AIDS Progress is Paradoxical

Thinking about AIDS and HIV is often depressing. Look at the Pope’s recent remarks—and the associated kerfluffle. On March 17, St. Patrick’s Day, Pope Benedict XVI said “You can’t resolve [the AIDS epidemic] with the distribution of condoms. On the contrary, it increases the problem.” Many religious and non-religious figures condemned the perspective. This sort of view was irresponsible back in 1989 when espoused by John Cardinal O’Connor at the First Vatican AIDS Conference. As the New York Times quoted the Cardinal then:

The truth is not in condoms or clean needles… These are lies, lies perpetrated often for political reasons on the part of public officials.

In 1989, the result (again citing the Times) was predictable:

On Thursday in Baltimore, the United States Bishops’ Conference dropped its earlier conditional support for condom education in schools, and urged that AIDS prevention emphasize chastity instead.

Cardinal O’Connor, the Archbishop of New York, said doctors had an obligation to discourage the behavior patterns that can cause AIDS, saying an estimated 72 percent of AIDS victims in the United States contracted the virus from homosexual acts and 17 percent from drug use.

“Sometimes I believe the greatest damage done to persons with AIDS is done by the dishonesty of those health care professionals who refuse to confront the moral dimensions of sexual aberrations or drug abuse,” he said. “Good morality is good medicine.”

That similar statements are still being uttered now, twenty years later, is depressing. And our wish that the Pope’s views can be easily dismissed as wrong and thus inconsequential is, as Freud would say, merely an illusion. Indeed, some are even defending the papal commentary, labeling criticism “unfair.” (See, here and here for two very different perspectives reminding readers that condoms are not as effective as abstinence in AIDS/HIV prevention, and noting that evidence does not support the notion that rates of condom availability are closely correlated with lowered societal rates of infection.) Depressing.

It is also depressing that April’s news stories included the following note:

Veterans Affairs said Friday that initial tests show one patient each from its facilities in Miami; Murfreesboro, Tenn.; and Augusta, Ga. has tested positive for HIV following exposure to potentially contaminated medical equipment. VA spokesperson Katie Roberts said the three HIV cases “still need to be verified” by additional tests.

The sites failed to properly sterilize endoscopy equipment, placing some patients—6,387 who had colonoscopies at Murfreesboro; 3,341 who had colonoscopies at Miami; and 1,069 who were treated at the ear, nose, and throat clinic in Augusta—at risk of blood-borne infections. There have also been six positive tests for hepatitis B and 19 for hepatitis C at the three centers, the VA said.

How long have we known about universal precautions? What’s wrong here?

Perhaps the same thing that is wrong when we see rising numbers in various populations globally and locally?

Wedding Bells and Decriminalization

And yet, not all the news is depressing. Not even all the news at the intersection of AIDS/HIV and religion is depressing. American governments and courts are hard at work legalizing same-sex marriage which, despite the cynic in me that thinks marriage equality involves joining the conservatives in valuing a very limited form of family, is still a move toward inclusion for some.

And, meanwhile, Dakar courts have overturned jail time for homosexuality, ordering the release of nine people whose involvement in AIDS education led to their imprisonment. As UNAIDS Director Michel Sidibe noted, such criminalization interferes with working against the AIDS epidemic.

Perhaps wedding bells and decriminalization bode well for human rights and AIDS prevention both.

Progress, though, is uneven. Progress is not only uneven, it is fundamentally paradoxical. Or, perhaps, fundamentally contradictory. While, on the one hand, it has been said that “Probably no other disease in human history has been associated with social and political activism to the extent that the HIV epidemic has,” this is likely because of the incredible (and, alas, ongoing) marginalization of populations most affected by the disease.

Many such organizations have undergone institutionalization—from AmFar to the Pediatric AIDS Foundation to the Gay Men’s Health Crisis—and have successfully built on the Boston Women’s Health Collective’s pioneering efforts in health advocacy and the transformation of patients (or victims) into activists (in this regard, see Kathy Davis’ important book The Making of Our Bodies, Our Selves). But while this has happened, ACT UP and other direct action organizations have faded. (For a key article on this topic, see here.)

While organizations like the Westboro Baptist Church continue to spew the notion that “God Hates Fags” and, indeed, “God Hates You,” other religious bodies offer solace, spiritual direction, health care and social support. As Sam Harris (author of The End of Faith and Letter to a Christian Nation) has argued, perhaps moderate and progressive religions benefit from the many ways in which the extremes of conservative religion seem to be readily dismissed. Perhaps even the moderates are (pace Freud) unrealistic. But wait, many have argued, Harris risks sending allies to the opposition. (See, for example, this review from Harris’ own site. )

When both religions and critics of religion are being labeled “extremists,” might the very word “extreme” have become the social control word (or key word à la Raymond Williams) marking our time? Certainly, by attaching the term to certain views and actions (often under the rubric “fundamentalist” when depicting religions), we seek to entomb the “other” as unreasonable and resuscitate our own reason.

AIDS is not going away. Same-sex marriage is moving forward. “God Hates Fags.” Dakar moves toward decriminalization. Like Freudian symptoms, the pain is in the contradiction, the conflict, the lack of realism. Perhaps not all the news is depressing. Might it, though, be symptomatic?