THE EARLY POLITICAL RESPONSE TO AIDS
Acquired Immune Deficiency Syndrome (AIDS) is caused by the human immunodeficiency virus (HIV) and is transmitted via blood, vaginal and cervical secretions and semen. To pass on the virus it must be healthy, be in a ‘generous’ quantity and go from one body tissue to another via an injection process. The ideal way for these three to occur together is through sexual intercourse or through intravenous drug use. These routes of transmission ca be seen as the main reasons HIV/AIDS has been conceptualized as a disease of the guilty, and why early policy response to the disease was driven by moral judgment.
In 1981 scientists at the Centre for Disease Control noticed a higher incidence of people with a rare type of pneumonia - Pneumocystis carnii pneumonia - and an increase in the number of people dying of a very rare cancer - Kaposi’s sarcoma. As all they really knew was that these diseases were connected to a poorly functioning immune system and that, for some reason, nearly all of the cases occurred in gay men; they put these, and a number of similar, illnesses together under the banner Gay Related Immune Deficiency or GRID. By 1983 scientists had isolated a common virus - HIV – and when cases of HIV infection occurred in people other than gay men this led to a change in the name of the disorder from GRID to AIDS. However, in many people’s minds it was firmly routed as a “Gay Illness".
Many posit that it was due to this label that government reaction to the disease in the early years was almost nil. Randy Shilts, author of ‘And the Band Played On’, wrote that by the time Ronald Reagan delivered his first speech on AIDS 20,000 people had already died; Simon Watney (1989) said of the UK’s response: "eight years into the epidemic, the British government has still not spent a single penny on directly communicating support, sympathy or information to the social constituency that makes up more that 80% of people with AIDS in the UK", i.e., gay men and intravenous drug abusers.
To understand the government and public reaction to AIDS and the policies surrounding it, it is very important to first understand some of the history of gay culture. Before the 1960s practicing ‘gay acts’ was illegal. One of the key factors in lifting this regulation was the attention paid to J.S. Mill’s ‘Harm Principal’, which states that: "the only purpose for which power can be rightly exercised over any member of a civilized community against his will is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant".
It would probably have been fine if gay men had ‘stuck to the rules’ but moral outrage was inflamed when being gay was not something ‘they’ would confine to the back room, it was something gay people wanted to publicly display and celebrate. Gay men frightened the ‘straight’ society and even undermined the idea of masculinity, as Dyer says, "by taking the signs of masculinity and eroticizing them in a blatant homosexual context". Jeffrey Weeks (1985) says of the proliferation of bath houses in the 1970s, that they were "all about having one purpose: sex, sex for its own sake, sex in isolation, or in couples or in multiples, sex for pleasure, detached from all conventional ties and responsibilities". It was this attitude that so outraged many people; it threatened the ‘family planning’ view that however much a heterosexual couple has sex it would eventually lead to reproduction. Many people, such as Jerry Falwell whose weekly television program ‘Old Time Gospel Hour’ touched over 50 million viewers, linked everything from the breakup of marriages and the family to the decline of the country, recession and rise in crime figures, with the undermining of society due to the flaunting and practice of homosexuality. It was in and around these issues that HIV/AIDS presented itself. To some in the ‘moral majority’ it was a blessing from God; they saw it as direct avengement for the ‘unnatural acts’ of homosexuality and proof that they had been right all along.
The next noted communities of people where a rise in cases was seen was intravenous drug users and prostitutes. Again, as soon as their lifestyle was mentioned an immediate moral screen came down. Additionally, in the USA, 80% of injecting drug users are African American or Hispanic and these populations are generally more below the poverty line, under-represented in power and segregated through memories of the past. African Americans make up 12% of the population, but 27% of AIDS cases, for Hispanics the figures are 6% and 13%.
It was not until ‘innocent’ people became infected with HIV that AIDS was seen more as a health issue for the general population as opposed to a gay or drug-associated one. ‘Innocent’ transmission is through blood transfusions; or through the clotting agent Factor 8, used by hemophiliacs; or when a man visiting a HIV+ prostitute passes the virus to his partner; or when an infected drug user has a baby and passes HIV on to the child. It was only the moving of the virus from the section of the community that could ‘help it’ to the section which ‘couldn’t’ that seemed to create a turning point for government intervention.
The initial British government response to AIDS, in 1987, was seen through the release of television and billboard commercials, as well as leaflets. The depiction of tombstones and icebergs showed an almost exclusively ‘doom and gloom’ attitude and they stated a predominantly moral position which heavily implied that to protect yourself you should only have ‘straight ‘sex within a monogamous marriage to a virgin who had never used drugs (thereby ignoring those who had been infected with HIV through drug transfusions and Factor 8). The commercials were also very vague as with regards to the facts of HIV transmission. When pamphlets showing pictorially how-to put a condom on male genitalia were shown to the government and Margaret Thatcher they were not allowed to be published. It was not until the 1990s that the actual most affected community, gay men, was addressed, and two men were pictured together. However even these ‘educational’ leaflets implied that all anal intercourse is a high-risk activity (as opposed to only being so if done with an HIV+ partner), thus indicating that the act of anal sex itself that causes AIDS, not the virus. It was only privately funded charities such as the Terrence Higgins Trust, that produced explicit, sexy, funny, pictorial, interesting and informative literature, such as a wallet size pack including a ‘photo love’ story, a detailed description of how HIV is actually transmitted, a condom and lubricant.
One of the main ‘issues’ surrounding HIV/AIDS is still that of condom use, the promotion of which is not only driven by religious and moral attitudes but by financial and health issues as well. The spread of HIV is overwhelmingly controlled by proper use of, distribution of, and access to condoms. In Africa the non-use of condoms, mainly due not only to money but to a predominantly patriarchal society, is one of the biggest reasons for the spread of HIV; in Europe and South America, the countries with high numbers of HIV positive people are predominantly catholic. Dominated by a religion which sees any birth control as wrong and where the ‘virgin bride’ is still seen as a prize, condoms are not widely available and much pre-marital sex is anal. In catholic France condom advertising was banned until 1987, and it was not until 1991 that it could be mentioned that it had a use as a contraceptive aid. Thus, despite having the third highest rate of AIDS patients in Europe, condom use in France in the mid-1990’s was only 3-7% of the population. The condom problem is also on the rise in poorer Eastern Europe where, although attitudes to sex are becoming freer, wages are becoming lower and condoms are an expensive luxury. Even in what may be considered a well-educated, rich group of people, American college students, condom use is still only 50%. The problems of condoms also involve prostitutes. In Brazil, a rent boy can charge three times as much for sex without a condom and surveys have shown that prostitutes are less willing to use them as they may imply that they are HIV+ or they are implying that their customers are.
Overall, into the 21st century there has been a step forward in the conceptualization of AIDS and the policies surrounding it; the USA government spends over a billion dollars a year on research, education and medical facilities. It is less seen as an issue affecting the ‘worried well’ majority and more work and money is now being spent on those populations who actually have to deal with it. However it is still looked upon with horror and as one sufferer, David Ruffell, has said “when I was first diagnosed it was clear that I was the one who had to have the courage and the strength. I didn’t have one friend that didn’t panic and throw themselves to the floor in a frenzy". Another positive step has been a toning down of the moral outrage of the disease simply through normalization and through programs and films showing what a horrendous syndrome it is to die of. This has been helped by the down to earth view of people who may ordinarily be counted as part of the ‘moral majority’, people such as Rabbi Julia Neuberger who so rightly said "it is a strange God who chooses to punish male homosexuals and not females, and who is angry with drug-takers who inject...but not those who sniff".