How To Have Promiscuity in An Epidemic PDF
How To Have Promiscuity in An Epidemic PDF
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DOUGLAS CRIMP
2. For an overviewof theoriesof the cause of AIDS, see Robert Lederer, "Origin and Spread of
AIDS: Is the West Responsible?" CovertAction,no. 28 (Summer 1987), pp. 43-54; and no. 29
(Winter 1988), pp. 52-65.
3. Quoted in Ann Giudici Fettner, "Bad Science Makes Strange Bedfellows," Village Voice,
February2, 1988, p. 25.
4. Randy Shilts,And theBand Played On: Politics,People,and theAIDS Epidemic,New York, St.
Martin'sPress, 1987. Page numbersforall citationsfromthe book appear in parenthesesin the text.
It was a great shock to read thisin 1987, aftersix yearsof headlines about "the
gay plague" and the railingof moralistsabout God's punishmentforsodomy,or,
more recently,statementssuch as "AIDS is no longerjust a gay disease." Lan-
guage destinedto offendgaysand inflamehomophobia has been, fromthe very
beginning-in science, in the media, and in politics-the main language of
AIDS discussion,althoughthe language has been altered at timesin order thatit
would, for example, offendHaitians and inflameracism,or offendwomen and
inflamesexism.But to ShiltsAIDSpeak is not thislanguage guaranteedto offend
and inflame.On the contrary,it is
bought the government'slies, never looked behind those lies to get the "truth."
There was, of course, one exception,the lonelyjournalist for the San Francisco
Chronicleassigned full-timeto the AIDS beat. He is never named, but we know
his name is Randy Shilts,the book's one unqualifiedhero, who appears discreetly
in severalof itsepisodes. Of course, thatjournalistknowsthe reason forthe lack
of investigativezeal on the part of his fellows:the people who were dyingwere
gay men, and mainstreamAmericanjournalistsdon't care what happens to gay
men. Those journalistswould ratherprinthysteria-producing, blame-the-victim
storiesthan uncover the "truth."
So Shilts would printthat truthin And theBand Played On, "investigative
journalism at its best," as the flyleafstates.The book is an extremelydetailed,
virtuallyday-by-dayaccount of the epidemic up to the revelation that Rock
Hudson was dyingof AIDS, the moment,in 1985, when the American media
finallytook notice.5But takingnotice of Rock Hudson was, in itself,a scandal,
because by the timethe Rock Hudson storycaptured the attentionof the media,
Shilts notes, "the number of AIDS cases in the United States had surpassed
12,000 . . . of whom 6,079 had died" (p. 580). Moreover, what constituteda
storyfor the media was only scandal itself:a famous movie star simultaneously
revealed to be gay and to be dyingof AIDS.
How surprised,then,could Shiltshave been that,when his own book was
published, the media once again avoided mention of the six years of political
scandal thatcontributedso significantly to the scope of the AIDS epidemic?that
they were instead intriguedby an altogetherdifferentstory,the one theyhad
been printingall along-the dirty little story of gay male promiscuityand
irresponsibility?
In the press release issued by Shilts's publisher,St. Martin's,the media's
attentionwas directed to the storythat would ensure the book's success:
"Sole judge of other people's woes and without anyone else to gaze on him,"
Shilts adopted a no-longer-possible universal point of view-which is, among
other things, the heterosexual point of view-and thus erased his own social
condition, that of being a gay man in a homophobic society. Shilts wrote the story
of Gaetan Dugas not because it needed telling-because, in the journalist's mind
it was true and factual - but because it was required by the bourgeois novelistic
form that Shilts used as his shield. The book's arch-villain has a special function,
that of securing the identity of his polar opposite, the book's true hero. Shilts
created the character of "Patient Zero" to embody everything that the book
-
purports to expose: irresponsibility,delay, denial ultimately murder.8 "Patient
Zero" stands for all the evil that is "really" the cause of the epidemic, and Shilts's
portrait of "Patient Zero" stands for Shilts's own heroic act of "exposing" that
evil.
If I have dwelt for so long on And theBand Played On, it is not only because
its enthusiastic reception demands a response. It is also because the book demon-
strates so clearly that cultural conventions rigidly dictate what can and will be
said about AIDS. And these cultural conventions exist everywhere the epidemic
is constructed: in newspaper stories and magazine articles, in television documen-
taries and fiction films, in political debate and health-care policy, in scientific
research, in art, in activism, and in sexuality. The way AIDS is understood is in
large measure predetermined by the forms these discourses take. Randy Shilts
10. Larry Kramer, The Normal Heart, New York and Scarborough, Ontario, New American
Library,1985. Page numbersfor citationsare given in the text.
by transvestites.
We all foughtlike hell. It's you Brooks Brothersguys
who
Bruce: That's why I wasn't at Stonewall. I don't have anythingin
common withthose guys,girls,whateveryou call them.
Mickey: . . . and . . . how do you feel about Lesbians?
Bruce: Not verymuch. I mean, they're . . . somethingelse.
Mickey: I wonder what they'regoing to thinkabout all this?If past
historyis any guide, there'sneverbeen much supportby eitherhalfof
us for the other. Tommy, are you a Lesbian? (pp. 54-55).
I want to returnto gay politics,and specificallyto the role lesbians have
played in the struggleagainstAIDS, but firstit is necessaryto explain whyI have
been quoting Kramer's play as if it were not fictional,as if it could be unprob-
lematicallytaken to representKramer's own politicalviews.As I've already said,
The Normal Heart is a piece a clef,a form adopted for the very purpose of
presentingthe author's experience and viewsin dramaticform.But mycriticism
of the play is not merelythatKramer'spoliticalviews,as voiced by his characters,
are reactionary- though theycertainlyare--but that the genre employed by
Kramer willdictatea reactionarycontentof a differentkind: because the play is
writtenwithinthe most traditionalconventionsof bourgeois theater,its politics
are the politics of bourgeois individualism.Like And theBand Played On, The
NormalHeart is the storyof a lonelyvoice of reason smotheredby the deafening
chorusof unreason. It is a play witha hero, Kramerhimself,forwhomthe playis
an act of vengeance for all the wrong done him by his ungratefulcolleagues at
the Gay Men's Health Crisis. The Normal Heart is a purely personal-not a
political-drama, a drama of a few heroic individualsin the AIDS movement.
From time to time,some of these characterstalk "politics":
Emma: Health is a politicalissue. Everybody'sentitledto good medical
care. If you're not gettingit, you've got to fightfor it. Do you know
this is the only industrializedcountry in the world besides South
Africa that doesn't guarantee health care for everyone?(p. 36).
But thisis, of course, politicsin the mostrestrictedsense of the word. Such
a view refuses to see that power relations invade and shape all discourse. It
ignoresthe factthatthe choice of the bourgeois formof drama, forexample, is a
political choice that will have necessarypolitical consequences. Among these is
the fact that the play's "politics" sound very didactic, don't "work" with the
drama. Thus in TheNormalHeart,even these "politics" are mostlypushed to the
periphery;theybecome decor. In the New York Shakespeare Festivalproduction
of the play, "the walls of the set, made of construction-siteplywood, were
whitewashed.Everywherepossible, on this set and upon the theaterwalls too,
factsand figuresand names were painted, in black, simple lettering"(p. 19).
These were such factsas
11. In October 1987, the New YorkTimesreportedthatthe New York CityDepartmentof Health
conducted a study of drug-relateddeaths from 1982 to 1986, which found an estimated 2,520
AIDS-related deaths thathad not been reportedas such. As a result,"AIDS-related deaths,involving
intravenousdrug users accounted for 53 percentof all AIDS-related deaths in New York Citysince
the epidemic began, while deaths involvingsexuallyactive homosexual and bisexual men accounted
for 38 percent." Even these statisticsare based on CDC epidemiology that continues to see the
beginningof the epidemic as 1981, followingthe early reportsof illnessesin gay men, in spite of
widespreadanecdotal reportingof a high rate of deaths throughoutthe 1970s fromwhatwas known
as "junkie pneumonia" and was likelyPneumocystis pneumonia. Moreover,the studywas undertaken
not throughany recognitionof the seriousnessof the problemposed to poor and minoritycommuni-
ties, but, as New York City Health CommissionerStephen Joseph was reported as saying,because
"the highernumbers . . . showed thatthe heterosexual'window' throughwhichAIDS presumably
couldjump to people who were not at highriskwas 'much widerthatwe believed'" (Ronald Sullivan,
"AIDS in New York City Killing More Drug Users," New YorkTimes,October 22, 1987, p. B1).
12. I borrow the phrase from Guy Hocquenghem, who used it to describe a gay movement
increasinglydevoted to civilrightsratherthan to the more radical agenda issuingfromthe New Left
of the 1960s.
13. I do not want to suggest that there are no gay communityorganizationsfor or including
sex workers,or Latino immigrants,
transvestites, but ratherthatno organizationrepresentinghighly
marginalizedgroups has the fundingor the power to reach large numbersof people withsensitive
and specificAIDS information.
14. Lee Chiaramonte,"Lesbian Safetyand AIDS: The Very Last Fairy Tale," Visibilities,vol. 1,
no. 1 (January-February 1988), p. 5.
15. Ibid., p. 7.
16. Cindy Patton,Sex and Germs:The PoliticsofAIDS, Boston, South End Press, 1985; and Cindy
Patton and Janis Kelly, MakingIt: A Woman'sGuide to Sex in theAge of AIDS, Ithaca, New York,
Firebrand Books, 1987.
17. Cindy Patton, "Resistance and the Erotic: Reclaiming History,SettingStrategyas We Face
AIDS," Radical America,vol. 20, no. 6 (Facing AIDS: A Special Issue), p. 68.
18. Ibid., p. 69.
21 Art Ulene, M.D., Safe Sex in a DangerousWorld,New York, Vintage Books, 1987, p. 31.
22. In facttherecontinueto be concertedeffortsto deny thateveryoneis at riskof HIV infection.
The New YorkTimesperiodicallyprintsupdated epidemiologicalinformationeditoriallypresentedso
as to reassureitsreaders-clearly presumed to be middle class, white,and heterosexual-that they
have littleto worryabout. Two recent articlesthat resurrectold mythsto keep AIDS away from
heterosexualsare Michael A. Fumento,"AIDS: Are Heterosexualsat Risk?" Commentary, November
1987; and RobertE. Gould, "Reassuring News About AIDS: A Doctor Tells WhyYou May Not Be at
Risk," Cosmopolitan, January1988. That such articlesare based on racistand homophobic assump-
tionsgoes withoutsaying.The "fragileanus/ruggedvagina" thesisis generallytrottedout to explain
not onlythe differencesbetweenratesof infectionin gaysand straights,but also betweenblacksand
whites,Africansand Americans (blacks are said to resortto anal sex as a primitiveformof birth
control). But Gould's racismtakes him a step further.Claiming thatonly "rough" sex can resultin
transmissionthroughthe vagina, Gould writes,"Many men in Africatake theirwomen in a brutal
way,so that some heterosexualactivityregarded as normal by them would be closer to rape by our
standardsand thereforebe likelyto cause vaginal lacerationsthrough which the AIDS virus [sic]
could gain entryinto the bloodstream."
23. Cindy Patton tells of similaradvice given to gay men by a CDC officialat the 1985 Interna-
tional AIDS Conferencein Atlanta:"He suggestedthatgay men onlyhave sex withmen of the same
antibodystatus,as if gay male culture is littlemore than a giant dating service. This advice was
quicklyseen as dehumanizingand not usefulbecause it did not promotesafe sex, but renewedadvice
of this type is seen as reasonable withinthe heterosexualcommunityof late" ("Resistance and the
Erotic," p. 69).
24. Ulene, p. 49.
The debate about condoms,and safe sex education generally,is one of the
most alarming in the historyof the AIDS epidemic thus far, because it will
certainlyresult in many more thousands of deaths that could be avoided. It
demonstrateshow practicesdevised at the grass-rootslevel to meet the needs of
people at riskcan be demeaned, distorted,and ultimatelydestroyedwhen those
practicesare coopted by statepower. Perhaps no portionof thiscontroversyis as
revealingas the October 14, 1987, debate over the Helms amendment.25
In presentinghis amendment to the Senate, Helms made the off-hand
remark,"Now we had all this mob over here this weekend, which was itselfa
25. Unless otherwise indicated, all quotations of this debate are taken from the Congressional
Record,October 14, 1987, pp. S14202-S14220.
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The "need" for the amendmentand the termsof the ensuingdebate (involving
only two other senators)were establishedby Helms in his opening remarks:
About 2 monthsago, I received a copy of some AIDS comic books
that are being distributedby the Gay Men's Health Crisis, Inc., of
New York City, an organization which has received $674,679 in
Federal dollars for so-called AIDS education and information.These
comic books told the story,in graphicdetail, of the sexual encounter
of two homosexual men.
The comic books do not encourage and change [sic]any of the
pervertedbehavior. In fact,the comic book promotessodomyand the
homosexual lifestyleas an acceptable alternativein American soci-
ety. ... I believe that if the American people saw these books, they
would be on the verge of revolt.
I obtained one copy of thisbook and I had photostatsmade for
about 15 or 20 Senators. I sent each of the Senators a copy-if you
will forgivethe expression-in a brown envelope marked "Personal
and Confidential,for Senator's Eyes Only." Without exception, the
Senators were revolted, and they suggested to me that President
Reagan ought to knowwhatis being done under the pretenseof AIDS
education.
So, about 10 days ago, I went down to the White House and I
visitedwiththe President.
I said, "Mr. President,I don't want to ruin your day, but I feel
obliged to hand you thisand let you look at what is being distributed
under the pretense of AIDS educational material....
The Presidentopened the book, looked at a couple of pages, and
shook his head, and hit his desk withhis fist.
There were, all told, two responseson the Senate floorto Helms's amend-
ment. The firstcame from Senator Chiles of Florida, who worried about the
amendment'sinclusionof IV drug usersamong those to whom education would
be preventedby the legislation-worried because thisgroup includes
effectively
heterosexuals:
27. Compare Larry Kramer's characterNed Weeks's statement:"You don't know what it's been
like since the sexual revolutionhit thiscountry.It's been crazy,gay or straight"(p. 36).
28. In the Senate debate, positionssuch as Helms's are referredto as philosophical.Thus Senator
Weicker: "This education process has been monkeyedaround withlong enough by thisadministra-
tion. This subcommitteeover 6 monthsago allocated $20 million requested by the Centers for
Disease Control foran educational mailerto be mailed to everyhousehold in the United States ....
That is yetto be done. It is yetto be done not because of anybodyin the CentersforDisease Control,
or not anybody in Secretary [of Health and Human Services] Bowen's office,but because the
philosophersin the White House decided theydid not want a mailerto go to everyhousehold in the
United States. So the education effortis set back" (CongressionalRecord, October 14, 1987,
p. S14206).
But of course the comic book has everythingto do withthe issue at hand-
because it is preciselythe sort of safe sex education material that has been
proven to work,developed by the organizationthat has produced the greatest
amount of safe sex educationmaterialof any in the country,including,of course,
the federal government.29
Given the degree of Senate agreementthat gay men's safe sex education
material was "garbage," in Helms's word, it seemed possible to compromise
enough on the amendment's language to please all three participantsin the
debate. The amendment was thus reworded to eliminateany referenceto IV
drug users,therebyassuagingSenator Chiles's fearsthatsomeone he knowsand
cares about--or someone in his neighborhood,or at least someone he doesn't
mind talkingabout-could be affected.Helms veryreluctantlyagreed to strike
the word condone,but managed to add directlyor indirectly after promoteor
encourageand before homosexual sexual Thus
activity. the amendment now reads:
. . none of the fundsmade available under thisAct to the Centers
for Disease Control shall be used to provide AIDS education, infor-
mation,or preventionmaterialsand activitiesthatpromoteor encour-
age, directlyor indirectly,homosexual sexual activities.
Afterfurther,verybriefdebate, duringwhichWeickercontinuedto oppose the
amendment,a roll-callvote was taken. Two senators-Weicker and Moynihan
-voted against; ninety-foursenatorsvotedfor theHelmsamendment, includingall
other Senate sponsors of the federal gay and lesbian civil rightsbill. Senator
Kennedy perhaps voiced the opinion of his fellowliberal senatorswhen he said,
"The currentversion[the reworded amendment]is toothlessand it can in good
consciencebe supportedby the Senate. It maynot do any good, but it willnot do
any harm." Under the amendment,as passed, most AIDS organizationsprovid-
ing education and servicesto gay men, the group mostaffectedand, thusfar,at
29. "George Rutherfordof the San Francisco Departmentof Public Health last year told a US
Congressional Committee investigatingAIDS that the spread of the virus dramaticallyslowed in
1983, when public health education programmesdirected at gay men began. The year before, 21
percentof the unexposed gay population had developed antibodiesto HIV, indicatingthattheyhad
been exposed to the virusover the previousthree months.But in 1983, thatfigureplummetedto 2
percent. In 1986 it was 0.8 percent,and researchersexpect that it will continue to fall. . . . The
campaigns to promote safe sex among gay men, and educate them about AIDS have been almost
totallysuccessfulin less than four years. Such rapid changes in behaviour contrastsharplywiththe
poor response over the past 25 yearsfromsmokersto warningsabout the risksto theirhealth from
cigarettes"("'Safe Sex' Stops the Spread of AIDS," New Science,January7, 1988, p. 36).
In a studyof the efficacyof various formsof safe sex education materials,commissionedby
GMHC and conducted by Dr. Michael Quadland, professorof psychiatryat Mount Sinai School of
Medicine, it was determinedthat explicit,erotic filmsare more effectivethan other techniques.Dr.
Quadland was quoted as saying,"We know that in tryingto get people to change riskybehavior,
stopping smoking,for example, or wearing seat belts, that fear is effective.But sex is different.
People cannotjust give sex up" (Gina Kolata, "Erotic Filmsin AIDS StudyCut RiskyBehavior,"New
YorkTimes,November 3, 1987).
highest risk in the epidemic, would no longer qualify for federal funding.5?
Founded and directedby gay men, the Gay Men's Health Crisisis hardlylikelyto
stop "promotingor encouraging,directlyor indirectly,homosexual sexual activ-
ity." Despite the factthatGMHC is the oldest and largestAIDS serviceorganiza-
tion in the US; despite the fact that it provides direct servicesto thousands of
people livingwithAIDS, whethergay men or not; despitethe factthatGMHC's
safe sex comicsare nothingmore scandalous than simple,schematicallydepicted
scenariosof gaymale safe sex; despitethe factthattheyhave undoubtedlyhelped
save thousandsof lives-GMHC is considered unworthyof federal funding.
When we see how compromisedany effortsat respondingto AIDS will be
when conducted by the state, we are forced to recognize that all productive
practicesconcerningAIDS will remain at the grass-rootslevel. At stake is the
culturalspecificity of thesepractices,as well as theirabilityto take
and sensitivity
account of psychicresistanceto behavioralchanges,especiallychanges involving
behaviorsas psychicallycomplex and charged as sexualityand drug use.31Gov-
ernmentofficials,school board members,public health officers,Catholic cardi-
nals insistthatAIDS education mustbe sensitiveto "communityvalues." But the
values theyhave in mind are those of no existingcommunityaffectedby AIDS.
When "communityvalues" are invoked,it is only forthe purpose of imposing the
purportedvalues of those (thusfar)unaffectedby AIDS on the people (thus far)
mostaffected.Instead of the specific,concrete languages of those whose behav-
iors put them at risk for AIDS, "communityvalues" require a "universal"
language that no one speaks and many do not understand. "Don't exchange
bodilyfluids"is nobody's spoken language. "Don't come in his ass" or "pull out
beforeyou come" is whatwesay. "If you have mainlinedor skinpoppednow or in
the past you maybe at riskof gettingAIDS. If you have shared needles, cookers,
syringes,eyedroppers,water,or cotton withanyone, you are at riskof getting
AIDS."32 This is not abstract"communityvalues" talking.This is the language
of membersof the IV drug using community.It is thereforeessentialthat the
word community be reclaimed by those to whom it belongs, and that abstract
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