What the ‘no’ case borrows from Trump

Patricia Karvelas is hosting RN Breakfast this week and this morning she interviewed two Liberal party officials about the forthcoming postal survey on legalising marriage for consenting adults regardless of gender.*

The guests were Christine Forster, Sydney City councillor for the Liberal party, lesbian advocate for equality and sister of former PM Tony Abbott, and Karina Okotel, Vice-President of both the Federal and Victorian Liberal parties.

It helped me crystallise my thoughts about how the ‘no’ case has been argued. In particular, the way it borrows tactics from the Trump and Brexit campaigns.

First of all, the ‘no’ campaign seeks to catalyse a groundswell of prejudice. This has a couple of effects: just as it did for Trump, it works as an informal ‘get out the vote’ campaign.

And it does that by provoking strong emotions among its primary audience by linking the marriage proposal to the campaign against Safe Schools — just as Trump did by linking Hillary (and indeed the Washington mainstream) to the industrial consequences of NAFTA and the economic ascendancy of China.

In its secondary audience, i.e. its opponents, the groundswell of prejudice stirred up by the ‘no’ case has translated into a distributed campaign of homophobic abuse — which is also intended to provoke strong emotions of anger and distress that wear down (and ultimately silence) advocates for the ‘yes’ case.

Finally, and this is what worries me the most: the ‘no’ case have clearly spent some time with strategic communications experts to develop a clear and simple, action-focused message: ‘it’s okay to say no’. This is the equivalent of Trump’s ‘Make America Great Again’ slogan.

There is clearly a digital media astroturf campaign underway, with social media accounts that are recently created and only have a couple of friends/followers repeating variations of the linkage and the message in the comments of any article published about the postal survey.

The message functions in a couple of ways: it provides language to people who have feelings but don’t have clearly articulated arguments against the proposal; it models a particular affective stance of feeling ‘bullied’ by people who are advocating for their own rights.

It borrows the language of consent from initiatives to prevent child abuse and sexual assault — a semantic move we call ‘dog-whistling’ in Australia and that communications researchers call ‘priming’, one that, in this case, links homosexuality with paedophilia. I have written about this move before.

But it’s the simplicity of the message that has the greatest effect, given the ‘yes’ case is being run by a coalition of groups with no clear leader and no single message.

I attended the Sydney rally/march on the weekend. The crowd was absolutely massive, filling the Town Hall Square and squeezing past the light rail works on George Street to fill the intersection to the edges of QVB and the Galeries. I was standing with my sister in line of sight to the speakers’ platform, but the sound system didn’t reach us. So the vast majority of that crowd stood there for two hours of speeches they couldn’t hear, before marching to Circular Quay.

That’s a metaphor — it suggests the small-L gay liberals are running the show, and they just don’t have experience of organising social change movements, because they imagine social change happens via deliberative democracy. Christine Forster tried to dismiss Karina Okotel’s fear-mongering about the ‘overseas experience’ as ‘isolated examples driven by activists.

Media advocacy isn’t a polite, rational discussion, though; it’s a blood sport, and right now, we’re bleeding.

Daniel Reeders is a PhD student in regulation and governance who analyses the role of culture in the regulation of health.

* MCARG for short. I have queer politics that cause me to choke on the words ‘marriage equality’ — marriage is a profoundly exclusive social institution — while ‘same sex marriage’ throws my trans and nonbinary friends under the bus. (‘Same sex marriage’ is the wording that will be used on the survey form.)

The great distraction

A meme crossed my twitter feed that claims to represent the views of Archbishop of Sydney, Dr Anthony Fisher OP. It lists five areas in which it claims ‘overseas experience’ has shown the potential for a loss of freedom should equal marriage legislation pass.

Fisher on SSM.jpg

  1. Freedom of religion
    People of faith and churches are already entitled to protections against discrimination and exemptions from laws preventing discrimination. For example, a religious school would be perfectly within its rights under current law to sack a teacher who married a partner of the same gender. Similarly, nothing in the current anti-discrimination law or the proposal for marriage equality would prevent religious schools from teaching children that gay people are depraved, etc, as they have done for centuries. Of course, there are still gay students in those schools, and gay communities will continue to have to mobilise to provide counselling and access to mental health care to mop up the damage in adulthood.
  2. Freedom of speech
    See answer to #1.
  3. Freedom of education
    See answer to #1 regarding faith-based schools. This item claims legislation on marriage for consenting adults regardless of gender would prevent parents removing their children from ‘radical gender programmes’ in state schools. Any parent can visit the Safe Schools website and view all the materials used in the programme — and you can make up your own mind whether these are ‘radical’. After all, this is about parents’ rights to make their own decisions, right? Unfortunately, the same can not be said for all the different Christian groups that offer ‘religious instruction’ classes in state schools.
  4. Freedom of association
    See answer to #1.
  5. Freedom of employment
    See answer to #1.

Notice a theme here? All of these claims depend on ordinary Australians not knowing that freedom of religion is guaranteed in s116 of the Australian Constitution, and in anti-discrimination lawand religious institutions are explicitly exempted from anti-discrimination law regarding sex, gender and sexuality.

What the meme doesn’t make explicit is that what all of these list items are talking about is the freedom to discriminate against gay people without legal or social consequences.

What this meme really objects to is not marriage equality, but changes in Australian society that treat same sex attracted and sex and gender diverse people as human beings deserving the same rights — and the same protections, including from discrimination.

But we are a long way from that. The proposal for marriage equality has important practical consequences for the many queer parents raising kids without the full protection of the rights currently afforded to heterosexual married couples. And it would remove a powerful insult to the human dignity of queer people in Australia.

Human dignity is something that churches were once concerned to promote — but right now, many church leaders are visibly more concerned to protect their right to discriminate. My hope is that Australian voters will see this for the mean-spirited bullshit that it is, and vote YES regardless.


Here’s some ‘overseas experience’ for you:

new zealand SSM.jpg

Place of Pride

The placement of the Pride Centre reflects a desire to revive St Kilda as a tourist destination rather than the changing needs of Victoria’s queer communities.

There’s a striking method used to visualise the distribution of inequity — it’s the simple train network map. In Glasgow, famously, each additional stop on your train journey home corresponds to two years off your life expectancy for men, and 1.2 years for women. Similar effects are found in other cities, including Melbourne.

This reflects a difference in wealth — people who can afford to live in the inner suburbs are more well-off than people living further out. But research also shows that the further you have to travel to your nearest health clinic, the less often you’ll make the trip. So the placement of services is materially relevant to the fairness of our society.

It’s great that the Andrews Labor government in Victoria has announced $15m funding for a Pride Centre — a landmark central location for queer community organisations, cultural events and ‘health and advisory services.’ The work-up of this proposal has been entrusted to a Board with substantial project management and financial management experience, which may help it avoid the sad fate of the London Lesbian and Gay Centre in the 1980s.

But the agreement to place the centre in St Kilda is catastrophically dumb a shame. It shows the blind spots of a Board made up of middle-class professionals: they haven’t thought about taken travel time seriously as a barrier.* St Kilda is not on a train line. Google reports it takes about 30 minutes to get there from Flinders Street, on a tram that services busy St Kilda Rd, and over an hour from Footscray, the inner-most suburb in the West.**

Edit: some have interpreted this remark as ‘blaming the Board’ when its hands were tied by the lack of alternative sites offered by councils within the EOI process. This misses the point that the Board designed the EOI process, seeking applications from councils — which basically guaranteed the Pride Centre would be placed in a wealthier local government area.

I would argue that if the EOI process didn’t turn up an appropriate site, it could have chosen a temporary site to accommodate organisations with a fixed timeline to move from their current facilities, and gone back to the State Government to explore options for a more centrally-located sites. There is recent precedent for taking this approach — both the Melbourne Recital Centre and the Library at the Dock were built via public-private partnerships in exchange for relief of contractual obligations or as planning conditions.

** Comments have also noted there’s the 96 from Southern Cross. I used to take this tram every fortnight, and it takes 20-30 minutes, mostly due to delays at stops and intersections between the station to the start of the light rail section. 

st kilda
Actual re-enactment of St Kilda’s location.

My guess is the Pride Centre placement reflects the history of the queer communities, rather than our present and our future. Our future includes a shift away from the traditional centres of queer community life, driven partly by rising house prices, but also by the way increasing acceptance of queer people has decreased the need to clump together for safety.

Let me give an example from my own experience. I don’t drive, and even when I lived in Prahran, it took about 30 minutes to get to the Centre Clinic in Fitzroy St. Later, like a lot of queer people, I got priced out of renting in the traditional gay enclave, and moved to the Western suburbs. When I lived in Footscray, I travelled across town to see a doctor at Prahran Market Clinic, forty-five minutes each way, because there weren’t any queer community-controlled health and support services in the Western suburbs.

Travel time becomes an issue when you need sexual health care every three months. Incredibly, unless you’re okay with the conveyor-belt experience at Melbourne Sexual Health Centre, there is no free walk-in sexual health service within walking distance of a train station. This is a problem when our HIV prevention strategy emphasises regular testing and early treatment to bring the HIV epidemic under control.

However, I’m conscious that HIV risk has long dictated funding for service provision to queer communities, often to the exclusion of queer women and families. The research is also clear that involvement in community leads to improved mental health and resilience to stigma and prejudice. Placing the Pride Centre in St Kilda fails on this count as well.

Research by Flood and Hamilton, although now quite old, showed a clear gradient in acceptance of same-sex relationships – highest in cities and decreasing in outer suburban, regional and rural areas. People who live further out have the greatest need for a safe, centrally-accessible space where they can take part in queer cultural events and community activities. Meeting these needs is more important than reviving St Kilda as a tourist destination and Melbourne’s answer to the Castro.

Melbourne is the same size as London, with half the population, creating a need for people in emerging population centres like Werribee, Melton and Cranbourne to travel more than an hour to access essential services. In our transit architecture, train lines are the arteries, while bus routes slowly wind across the suburbs like varicose veins.

Locating the Pride Centre in St Kilda ignores the needs of queer people in emerging population centres in the West, the outer North, and the outer South-East. The Pride Centre Essential services must be located near a major train station, within easy reach of the centre of Melbourne’s hub-and-spoke transit network. In creating a centre to celebrate the triumph of queer community over historical inequities, the Andrews Government should not be creating new ones.


Messages as ‘cultural resources’

When the Trump campaign tweets, it seems to be a progressive instinct to reply “But facts!” But the point of a political message is not its truth value but what it does. Trump’s on-message tweets — when he’s not whining like a manbaby about his press — often seek to furnish his supporters with replies to common objections to his presidency that come up in everyday face-to-face discourse. ‘Oh, that judge in the Trump University case? I heard he’s Mexican, soo…’

For now, I am tentatively locating the empirical component of my PhD within linguistic anthropology. Here’s how Alessandro Duranti distinguishes that field from others:

What is unique about linguistic anthropology lies somewhere else, namely, in its interest in speakers as social actors, in language as both a resource for and a product of social interaction, in speech communities as simultaneously real and imaginary entities whose boundaries are constantly being reshaped and negotiated through myriad acts of speaking. (source)

‘Language as a resource for social interaction’ is a useful way of thinking about political messages. For instance, in a discussion panel I convened last year as part of the RegNet Conversations series on resistance, I argued that the Trump and Brexit votes can be understood, at least in part, as protest against bipartisan political support for neoliberal social and economic policy.

Just yesterday, my local member Andrew Leigh e-mailed his constituents about ‘the progressive case for competition’, in which he argued that ‘uncompetitive markets are a key driver of rising wage inequality’. The progressive side of politics has failed to offer working and welfare class voters cultural resources to protest the impacts of globalisation in ways that don’t draw on existing vocabularies of anti-immigration, sexism and racism.

I think we’re all a bit sick of reading think-pieces about the Trump result. Here’s a different example: recent articles have reported on research that argues that moderate drinking confers a health benefit. This is a classic example of a message — a cultural resource that can be used, in this case, stored away and recalled when needed in order to question future messages about alcohol being a health risk.

Outside Richmond Station in Melbourne (Andrew Sampson, Sep 2011)

‘Messaging’ is a key tool of lobby groups. In the case of the alcohol research, there was an article recently by Professor Charles J Holahan from a prestigious university in the United States, which did not disclose any conflicting interests. Reading his faculty bio, however, revealed that much earlier in his career, he had accepted funding from the ‘ABMRF/Foundation for Alcohol Research’.

holahan bio.PNG


The Foundation describes its approach in these words:

The Foundation’s unique partnership between academia and industry grew out of a shared concern over the lack of factual information about the health effects of alcohol for the vast majority of consumers who drink in moderation. (…)  Established scientists formulated epidemiologic studies to understand the effects of moderate consumption of alcohol. (source; my emphasis)

In fact, the ABMRF makes a point of funding early career researchers:

  • Highest priority is given to young investigators, new to the field or trained in the field, to start a new line of independent research. 
  • The next level of priority is given to investigators outside alcohol research bringing an innovative idea to the field. 
  • Lowest priority is given to established investigators in the alcohol research field unless the application offers an extraordinary new idea. (source)

The study I read recently might not have been funded by this foundation, but for the researcher who led the study, receiving this funding early in his career may have increased the likelihood of him continuing to work on the issue of moderate drinking — and publishing results that confirm, rather than overturn, his earlier findings.

Funding research that focuses on moderate drinking almost guarantees a steady stream of research publications and news coverage of studies finding little harmful impact from alcohol usage. (Bernard Keane is convinced by this data. Actual experts, not so much.)

The political effect of this stream of research is to support the moralising framing adopted by the Australian industry lobby for licensed establishments, suggesting the problem is individuals making unhealthy choices, rather than the widespread availability of cheap drinks.

For me, this is a nice example of why the “But facts!” response misses the point of political messaging. The message can be true and still have effects that we might want to challenge.


Why study stigma?

Just before the December break, I asked my Facebook Brains Trust (FBT) what questions they have about stigma. As always, the answers were exceptionally thoughtful — I’m lucky to be friends with intellectually and emotionally generous people. Here are some of their questions:

  • I want to know if HIV stigma can be eliminated, or even significantly reduced. I want to know this so that I can see clearly whether we should be trying to eliminate it or learning how to live better with it.
  • I want to know how we can effectively measure stigma in a meaningfully qualitative and quantitative way, so that we can assess the impact of both our work and the impact of other changes in the broader social environment.
  • The question of untangling HIV stigma from all the associated stigmas (drug use, sex, homosexuality, race, etc etc) – how intersectionality plays into it; what other stigmas inform HIV stigma & what can be done about that.
  • Is the educational investment required to de-stigmatise the opinions of one average person with no understanding of the stigmatised issue so great that it could never be scaled up to the population level and/or expanded across all stigmatised issues?
  • What is the cost benefit threshold at which someone who benefits from stigma begins to feel compelled to divest from it?
  • Why 30 years of effort addressing HIV stigma seems to have had so little impact.

Thanks to Paul Kidd, Jason Appleby, Jed Barnum, Aaron Cogle and Bernard Gardiner for these questions. I’ll be keeping them in mind.

So why study stigma? In part, it’s to answer questions like these. They concern human suffering and the scope of our potential to end it. That’s my starting point. But I’m also coming from a decade as a practitioner in a genuinely community-based response to a public health concern — the Australian response to HIV. That experience, and my work with Dr Graham Brown, has posed some thorny questions about how public health decision-makers think about the complex social systems this work is engaging with.

If this thinking is simplistic, the interventions that get funded may not take advantage of the full capabilities of the networks, cultures and communities they take place within. Or they might take an overly rosy view of ‘community’ and miss out on some of the harmful dynamics that can exist in a close-knit network of people.

Although stigma is a horrible thing, it has one helpful property: the minute you are thinking about stigma, you are immediately thinking about ‘sociality’ as well — the whole complex of ways of living in relationship with others. Thus, studying stigma is a ‘can-opener’ that lets me explore how public health thinks about ‘the social’.

Why do I want to do that?

Currently, we have a case study of effective community-based prevention in the Australian response to HIV — but it is very much an exception to the norm in the wider health system, and as the meaning of HIV changes, this places pressure on funding and policy support for the exception to continue.

In order for the HIV model to survive, we need to understand it, theorise it, and promote it as a model (with appropriate adaptations) for other public health issues. The foundational stories that we told to get it started are based in political movements from the 70s and 80s that are no longer salient to politicians and policy-makers, so we need to articulate it in the language that resonates with contemporary public health in the 21st century.

My comparison case is the policy response to obesity. In case this seems odd, remember that the social movement that underpinned Australia’s community-based response to HIV came out of a movement created to challenge anti-homosexual stigma. I think we are seeing the same thing happening with obesity, with the emergence of the Health At Every Size (HAES) movement.

Very often the target of fat activism is public health messaging about healthy eating and body size, and I’m aware of clinicians who are frustrated by the challenge fat activism poses to their authority over what they see as the medical problem of obesity. The same battles were fought in HIV activism.

These battles obscure the potential for the HAES movement, via its crystallisation in myriad blogs, twitter networks, on tumblr and in Facebook groups, to become the social substrate for community-based health promotion. The essential challenge here is the same: it is the need to support public health decision-makers in thinking about these social systems as having capabilities — and developing practices that engage them effectively.

My proposed study involves observing the development of interventions in HIV and obesity, in Australia and overseas, and paying attention to how the stakeholders at each site talk about the task of engaging with complex social systems (such as networks, cultures and communities). I will analyse the policy context and project documentation in order to tell the story of how a particular campaign message slowly crystallises out of a cloud of talk and text. By collecting and analysing this data, and comparing it across health issues, countries, and established/emerging responses, I aim to develop a theory of engagement for researchers in public health as well as practical guidelines for funders, policy-makers and practitioners.

In the longer term, however, I would like to end up researching public health from an academic department focused on culture and communications, rather than being the ‘culture guy’ in a public health department. In my first year of the PhD, I already had the bones of the project in place, and I did a lot of reading across the different disciplines to locate my project and a possible career path.

My provisional location — basecamp, if you like — is communications ethnography. I’m located for now in a centre focused on regulation and governance, which is a great fit for my perspective on public health. I’m drawing on linguistic and visual anthropology to ground my analysis of campaign documents and images. But all of that is subject to change: my task for this year is to take my pockets full of preconceptions and go and get mugged by reality.

Writing through deadlines

During the week a colleague put a call out for tips on how to advise students who are gripped with anxiety in the lead-up to deadlines for written assignments.

This post is pure hypocrisy, because this is something I still struggle with myself. But I can offer some suggestions based on what has worked for me.


There’s some suggestion that students today struggle more with this than past students. I’m not really surprised by this. I went to high school in the 90s, in the aftermath of three events: the introduction of HECS which created intense competition for scarce places at the ‘best’ universities; the intensification of assessment in new Victorian Certificate of Education, where your final mark rested on your performance on three assessment tasks; and the recession of the early 1990s, when youth unemployment was above 20%, making it seem like academic performance was no guarantee of a job at the end of it all.

The discourse on fragile young people tends to emphasise the emergence of the risk society, helicopter parenting, and ‘cotton-wool kids’, and no doubt there’s truth in those claims.But fragility also comes from the intensified expectations placed on moments of assessment — and the frankly terrible advice to ‘begin with the end in mind’, never losing sight of a goal that may be years down the track, rather than focusing on the ‘next action’.

There is a discourse of resilience that emphasises ‘grit’, which I think gets heard as being unemotional and unrelenting about setbacks, and that just becomes another expectation. The superego gets the upper hand over the ego and the id; rumination takes the place of action; and the end result is panic. Once panic sets in, it’s nearly impossible to write.

Panicked students make demands for emotional labour that, for subject coordinators, probably call to mind the advice to use a broomstick to assist a drowning person — because otherwise they will latch onto you and you’ll both sink and drown.

Similarly, the Lifeline operator training emphasises containment rather than soothing: managing panic not via reassurance that everything is going to be okay, but by asking the caller to pick the issue they want to focus on, and then addressing that specific issue. This isn’t a cold and unfeeling process — it can be warm and empathetic — but it seeks to avoid rewarding and reinforcing the demand for an outside source of emotional regulation.

I want to mention one last part of the background: the relationship between perfectionism, rumination and paralysis (or depression). In a perfectionist student, the superego is running the show. They’re a smart person for whom thinking has been the solution in the past, but the problem requires action (writing). The more they ruminate, the closer the deadline gets. And by this point, the unconscious mind — the body, where emotions are experienced — has gone from whispering to SHOUTING its anxiety in order to get the attention of the conscious mind. In that state, it is very hard to do the action that is required, because complex tasks benefit from lower arousal.

So these are the steps that have helped me:

  1. Stop trying to ignore how it feels: listen to those feelings instead. There’s a short guided meditation called RAIN that goes through four steps: Recognise, Allow, Inquire, Nourish (or the more Buddhist practice of Non-Identification — this is happening but it’s not me).  As soon as you have heard them, they will stop shouting.
  2. Re-establish your routines for bodily self-care. Go and do the grocery shopping. Cook yourself a meal. Go for a walk in the sunlight (or in the rain). Go to bed on time.
  3. ‘Throw away the stick.’ This is advice I got from the wonderful therapist Carol-Ann Allen in Melbourne. Stop using this piece of work to beat yourself up.
  4. COMMUNICATE. When I was in undergrad I had somehow picked up how annoying my lecturers found it to receive special consideration requests and the various demands for emotional labour that came with them. So when I got stuck, I stayed silent, I didn’t ask for help, I didn’t see a GP or a counsellor. It wasn’t until I got kicked out of uni that I finally learned how to seek help. For students, the thing to remember here is that your lecturers have worries of their own and they don’t give a damn if you need more time, so long as you’ve submitted the paperwork. You need to send a just-the-facts e-mail — this is happening, I’m seeing the counselling service about it, I will submit a request for special consideration, can I please have x additional days deadline.
  5. GET HELP. If you can get an appointment, a student counselling service is a better option than your GP. The GP is going to give you a note that postpones the deadline, but probably isn’t going to help much with the panic. A counsellor will still give you the letter, but also help you address the panic and come up with a plan to get it done. For subject coordinators: there is an issue here that universities are not addressing at all well, which is that students with social anxiety/social phobia often have enormous trouble with the first step — communicating that there’s a problem and they need help. At a bare minimum counselling services should take web bookings.
  6. Write the fucking essay. You know how to do this. You’ve done it before. What did you do the last time? Remember that, and restart the process. Sure, it may be a scramble and the end result may be scrappy, but you’ll get it done.
  7. Most important step: continue to seek counselling and to build your repertoire of self-care practices after the essay is submitted, or this is just going to happen again.

I want to close with a wonderful quote from an essay by Prof Elspeth Probyn in the Affect Theory Reader that I re-read whenever I’m going ten rounds with the cursor.

I lectured my body sternly, but it wouldn’t listen to reason. To my mind, it was just the pressure of a deadline that was making me ill… It dawned on me that I was experiencing the terror of not being equal to the interest of my subject. The idea that I would not interest readers triggered what seemed to be a mixture of fear and shame.

There is a shame in being highly interested in something and unable to convey it to others, to evoke the same degree of interest in them and to convince them that it is warranted. The risk of writing is always that you will fail to interest or engage readers, Disappointment in yourself looms large when you can’t quite get the words right or get the argument across. Simply put, it’s the challenge of making the writing equal to the subject being written about. (Probyn, 2010[2005])

Writing is fundamentally about vulnerability. Thus, another part of my writing routine is to re-watch this lovely TEDx talk by Brené Brown, from before she got all Oprahfied.

Country Zero

This week a study of the phylogenetics of the early AIDS epidemic in America was published. Nature reported this as ‘clearing the name of Patient Zero‘, the Canadian flight attendant Gaetan Dugas named as such in publicity for Randy Shilts’ book, And The Band Played On.

I’ve never been able to get more than ten pages into that book — each time I’m put off by the heavy-handed journalistic writing style and tactics. I’ve heard the argument that Shilts simply misunderstood Dugas’ study participant code, patient ‘O’ for Oscar:

In fact, Dugas’ moniker “Patient Zero” was actually a misinterpretation of the identifier “Patient O” used in a dataset for an AIDS cluster study centered in California. Patient O was meant to signify that he was a patient from Outside California. (source)

But I have trouble buying that because it is the most journalistic thing on earth to want to nominate a villain, to give him a name and a face and a story.


As I understand it, nobody few in the gay community thought Gaetan Dugas was the literal starting point of the AIDS epidemic, and some have now asked ‘how can this be news?’ It’s news because it contradicts accepted facts about the epidemic in the mainstream news audience. I’ve seen some very rosy assessments of the study. Mark Harrington wrote:

It’s hard to overestimate the damage that the “Patient Zero” myth has done to expand the hatred and discrimination against gay men for allegedly “starting” AIDS; and probably as well deepening the shame and guilt many PWAs must have felt in the first two decades of the epidemic — many people with HIV still suffer from internal shame or guilt as well as from external stigma and legal, structural, social, and often violently destructive and often fatal discrimination or criminalization; just as Haitians have been blamed for “bringing HIV to the Americas,” or others have been blamed for becoming infected without their knowledge or agency by a new infectious agent. The beauty of Worobey et al.’s paper is that is it combines both human history and a deep reading of the literature with the most modern phylogenetic analyses and synthesizes the work of scores of scientists over the past 35 years first to understand, and then to defeat, AIDS and HIV. This paper represents science as enlightenment, and, one hopes, the truth will set many free from destructive self-blame or social stigma. Let the healing begin.

If HIV stigma teaches us anything, it’s that stigma is not a set of incorrect beliefs that can be rebutted by a clear statement of the facts or by new scientific research findings. People are not just ignorant, they literally cling to falsified beliefs, because those beliefs are the foundation for power relations. It is not the case that myths about homosexuals wilfully spreading the illness followed from the nomination of Dugas at ‘patient zero’; rather, they came first and he was selected as their exemplar.

While the new study lets Dugas off the hook, my concern is that it substitutes Haiti as the ‘country zero’ of the American epidemic. Although the Worobey study describes its methodology as ‘phylogeography’, it falls down in one very big way: it fails to explain why it stops its backward-tracing of the epidemic in Haiti. We know, from research wonderfully summarised in the RadioLab episode also titled ‘Patient Zero‘ that HIV entered the human population at the turn of last century in the Congo. How does it wind up in Haiti?

We could make an educated guess. European powers trafficked African people to Haiti as slaves from the 16th century onwards.  About 22% of Haiti’s population traces their heritage to people kidnapped from Cameroon and the Congo. Second, when Patrice Lumumba negotiated Congolese independence mid-last century, Belgium and America worked hard to destabilise his leadership and disrupt the de-colonization process, inducing a political crisis and a stream of migrants and refugees. Lastly, as Paul Farmer has documented, Haiti itself has grappled with terrible poverty, having been forced to pay reparations to France for loss of property (i.e. slaves) when it declared independence.

There’s another question the study leaves unanswered: why did nobody notice this terrible illness had showed up in America until it started affecting gay men? Answer: because they were white, middle-class men, with access to health care and a political voice. In his essay for Drain, Theodore Kerr undertook a careful tracing of the deaths that were subsequently discovered to have been due to AIDS. When asked what he made of this study, he said first ‘it’s not news’. I was powerfully reminded of this quote from Eve Kosofsky Sedgwick’s essay on paranoid readings in cultural critique:

Sometime back in the middle of the first decade of the AIDS epidemic, I was picking the brains of a friend of mine, the activist scholar Cindy Pat­ ton, about the probable natural history of HIV . This was at a time when speculation was ubiquitous about whether the virus had been deliberately engineered or spread, whether HIV represented a plot or experiment by the U.S. military that had gotten out of control, or perhaps that was behaving exactly as it was meant to. After hearing a lot from her about the geography and economics of the global traffic in blood products, I finally, with some eagerness, asked Patton what she thought of these sinister rumors about the virus’s origin.

“Any of the early steps in its spread could have been either accidental or deliberate,” she said. “But I just have trouble getting interested in that. I mean, even suppose we were sure of every element of a conspiracy: that the lives of Africans and African Americans are worthless in the eyes of the United States; that gay men and drug users are held cheap where they aren’t actively hated; that the military deliberately researches ways to kill noncombatants whom it sees as enemies; that people in power look calmly on the likelihood of catastrophic environmental and population changes. Supposing we were ever so sure of all those things– what would we know then that we don’t already know?” (source)

Before AIDS was re-named, after it was Gay-Related Immune Deficiency or ‘Wrath of God Syndrome’, in the earliest days of the epidemic, it was attributed to the ‘4H’ — homosexuals, Haitians, haemophiliacs, and heroin users. By omitting the question of how HIV ends up in Haiti, we are left with a story as old as public awareness of the epidemic itself. For that reason I don’t share Harrington’s confidence that we’ve beaten stigma; we’ve just reshuffled the characters in the narrative. We’re still looking for a bad guy instead of seeking to understand the system that helped HIV on its journey.

Further reading: Theodore Kerr’s incredible piece on ‘AIDS 1969: HIV, History, and Race‘.