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Short abstract:

This paper investigates alternative medicine in ACT UP. Based on research from AIDS activist video archives, this paper explores a particular action called the “quackbusters” in 1990, exemplary of the terrain of debate over knowledge of AIDS and alternative treatments.

Long abstract:

This paper investigates something that has often been relegated to the “scrapheap” of history: alternative medicine in the AIDS movement. “Investigate garlic!”, a refrain of AIDS activists in the early 1990s who wanted the federal government to fund research on alternative treatments, flourished in the AZT moment and all its toxicity, yet from today’s standpoint is subject to cringe. I examine how uncertainty surrounding the future and efficacy of AIDS treatments created discursive space for debates over scientificity. Leaders in ACT UP’s alternative medicine caucus created reverse discourses. As researchers critiqued these activists for prompting “snake oil” treatments without evidence, AIDS activists in turn critiqued the scientists for denying rigorous research on garlic, Vitamin C, and acupuncture as treatments for AIDS. (Will the real scientists please stand up?) Based on research from AIDS activist video archives, this paper explores a particular action called the “quackbusters” in 1990, exemplary of the terrain of debate over knowledge of AIDS and alternative treatments.

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Short abstract:

This paper highlights how market actors and US federal agencies construct new biomedical subjectivities for people living with HIV in a time of expanding treatment options and describes how this defers addressing the social determinants of HIV treatment adherence.

Long abstract:

Adherence to HIV treatment regimens has been a long-standing concern for healthcare providers, public health institutions, and people living with HIV (PLHIV). Adherence is critical to maintaining a suppressed viral load, enabling long-term health while making one’s HIV untransmissible. Although dominant narratives moralize the “irresponsibility” of PLHIV who miss daily medication doses, several scholars in STS highlight adherence as more than consuming a pill every day, revealing numerous human and non-human actors that shape adherence. Amidst these debates, pharmaceutical companies have capitalized on HIV treatment adherence, designing novel regimens such as long-acting injectables that require less frequent dosing (e.g., every two months). Long-acting treatments are aimed at PLHIV whose competing priorities undermine daily adherence. In this paper, I analyze pharmaceutical infographics, advertisements, and regulatory applications related to long-acting injectable treatments, revealing how market actors and federal agencies construct new categories of people living with HIV. I theorize these biosocial positions as “treatment kinds” – different biomedical subjects diagnosed with HIV understood to need specialized interventions to remain adherent. Developing products around particular treatment kinds enables state and market actors to reconfigure treatment adherence as a site of pharmaceutical intervention that can afford PLHIV agency to navigate competing priorities. I argue that HIV "treatment kinds" do empower some people living with HIV, while also creating niche markets for pharmaceutical profit-making. Organizing novel HIV treatments around treatment kinds thus allows market actors and public health institutions to defer addressing the social determinants of HIV treatment adherence in favor of medicalized solutions.

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Short abstract:

This presentation delves into how governments, pharmaceutical companies, NGOs, and PLWHA shape the chronicity of HIV/AIDS in Taiwan. Through ethnographic data, the temporal logics of pharma practice, data production, and digital narratives reveal the dynamics in knowledge production of HIV/AIDS.

Long abstract:

Since 2013, the UNAIDS "Ending AIDS by 2030" initiative has significantly influenced HIV science discourse. Innovations like rapid testing, 72-hour PEP, daily and event-driven PrEP, quarterly long-lasting injections, and the U=U campaign have underscored the importance of temporal governance of HIV/AIDS. These advances have transformed HIV/AIDS in Taiwan into a chronic condition, fostering optimism for its control and eventual elimination. This presentation considers the chronicity of HIV/AIDS at a time when the pandemic is biomedically manageable yet socially and sexually challenging. Drawing on ethnographic work conducted in Taiwan and interviews with Asian AIDS experts, this presentation unveils the layered chronicity of HIV/AIDS through three interrelated temporal logics. First, Pharmaceutical Time illustrates how global pharmaceutical firms collaborate with the Taiwanese government to secure market share while extending the patent protection of their products. It also examines how pharma practices improve previously strained relationships with NGOs. Second, Data Time considers how local LGBTQ health centers sometimes embellish data (e.g., testing numbers and HIV-positive cases) to meet the government's stringent Key Performance Index requirements. Third, Chemical Time recounts how individuals in chemsex disrupt treatment regime by resisting ART adherence just to assert personal autonomy and control over their pleasure and intimacy. By exploring the tension of these three troubling temporal logics, the presentation demonstrates how scientific communities, LGBTQ activists, governmental bodies, international pharmaceutical companies, and individuals reshape the knowledge and temporal understanding of AIDS. In Taiwan and Asia, the chronicity of HIV/AIDS is being visualized and narrated in unprecedented ways.

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Short abstract:

This paper traces how poppers’ changing purported link to AIDS, first as suspected cause of the syndrome, then as co-factor in immunosuppression, and last as impediment to condom use. Drawing on anti-poppers activist archives, I ask how panic within expert cultures manifests as lingering doubt.

Long abstract:

Poppers are the ‘bad object’ of historicizing AIDS etiology debates. Nitrite inhalant vasodilators used in anal sex, poppers were widely suspected for playing a role in AIDS before and after the HIV virus was discovered. Histories of public health experts and citizen science on AIDS cite poppers as a moral panic at the outset of the epidemic. But the intertwined significations of poppers and AIDS though the 1980s and 1990s reveal a more complicated story around the consolidation of an AIDS consensus and the porous boundaries between mainstream public health and AIDS dissidents. Well after the HIV consensus, a significant cohort of AIDS knowledge workers continued investigating poppers as a co-factor in immunosuppression, and then as a barrier to condom use and risk for seroconversion (the working theory of most public health scholarship on poppers today).

How did concern over poppers remain in the AIDS mainstream, even as activists and experts kept changing the goalposts over risks? I tell the story of The Committee to Monitor Poppers (CMP, 1981-2008), a San Francisco-based collective in constant correspondence with AIDS activists, epidemiologists, consumer-protection agencies, elected officials. CMP presented themselves as gay male advocates and emphasized poppers as an unregulated product that merited oversight. They counselled their different constituencies on how to frame poppers’ health risks. The connection between poppers and AIDS prompts challenges the moral panic model as punctuated unreason against established knowledge. This case study asks us to consider how panic lingers in expert cultures as an unwillingness to discount risk.

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Short abstract:

In my presentation, basing on my research in Germany (2023) and France (2021), I will focus on the building of the PrEP and TasP literacy among GBMSM and trans* migrant and refugee communities through the sexual health activism of HIV/AIDS-prevention and LGBTQ+ organisations.

Long abstract:

New biomedical technologies, such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP), have become scientifically established to be highly effective HIV/AIDS prevention methods. In a radical shift, PrEP and TasP may be seen as providing biomedically informed contexts in which the spectre of HIV is removed from male-to-male and people living with HIV are destigmatized. To work and to bring (social) change, PrEP and TasP, being products of modern biomedical science, have to be "translated" into discourses and languages spoken by the communities that may benefit from using them.

In my presentation, basing on my research in Germany (2023) and France (2021), I would like to focus on PrEP and U=U activism of HIV/AIDS-prevention and LGBTQ+ organisations towards GBMSM and trans* migrants and refugees. PrEP and U=U literacy is part of HIV literacy which is defined as “[t]he ability and skills of individuals and communities that means they are equipped and willing to engage with HIV, have access to and understand HIV information, able to apply learned HIV information within their sexual practice and able to engage with others about this HIV knowledge and related sexual practices” . Thus, it is essential that biomedical discourses of transnational actors (e.g., WHO, ECDC) are translated within the local context, with socio-cultural, ethnic, economic, migrant factors taken into account, by place-based institutions and community-based organizations into languages that could be understood by local GBMSM and trans* communities.

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Short abstract:

Materialist virology is a queer and trans of color STS method for historicizing virus knowledge. This paper uses it to study the foundational “tobacco mosaic virus” and ask: How have settler colonial plantation economies shaped the emergence of HIV/AIDS and COVID-19 and global medical apartheid?

Long abstract:

In the 1980s, US-based HIV/AIDS activists initiated the slogan of “drugs into bodies.” By the 1990s, queer radical thinking and politics transformed their call into “healthcare not warfare.” These activists’ agenda became explicitly anti-capitalist and increasingly anti-war with the aim of building global South solidarity. COVID-19 has prompted present-day activists to build on HIV/AIDS activists’ intersectional and internationalist movements to redouble coalitions and redistribute care for collective survival.

To further intersectional analyses and internationalist solidarities, this paper historicizes the knowledge generated about viruses by using a queer and trans of color STS approach it terms materialist virology. It demonstrates materialist virology, as a method and a historical study of virology by revisiting its emergence, beginning with Dutch botanist Martinus Beijerinck’s late nineteenth-century conceptualization of the inaugural “tobacco mosaic virus” (TMV). Materialist virology is deployed to examine archival scientific literature and media produced on tobacco—a plant indigenous to the Americas— as a model for plantation agriculture and industrial monocropping which together laid the foundation for the twentieth-century US-led field of virology and racial capitalism. TMV presents a blueprint for today’s mass extraction, state-sponsored and military imperial violence, ecosystem dismantle, and globalized crises. What is the relationship between historical tobacco plantation agriculture to viral disease emergence among humans and other animals? Between the racialized labor of settler colonial plantation agriculture and the global medical apartheid maintained by policing and military violence in the age of HIV/AIDS and COVID-19?

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Short abstract:

In this presentation, I will share a series of images from Turkish newspapers (1985-2002) and discuss how the media, politicians, and doctors invented the Turkish patient-zero whose dead body was washed with bleach before he was wrapped in plastic bags and encased in concrete.

Long abstract:

“Representation,” writes Stuart Hall (1982, 64), “is a very different notion from that of reflection. It implies the active work of selecting and presenting, of structuring and shaping: not merely the transmitting of already-existing meaning, but the more active labor of making things mean.” This explains how the media representation, especially the printed press, has played an enormous role in the making of HIV/AIDS epidemic. This is particularly true in a country such as Turkey where government’s strategic ignorance and the manufactured silence made sure that the public turned to the press to be informed about HIV announced to be “the plague of the era.” There are no oral histories, no books, no articles, or no exhibitions that would help create an archive of the HIV/AIDS epidemic in Turkey. There are, nevertheless, a plethora of newspaper articles and images through which we can uncover the not-so-scientific meanings attributed to HIV and write the history of Turkish HIV epidemic, while creating a “simulacrum” of an archive. This presentation will focus on the nationalist, heteronormative, sexist, and xenophobic representations of HIV/AIDS which took their power and authority from blaming the epidemic on a wide range of others, varying from Western queers to Eastern European prostitutes to tourists. In this presentation, I will share a series of images from Turkish newspapers (1985-2002) and discuss how the media, politicians, and doctors (1) invented the Turkish patient-zero whose dead body was washed with bleach before he was wrapped in plastic bags and encased in concrete; (2) put the responsibility of the epidemic on the shoulders of Eastern European sex workers and women tourists, who were likened to “ticking bombs ready to explode” and “a danger larger than the Chernobyl explosion”; (3) and, used the HIV epidemic to construct and strengthen the figure of “virtuous Turkish women” whose code of honor was deemed sufficient to protect Turkey from HIV.

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Short abstract:

This paper analyzes US initiatives to end HIV/AIDS epidemics. I develop the concept of a “sanguine governmentality” to describe naively optimistic strategies for managing HIV that emphasize using routine blood work data reported to public health surveillance systems to pursue unrealistic targets.

Long abstract:

This paper analyzes the implementation of recent US federal HIV/AIDS initiatives to develop the concept of a “sanguine governmentality.” This framework draws on the Foucauldian framework of governmentality and theories of datafication to describe strategies for managing epidemics that use routine clinical blood work data reported to public health agencies to pursue unrealistic population health targets. I draw on analyses of policy documents and ethnographic fieldwork in Atlanta’s HIV/AIDS safety net from 2016-2019. I have observed actors enthusiastically promoting datafied public health surveillance systems as vehicles for pursuing unachievable HIV viral suppression targets, given the country’s inequitable healthcare system. Surveillance data are used for epidemic response, including for resource allocation, epidemiology, and outreach to people living with HIV. I call this strategy for managing HIV “a sanguine governmentality” because it is rooted in the naïvely optimistic–or sanguine–promise of a future that never arrives: the “End of AIDS” or “Zero” new infections. Those goals are so utopian that their failure is written into their pursuit. In this future-always-deferred, every person living with HIV is incorrectly imagined as being able to access medical care, physiologically capable of becoming virally suppressed, and personally able to remain adherent to medications. However, datafied strategies for governing HIV are also “sanguineous,” as in “of, relating to, or containing blood,” because they rely on routine clinical blood tests reported to public health. Sanguine governmentalities offer a useful lens for other cases in the governance of biosocial problems that mobilize data systems, blood tests, and forms of optimism.