks viewed AIDS. Endgame: AIDS in Black America, a PBS Frontline documentary, ably shows the reach of AIDS in the disadvantaged minority populations of the rural and urban United States. The documentary Deepsouth looks at people in the rural South affected by HIV—for example, a young, gay, HIV-positive black man in Mississippi who looks for support from his “gay family” instead of his “blood family.” The popular literature also includes useful titles on HIV/AIDS in the black community. Among the interesting—if not scholarly—works are J. L. King’s On the Down Low: A Journey into the Lives of “Straight” Black Men Who Sleep with Men and Keith Boykin’s Beyond the Down Low: Sex, Lies, and Denial in Black America, which describe the denial and shame of bisexual black men who lead secret lives and do not identify themselves as such. In Structural Intimacies: Sexual Stories in the Black AIDS Epidemic, Sonja Mackenzie uses interviews to reveal how blacks feel about the racism, stigma, and poverty associated with HIV/AIDS and discusses how operating “on the down low” adds to the shame and stigma of black gay males, thus the racism of the expression. The denialism issue is addressed in Not in My Family: AIDS in the African-American Community, an edited collection of essays from black religious and political leaders and public figures recounting their personal stories about HIV/AIDS and the stigma, beliefs, and discrimination in the African American community.
Other sociological studies include Robert Klitzman and Ronald Bayer’s Mortal Secrets: Truth and Lies in the Age of AIDS, which looks at people living with AIDS (commonly referred to as PLWAs) and their attitudes about disclosing their HIV status. In In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS, clinical psychologist Walt Odets assesses psychological issues of those who test HIV-negative. In 2010, the American South accounted for almost half of new AIDS diagnoses.[1] In You’re the First One I’ve Told: The Faces of HIV in the Deep South, Kathryn Whetten and Brian Pence expand on the first edition of this work—subtitled “New Faces of HIV in the South,” and published more than a decade ago—by adding first-person life histories in which participants in a Duke University research study, “Coping with HIV/AIDS in the Southeast,” reveal their distrust of the health care system and the additional burden HIV infection places on the poor. Edited by Negar Akhavi, AIDS Sutra: Untold Stories from India, a collection of essays written by Indian authors known mostly for their literary works (e.g., Salman Rushdie), looks at the effect of HIV/AIDS on India’s people. The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS, by journalist-turned-epidemiologist Elizabeth Pisani, provides a lively, candid picture of boots-on-the-ground public health work in Indonesia. In Religion and AIDS in Africa, Jenny Trinitapoli and Alexander Weinreb discuss the implications of the United States President’s Emergency Plan for AIDS Relief (PEPFAR), which provides funding for prevention and treatment to many developing countries (e.g., South Africa, Vietnam). PEPFAR includes a congressionally mandated “ABC policy” (Abstinence, Be Faithful, Use Condoms).[2] The authors note the sad irony that condom use is prohibited in some of Africa’s main religions and abstinence-based prevention efforts have been found to be ineffective.[3]
As the HIV/AIDS epidemic has aged, its effect on society and culture has been the subject of scrutiny. Sarah Schulman’s The Gentrification of the Mind: Witness to a Lost Imagination is part memoir and part analysis of how society has assimilated AIDS. She believes that older gay people will become marginalized and that a new generation studying “queer theory” in college will know next to nothing about the fight against AIDS. In AIDS and Its Metaphors, Susan Sontag traces the language used to depict what was, when the book was published, a new disease and often described metaphorically as an invasion with the victims under assault. In How to Have Theory in an Epidemic: Cultural Chronicles of AIDS, Paula Treichler asserts that the AIDS epidemic is “cultural and linguistic as well as biological and biomedical” and that the language society uses to describe AIDS permeates the culture. Much like Sontag’s and Treichler’s books, Cindy Patton’s Inventing AIDS looks at AIDS through language and cultural analysis. Patton states that HIV infection assists in identifying and classifying people into categories—class, race, sex—that allow for discrimination. In another book, Fatal Advice: How Safe-Sex Education Went Wrong, Patton shows how safe sex is portrayed in HIV prevention. Illustrated with ads from the era, the book compares government-funded AIDS education for the general public and ads created by activists for the gay community: the former feature bullet points and clip art of white people, the latter provocative images of minorities and condoms. Another intriguing visual resource is AIDS Demo Graphics by Douglas Crimp with Adam Rolston, which shows the posters, ads, street art, leaflets, and stickers developed by ACT UP New York to create AIDS awareness and incite political action. An excellent online resource is AIDS Education Posters Collection, developed by Edward Atwater, which charts the “evolution of AIDS rhetoric.” Last, the National Library of Medicine’s Visual Culture and Public Health Posters website includes essays and posters and provides an overview of the medical establishment’s attempts to convey HIV/AIDS information.
[1] Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, HIV and AIDS in the United States by Geographic Distribution, http://www.cdc.gov/hiv/pdf/statistics_geographic_distribution.pdf
[2] U.S. Government, President’s Emergency Plan for AIDS Relief (PEPFAR), http://www.pepfar.gov/reports/guidance/c19545.htm
[3] K. Underhill, D Operario, and P. Montgomery, “Abstinence-Only Programs for HIV Infection Prevention in High-Income Countries,” Cochrane Database of Systematic Reviews, 4 (December 2007).
