Anton D. Mischewski
Centre for the Study of STDs, La Trobe University, Australia
Abstract and Introduction from a thesis submitted in partial fulfilment of the requirements for the degree of Master of Arts in SociologyThe University of Auckland, January 1996.
ABSTRACT
The aim of this research is to open up for consideration a range of factors that mediate between knowledge and practice in the sexual behaviour of young gay men and young men who have sex with men. Firstly, this thesis deals with how HIV/AIDS has been named from within 'biomedical' and 'political' discourses. In particular, it deals critically with the construction of HIV/AIDS as a 'sexual epidemic' and asks: who authorises the 'facts' about HIV/AIDS?; what are some of the 'discursive formations' surrounding health promotion, health professionals and community action that answer the challenges presented by 'youth' with respect to HIV transmission and infection? These questions are approached by critically investigating the area of 'knowledge' and 'information' concerning 'safe sex' as an important starting point for health promotion. Secondly, the place of 'reason' in sexual conduct is examined in order to locate 'desire' as a (predominantly) absent discourse in health, sexuality and HIV/AIDS. How might 'desire' be conceptualised and dealt with in prevention discourses and strategies? How might a socio-cultural approach 'read' that (re)conceptualises sexual practices as interpersonal, socially mediated and a pre-eminently cultural encounter mediated by 'desire' rather than individual rational acts which process sexual 'facts'?
ACKNOWLEDGEMENTS ii
ABSTRACT iii
INTRODUCTION 1
1 Naming HIV/AIDS 7
2 Youth as Contingent Pluralities 38
3 The Disputable Arena of Knowledge(s) 59
4 Limitations of Reason 76
5Disciplined Pleasures and Desirable Disciplines 92
Conclusion 118
APPENDIX 1 125
APPENDIX 2 126
APPENDIX 3 127
APPENDIX 4 128
BIBLIOGRAPHY 129
INTRODUCTION
HIV/AIDS is a pervasive concept now embedded within our cultural vocabularies, one that has come to be a major characteristic of our fast approaching 'fin de siècle'. It has been suggested that HIV/AIDS will become a significant legacy taken through to the twenty-first century (Derrida 1993), exemplifying another aspect of what has been termed, our "risk society" (Beck 1992). As HIV/AIDS is proving to behave as a sophisticatedly complex and mutating 'viral entity', it becomes testimony to the limits of scientific 'cures', control and eventual eradication, along with other globally faced dilemmas such as poverty, deforestation, the unknowable consequences of 'nuclearism' and the impact of industrialisation on the ecological biosphere, to name but a few 'social problems'.
Yet it is not the first time that humanity has had to face a situation in which 'solutions' or responses (seem to) demand nothing less than a 'revolutionary paradigmatic shift', in the Kuhnian sense (Kuhn 1970). Science's capacity to 'deliver the goods' in relation to HIV/AIDS, provides troubling reminders of the limits of the human capacity to control, take charge, eradicate and ameliorate 'biological' disasters. If science is claimed to be 'holding the mantle of knowledge that social science would dearly love to share' (Gellner 1985) then perhaps HIV/AIDS provides a case that challenges this 'superiority' and certainty in the face of such dilemmas. Moreover, HIV/AIDS provides a vital site for the imperative revision and reassessment of the 'emotional' investment in and desire for cures, towards primarily, a need to offer a "critical analysis of the conditions in which people find themselves in order that they may be better able to disengage from prevailing forms of experience and thereby constitute new forms of life" (Smart 1993:83). More generally, my thesis argues the need to understand HIV/AIDS from its significations and meanings rather than solely from conceptions governed by an (assumed) truth founded in biology.
Epidemics within numerous historical epochs, have the capacity to generate and incite a state of 'panic'. This theme of 'sexual epidemic' is discussed in the first section, where I argue that HIV/AIDS depicts the re-emergence of old troubles in new conditions. To this end, it has been suggested that "the AIDS crisis was a crisis waiting to happen" (Weeks 1990:303). Weeks goes on to suggest that
AIDS is much more than a medical problem. It throws a bright searchlight into the complexities, contradictions, divisions and needs of the contemporary world. It poses difficult questions about personal behaviour and social policy (especially the priority that should be given to appropriate funding of the health services). It dramatises the debate about moral and ethical values that had rumbled on since at least the 1960s...Its connection with sexual behaviour made it also a conductor of all the other sexual tensions and anxieties that had been accumulating for years...dramatising the sexual contradictions of the 1980s (Weeks 1990:303).
Such suggestions will form the basis of the first section of this thesis, by examining the 'naming of HIV/AIDS'. As HIV/AIDS comes with its fair share of cultural and political baggage, I argue that this is a necessary point of departure to examine these aspects given the diversity and multiplicity of concepts and meanings that mediate the general label of HIV/AIDS. For some, HIV/AIDS becomes unmentionable, the 'big A', 'it' or the platform for 'consciousness raising', 'moral advising' and scare-mongering, (re-circulating) reminders of the fatal consequences of sexual conduct in the late twentieth century. Concurrently, HIV/AIDS has now become a political site for the "tactical interruption of public forums by lesbian and gay activists in favour of drawing public attention and outrage to the failure of government funding of AIDS research and outreach" (Butler 1993:233) while signalling "the chance for a renewed communal solidarity and activism" (Connell, Dowsett and Davis 1993). The wealth of multiple and contestable responses to HIV/AIDS will be argued as one in which its representations "...are and will remain...provisional and deeply problematic" (Treichler 1992:70).
This thesis grew out of a need to interpret a situation which I was becoming confronted with daily: given that young men whom I had contact with knew about safe sex, and in some cases were involved in teaching others about the necessity to practice 'safe sex', why were they becoming HIV positive or still (sometimes) practicing 'unsafe sex'? Indeed, similar situations could arguably be drawn in other areas of human conduct such as smoking, drink driving, drug taking and teenage pregnancy, where we are urged to take some form of prevention, exercise caution, be(come) mindful and aware of the risks, the unanticipated and unintended consequences of our actions. In this sense then, I wanted to explore this split between 'knowledge' and 'practice' of 'safe sex', by examining the limits of a 'reasoned approach' to HIV prevention that:
1. Supplies information on the methods of 'safe sex'
2. Warns us of the unintended consequences of 'unprotected sex' (or i.v. drug-use)
3. Encourages us to carry these practices through successfully when they are needed at the time, each and every time.
This study then focuses on the area of sexual conduct, where it seems we are having to exercise a constant, self-imposed surveillance and vigilance over our desires and our actions, when we are 'turned on' in the emotionally-charged 'heat of the moment'.
It could be argued that there are more 'spaces' now available for men to congregate in order to have sex with other men: gay saunas, cruise-clubs, night-clubs, exclusive 'gay' holiday resorts, public cruising sites, the advent of 0900 numbers, escorts agencies, personal columns, sex clubs through the internet and an internationally published directory of 'gay' hot spots, world-wide 'fetish' groups and magazines which cater for an ever increasing variety and diversity of sexual practices. These collectively constitute a plethora of spaces for sexual possibilities yet concurrently, there are constant reminders (and the ethical responsibility) to practice 'safe sex', where 'safe sex' has become a normative practice to be encouraged by arguably, the whole population.
However, these opportunities for sexual conduct are mediated by the need for disciplined pleasure to be brought to bear on our sexual pleasures, where the desirable disciplines constitute a care of oneself and care of the other partner. In the conclusion, I will examine 'negotiated safety' as the promise of realising this disciplinary necessity of practicing 'safe sex', which is assumed to allow the freedom of sexual pleasure without the unintended consequences of HIV. Before this aspect can be discussed though, I suggest that sexual conduct be appreciated as not that amenable to a reasoned intervention of conscious choice-taking and decision-making processes (even though this 'amenability' might be the desire of some researchers and educators). Instead, in chapters four and five, I contend that recognition of the potential risks and consequences can be outweighed by the immediacy of pleasures and the 'innervation' of desire, where the spontaneity of the moment and the uninterrupted pursuit of fantastic sex, can fly in the face of taking precautions and adopting preventive measures.
This thesis could be generally characterised firstly as a critical examination of the place of reason in sexual conduct, with a specific focus on how youth might cope with the impact of HIV/AIDS in their lives and secondly, how we as researchers and/or educators, cope with the problematic concept/category of 'youth', in particular, young 'gay' men and young men who have sex with men. However, the issue of how sexual conduct is to be changed in order to curtail and/or minimise HIV infection begs the question of how have we (pre)determined the ways in which sexual conduct is assumed to take place. My study therefore takes seriously the contention that sexual practices are not that amenable to attempts of 'change' based on reason or rationality, especially when 'changes' appear to be necessary for one's entire life-time. In this sense then, 'safe sex' might not just be an intermediary response or a temporary measure, but one that is to become a permanent fixture of our 'erotic economies' (Singer 1993). Recognition of this future possibility casts an urgent shadow (or light) over the measures adopted to date that aim to change people's sexual behaviour. In this respect, I will examine the ways that prevention discourses treat 'information' and 'safe sex' as a means of creating knowledgeable actors aware of the consequences of their actions in sexual situations. My aim is to problematise the ways in which 'safe sex information' mediates a young man's prior knowledge of sexual conduct by suggesting that communication or informing people about 'safe sex' is a social phenomenon. Here I develop an approach where both 'communicators' (educators) and 'receivers' (young gay men) are co-creators in the information-sharing process.
To address the contemporary situation around HIV/AIDS, I propose to take seriously the idea that sexual practices - a domain more commonly known as our 'sex-life' - is an area that is not simply amenable to a rational organisation. In short, increasing rationality brought to bear on sexual conduct "has not been synonymous with an enhanced understanding of self and others, or the promotion of moral progress and human happiness" (Smart 1992:162). This suggestion is however not intended as a cause for an elegy of despair, or an abandonment of pro-activism, but rather a chance to realise that "increasing rationality cannot guarantee increases in freedom" and sexual fulfilment where "one important implication...is that changing the world cannot be divorced from the unavoidable necessity of continuing to (re)interpret it" (ibid 1992:220).
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