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Chapter 4: Gendering AIDS

AIDS takes us to the heart of feminist inquiry … including the question of how sex and sexuality are constructed. (Paula Treichler)1 Chapter 2 highlighted the way that the dominance of racial and political concerns has displaced AIDS and HIV-positive people in AIDS-related discourse, and in a comparable way, gender-related discourse has displaced AIDS and women, particularly, from the epidemic. The prevalence of patriarchal values in society, which accords women a lower status than men, has meant that the woman’s experience has been under-represented and under-valued, in spite of the fact that more women than men are infected and affected by AIDS. 2
This reflects the discursive assumption that ‘what happens to men is more important and/or more “real” than what happens to women’ (Felman 1975: 12). Where women are represented in AIDS discourse, it is most often in a negative way. Women are thus under-represented and misrepresented. This chapter explores the patriarchal discourse which frames AIDS in a gendered way, perpetuates stereotypes prejudicial to women, and displaces AIDS as a central concern. In the latter part of this chapter I consider discourse that runs counter to this trend, and analyse texts by women asserting their right to be replaced in the discourse and to have their experience of AIDS heard and validated. Biomedical discourse – as mentioned in Chapter 1 − is commonly thought to be ‘objective’ and ‘scientific’, but closer examination reveals that it is often discriminatory towards women. This is not surprising when it is borne in mind that biomedical discourse is part of hegemonic discourse linked to the patriarchal structures of society. Paula Treichler comments that medical authorities are ‘heirs of an ancient medical legacy of semantic and gendered imperialism … [which serves to] define and categorize, codify and regulate, and contain and silence the diseased others whom they diagnose,treat, and study’ (1999: 45).Biomedical discourse includes and is supported by ‘an extensive economic and social structure in the form of an academic and pharmaceutical research complex with literally billions of dollars at stake in the development of vaccines, antibiotics and antiviral agents’ (Rodrigues 1997: 30). The combination of personal and economic interests in largely male-dominated professions means that the discourse is inevitably androcentric. Medical knowledge and power are closely linked. Kathryn Anastos and Carola Marte, physicians who work in women’s health and with HIV-infected people, observe that research on heterosexual HIV transmission is ‘permeated with sexist assumptions’, and that women are ‘studied by the medical profession as vectors of transmission to their children and male sexual partners rather than as people with AIDS who are themselves frequently victims of transmission from the men in their lives’. They state that ‘until recently, one could gain epidemiologic information concerning women and AIDS mainly from perinatal studies, 3 and to a lesser extent, from studies of prostitutes. Women have been defined primarily in terms of childbearing activities … not as individuals with a life-threatening illness’ (Anastos and Marte 1989: 10). In South Africa, the TAC and other activists won the battle in 2001 to have anti-retroviral medication supplied free of charge to pregnant HIV-positive women to prevent transmission to their babies, and this was hailed as a great victory for women. However,it is significant that this medication does not help the women themselves, but decreases vertical transmission to their babies. Implicit in this policy is the view that women are not valuable in and for themselves but only in terms of their reproductive role, as incubators for the next generation. Ida Susser discusses the need to develop programmes that aim at saving the mother as well as the child (2009: 17-28), commenting that, in the United States, women were ‘chiefly conceived as vectors of [AIDS] for men and infants more than victims themselves and sometimes this emphasis remains the focus of research’ (2009: 20). In her article titled ‘Gender Bias in AIDS Research’, Diana Hartel – also using the United States as her reference point − asserts that ‘the central struggle for advocates of female AIDS patients revolves around changing research focus from the infectious female body to the body in need of care’(1994: 47).Studies that focus on prostitutes are undertaken because this affects heterosexual transmission to men. Anastos and Marte point out that ‘prostitutes are frequently seen as the guilty parties in the infection of women whose husbands or steady partners are the clients, … shift[ing] the responsibility away from the man who engages in risk-taking sexual encounters’ (1989: 11). Murrain comments that the ‘framing of women as “vectors” of HIV has been the dominant paradigm for research on women with AIDS’ (1997: 64), while Paula Treichler describes as an ‘historical axiom’ the enduring way that prostitutes have been represented as ‘so contaminated that their bodies are virtual laboratory cultures for viral replication’ (1999: 20); and as ‘reservoirs’, ‘harbours’ and ‘vectors’ for venereal disease. They are constructed as ‘infectors’, not ‘infectees’ (1999: 53).With regard to the perception of women as ‘vectors’, there is a long discursive history connecting women and disease, and specifically sexually transmitted ones. This has been studied by the historian Allan Brandt who gives examples − drawn from the United States from 1880 onwards − of the way that venereal disease (VD) has traditionally been assigned a female identity. He gives one example where a World War II poster warning US servicemen about the risks of syphilis shows a woman walking armin-arm between Hitler and Hirohito above the caption: ‘VD: the worst of these’ (Brandt 1985: 165). The identification of women, and particularly prostitutes, with sexually transmitted diseases is deeply entrenched in discourse. Women have long been blamed for being ‘the primary locus of venereal infection’ (Brandt 1985: 72) and active agents in the spread of disease, with ‘few stopp[ing] to consider from whom the prostitute acquired her infection’ (Brandt 1985: 92). Brandt critiques the dichotomous discourse on which venereal epidemiology was based and which constructed ‘two types of women– good and bad, pure and impure, innocent and sensual’, and in terms of which ‘an “innocent” woman could only get venereal disease from a “sinful” man, but the man could only get venereal disease from a “fallen woman”. This uni-directional mode of transmission reflected prevailing attitudes rather than any bacteriologic reality’ (1985: 31-2). Hartel shows that, ‘in syphilis and HIV, two class-dependent stereotypes dominate: the lower-class whore and the middle-class innocent’ (1994: 36). Women from the lower social classes were seen as ‘naturally susceptible to immorality’, while the middle-class woman was the ‘appropriate child-bearing vessel and could not be identified as infective to men’ (1994: 35). Paula Treichler describes as ‘dizzying’ the ‘ease and simultaneity with which women can be both invisible and culpable,transparent instrumental carriers and reservoirs of contagion, dangerous and willful infectors and naïve, irresponsible infectees’ (1999: 274). These points relate to representations in the West, but South African examples demonstrate similar patterns of stereotyping and blame.

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Title Page
Dedication
Declaration
Summary
Table of Contents
Acknowledgements
Key Terms and Acronyms
INTRODUCTION
CHAPTER 1: DISPLACING AIDS THROUGH LANGUAGE
CHAPTER 2: POLITICISING AIDS
CHAPTER 3: SATIRISING AIDS
CHAPTER 4: GENDERING AIDS
CHAPTER 5: NARRATING AIDS
CONCLUSION
REFERENCES