Sex Wars:

The New Left's AIDS-Related Scientism

by David Mertz

Initial version: November 1994; slightly revised 1995-96

The Conceptual Field.

In the last decade, the so-called Sexual Revolution of the 1960s and 1970s died. It did not die in the sense that people's sexual habits reverted to some pre-1960 standard of heterosexuality and monogamy. Actual behavior changed very little in the 1980s; and, at any rate, the 1950s and before were never as sexually limited as they are often imagined in contrast to what seemingly "must have" happened with the Sexual Revolution. In a sense, very little has probably changed in human sexual behavior since the advent of mass urbanization in the early nineteenth century. What has changed dramatically in a decade is the ideological tools and strategies used in conceptualizing sexuality, and the relation of sexuality to broader notions of social power, political struggle, freedom and responsibility. Most of the renegotiation of sexuality has been a determined effort on the part of the right-wing to reinstitute its fantasy conception of "family values," normative heterosexuality, and condemnation of non-monogamy. An additional contribution to such a conservative renegotiation of meaning has come from certain self-identified feminists who have repeated the puritanical strains of 1920s "first wave" feminism in its "anti-prostitution/anti-vice" crusades. Both of these renegotiations have been extensively critiqued and analyzed in leftist philosophical circles, and such shall not be repeated here. What has been overlooked by most of us on the Left has been a third current of renegotiations of the ideologies of sexuality which is associated with the meanings given to AIDS. Or perhaps we have not overlooked it, but have been so completely blinded by its glaring ubiquity that we have not seen the ideological functions of AIDS.

AIDS has succeeded in shifting the left-wing discourse of sexuality away from one of liberation, freedom and resistance, to one of responsibility, danger and obligation--concepts much more at home with a right-wing scheme of social control, xenophobia and authoritarianism than with anything on the Left. "Safe sex" has succeeded in performing this conceptual shift--a shift which would be seen through if it came from traditional conservative forces, and which would be largely resisted if it came from anti-porn "feminism"--precisely because the language of "safe sex" is one inextricably signed with the imprimatur of medico-scientific authority. Sexual liberation has not always been liberatory, sexual freedom not always free, and sexual resistance not always contrary to broad forms of domination. Sometimes, and in some ways, it has been, in other times and ways not. But there was a time, before this last decade of AIDS, when the discursive apparatuses of liberation, freedom and resistance had not been blanched out of sex.

The altars of science--in particular scientific sounding pronouncements about AIDS--have been the one significant form of social authority generally unquestioned--or at least not very deeply questioned--by academic leftists. Somehow science has served in dismantling the language of liberation in the Left more than any other institutions possibly could have, because the Left has not gone beyond an automatic doxastic presumption in favor of moralism bearing the imprimatur of science.

A Factual Gloss.

The places where AIDS-science and its popularization have gone wrong are rather numerous. The HIV hypothesis itself, despite its longtime almost univocal acceptance by official science and by the media, rests on much shakier evidence than would be accepted in a less politically contested area of science.[1] For reasons having little to do with the sexual moralities discussed herein, there is a bias of reductionism and monocausalism in science which makes the HIV one virus/one disease model very appealing, even where evidence does not support it.[2] Beyond that, the "war on cancer" of the 1970's promoted a more limited bias towards explaining disease with viruses, and with retroviruses in particular.[3]

Quite independent of what is causing it, something is going on with some new kinds of deaths in the last fifteen years. The two dogmas, as it were, of the folk epidemiology of AIDS seem to be (1) that it is an ongoing epidemic; and (2) that it is poised on the verge of afflicting non-traditional groups (basically non-drug-injecting heterosexuals). These dogmas have been held pretty firmly by just about everyone since about 1984: both scientists and laypersons. I recommend disregarding all the articles, scientific and popular, which excitedly, almost reverently, declare an explosion of AIDS cases amongst heterosexuals, and go straight to the raw data. AIDS is mostly a gay male disease, and those persons with AIDS (PWAs) who are not gay men, whether male or female, are overwhelmingly IVDUs. [4]The 1994; 6(no.1). See Table 3. "AIDS cases by age group, exposure category, and sex, reported July 1992 through June 1993, July 1993 through June 1994; and cumulative totals, by age group and exposure category, through June 1994, United States." 59% of cumulative AIDS cases are in the exposure category of men who report having sex with men (some of whom also inject drugs), while an additional 25% of cumulative cases are reported in injecting drug users exclusive of men who have sex with men. 7% of cumulative cases are purportedly transmitted by heterosexual contact. See footnote for evidence that the actual heterosexual transmission may be less than is here reported. An argument can additionally be made that even many of the cases which are reported as exposure from heterosexual contact are false reports which hide other risk categories.[5]

The other dogma about the plague-like epidemic doesn't do too well with the raw numbers either. In 1994, the total number of new AIDS cases in the United States declined significantly. [6] They will continue to decline at roughly the same rate, year by year, that they increased prior to 1994. The increase in cases in 1993 was purely a statistical artifact of a definition change in January 1993 which defined a lot of people as having AIDS who would not have been defined as having AIDS had they presented to doctors in 1992. If you look at only the cases under the 1992 definition, 1993 also showed a sigificant decline in cases.[7] If you look at deaths, rather than at new diagnoses, the peak was probably reached sometime in 1991 or 1992. Whenever the normal distribution reached its exact maximum, the fact is that AIDS is not going to be fundamentally different from every other new disease in human history in following a bell curve of initial incidence.

As terrible as it is that as many people have died as have, the worst is over, and this worst doesn't come close, for example, to the three million people who died in a much shorter time of so-called Asian Flu in 1917 and 1918--when the U.S. had about half its current population. My point is not insensitively to dismiss AIDS deaths on the grounds that they lack the magnitude of influenza, but rather to observe that however many more people died of influenza earlier this century than will die of AIDS, influenza never carried the same pretense of its very numbers making moral and political arguments. Those were merely deaths: tragic, regrettable, unfortunate, but not able to convince us to compromise a language and hope of political liberation. Similarly, a lot of things like cancer, heart disease and auto fatalities kill a lot more people than AIDS--but leftists do not insistently and obsessively lecture on the techniques for prophylaxis against these deaths. On the other hand, there was another disease of the early 20th century which wore the same shady deontic veil that AIDS does now: syphilis, which is discussed later in this paper.

Abjection and Moralism.

When I was writing an earlier version of this paper, and mentioned it to friends and colleagues on the Left, the very first reaction I received was inevitably a sort of gasp, followed by an exasperated warning that I had best be careful to emphasize the importance of "safe sex." For speaking before a group of leftist academics, my colleagues implicit premise remained that lest I admonish my audience explicitly on the virtues of condoms--and perhaps of monogamy--I might precipitate a breakdown of all standards of sexual restraint in my audience, thereby exposing them to the sexual diseases. Most importantly and insistently, a ritual prescription of safe sex is insisted upon for speech before the "innocent" undergraduates whom we teach. The magical powers attributed to a simple lack of obedience to the idol of safe sex is quite remarkable. A faith in this new orthodoxy of safe sex has, in my experience, brought out some shockingly unprofessional behavior in leftist academics whom I know. Leftists have been amongst those who vilify HIV dissenters like Peter Duesberg on the grounds that insufficient dogmatism about the HIV hypothesis might somehow lead to insufficient respect for condoms and monogamy--even though etiological doubts are quite orthogonal to epidemiological facts. It is not just those who denounce safe sex, like the Christian Right, but those who fail to preach safe sex with sufficient enthusiasm, who raise the ire of safe-sex'ers.

"Safe sex," I believe, has become a secular scientistic religion of the Left. Certainly many non-leftists share in the faith, but the fundamentalism is greatest amongst us. The cardinal sin according to this religion is an old Catholic one: accidie, the failure to perform one's duties with sufficient zeal. Under this sin, silence becomes death, or more precisely murder; wherein everyone not mentioning condoms in every context becomes culpable for AIDS deaths. The absurdity of the imperative only witnesses its structural importance. Condoms are now made to be exhibited, in a kind of paean to the regulation of sex. Condoms serve as talismanic objects for the feel-good "do something about AIDS" testifiers, amusingly safety pinned onto clothing in a manner to render any functional potential void, and advertised on buses and billboards underlined by homilies intended to affirm the political radicalism of the passive viewer who assures herself that she knows their importance. The content of this regulation is a bit ethereal: it doesn't prescribe all that much, and what it does prescribe is hardly ever followed by its proponents. The percentage of heterosexuals in any demographic group who use condoms with any regularity hovers below twenty.[8] The percentage of gay men who use them is higher, which is fortunate given that it is gays who are at a real risk; but this religion is quite catholic: its prescriptions, like its grace, apply equivalently to all the devout.

Two related points need to be drawn out to see where the officially positivistic reasoning of leftist AIDS discourse breaks down. Overtly, leftist safe-sexers have no more than a purely objective concern with public health. However, those whom we--as academics, the same does not necessarily apply outside the academy--most forcefully and frequently try to "educate" about AIDS, are precisely those at the smallest--and in fact quite minuscule--risk. Basically the message of "safe sex" is one we preach to our undergraduate heterosexuals. It may have a magical power to proclaim that "everyone is at risk!;" but on the facts, not everyone is. The arguments in favor of AIDS catholicism, and arguments on the greater ease of convincing everyone than convincing those who matter, are simply so many "Noble Lies." The second point in critiquing the official legitimization of our AIDS ideology is that the many risks which are greater than that of heterosexual AIDS are treated with absolutely none of the moralizing quality which is given to slogans on safe sex. Neither is the insistence ever so great; nor the almost compulsive quality present.

Our False Catholicism about Who Is At Risk

I have communicated with AIDS educators who have asserted that only 5% of all U.S. AIDS educational materials are directed at gay men. I don't want to put too fine a point on that particular fraction, since it is very difficult to trace even the federal funding of AIDS, let alone all the local efforts. Further, not every safe sex pamphlet and billboard not specifically targeting gay men thereby automatically exclude them. But the overall pattern is clear: a sizable majority of safe sex material is specifically targeted to young, white heterosexuals. Injecting drug use receives similarly short shrift in these materials. When, occasionally, the actual demographics of AIDS faintly tugs at the consciousness of safe sex pamphleteers, gay men and IVDU's might receive a passing footnote for their specificity of risk. The tone here is generally one in which, in a pamphlet warning of the dangers of unsafe sex, one might read a parenthetical allusion to the fact that gay men are at particularly high risk, or that sharing needles should also be avoided. These pamphlets never contain a frank acknowledgement that, depending on how many men you think you are having sex with men, the risks are different by powers somewhere between several hundred and several thousand--on par, for example, with the difference in risk that men and women face from breast cancer.

Beyond the pamphlets produced by U.S. Public Health Service, and by a variety of local groups everywhere, I find it important to examine the attitudes which leftist academics bring to their pedogogy in connection with AIDS and sexuality. While it is both easy and common to overestimate the importance of academics in shaping the intellectual and political climate, our reactions to recent these sexual ideologies are important insofar as one might have hoped for a bastion of resistance against repressive changes from us academics. Were we leftist academics merely to tell our students that insofar as they are men having sex with men, and insofar as they share needles, they face relatively high risks of developing AIDS, I would have no ideological critique against such factual advice. Below is a bit of discussion about what I think is a false normativity often accompanying such statements; but this suggested statement, by itself at least, is quite fair.

In my experience, however, these prosaic accuracies are not what most of us leftist academics are telling our students. What we are doing is warning our predominantly heterosexual and non-needle-sharing undergraduate classes that they had, sui generis, all better be careful so as not to contract AIDS. Occasionally, we are getting scared young heterosexuals coming into your office hours after having had their first one-night stands, terrified that they have now contracted AIDS. What most of us are telling them is exactly what gets us off the hook most easily: that they should go to the local health clinic for HIV testing, and use condoms in every future sexual contact. The first part I think is rather bad advice inherently. [9] The second, however, while not harmful of itself, reflects a backing down from a radical stance, and a failure of leftist pedagogy. What we are doing in giving this "safe" advice is granting the legitimacy of our students' irrational fears because of their sexual contents. Thereby we fail to critique the systematic regulation of sexuality in the maintenance of a repressive social order. Even if the content of the regulation--at least of condoms, if not of abstinence or monogamy--is fairly uninteresting, our facile advice simply affirms the necessary primacy of regulation itself. We ourselves embody a sort of psychoanalytic Paternal Law, for which it matters not so much what is commanded as that something, at least, be so commanded. I think the failure is easily understood by analogy with places we, hopefully, do not fail. If a young woman student despairs, to us, of ever "finding a man," I hope we do not formulaicly assure her of her future marital bliss--but rather say a few (gentle) words on the dependent position women are cast into by patriarchy. And if a young Christian becomes convinced of his future damnation, I hope we do not tacitly mutter a few words about redemption of sin--but rather a few about how moral ideologies serve to blind individuals to their material realities.

Our Lack of Catholicism about Risky Activities

While the notion that "everyone is at risk" from AIDS is dogmatically prescribed by the Left, our concern for risks is oddly curtailed to those accompanying sex. If I tell them I am going rock climbing, my leftist friends might say "be careful" or "use precautions" offhandedly; but they probably would not say anything besides "have fun." If, on the other hand, I say I am going to go fuck around heterosexually and promiscuously, without condoms, they will react angrily with accusations of my foolishness and moral irresponsibility. But in fact, the rock climbing--even with ropes and such safety measures--poses significantly more actuarial danger (to myself, or also to my climbing partner). Of course, a lot more people have sex than rock climb, so the totals are a higher for heterosexual AIDS, despite the percentagewise greater mortality risk of rock climbing. Part of the difference in reaction is simply a misappraisal of the relative odds--but I think there is a much larger part which is symptomatic of an adoption of a normativity of sexual regulation.

Even clearer examples of differently preached risks come with other diseases. Heart disease is every bit as much behaviorally related as is AIDS, but recommendations for its prophylaxis are seldom stated so moralistically by the Left as are those for AIDS. For non-drug-injecting heterosexuals (or lesbians), dietary linked deaths are a good bit more numerous both proportionally and absolutely than are sexually linked ones. This is not the case for gay male sex, nor is it for drug injecting--but our proselytizing is not directed solely, or even primarily, at those activities. One might receive a word of friendly advise from a leftist about the health dangers associated with fatty foods, lack of exercise, or smoking. But if one persists in these activities, our good leftists will probably shrug to themselves over the foolishness of fat eating, but recognize that such a risk is simply each individual's to take. Such magnanimity over the self-endangerment of others does not generally extend to sexually incurred risks. [10] Rather, leftists--here acting no differently than most everyone else, the distinction being that we should know better--cling to the supposition that those indulging in "risky" sex (however small the actual risk) must be doing so out of lack of information, self-deceit, or because of some sort of repressive imposition of the sexual acts upon them. While I do not wish to proclaim some high romanticist sentiment about untamed passions, it seems the Left has curiously overlooked the rather commonsense point that people generally have sex because they want to; and they want to even though, or sometimes even because, sex is not free of risks. Within feminism, much of this sanitized notion of sexuality harks back to some familiar refrains of cults of true womanhood, and to the moral pureness of women. Perhaps now women maintain their purity through condoms rather than marriage, but either is ritualistic at best as far as the near-nonexistent risk of heterosexual AIDS is concerned.

Naturalistic Fallacies.

The unequal treatment of sexual and non-sexual risks leads to a philosophical observation. An ontological error, I think, has been committed by the Left in its derivation of a political ought from an alleged biological is. This naturalistic fallacy reasons that since AIDS is pandemic, there exists a moral obligation for each person to minimize her risk of AIDS. Failure to utilize prophylaxis is thus cast as an ethical failing. It happens that even the factual premise is rather weak for heterosexual contacts, but among gay men AIDS is indeed fairly prevalent, albeit not actually epidemic since the incidence is decreasing[11]. It has been suggested to me that underlying the Left's naturalistic fallacy about safe sex is an enthymatic moral principle according to which avoidance of disease is good. There may indeed be such a moral principle to which leftists subscribe--although more likely the valuation is mostly pragmatic--but the problem is that we simply have no right to impose this moral principle on the unwilling. Deep down we all value other's autonomy enough to recognize that we should not try to impose our moral valuation of health and risk on others; but most often that respect for autonomy is paved over with the specious rationalizing claim that all those others are merely ignorant of the risks they face. This claim is facile. Very few people, gay, straight or lesbian, drug injecting or not, are really much unaware of the health risks of sex--how could they be after a century of constant barrage on this, and after 15 years of this barrage having the name "AIDS?" Indeed, those who misevaluate risk almost universally believe their danger greater than it is.

People, in full awareness of risks, decide to engage in "risky" sex. Both heterosexuals and lesbians whose risk is minuscule, and gays whose risk is much greater, choose the psychological, physical and political benefits of "risky" sex to be more important than the associated risks. It is easy enough to say that had the eventually afflicted amongst them known the result, they would have acted differently. That might well be true most of the time. Similarly, that subset of pedestrians who are struck by cars almost universally retroactively evaluate their injury as more serious than the purpose of their errand. This reasoning is quite a bad argument for avoiding walking, and just as bad for avoiding unsafe sex. It is only by abandoning a possibility for the discursive construction of notions of liberation and freedom in sexuality that we have come to believe every virtue associated with non-risk-free sex to be outweighed by the potential for harm also accompanying it. In the end, this is a perfectly legitimate choice for each of us to make for ourselves, but it is not one we should try to impose on others, as we have so univocally done.

Syphilis and History.

It happens that AIDS is nothing like what is widely believed in its epidemiology or causality; but there was a disease, not so long ago, which fit almost to a "T" the current misconceptions about AIDS: namely, syphilis. Progressive groups of the nineteen-teens, such as the American Social Hygiene Association, produced stunning estimates of syphilis affecting as much as 10% of the adult U.S. population. [12] While such estimates were, no doubt, exaggerations used to support a political agenda--much as are most projections of AIDS cases today--it is nonetheless quite believable that several percent of U.S. residents had indeed contracted syphilis. Mortality and crippling morbidities were common in the disease. What I find most interesting in the history of syphilis is that virtually every argument made today about AIDS was made almost verbatim prior the 1930's about syphilis: the arguments of the public health authorities, of today's feminists, of today's gay press, of leftists and liberals, and the arguments of today's rightwing Christian fundamentalists. Alan Brandt's Social History of Venereal Disease[13], which is a remarkable description of these myriad confluent groups who united around venereal diseases.

Disappointingly, the Left suffered all the same failures in its ideological construction of syphilis as it has with AIDS. It was largely self-identified progressives, and especially self-identified feminists of the nineteen-teens who led the anti-prostitution and anti-vice campaigns which were some of the most widely orchestrated state repressions of 20th century U.S. history. The victims of these repressive campaigns were, of course, poor women. Aside from a language of "female spirituality"--often invoked also by feminists nowadays--the chief argument for these police state measures was syphilis. The very same derivation of moral laws--and thereby state actions--from epidemiological facts was the centerpiece of much progressivism and feminism of the early century, just as it is today. Then, as now, it was only a specifically sexually-related disease which convinced leftists of the need for police action. Other diseases, then as now, never seemed to carry such an imminent demand for the forfeit of freedoms.

An Hegelian remark on the history of venereal disease might serve to conclude these observations. Despite the analogies I suggest, there has also been a developmental process in the language of venereal disease. The dominant ideological construction of sexual disease had a religious framework in the teens. The language concerned moral failings and corruptions, and mentioned the essentially ethical dangers of unsafe sex. By the 1940's, when treatments for syphilis had become much more effective, a much more medicalized language became dominant. A positivistic discourse of public health and biology was the rhetorical strategy one used in understanding sexual dangers. With the emergence of AIDS as a discursive phenomenon the positivism was not abandoned, rather the very language of science was recycled into the construction of a fully scientistic theology of disease. The language of science, remaining on the surface value-neutral, became the framework for conceptualizing moral necessity!

Acknowledgements: Thanks for assistance with preparation of this paper, both for kind suggestions on the arguments and with bibliographical direction go to Udo Schüklenk, Mary Ann Sushinsky, Rachel Roth, Greg Nigh, and Todd Miller.