Vernon Rosario II of the University of California, Los Angeles:
In the queer academic community, we have all be stricken by HIV / AIDS. Some are HIV positive; we have lost lovers, friends, family, and colleagues to AIDS, and we have all experienced how AIDS has altered the American and global climate towards lesbians, gays, and bisexuals.
Few people have been more dedicated or insightful analysts of the social and scientific reaction to the AIDS epidemic than Paula Treichler. She has been speaking and writing about AIDS since the mid-1980s, and her work is characteristically complex, subtle, and equally well-informed of activists' concerns and biomedical literature. This volume brings together nine of her previously published essays from 1988 through 1993. They have been revised to varying degrees to reflect new primary and secondary sources, as well as the author's evolving historical vantage point. The older essays, in particular, are caught between being documents from the front of the AIDS battle and reflections on that past. As Treichler points out, one of the difficulties of revising an anthology on AIDS is that, unfortunately, the epidemic is not over—there is no Archimedan point from which analyze.
Treichler has always offered a sophisticated form of constructivist theory that refuses to dichotomize “discourse” from “reality,” “theory” from “practice,” or “culture” from “biology.” “The AIDS/HIV epidemic is,” she argues, “cultural and linguistic. But it is also biological and medical and takes its continuing toll on real human bodies” (298). Yet she demonstrates how scientific knowledge production and dissemination are cultural processes dependent on and productive of meaning: the meaning of gender, class, race, sexuality, global socioeconomic status, and of the meaning of health and illness. This is what she means when she describes the AIDS epidemic as having produced a parallel “epidemic of signification.” Rather than restrict her analysis to any one of these semantic threads, Treichler's work elegantly and readably strives to show how the diverse treads are knotted together within scientific and popular cultural systems of discourse.
The order of the essays roughly follows the chronology of the epidemic. The first chapter chronicles the emergence of HIV and the syndrome in the biomedical and popular media in the early 1980s and examines how AIDS was largely constructed as a homosexual disease. Chapter two explores the sexism of the early AIDS literature and how this led to deadly delays in prophylaxis and treatment of HIV among women. Treichler returns to gender in the eighth chapter, examining deceptive representations of AIDS in Cosmopolitan magazine and the response of AIDS activists who struggled to publicize the tremendous impact of HIV on women. The third chapter examines literature on AIDS in the Third World and theories of its African origins. Racist and imperialist notions of “primitiveness” and “backwardness” are central here; however, Treichler also notes the political resistance and cultural complexities of promoting HIV awareness in underdeveloped nations.
Chapters four and six examine AIDS representations on television news and in movies, respectively. She tracks how, in the early years of the epidemic, media constructions of AIDS were riddled with homophobia, racism, and sex phobia—tending to sensationalize and demonize while lulling the “general population” into a false sense of security. She finds that some of the fictionalized television representations of AIDS, while flawed, were far more sympathetic to people with AIDS and, at times, better informed.
The central chapter is also the strongest one, where Treichler relies on recent literature from science studies and the sociology of knowledge to powerfully articulate the meaning of the “cultural construction” of HIV/AIDS and the political import of such an analysis. Her focus is the Fifth International AIDS Conference in Montreal (1989), where the very nature of AIDS and HIV was contested by competing researchers and by AIDS activists. This just serves as one example of the broader, ongoing generation and legitimization of scientific “facts” under the pressure of diverse professional and social forces. The final chapter focuses on conflicting views among activists and scientists concerning treatment with AZT. As she points out, AIDS activists and theorists have brought to the fore the tremendous biomedical uncertainty and indeterminacy in the treatment of disease (not just AIDS), and AIDS activism served as a model for promoting patients' agency in research and treatment.
I found the essay on “AIDS, Africa, and Cultural Theory” the weakest in the collection, perhaps because it is too ambitious. Its conclusion is well taken: cultural theorists, artists, and intellectuals can be vital in the practical fight against AIDS. However, the chapter often seems to lapse into lists of initiatives or journalistic reporting of AIDS conferences. My only other concern is that the volume presumes a familiarity with the evolving theories of the biology and pathology of HIV. Since this is a collection of thematic essays and not a chronological analysis, some readers may be wishing Treichler had included a brief primer on HIV.
Overall, this volume is a convenient compilation of Treichler's work that is essential for cultural theorists and historians of the AIDS epidemic. It will prove valuable in courses on AIDS, thanks to the breadth of its arguments and Treichler's approachable style. Finally, her work is an elegant example of how to do the cultural history of medicine and how to make it change our understanding of the present.
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