AIDS: A Cultural History

I'm gonna start just with a brief history, um, because I'm not sure how much people, um, know here. I imagine quite a lot. Um, looking at then I'll turn to questions of representation and risk. Gay pride and homophobia. It's the social gospel and the turn to moralism human rights, and as it morphs into risk management, the criminalization of hiv. Um, and along the way, we're gonna have a band is playing. Nebraska is calling, and the virtue of bananas is being besmirched. So that's the, uh, agenda for the, the next 45 minutes. Okay. Between, uh, 25, between 25 and 40 million people worldwide have already died as a result of opportunistic infections resulting from aids. It may therefore seem obscene for me to claim that knowledge about AIDS has always been refracted through images, through symbols, and through other forms of representation for people living with hiv, dying of aids and witnessing it, as well as grieving dissolution and death. Suffering is of course, complex and embodied. Nevertheless, debates about aids have remained relentlessly representational, and this is why I'm gonna start this talk by looking at one image. This year. Tom Moray, a 37 year old physical therapist who grew up in a large Catholic family in the southern suburb of, uh, Quincy, just outside of Boston. The photograph was taken by Nicholas, um, Nixon shortly before man died on the 8th of February, 1988, and it's part of a series he did entitled People with AIDS tracing the devastating impact of AIDS on the bodies of men and women. Over several months, Nixon claimed the photographer claimed that he sought to humanize the disease to make it a little bit less something that people, uh, see at arm's length, a a little bit less something that people see at arm's length. He hoped that his photographs would, in his words, add an extra dimension to the fact of the illness and help people understand that it is just a virus and could hit any of us. So what do you see when you look at this photograph of Tom Moran shortly before he died? Well, Dixon's photographs, um, divided opinions in the 1980s and nineties. In Art Forum photographer Charles Hagan observed that what is usually lacking in all the media uproar about AIDS is a sense of the victims as something more than cases anonymous components of statistics. It is precisely their identity as individuals that society denies them. In contrast, Hagan contended that Nixon never treats the aid patients he photographs as cases or specimens to be examined dispassionately at a distance. His final photograph of Tom Moran is a close up so that in print, it appears life size. Moran looks at the camera and through it at us. This is a human being, not a statistic, not a convenient object for moral judgment, but lots of people who saw this exhibition or, um, disagreed. And most importantly, many of those people protesting the photographic depictions in people with aids were those who were also witnessing the deaths on of friends and lovers, as well as struggling with the emotional and physical consequences of their own H I v diagnosis. The most trenchant I think of these complaints was made by Douglas Crimp, an activist in Act Up AIDS Coalition to Unleash Power, founded in 1987. Now, Crip was appalled that Nixon was reproducing highly damaging tropes. The photographs not only portrayed people with AIDS as isolated individuals where were their lovers, friends, families, but also were frightening for many communities. The photographs he said showed people ravaged, disfigured, debilitated by the syndrome. They are generally alone or desperate, but resigned to their inevitable deaths. In other words, the photographs lacked political context. In Cris words, the photographs could produce a phobic effect in which the last thing one would ever want to do would be to identify with their subjects. A viewer could see them neither as human nor as possible self images, but rather as images of objection and otherness. This was part of what many Act UP activists saw as the Depoliticization of AIDS portraiture. It was a comment echoed by Simon Watney, British AIDS activist and co-founder of Outrage, which campaigned for lesbian and gay rights between 19, um, 1990 and, uh, 2011. Wat ne was outraged by the fact that photographs such as the ones by Nixon, in his words, abstract the experience of people living with aids away from the determining context of the major institutions of healthcare and state. As I quoted Nixon, the photographer saying earlier, he hoped that his photographs would help people understand that it's just a virus and could hit any one of us. A comment that ignores wide disparities of suffering caused by inequalities, discrimination, and political othering as I'm gonna be arguing later, but first I'm gonna take a few quick steps back, um, in order to trace the history of knowledge of the virus, which was this virus, which was, you know, to kind of define, um, the late 20th century in a similar way to the polio virus epidemic, which I looked at in earlier lecture, and I can see that some of you were at that polio, um, lecture. Um, it defines in the 20, late 21st, 21st century, 20th century, like that poliovirus defined the mid 20th century. The story I'm gonna tell, and apologies here, is largely British and American, because those are my areas of expertise, and it would be wrong of me to pretend otherwise. But please remember that there is a global dimension that is very, very, very different, um, to this, okay, almost exactly 42 years ago, on the 5th of June, um, 8 19 81, the US Centers for Disease Control and Prevention c D C registered the appearance of a previously rare form of pneumonia in five gay men in Los Angeles. A month later, the C'S morbidity and mortality report noted that 26 young gay men from New York had presented with, um, Kaposi sarcoma. Before the end of that year, public health experts were warning of an epidemic of the disease among gay men and intravenous drugs users, although initially labeled gay cancer, then gay related immune deficiency. Good. By the summer of 1982, it had been named acquired, uh, immunodeficiency syndrome aids. In 1983, the human um, virus HIV was identified leading Robert, uh, Gallo, the Vir Virologist, who discovered or co-discovered the virus tidi that a vaccine would be found in just a couple of years. It took another two years to invent a test that could identify the virus, an important step, because otherwise the virus remained undetected or could remain up undetected for up to a decade. By 1985, in this quick run through of that, this history, by 1985 at Panic, was under Wave with Life Magazine, running a cover in July of that year, announcing that now no one is safe from aids. An invidious headline subtly conveying the view that homosexuality was not only a, um, lethal disease, but also contagious. The headline also, of course, implied that there was this distinction between innocent and guilty. The former included children, heterosexuals and hemophiliacs, the latter of course, gay men and, um, drug users. The poster boy, um, for distinguishing innocent sufferers was Ryan White hemophilia, um, who acquired HIV through contaminated Factor eight blood treatment, and who died in 1990, just one month before his high school graduation. By 1994, AIDS had become the leading cause of death for Americans aged 25 to 44. But certain communities were experiencing higher morbidity and mortality, although the syndrome is typically represented in terms of white homosexual male populations. Of the 355 cases, um, reported in the medical literature in the year after June, 1981, 13, were heterosexual women even a decade later. However, the C D C Centers for Disease Control and Prevention did not include in their case definition of aids, the most common illness manifestations in women. That is eva invasive cervical cancer and recurrent vaginal, um, yeast infections. Women were also excluded from drug trials. This was despite the fact that by 1990 AIDS was the leading cause of death for African American women. Today, 19% of new H HIV V infections are among women. 54% of whom are African American, 84% were infected by the virus through heterosexual contact. Although the illness is even today still raced white. Um, 42% of new infections reported in 20 uh, 19 occurred amongst African Americans, who are only 13% of the American population. As we've seen throughout this whole series of, um, of lectures, these statistics are of course, definitely underestimates, minoritized. People's illnesses and deaths often don't count, and so are uncounted. Many poor people can also not afford, um, Medicaid dying before any diagnosis can actually be made. Now, scientists in this quick run through of the the actual history, um, struggled of course to find ways to halt infections. The first antiretroviral drug to be approved was azt, um, which diminishes the virus's ability to replicate as a monotherapy. It proved inadequate since the virus quickly built up resistance and mutated. Decade later, 1996 Virologists, um, David Ho announced to a stunned audience at the 11th International AIDS Conference in, uh, Vancouver, that antiretroviral drugs combined with prot inhibitors would fight off the disease almost overnight. HIV positive people who could afford the drugs became chronic patients as opposed to people living out what they thought was a death sentence. If diagnosed early, regular, taken regularly, antiretroviral, I A R t medications, uh, can be effective. The drugs have very severe side effects. However, furthermore, people have two take very large quantities of the drugs their entire life. Um, discontinuing, uh, can lead to reactivation as a result. What you see in the medical literature is a shift of focus in this period, and the focus goes from prevention to, um, adherence. That is behavioral studies about how to ensure that people with HIV adhere to a strict regime of drug taking. The drugs, of course, are made available in very unequal ways. Regular uses was found to be challenging for people with less stable lives. The new technologies failed to take account of sociopolitical context in which these technologies circulated, including their costs and need for punctuality. They ignored the disproportionate impact of homophobia drug use, colonialism, discrimination in employment, housing, and healthcare for certain groups. 2012, for example, a meta-analysis published by the Lancet found that HIV positive black men who have sex with men M sm, um, were 22% in Britain and 60% in the us less likely than other HIV positive msms to receive combination antiretroviral therapy. So, in other words, HIV positive men of sex with men, MSM with 22% in Britain and 60% in the us less likely than others to, than other HIV positive msms to receive. Um, combination anti, uh, retroviral therapy. The Lancet researchers themselves concluded that elimination of disparities in HIV infection in black s msms cannot be accomplished without addressing structural barriers or differences in HIV clinical care and outcomes. Now, HIV and AIDS came as a shock. Two populations who had come to believe that infectious epidemics were a thing of the past, and that the main public health issues were chronic diseases such as cancer and heart problems. A shock, of course, that's been repeated with the current, um, COVID 19. The epidemic also came immediately after a period of optimism and pride for many gay individuals and communities. Now, no one doubted doubts that homophobia was prevalent throughout the 1960s and 1970s, but in that period, nevertheless, there were reasons to be at least hopeful. For example, in the us, the Civil Rights Act of 1964 had outlied Lord discrimination based on sex as well as religion, color, and race. 1969, the Stonewall Uprising Greenwich Village served as a catalyst, the gay, lesbian, and queer protest and pride. Throughout the 1960s and seventies. Sexual restrictions loosened. The counterculture was exploding. Feminism was thriving. Human rights as well as the rights of the disabled and other minoritized groups were being championed. Now, medically too, there was a mood of optimism, including an assumption that antibiotics had minimized the longer term risks of contracting sexually transmitted infections. AIDS activist Michael Calan even bragged that in his pre I v life, he wore his STDs as red badges of courage in a war against a sex negative society. It was also made official that homosexuality was no longer a psychiatric disorder. 1973, it was removed from the second edition of the Diagnostic and Statistical Manual of the American Psychiatric um, association. Although some of you who've been here for other lectures will know that in fact, yeah, it was removed, but it, um, it continued to lurk in other diagnostic categories. But anyway, by the mid 1970s, more than half of US states had decriminalized homosexuality in private, in the main cities, vibrant, supporting and proud communities of L g BT Q our people became much more visible. This mood of optimism shattered in the 1980s. The hiv aids epidemic both coincided with and fueled a homophobic backlash. The trend towards increased acceptance of sexual difference was reversed. There were calls for the re criminalization and re medicalization of homosexuality. Homosexuals and queers were blamed for the decline of the nuclear family and the rise of promiscuity. While in 19 83, 60 2% of people polled thought homosexual relations were always, always to mostly wrong. By 1987, this had jumped to 74%. Now, the two thousands did see a shift to more acceptance. 2000, the percentage of people who disapproved of homosexuality dropped to 46% and then to 30% 2010. But by this stage, two decades of heightened homophobia had severely hampered medical research and treatment, while serving as a deliberate attack on the dignity of minoritized communities. L G B T Q, people had long been denied moral citizenship. The AIDS epidemic set them either even further outside the human, the fully human, let alone any entitlement to be regarded as upstanding citizens entitled to full rights. Now, the ascendancy of, of conservative religious organizations boosted, um, hostile, um, attitudes. Now, I find it really interesting. At the start of the HIV crisis, the Catholic Church had taken a compassionate stand. An emphasis on the social gospel meant a focus on the equality of all people under God, coupled with an urge to tackle the wrongs associated with poverty and discrimination. By the 1980s, however, a more conservative wing of the church had come into power, obsessed less with social issues and more with morality, specifically the universal blessings of heterosexuality and the monogamous family unit. The Catholic's church's powerful stake in healthcare, including hospitals and hospices, um, meant that their insistence that good morality is good science. That's the phrase used by Cardinal John O'Connor of New York was especially damaging. In effect, deviance were blamed for their own suffering. Religious organizations routinely claimed that the virus was a moral as much as a medical issue. It was God's punishment for sinful sexual behaviors claimed evangelical tele televangelist Jerry Fal. Well, in a 1986, um, poll, Gallup Poll, 43% of Americans believed that hiv aids was, were divine punishment for moral decline. For many people living with hiv aids, rejection by their spiritual advisors and communities could be particularly painful. The impact on dying people with AIDS could be devastating. Even those who had abandoned the religious views of their families might be still terrified to be told that their lifestyle was leading them straight into the fires of hell. Now, in the early years of the epidemic, a lack of knowledge about roots of transmission helped foster such, um, hostile responses. Was AIDS passed through the air by breathing? Could it be spread by perspiration? Authorities abruptly shut down gay bath houses and many gay community centers. If a person's diagnosis became known, they could be fired from their job, refused health insurance evicted from their homes. Immigrants faced huge stigma and incarceration, especially a Haitian restaurants who employed gay waiters noticed a drop in the number of customers in public facilities. Toilet seats became an object of hysteria, even after though it had actually been established that the virus could only be transmitted through the exchange of bodily fluids. Some medical professionals still refused to treat people. They suspected of being HIV positive. Some funeral parlors refused to bury people whom they suspected of, um, dying of AIDS complications. Parents sought respectability over honesty about their loved ones lives. Obituaries were often coy in recording cause of death. Euphemistically noting that a person died after a long fight with cancer. The families of patients disregarded the preferences of their, um, of their family, the preferences of their, um, the patients. They refused to allow partners, lovers, and carers to say goodbye, then claimed ownership of any remaining financial resources such as property. For example, politicians, no surprise here were, could be, uh, particularly punitive in their responses. Some such as Senator Jesse Helms argue that infected people should rebut acquired to live in segregated housing facilities. 1987, he was successful in proposing a budget amendment, banning federal funding for HIV aids initiatives that mention homosexuality. March, 1986, William Buckley, conservative editor of the National Review, made the case that everyone detected with AIDS should be tattooed in the upper forearm to protect common needle users and on the buttocks to prevent, prevent the victimization of other homosexuals. Pat Buchanan communicated shins director for President Reagan contended that AIDS was nature's revenge on gay men, and these were not isolated views. In California, for example, a poll calling for mass quarantines collected nearly 400,000 signatures. 19 85, 50 1% of Americans supported quarantining people with aids. 51% supported a law making it a crime for a person with AIDS to have sex with another person, half approved of ID cards. For those who tested positive, 45% supported testing job applicants for H AIDS antibodies and one in seven favored tattooing those with the disease. Violence against gay men in particular soared black communities experienced additional prejudices and threats. Racists claimed that black communities were teaming with sexual deviance, drug addicts, prostitutes, high levels of unemployment, homelessness and incarceration, fueled racialized forms of homophobia. High levels of H I V amongst black women confirmed longstanding xenophobic narratives about black women as sexually promiscuous and transmitters of all kinds of sexually transmitted infections. So, so in these contexts, misinformation spread widely. This was especially the case when it came to safe sex and some advice was, frankly, ludicrous. My favorite, um, art Yuen writing in safe sex in a dangerous World, 1987. He seriously argued that it's, it's time to stop talking about safe sex. I believe we should be talking about safe partners. Instead, he then contended that one way to find safe partners is to move to a place where the incidents of AIDS is low. There are two states that have reported only four cases of AIDS since the disease was discovered. While others are crowded with AIDS patients. In other words, new Yorkers moved to Nebraska.<laugh> adverts about the need to use condoms also generated some ridiculous advice. And here's my top favorite of them all. Um, president of the International Banana Association. You wondered how I was gonna get bananas into this, didn't you? Uh, wrote a letter of complaint to the President of the Public Broadcasting Service. He complained that the choice of the banana, rather than some other inanimate prop in demonstrating how to put on a condom constitutes arbitrary and reckless disregard for the unsavory association of bananas that will be drawn by the public and the damage to our industry that will result there from, I never thought about bananas in the same way Anyway, uh, unsurprisingly, conspiracy theories spread like wildfire. Was H I v A manmade bio, a weapon deliberately created and released by US research laboratories or the cia? Was it part of a plot to kill black people? Some scientists even embraced these, um, conspiracy theories, claiming that governments, multinational corporations, pharmaceutical companies, were actually in league. They were refusing to investigate whether H I V was really linked to aids. They were lying to people about the toxic nature of antiretrovirals. They were exaggerating the numbers of deaths. Virologists. Uh, Peter Berg publicly argued that AIDS was not caused by the H HIV virus. He offered to inject, um, it into his own veins as proof channeling, but warned that anti, um, retrovirals were simply a way to channel profits to major pharmaceutical companies. South Africa's president and Beaking and members of his cabinet were converts. Maki's Minister of Health urged South Africans to sperm, the toxic a r v treatments and resort to traditional remedies, including garlic, berut, African potatoes, and lemon juice. And this advice actually is, um, estimated to be, um, responsible for the deaths of around 300,000 hiv, um, infected South Africans throughout the globe, aged deniers and cult throat. That is entrepreneurs who disregard science promote conspiracy theories and seek to profit from alternative, um, remedies have resulted in devastating public health consequences. These deadly prejudices were inflamed. Further, in 1987, after Randy Schultz published and the band played on as the first history of the syndrome, he was persuaded by his publishers to sensationalize patient zero, um, um, Gaden Gaden, uh, duke, a gay French Canadian flight attendant. As the person who brought AIDS to North America, dukus was diagnosed with cancer. May, 1980 died March, 1984. His portrayal of dus was one was that over one dimensional diabolical foreigner. For Schultz, DUIs was a psychopathic villain who could have stepped straight out of a gothic novel. And the band played on was one of the most widely read books on hiv aids and became one of the most influential books of the time. This, um, was despite the fact that even the designation patient Zero was wrong, it was actually a slip of a pen that transformed the C'S epi epi epidemiologist, o meaning outside of California, um, for zero, uh, meaning patient, um, zero. Furthermore, as historian Richard McKay has shown in Patient Zero and the making of an AIDS exhibition expedition epidemic, um, which came out in 2017, Sealy recommend this book. Nearly everything published about Dukas was inaccurate. Rather than being an irresponsible spreader of death, he was actually charming, personally attractive, proudly out gay man, much loved by his family and his friends. At the time dus was diagnosed, little was known about the way the virus was transmitted. The gay community had very good reason to be wary of the medical establishment and the way they moralized about homosexuality, um, contributing to homophobic rhetoric and sought, and how the way they sought to monitor, um, gay communities. Although Dugas assessed what evidence was throughout, I should say throughout, he assessed what evidence was available and acted accordingly. Even participating in HIV support, uh, groups, um, Gatan Duka, along with a large section of the gay community of the time, believed in the overload theory of the disease. As propagated by New York infectious diseases expert Joseph Sobe bend. This held that the disease was the result of the collapse of the immune system due to multiple partners. If people restricted the number of partners their immune system would recover. And this was exactly what quite sensibly DUIs did. Um, unfortunately, um, it was wrong. Nevertheless, Lucas's name is constantly mentioned, why By people advocating for the criminalization of virus transmission. He is kind of the mythical, malicious criminal blame for deliberately spreading infection. This made him a very convenient scapegoat for politicians, policy makers, public health officials seeking to introduce laws prosecuting people who fail to disclose their positive status to their partners, or who engage in behaviors that increase risk of transmission. Now, the laws differ, of course, in every jurisdiction, but most actually do not criminalize actual transmission, but potential transmission that is the victim in the crime need not have contracted the virus at all. Although most of the laws refer only to sexual intercourse. Some include oral sex spitting or throwing bodily fluids. All actions where the risk of transmission is, is low, extremely low. As of 2020, criminal laws associated with hiv, aids and aids have been passed in at least 72 nations and convictions in these laws can result in a lengthy prison sentence. Canada, just to give you one example, has particularly harsh laws associated with HIV transmission. From 1998, uh, people living with HIV had a legal duty to disclose their viral status to sexual partners if sex proposed a significant risk of HIV transmission. 2012, however, a judgment by the Supreme Court significantly broadened this. It ruled that people were required to tell a sexual partner if they had HIV before engaging in sex, if there was a realistic possibility of transmission. And what this means is that, um, unless a person has both a low viral load and wears a condom, their partner's consent to sexual intercourse is assumed to beated leading the way to prosecution for sexual assault. Aggravated sexual assault, people can be imprisoned even if they're not infectious. And there has been no transmission of hiv. And the evidence shows that more than half of cases in Canada that ended in a conviction, there was no HIV transmission. And of those convicted, 93% received a prison sentence. Now, castle responses to public health crises. Public health governance through criminal law has been, had been made necessary by the introduction in spread of neoliberal economic policies, resulting in severe reductions in social welfare, including public health. This turn to the caster state was not, of course, new queer communities and other minoritized or deviant groups such as impoverished, unmarried mothers blamed for giving birth to crack. Babies have a long history of persecution, as with other forms of health related criminalization. However, it's counterproductive. By increasing the stigma associated with infection, people are discouraged from disclosing their status, let alone seeking treatment. These forms of discrimination disproportionately affect minoritized communities. Study based in California between 1988 and 2 20 14, black, all Latino made up two thirds of the people who came into contact with a criminal system based on HIV status alone. Although they make up only less than a half of the population. Um, criminalization has worked alongside another shift in the state's management of HIV aids in Europe, although there are country-wide differences, a significant turning point was the financial crisis of 2008. Up to that time, European states had operated according to a rights-based model, founded on the European Convention of Human Rights and the European Social Charter, both of which, um, asserted a universal right to health in the uk. Positive initiatives included the syringe exchange program, 1987 Food aid program, psychological psychological Support groups. US successful example of the universal rights approach was the passing of the Americans with Disabilities Act 1990, which gave people with hiv aids protections in employment and healthcare, as well as, um, cementing their rights not to be discriminated against. After 2008, however, this emphasis on universal rights changed towards risk management. Efficiency regimes, regimes, ideas about containment and protecting intellectual property. Rights of pharmaceutical companies came to the fore as universal or broadly based rights fell out of favor. Neoliberal policies emphasized the need to prioritize certain populations, including ensuring that risk was not spread to previously unaffected groups and assessing politics to assu ensure that they were economically effective. So in Britain after 2008, there were sweeping cuts to health and social budgets, including incapacity, um, benefits, psychosocial services, all of which proved particularly harmful for people, uh, living with HIV aids. There was also a distinct change in tone amongst researchers. Early years of hiv aids management emphasized individual community needs. The voices of those people affected were heard and heard quite loudly. Um, however, this under the new dispensation an abstract concept of populations who are at risk dominated in addition to the financial implications of the disease. So we have a shift in language to economic evaluation of the net benefit, limiting economic burdens, cost-effective strategies, and so on. No surprise here. Throughout the period, people influenced or affected by H hiv, um, AIDS resisted the stigmatization and discrimination quickly, mobilizing keen to understand the disease, prevent, prevent transmission, and educate the wider public. Most famous of these activist groups, of course, is Act Up AIDS Coalition to Unleash Power. A grassroots democratic political, uh, movement founded 1987. It borrowed campaigning tactics from civil rights organizations, feminist groups, anti-military groups, extremely diverse initially in terms of personnel strategies, tactics, chief aim was to disrupt business as usual. So sit-ins, dins, community Artworks, um, public displays of, of, of grief, criticizing pharmaceutical industries who allowed, for example, the profits, um, from a central drugs such as Daraprim, which helps prevent, uh, pneumonia and people with hiv aids, which skyrocketed the price. Skyrocketed 50 fold from $13 50, um, to 750 part dollars per unit. Uh, by 2015, they provide proved particularly effective communicators in, um, things like the, uh, the quilt, the AIDS memorial notable victories, um, of AIDS activism includes streaming US food and drug administrations. The FDA's processes for approving drugs such as a Z T, um, advocating for Clean needle exchange, insisting that HIV positive women be included in drug trials, providing accurate information to public working to create adequate social services and disability Pensions Act Up also championed the rights to sexual pleasure and bodily self-determination. They linked up with WHAM Women's Health Action and Mobilization, uniting debates about AIDS and abortion. Instead of remaining as objects of medical and scientific inquiry, members of activist communities directly challenged the Medicalizing discourses. In 1985, after a, a drug became available, a test, sorry, became available for the H HIV v um, uh, virus. They argued persuasively against mandatory, um, testing. Lesbians also were very active in the movement because they too were under attack by conservative media and politicians. They understood the struggles of their gay brothers. Lesbian activists were particularly prominent in organizing blood drives, volunteering as buddies, marching in protest movements and staging public, uh, prevention events. Prominent activists include, um, feminists, uh, lesbian feminists such as Evelyn Hammonds, who'd been involved with the Kohi River Collective, which we've heard quite a lot of. In my series, um, of talks, Linda Val Rosa, who in 1987 co-wrote the first article on AIDS in a bme, uh, magazine. And, uh, Katherine Kathy Kohan, author of 1999, the Boundaries of Blackness and the Black Lesbian and Gay Organization, bam, black AIDS Mobilization Art also played an central role in resistance strategies of all the activist groups. My favorite, and probably one of the most prominent in this period was Grand Fury. The artistic wing of Act Up one of their billboards was entitled, and I'm sorry about the poor image here. It's entitled, welcome to America. And the text below which you can't eat <laugh>, um, goes, welcome to America, the only industrialized country besides South Africa. Without national healthcare, the power in the billboard re rested in the fact that it was not only addressing HIV v aids, but also related issues of homelessness, reproductive rights, poverty, inequalities in healthcare Act Up was vocal in resisting the artistic commercialization of aids, also staging their own counter artistic campaigns. Most prominent one was their response to, uh, this 1992 appropriation of, um, Theresa Va, photograph of David Kirby by the Fashion Sweater Company Benton. Um, they published the version of the statement, there's only one piva. This photograph should be used to sell another, uh, powerful but also controversial article. Um, artistic response was, let the record show 19, um, 87, which was a photo installation and a particularly, um, powerful one. If you want to read more about this, remember, a long version of my talk with a lot more detail, um, is on the Gresham website. Um, so you can, um, have a look at that. The reason Reagan, of course, was, um, targeted here was that he refused to even say the words aids. June the first six years of the Epidemic Act Up was also important in theorizing sex and sexuality. Early activists, of course, drew on, um, the writings of, uh, Fuko. According to activist, uh, Douglas Crimp Fuko, the history of sexuality had something of the effect that Herbert Macu Aeros and Civilization had on political movements during the 1960s. By the 1990s, however, they had the writings of queer theorists. Um, so they drew instead of, well, they all, they continued to draw on Fuco. They also drew on due to the Butler in Gender Trouble and Eve Sedgwick Theology of the Closet. Um, such text of course, changed worlds well beyond LGBTQ one s, but there were also, um, divisions, uh, responses split, particularly or notably between activists who advocated condom use, monogamy or celibacy, as opposed to those who believed that such, um, uh, responses were anti-sex or represented internalized homophobia. And you can read about this, um, in the long version of this paper, there was also a lack of agreement over sexual practices, which paled besides con, uh, alongside conflicts associated with strategy and indeed identity. The story has been told much more eloquently by other historians. So I'm giving you a short version here. But in short, there was a tension between white gay male activists on one side and people of color and women on the other. One side was accused of defending white privilege. And conformism the other side of political utopianism Act Up had operated a, what they called an inside outside strategy. In other words, while some parts of the movement worked in direct personal relationship to government or corporate officials having intimate interactions and creating identifications, other parts of the movement provided backup and pressure through street action playing the role of outside. But as Sarah Schulman explains, and you can also get the references for this in the, the online, the paper version, which is online Gresham's, um, website, as she explains, the problem was that most people in power within the aids, um, activist movement were white males. And this determined which AIDS activists had the potential to be inside and which ones would be relegated to outside. Because the leadership of ACT Up was white educated and well off. Many black activists felt marginalized either because they lacked the, uh, economic, um, power or personal support mechanisms to devote their energies and time to the cause, or because they were deliberately relegated to the margins to the outside. In the words of Alexander Juda, when Act Up is remembered, other places people and forms of AIDS activism are misremembered. The Minority Action Committee, MAC of Act Up drew attention to racism within the organization led by gay men of color. Mack enlisted the support of SisterLove, the Black church, the Nation of Islam and other organizations for people of color to argue that finding a magic bullet that is prioritizing drugs into bodies was less important strategically then transforming cultures of discrimination and inequality. They were upset with the assumption that people of color were drug users and by ACT ops failure to consult black and latino com communities. When the white male advocates in the treatment and data committee of ACT UP accused the street activists of setting the movement back by alienating allies in government and in science, they responded with bitter claims that act up sought respectability and assimilation over political transformation. Now, the introduction of medication also changed the dynamic of the movement. The erroneously called post aids World saw a depoliticization individualization and commercialization of HIV V aids power moved away from local communities and support groups and towards state regulation and medical as well as pharmaceutical interventions. When gay lifestyles became more a similar assimilationist, local authority shifted their attention to drug users in a per especially AST stringent assessment. In 2017, critical sexuality studies scholar Gary Dset maintained that gay men were all peeled up and potion into subjection in a biomedical reregulation of our sexuality. The gay lifestyle now included adding a r t to our shopping list of goods and services along with moisturizer, protein powder and dildos. Queer theorist Jaque Perra has coined a witty term to refer to this, and that is Homo normativity replicating some of the hierarchical ideas found in hetero normativity in terms of race, class, gender, nation state, conclusion, HIV aids remains a major global problem Today, more than 38 million people are living with hiv. It is yet another example of health as a political as much as a medical issue. But of course, there is no single story of, um, hiv aids. This is why I just want to end in a couple of sentences with, uh, Tom a Moran, the photograph man with whom I started this talk wrong direction. Although I agree with the criticism of Nixon, um, who took the photographs, I think it's important to note that Tom Moran was keen that the photographs were taken and Tom Moran was of course, much more than his photograph. He was secretive, he was abrasive, he was loved by his family. He was a very good friend. He was a man with a cheeky smile, 1996, Tom Gunn composed a poem in the Circle of Peace at the National AIDS Memorial Grove in St. San Francisco's Golden Gate Park. The only, I think it's still the only, you may correct me, the only federally, federally designated age memor AIDS memorial in the US and some of the lines go like this. And I'm gonna end with these lines walker within the circle pause, although they all died of one cause remember how their lives were dense with fine, compacted difference. Thanks. Thank you very much. Joan. I'm just gonna start with one question here and then maybe some people, um, in the audience would like to ask some. So we have one here. How do you know the conspiracy theories about the cause of aids were wrong in terms of the disproportionate effect on gay men and the African population? Yeah, um, there's really great research done on conspiracy theories more generally. We don't know that some of them are wrong. What we do have is the best, um, evidence, um, both scientific evidence, um, and experiential evidence that suggests very strongly, um, certainly medical and scientific evidence that the, those conspiracy I mentioned here actually are not correct and they do great harm to people. It's a really big question because of course, conspiracy theories, um, the term itself is used just to denigrate any theory that you don't agree with yourself. But I think if we are talking about, and we are talking about illness and a cultural history of illness, we do have to take two things seriously. Firstly, we have to take very seriously the scientific evidence that we have, which is always under revision. And I mean, that's what science is.<laugh>, you know, experimenting and, and proving and disproving hypothesis hypotheses. And as we saw here, the scientists did differ, um, at times and revised their, their views. That's the first thing that we have to take into serious consideration, um, that, you know, we need to pay attention to what the best knowledge that we have is. But I think the second thing we need to take into consideration, which is almost as important, is that conspiracy theories have an impact on people's lives, and we need to take them seriously in the sense that if we are to tackle something like a, um, infectious disease, um, we also have to take those conspirator, those, uh, discounted knowledges very, very seriously in order to persuade people to, to act in ways that that keep them healthy. Yeah, yeah. Great. Right at the back cycling, the blue shirt, Uh, just wondered what you thought of recent movies and, uh, TV series. I'm thinking like 120 bpm, the, the French, uh, movie that, uh, looked at particularly Act Up and something like the Channel four series at , I dunno, that German, uh, film. So, um, can you come up afterwards and write it down for me? That would be great. Um, I think that in terms of those, in terms of the documentaries that have been made about, uh, groups such as Act Up, um, I think actually some of them are really interesting and, and very good. I think that they fail occasionally to the ones I've seen fail to or fail are scared or timid when they're kind of pointing out the divisions within the movement because there is a sense that, um, you know, they did good things. They really, uh, changed the world for people who are living with, um, HIV and AIDS and their families, friends and communities, and therefore you don't want to, there's a sort of timidity about criticizing them, and I think this is what, um, I don't think we should be afraid of, of that because, you know, by actually looking at the fractures within a movement, we not only learn about what is actually happening in the ti at the time in the context of the time, and here I'm talking particularly eighties and nineties, but we also learn about what we can do in the future in terms of effective activism and where we made mistakes in those earlier years. And I mean, this is not unique, of course, to representations, tv, documentary, whatever, representations of any group. We certainly have it. I mean, I remember, um, you know, we certainly had in the early feminist documentaries about seventies, eighties, feminism, very, very similar issues about timidity, about criticizing. Um, but I don't think we should be afraid of that. And I think, in fact, I think it's a good thing, um, to talk about and just one sort of footnote to that by being timid, you're actually silencing people within those movements and you're, you're silencing particular people within those movements in those activist movements. And I think that's something we really need to resist. Great. There's a lady at the back. Hi Joanna. Thank you once again for a great presentation. There's so many different things to think about here, so I'm great that I'm really happy that there's a longer version for us to explore. But I was wondering if, if in your research you'd encountered anything, um, around the, um, sub subculture of bug chasing around the eighties and busy of what bug chasing in terms of the, um, transforming the narrative around, um, the kind of the, the, the gloo, the gloom and the risk and the, and the fear around, um, uh, um, uh, contracting hiv aids, um, and how different subcultures try to re sort of reclaim some sort of strength or courage from that position. I dunno if you had anything about that in, in your research. Yeah, I do. And it's in the long version. It was in the cut version here, which I cut it as as I was speaking. I mean, I think that that is, that is really important. And one of the things that I do speak about in this talk and, and the longer version is precisely that the divisions between the different approaches about, you know, celebrating sex within the gay community versus celibacy, monogamy, the fear and the anxiety around sex. And that is a huge, you know, debate in particularly early 1990s, um, that some of the people that I, I showed very quickly the slides, which I went through really quickly, they were really at the heart of this tension between those two, those two movements. Um, so very much so. It's a really good point. Thank you. An important one. Thank you. Um, if no one else has a, another question, we've reached seven o'clock, so it's the end of our time and I'd like to thank you very much Professor Burke, for, for that of Joanna's last lecturers on Thursday. Please come on. Thank you very much.