Though I do not have HIV-AIDS and am not at risk because: I am 74, sex is only a dim memory, I don’t use IV drugs, I don’t work in a lab or a hospital, and the pool of carriers in Montana is pretty small. In spite of all this I spend quite a bit of time thinking about the problem for one over-riding reason: it’s interesting. Diseases are always interesting because they connect to so many dimensions of being human. Here’s a list of things I ponder:
1. How is HIV like smallpox? In some cases smallpox was deliberately spread to the Native population, but for the most part the disease spread quickly with deadly but convenient consequences for white Euros, because the Natives had no immunity. Whites caught it, some of them knew to be vaccinated, and most survived. But Indians did not. Jefferson had Lewis’ expedition carry the vaccine and offer it, but for the most part the NA people didn’t understand the concept. A natural susceptibility combined with the demonization of a whole people, so that when they died, they were not mourned, nor were white Euro people very aware of their suffering.
2. The timing is crucial. Gay people had just begun to assert their humanity and to flower into a kind of SF climax culture based on freedom, the arts, and unconstrained sexuality. Just as it was beginning to resolve into something permanent, the AIDS epidemic struck. There were two results: one was demonization again, so that Gay and AIDS were conflated in the public mind and AIDS was seen as the natural punishment, supernatural. The other was the response of the HIV survivors as they nursed and buried their lovers and friends. Horror was mixed with compassion and intimacy. Their openly acknowledged love for each other meant organizing to care for each other. What had been sex deepened into something more, but terrifying.
3. In fact, HIV is not particularly linked to circumstances: any class, gender or education-level can catch this virus through blood exposure. The IV drug route has not been as publicized as the anal sex route (which is not confined to one gender) or mother/child contagion. But educated, prosperous, well-placed gays often want to avoid all stigma and they can afford the drugs to keep HIV contained. They are NOT interested in the plight of sex workers or trafficked children. The younger ones have NOT gone through that massive lesson enforced by the deaths of a generation of gays. These young men want marriage, children, prosperity and to be priests -- they don’t want barriers. Or any limitations at all.
4. Third world (including the internal ghettos and reservations or whatever) HIV people are caught in a tangle of diseases enforced by stigma. HIV is just one more disease among TB, Hep C, malaria, and ordinary infection, exposure, malnutrition, and violence. They constitute a reservoir of contagion that strangely has a magnetic attraction for two opposite types of people: those who like to flirt with danger -- partly because of what some call “low self-esteem” and others call a death wish -- and those who are do-gooders. (The dynamics of “doing good” are mostly outside this discussion.)
5. Those who try to improve the world are again of two types: hands-on who plunge into the streets and soup kitchens, going one-on-one; and those who try to understand the social structures and economics that enforce ghettos and poverty. The first kind tends to burn out (or to remain, but so hardened by experience that they are hostile to the people they originally came to help) and the second kind gets bought out. This latter is a kind of mission drift: the fund-raising activities and the world-class conferences eat up their lives until they replace the original problem.
6. This second dynamic is entwined with government in the same way as corporations, because NGO’s that become consumed by producing papers and attending seminars ARE corporations. They become self-perpetuating economies that put the money into salaries, travel, and theories rather than field workers, localness, and practice. The result is that they become so separated from the actual problem that they are little more than advertising agencies. There’s no more research, no more insight.
7. Which brings us to the Big Pharma vultures who use all these dynamics on an international scale for profit. They offer false cures, useless testing, double standards, overpricing, and a host of other strategies that they pretend are medical when they are actual economic profiteering.
8. And governments find this all very useful. Buying necessary meds for Third World Countries at reduced prices, they tolerate high prices for their own citizens. Offering or withdrawing support for meds is an excellent way to control other countries. Maybe better than predator drones. Letting people die is much more covert than killing people.
9. Even Third World countries cannot afford to simply let the infected die. The most contagious state of infection comes BEFORE they know they are infected. Stigma is so high that they have every reason to conceal their status. Two commodities are in high demand in poverty cultures: sex and secrets. Together they are explosive even without disease.
10. If the number of people on the planet declines in the long run, that may be a good thing. But in times as short as generations, it means the hollowing of nations, diminishing institutional and financial resources, and the loss of cultural order and hope. Humans who live long enough to reproduce but not long enough to raise their children are not producing human beings because humans are as much culture as flesh. A child without protection and support becomes, as the popular metaphor would have it, a zombie, staggering along, craving identity and meaning. Or a vampire, living off the vitality of others.
Native Americans have been rebuilding their cultures and rehumanizing their children for a hundred years now. For fifty years I’ve been close enough to watch. It’s an emotional rollercoaster, but deeply absorbing -- more at the heart of humanness than most religion. In the end and in addition, I also think about HIV-AIDS because of friendships with people I cherish: those who have died of it, those who live with it, those who are gay but not infected, and even a few street kids or memories of them.
But all this stuff is social dynamics. The scientific angle is even more absorbing. The genome, epigenetics, histones and methylization, heredity winding its way through identity, and identity like a flame dancing through the cells. They say that the silver side of war is the advance in technology and medicine. When AIDS is figured out, it will be like a searchlight going on. A true game-changer.
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