Women and AIDS: Toward a Feminist Analysis
Any analysis of AIDS based on a faith in stable boundaries between risk groups ignores everything we know about the realities of human sexual behavior and sexually transmitted infection. It further ignores the growing presence of AIDS as a dominant factor in the social life of the twentieth century in behavior, in law, in policy, in education, in health-care coverage, and in virtually all other areas of experience which, sooner or later, will touch every citizen.
Unless feminists take a broader and more active role in articulating the nature and meaning of the AIDS crisis, what is in store? One answer is that we will not understand the potential consequences of our own everyday sexual behavior, and this, I think, goes for gay as well as
straight women. Sexually liberated from the hegemony of the magical projectile penis, we should not assume the absolute truth of the scientific hypothesis that an "injection" of the virus is the sine qua non of infection. Even if it turns out that a critical mass of HIV is a relevant factor, this may vary in individuals. More crucially, sexual practices vary enormously among gay women as among all other people, and some of these practices may facilitate HIV transmission.
The point, again, is that statistical probabilities should not be transformed into theoretical absolutes. A second answer, however, is that as women become aware of the potential for risk, only a collective, feminist political analysis can contest the purely self-interested, self-help perspective now beginning to emerge in many publications by and /or for women. In April 1987, for example, full-page advertisements for Mentor contraceptives appeared in several women's magazines (fig. 6). A healthy and attractive woman, in full color, looks pensively out at the camera: "I never thought I'd buy a condom." Underneath, the copy reads: "INTRODUCING MENTOR CONTRACEPTIVES. THE SMART NEW WAY TO PROTECT YOURSELF." And at the bottom of the page, under a photo in which the individually packaged condom resembles nothing so much as a container of yogurt: "SMART SEX IN THE 80's."[139] The self-congratulatory tone of this advertisement echoes, in my view, much of what has appeared in publications for women.
Another example: "For some women," writes Erica Jong in the April 1986 issue of New Woman , "the AIDS crisis may be a way to come to terms with the fact that they never really liked multiple-partner sex in the first place." And, she adds playfully, "think of the time saved for working, for playing, for family, for gardening, for needlepoint!" AIDS was not even an issue two years ago, she continues, so the current flood of information on heterosexual transmission is so sudden, it is overwhelming—and hard to assimilate. Given the "plague mentality" of the media, "what's the informed woman to think—and beyond that, to do—about AIDS?" She continues:
By far the sanest and most detailed discussion of the disease I have read was published in Discover magazine's December 1985 issue. Its message to women was for the most part reassuring. Discover concluded that AIDS is 'the largely fatal price one can pay for anal intercourse'; that the virus 'is only borne in the blood and semen'; that AIDS is a difficult disease to catch; and that vaginal intercourse is much less likely than anal intercourse to spread the disease because of the ruggedness of the vaginal lining and its relatively few exposed blood vessels.
6. In ads in major U.S. women's magazines in the spring of 1987, a beautiful woman
praises a condom that sounds like a Greek god and looks like a container of yogurt.
It is said that AIDS has brought back the 1950s, but back then it wasn't women who
bought the rubbers. DON'T GO OUT WITHOUT YOUR RUBBERS advises another
ad for women, because, "if a woman doesn't look out for herself, how can she be sure
anyone else will?"
So here is Langone's article, with all its problematic, false certainties reproduced intact to reassure women.[140] To make matters worse, Jong highlights a set of boxed "facts" entitled "Good News (for Women) about AIDS." She begins by contrasting our old friends, the vulnerable rectum and the rugged vagina: "moreover, the tissue in the vagina has fewer blood vessels than the rectum, and natural lubrication during intercourse lessens the chances of tears." Then come the alibis (it 's them , officer , not me ; there , not here ):
1. Women with AIDS in Africa actually got it from needles, or anal intercourse (denied by them ), or by contact with bisexuals (also denied by them ).
But heterosexual cases in Africa are now confirmed and appear to be wiping out whole villages .
2. The AIDS virus is fragile and cannot be easily transmitted especially if "simple sexual precautions like not exchanging bodily fluids" are followed.
Considering that organizations like New York City 's Gay Men 's Health Crisis and the San Francisco AIDS Foundation devote entire pamphlets and videos to explicating euphemisms like "exchanging bodily fluids ," it does seem that we might have expected more from the author who once brought us the "zipless fuck ."
3. Most women in the United States whose cases of AIDS are attributed to heterosexual transmission are long-term partners of intravenous drug users. The small number of these cases suggests that AIDS cannot be transmitted heterosexually, but if it can be, Jong quotes a physician who argues that "women who contracted AIDS got it from steady sex partners, not from one-night stands."
The conflation of "safe sex " with monogamy is clearly problematic ; and is the implication here that one-night stands are SAFER than "steady " relationships?
4. Researchers estimate that only 5 to 20 percent of those who test positive for the virus will develop the disease.
Even 5 to 20 percent is an enormous number—half a million to two million depending on who 's counting— but as of January 1988 the estimate was up to 25-50 percent, and it is now considered possible that few will be entirely symptom-free forever. The fact that the virus has now been known to be dormant for as long as fourteen years means it
may take some time before our understanding of the natural history of AIDS is complete. (Indeed, the large number of asymptomatic carriers is a key to the "success" of HIV: The fact that the virus does not kill quickly means there is ample time for it to be conveyed to new hosts via carriers temporarily without symptoms.)[141]
5. "Men haven't been very good to their immune systems" and therefore appear to be more susceptible to AIDS.
But this statement is apparently based on the health histories of men who already have AIDS—it is hardly fair to make it a statement about men in general (and probably not even about men with AIDS ).
And here is Jong's last piece of "good news (for women)": AIDS, she writes, is like the terror of kitchen-table abortions in the 1950s. But maybe this is okay, she says, because it will make sex "a little more mysterious and precious again."
In April 1987, one year after Jong's "good news," AIDS appears in a Ms . magazine special issue on "The Beauty of Health." On the cover, an attractive woman in an orange shirt is eating an orange and smiling (fig. 7). "Wake up and be healthy!" the cover blurb commands, and lists what we should wake up to :
Skin Problems
RU-486 the Unpregnancy Pill
Exercises You Can Do In Bed
Guarding Against AIDS
Why Doncha Smile, Honey?
The two-page story by Lindsy Van Gelder (who earlier wrote a reasonably intelligent piece for Ms . and coauthored a competent article on "AIDS on Campus" for Rolling Stone ) begins with an anecdote in which she asks a sexually active woman friend whether she has asked her male friend to begin using condoms: "Rubbers?? " says the friend, "Yuck!!"[142] But, the author graphically points out, "You sleep not just with him but with all his sex partners." Should you trust him? she asks, and slips into the voice of Seventeen magazine in the old days: "This is a toughie." She offers some straight talk: "Brace yourself for a shocker: men lie to get laid." Van Gelder emphasizes some important points: The term "heterosexuals" is misleading, because "most people who contract
7. An attractive woman in an orange shirt eats an orange on Ms . magazine's April 1987
cover, which urges us to WAKE UP AND BE HEALTHY! Skin, exercise, AIDS: The
special issue offers tips for all kinds of pesky health problems. "Why Doncha Smile,
Honey?" the cover asks. But where AIDS is concerned, there's a better question:
Why is this woman smiling?
AIDS heterosexually are women"; she also argues that "safe sex with many different men is less risky than unprotected sex with one [infected] man," a logical deduction, but one that many writers fail to make. But the article ends with a breezy reinscription of conventional sexual division—that outdated staple of Ms . magazine's version of feminism—us against them (women against men): "How much do you want to bet that if female-to-male transmission begins to be documented in
great numbers, men will be demanding safe sex—with no wimpy worries about turning women off?"
Van Gelder's article is an example of condom journalism, a new genre that ranges from the Village Voice 's "Better Latex Than Never" to the safe-sex kits distributed to all Dartmouth students to the "how to" lessons of New Woman and Spare Rib to the critiques of condoms and condom advertising that have appeared in, among other places, the New York Times .[143] All of which prompts mention of another recent genre, the Heterosexual White Male's commentary on AIDS. Although the New York Times , as the "newspaper of record," has improved its coverage of AIDS (there is now a virtual AIDS page in almost every issue), even recent features in the New York Times Magazine leave a great deal to be desired. Peter Davis, for example, offers familiar insights about AIDS as though he had thought of them all by himself (AIDS connects "sex and death" is a sample) along with a significant amount of misleading information. In his search for heterosexuals reputed to be at risk for AIDS, for instance, he interviews what appear to be an elite assortment of investment bankers, executives, and elegant divorcees (his phrase). Already-infected heterosexual people, in the real kingdom of AIDS, remain invisible as we listen to the voices of Davis's upscale informants: "God," one woman tells him, "I wish I could have just one lunch in the Russian Tea Room where we talk about something besides AIDS." Davis quotes Dr. Mervyn Silverman's prudent advice ("just because there's no reason to panic doesn't mean there's no reason to be careful") but ultimately trivializes the gravity of the problem.[144]Newsweek , which has provided fairly steady coverage of AIDS and rarely downplayed its seriousness, ran a long and moving photo-story on those who died during 1987. Under the photographs ran captions that displayed what journalist Rex Wockner has called "back-door homophobia." The captions of the heterosexuals, for example, tell how they got infected (transfusion, etc.) while those of the gay people state their occupation without any transmission information. It is as though, says Wockner, even the dead must be kept clean from the suspicion of homosexuality.[145] As a final example of publications I consider problematic for women, I will mention sex therapist Helen Singer Kaplan's 1987 book The Real Truth About Women and AIDS . The book is both depressing and interesting. Geared toward heterosexual middle-class women and their "unborn babies," the book is depressing because it retrogressively asserts, in the name of saving women from a fate synonymous with death, that AIDS is caused by who you are, not by what
you do. The advice to "avoid unsafe practices," says Kaplan, is "nonsense!" Rather: "avoid infected partners." The only way to "avoid sexual exposure to high-risk males" is to (1) make any candidate take the ELISA test; (2) wait; (3) make him get tested again; and if he's clean and you still want to (4) go ahead and have a sexual contact.[146] And then, presumably, (5) handcuff him to you for the rest of your life.
An interesting feature of Kaplan's book, however, is her inclusion, in an appendix, of the transcript of a telephone conversation between a woman caller and a New York AIDS hotline. This transcript not only graphically dramatizes the complex and, as Kaplan points out, often problematic understandings of AIDS-related concepts, but it also lets us see AIDS as it is constructed in everyday talk.[147] Likewise, a BBC special on AIDS, broadcast around the world in September 1987, wove together commentary from professionals and from women on the front lines of the AIDS crisis: A Kenyan health care worker describes her workshops on AIDS and safer sex for prostitutes in Nairobi; a British woman, who, like her roommates, formerly used drugs and now tests HIV positive, talks about living with the knowledge of infection; a woman from a prostitute's organization describes her group's concerns about AIDS and preventive techniques, pointing out that prostitutes have extensive knowledge about alternative sexual practices that they could usefully be sharing with other women.[148]
In recent months (at any rate, in the September 1987 issue), Ms . finally got serious and published a photo-essay called "Facing AIDS" made up of photographs and words of women with or facing AIDS (fig. 8). This is not to say that such a representation is unmediated or closer to the "true experience" of AIDS, but it is a welcome departure from the chipper good news/bad news tone of other articles. The Spare Rib series initiated in 1987 also expressed a determination to begin—as women and feminists in alliance with others and in a larger social and economic context—confronting and working through the numerous questions and problems that AIDS creates (fig. 9).[149] Likewise, the 1987 Gay and Lesbian March on Washington moved dramatically toward the integration of the AIDS issue with broader cultural issues: the refusal to be extinguished, the refusal to die.[150] At the same time, as AIDS moves out of scientific journals, news stories, and print journalism and becomes increasingly a focus in the arts and mass culture, we can expect the continued diversification of discourse and resources.[151]
To sum up, then. A body of evidence suggests that AIDS is like other sexually transmitted diseases, capable of infecting women and men in
equal numbers and now spreading as rapidly by way of heterosexual contact as it once did by way of homosexual contact. Current data suggest, in other words, that the consequences of ignoring earlier evidence of heterosexual transmission may be devastating. Large numbers of people are already infected; many will die. Just as male homosexuals and intravenous drug users in the 1970s and early 1980s engaged in behavior that gave them pleasure without thinking it could kill them, many people today are engaging in activities that a few years from now may kill them.
My general argument is not that biomedical scientists have been "irresponsible" or that "the media" have created a sense of false security (or false terror), or that we can never truly know the biological "facts" about AIDS. What is important is that even scientific characterizations of the reality of AIDS are always partly founded upon prior and deeply entrenched cultural narratives. One step is to ask, as new narratives and new meanings are produced, such questions as the following:
How and why is knowledge about AIDS being produced in the way that it is?
Who is contributing to the process of knowledge production? To whom and by whom is this knowledge disseminated?
What are the practical and material consequences of any new interpretation? Who benefits? Who loses?
On what grounds are facts and truth being claimed?[152]
Any characterization of AIDS has a history, it has a vocabulary, origins, and consequences. Even a seemingly innocent and straightforward term like "the AIDS virus"—a term that now permeates technical and general AIDS discourse—is in fact profoundly misleading. Simon Watney, for example, scrupulously insists on calling the virus HIV and, speaking of a person known to be infected, HIV-positive . His point is not that what we call "HIV" is "real," but that this term is a much more preferable representation . What we call "AIDS," he argues, consists of some thirty diverse clinical entities and conditions. Although a virus may initiate the breakdown of the body's immune system, which in turn makes possible the development of one or more of the thirty diseases and conditions, it does not cause "AIDS."[153] Suppose a thief enters your house, ties you up, cuts your phone cord and burglar alarm, steals your silver, and uses your credit cards to catch the next plane to Copenhagen.
8. In April 1987 the British feminist magazine Spare Rib initiates a series on women and
AIDS that calls for a broad analysis of the AIDS crisis and coalitions with others. Authors
Susan Ardill and Sue O'Sullivan "attempt to focus on the impact AIDS is primarily having,
or will have, on us as women—through our sexuality, sexual practices and sexual identities."
Rather than pretending to have total knowledge and control, the authors urge readers to ask
questions, and "from there to go on and ask more questions, loudly and clearly" ( Spare Rib
177 [April 1987]: 14-19). Courtesy of Spare Rib , London.
9. Ann and Juliette at New York City annual AIDS vigil, 1985. In September
1987, Ms. runs a different kind of story on AIDS, a photo-essay by Jane Rosett
and Gypsy Ray, two women who work with AIDS; in photos and text, the darker,
exhausting dimensions of AIDS emerge. Courtesy of Jane Rosett, Brooklyn.
Because you're still tied up, you can't do anything when the microwave explodes and starts a fire. Is the thief an arsonist?[154] In the end, we cannot look "through" language to obtain knowledge about AIDS. Rather, we must examine how language itself produces what we think we know; and if we are to intervene, language is one place where that intervention must take place. Thus we can also ask:
What are the origins and implications of the language used to talk about such concepts as behavior, risk, persons at risk, modes of transmission—interpersonally and "epidemically" (Greek for among the people )—agents of transmission, health and illness?
What is the nature of the bodies said to be most "at risk" for AIDS? How are these bodies gendered? What is their discursive history?
What are the differences between "dominant" and "oppositional" accounts of this complex phenomenon?[155]
My argument in this essay is a simple one. Contests over meaning come into stark relief in the case of AIDS, which in multiple, fragmentary, and often contradictory ways we (as feminists perhaps, certainly as global citizens) struggle to understand. The name AIDS—and indeed the entire biomedical discourse that surrounds it—in part constructs the disease and helps make it intelligible. The construction of AIDS as a "gay disease," for example, is not based on "material reality"—which challenges any stable division between male and female, gay and straight, "promiscuous" and monogamous, guilty and innocent. Yet the construction inscribed again and again throughout our cultural discourses radically contains and controls this diverse and contradictory data, producing and reproducing monolithic identities of those "at risk" or not at risk, depending on their official classification.
The feminist community, or the communities of feminisms, have only recently begun to address the AIDS crisis. Feminists, who have learned to analyze and theorize about complex and contradictory data, can usefully contribute to an analysis of AIDS that brings together the collective insights of feminist scholarship and feminist theory to date. These would include historical description and analysis of women's experience during past epidemics and panics over sexually transmitted disease; critiques of conventional sociological categories in which women are inexorably linked to their male partners and to the diseases they contract; the intersections of gender, race, and class in relation to an
illness profiled in terms of nonintersecting categories; and theoretical work on the nature and history of gendered representation and on the evolution of Woman as a constructed identity. Finally, we might wish to ask whether the call for a "feminist analysis" is theoretically paradoxical: AIDS is complex, after all, in part because it exposes the artificiality of the categories and divisions that govern our views of social life and sexual difference. It challenges the existence of "women" as a monolithic sisterhood and as a meaningful linguistic entity. But feminist theory also suggests why a feminist analysis remains imperative: for women are both linguistic and material subjects who exist within language and history. Even as we work to deconstruct and perhaps finally to dissolve the linguistic subject, we must nonetheless keep our attention fixed relentlessly on the inequities still embodied in the material one.[156]
At the very end of The Intern 's Tale , after the scene I quoted when I began this chapter, one of the interns—Mac—dies, and Campbell, the protagonist, suggests that Maggie should be told. He learns she has read about Mac's death in the newspaper and called the hospital to inform them that she is a carrier of the virus but never developed the full-blown disease. The following morning she is found dead from an overdose of sleeping pills. Like many of the deaths of diseased women in history and literature, Maggie's suicide destroys, in a single gesture, the treacherous host—that is, the conscious subject, the material body required for replication—of the virus, of sexuality, of children, of life, of mind, of desire. Such self-extinction is part of women's discursive and historical legacy. We must therefore be alive to its potential incarnations in this latest social crisis. Nancy Shaw and Lyn Paleo point out, for example, that as more childbearing women become infected and more babies develop AIDS, childbearing may come under even more intense scrutiny by the state: Because if everyone practices safer sex, no babies will be born at all. Women, not gay men, may thus be among the first groups tested for HIV antibodies (with, presumably, a subsequent separation of the "clean" from the "dirty"). They also note that women, as caretakers in this epidemic, have thus far not felt they could protest sexism as they would under less life-threatening conditions.[157] And what of Kaplan's message that women must refuse to be the "bridges" between one infected pool and another; is there something of an extinction process working here? Meanwhile, a film like Fatal Attraction recapitulates for women the message gay men received when AIDS first occurred: What you have done for twenty years is wrong, what you desire is evil, sexuality is wrong, you are sick, you are dangerous, you must be punished.[158]
Maggie's death is the symbolic conclusion we must find ways to challenge and disrupt. This means, it seems to me, that we need to refuse the appeal of "binary division," of them versus us, of distinguishing ourselves from gay men and members of other "high-risk" groups. If we, as women, are to cope with AIDS in any reasonable and intelligent way, we must unequivocally see ourselves connected to it and refuse the lie that our own identities and gender offer magical protection against the invasions of that alien Other.