Cassell, London; 1996
When human rights and dignity are respected within a society, people live healthier lives. For this reason the normative experience of a healthy woman is already a state of crisis. This provocative, enlightening and sometimes infuriating book by British activist Robin Gorna explores the personal, political, and medical consequences when women become infected with HIV.
Gorna "would be astonished if anyone were to write a tome on Men and AIDS," she writes. As a result, her focus is on how the separation of women from power has codified the categories used in considering women's AIDS experience. Particularly insightful is her analysis of how women have been used to "heterosexualize" AIDS. The preference of journalists for interviewing women rather than men has long been observed. But Gorna goes further to point out how "heterosexual AIDS" terminology obscures the differences between women and men and is instead used to construct a normalizing AIDS model not tainted with homosexuality. She claims that "heterosexual AIDS" has been used to panic heterosexual men, who hold the most social power. "It is not a discourse that serves women with HIV."
Since heterosexuals as a group have no internal sense of identity, they simply see their sexual orientation as neutral, objective, and value-free. So, argues Gorna, the construction of "heterosexual AIDS" is a homosexual construction in that it reflects the point of view of gay AIDS pioneers who saw these distinctions from their own experiences of oppression. Heterosexuals would view their sex as Sex, not "Heterosexual Sex." Gorna then breaks down these categories into falsely attributed sexual practices. She notes, for example, that numerically (not proportionally), more women than men are anally penetrated by men. Yet the refusal to recognize anal sex as a heterosexual activity is due to the propaganda purposes of these distinctions and therefore does not serve women.
"AIDS is not normal," she writes. "It is not like any other illness. It has always created a level of fascination and prurient interest out of proportion with the reality." Therefore, she says, the AIDS arena is littered with false assertions promoted in the interest of acceptance rather than the epidemic. At this point, most AIDS-sophisticated people understand that early efforts to warn of a "heterosexual epidemic" were primarily strategic. The current revisionism attributes this to gay people's belief that straight people would not care unless they themselves felt threatened. It is also generally accepted that this larger epidemic never came to be, while the propaganda actually "de-gayed" AIDS and shifted the public discourse to a euphemistic, closeted, and ineffective level. While Gorna documents the transition and rightfully decries this course, she is a bit harsh when considering the motives of early activists. Many gay activists did believe a heterosexual epidemic was at hand, and thought they were acting responsibly for the greater good. But gay people have always had sex with others who were officially heterosexual and would logically conclude that the sexual categories were falsely delineated. This did have some positive consequences: the myth of straight men's risk was, for a while, the only thing that would convince them to use condoms. So the myth of female-to-male sexual transmission ultimately did save some women's lives.
One personal note. I was disappointed to see Gorna jump on the anti-ACT UP bandwagon. While criticizing ACT UP for its theatricality at the Montreal Conference, Gorna simultaneously praises women like Theresa McGovern and Rise Dannenberg for their courage at the same moment, without identifying them as ACT UP members. By disassociating the individual integrity and accomplishments of the members from the legacy of the group as a whole, she paints a false picture.
Finally, of special interest to US readers is Gorna's perspective as an English service provider. Not only is there extensive analysis of the African model, both globally and with regard to immigration. But, she also has a revealing take on the specificities of the American AIDS experience. She describes our system as "so remarkably complex that only the savvy have found ways through it, but these are often complicated, time-consuming and draining and guidance through the maze is rare." She cites our inequitable healthcare system as the centerpiece of our epidemic and sees the depth of inequity as fundamental to our response to the crisis. Her analysis includes some important observations including that the healthcare system is fundamentally inaccessible to women. As a result, women with AIDS are more likely than men to receive ZDV monotherapy and then to be treated by less experienced doctors.
Writer and activist Sarah Schulman is the author of seven books, including her most recent novel Rat Bohemia (Dutton, 1995) and My American History: Lesbian and Gay Life During the Reagan/Bush Years(Routledge, 1994).