ABSTRACT
In June 1981, the first cases of what the Center for Disease Control (CDC) initially called “GRID” (gay-related immune deficiency), began to appear in the U.S., and already it was a term that carried as much implicit, hidden, subliminal meaning as it did clinical, medical meaning. Language has a hidden curriculum to it, teaching us both more and less than what it appears to. The clinical marker GRID seemed logical enough since it was designed to capture those aspects of the disease most recognizable, that made it stand out and announce itself as a threat-its emergence within the gay male communities of New York City and San Francisco. Patients were dying of opportunistic infections their bodies should have resisted, and early newspaper reports called it the “gay cancer.” The CDC’s rush to label the disease as GRID was an attempt to be more accurate, but also to counter some of the antigay prejudice being stirred up in the media around fear of a gay cancer. But “gay-related” was not much of an improvement; and gay-rights leaders pressured the CDC to come up with a better designation for the disease, one that did not associate the disease with being gay. When the CDC finally settled on “acquired immune deficiency syndrome” (AIDS), that seemed to remove any politics from a clinical naming process. As Carol Reeves observes in her history of the language of science, the term “acquired” indicated that the disease was not the result of being gay per se. The disease was acquired through individual behavior. At the same time, the word “acquired” carried an additional meaning, that of behavior causing infection, “that placed blame on the infected for ‘acquiring’ the disease in the first place.” For these reasons, the CDC since the mid-1990s has encouraged a shift toward a language of AIDS/HIV, or just HIV, which is designed to erase all negative connotations.1
AIDS education has thus slowly evolved into HIV education. But does “HIV” stand as a purely medical, scientific signifier, without cultural
connotations? Might it not encourage some to think of HIV-positive individuals as
viruses in the body politic? And what interventions might such an analogy require? My point is not to disparage the search for a better name for a medical disorder and disease of the body. It is instead to say that this search can never entirely succeed. Even deliberately and self-consciously neutral names placed on stigmatized groups by the dominant culture become stigmatizing, and so pressure will exist to find a better, less-stigmatizing name. The term “persons with AIDS” (PWAs) implies an attempt to reclaim control of the naming process by those inflicted and those stigmatized. Through this naming and renaming (gay cancer, GRID/AIDS/HIV/ PWA), the AIDS crisis has helped us understand that the “truth” about a disease is as much socially constructed as it is medical. It might have once been possible to see language as just a neutral lens for revealing a “truth” already out there. The AIDS crisis and the national response to it demonstrated the power of language to produce what people see and feel when they look into the face of AIDS. Treating the immunosuppressive disease was one thing. Treating the social disorder-the fear of the new plague and of those groups and individuals perceived to be its carrierswas another. AIDS/HIV education would be constructed as a response to both the medical and the social condition. It would blend health and social-justice language together in a powerful new discourse, with broader implications for reframing sexuality education. And when political leaders and public schools proved not up to the task of doing what had to be done, AIDS educators and activists would create new forms of education through community agencies and drop-in centers, political theater, and political activism. The Reagan administration pursued a two-sided (some would say two-faced)
educational response to the AIDS catastrophe. On one side of the issue within the Reagan administration was William Bennett, who served as chairman of the National Endowment for the Humanities from 1981-1985, when he became Education Secretary, a post he held until 1988. But Bennett was not alone as the voice of social conservatism in the administration. He formed powerful allies with Gary Bauer, then a domestic-affairs advisor to the President (later to lead the conservative Family Research Council and Focus on the Family), and Patrick Buchanan, the President’s communication director. Together, they called for sex education grounded in the teaching of traditional family values and moral virtues. Theirs would turn out to be the more powerful and persuasive voice within the administration, particularly since it was consistent with the Republican Party’s Christian right constituency that could no longer be ignored. In 1989, after resigning his post as Education Secretary to become drug czar in the new Bush administration, Bennett and Bauer published a booklet What You Need to Know About AIDS in which they called for the testing for the HIV status of all Americans, and “contact tracing” of all sexual partners for those identified as having the virus. This they positioned in opposition to what they characterized as progressive sex education, which preached “moral relativism.”2 In a time of crisis, there was no time for moral relativism, they argued. Playing on a term that was being popularized among progressives at the time-“safe sex”— Bennett and Bauer called for safe-sex education for all young people. They
reterritorialized the language of safe sex from a usage that implied caring for the self by taking precautions and using condoms, to a usage that implied learning how to “just say no.” For those “intravenous drug users and male homosexuals” who threatened the “contamination of our nation’s blood supply,” the only virtuous response, Bennett and Bauer argued, would be to protect the public by quarantining those with AIDS.3 Elsewhere Bennett had argued that “in the face of this terrifying AIDS epidemic” the moral teachings of the Catholic Church offered the “only solution possible, chastity.”4 The triumvirate of Bennett, Bauer and Buchanan also tried to position the battle against AIDS as a battle against the moral degeneracy they associated with the “homosexual agenda and lifestyle.” Buchanan had written in his newspaper column before he joined the administration that “the poor homosexuals have declared war on nature and now nature is exacting an awful retribution.”5 The language of God’s retribution infected policy discourse throughout the Reagan years, even if it had to be officially framed as a secular discourse. God was punishing not only the homosexual, but also the nation as a whole for its permissive attitudes toward the “homosexual agenda.” The alternative, more enlightened voice in the Reagan administration was that of
Surgeon General C. Everett Koop. From the beginning Reagan had made it clear that he appointed Koop because of the latter’s strong antiabortion stance and his conservative religious values. Women’s rights and gay-rights leaders initially were outraged by Koop’s appointment. In 1985, when the AIDS crisis could no longer be ignored or go unnamed, Reagan asked Koop to issue a report on AIDS, with the expectation that he would endorse Christian moralistic responses. Instead, the report, released in October 1986, turned out to be quite the opposite of what was expected. The release of the Surgeon General’s report is often considered by AIDS educators to be a turning point in the fight against AIDS. Koop began by declaring that those looking for “value judgments” in the report would find that they are “absent.” Instead, this was an “objective health and medical report.” Without a cure, he called on people to “take the responsibility of protecting” themselves and others, “through preventative measures that are simple, straightforward, and effective.” The disease had evoked “highly emotional and often irrational responses,” he warned, compounded by the fact that those most immediately affected by the disease-homosexual men and intravenous drug users-evoked strong personal feelings of moral condemnation among many. The best protection against infection, he argued, was education, and “barring abstinence, … use of a condom.” As for calls for compulsory blood testing of all Americans, Koop argued that it was “unnecessary, unfeasible, and cost prohibitive.” Furthermore, testing could cause “irreparable harm.” If someone recently infected had not developed antibodies yet, the test would encourage them to feel safe to engage in unsafe sexual practices; and if they tested positive, they could face job loss and stigmatization. Quarantine also had no role in AIDS prevention, according to Koop, since AIDS was not spread through casual contact.6 Following release of the report, Koop went on a national tour to promote AIDS education through television, radio, and newspapers. His
message was everywhere the same. “We can no longer afford to sidestep frank, open discussion about sexual practices, homosexual and heterosexual.” Young people had a right to know “the behaviors to avoid to protect themselves from exposure to the AIDS virus.”7 He recommended a vastly expanded sex-education program in the nation’s public schools-with sex education to begin in elementary education and with adolescents to learn about proper use of condoms. Although Koop apparently continued to hold conservative religious values, including a belief in abstinence until marriage, he somehow had managed to rise above, or at least set aside, these values in the face of a medical-health crisis where he felt called to assume responsibility as the nation’s first physician. By calling for a massive public education project to help check the spread of the epidemic, Koop also implicitly was critical of his own administration for not doing enough. He began to publicly question why he and other government officials were still occupied writing reports on how to respond to the AIDS crisis (which were then largely ignored by political leaders) when physicians already knew what was needed.8
