How to Have Theory in an Epidemic: Cultural Chronicles of AIDS (review)

Abstract

This ambitious book expands on Paula Treichler's groundbreaking 1988 essay "AIDS, Homophobia, and Biomedical Discourse: An Epidemic of Signification." In that essay, reprinted here as the book's first chapter, Treichler argues that "the very nature of AIDS is constructed through language and in particular through the discourses of medicine and science" (p. 11). The epidemic has generated "a chaotic assemblage of understandings of AIDS," "an epidemic of . . . signification." Insisting that our understandings of what AIDS and HIV infection mean be regarded as "culturally constructed," Treichler proposes that we pay careful attention to how language creates rather than simply reflects the meanings of illness. Far from being objective, biomedical definitions of AIDS are based "on prior social constructions routinely produced within the discourses of biomedical science" (p. 15). Familiar "semantic oppositions" derived from existing social constructions—oppositions such as those between "self and not-self," "homosexual and the 'general population'," "addiction and abstention," "normal and abnormal," "prostitute and paragon," "First World and Third World"—pervasively shape scientific as well as popular concepts of the material reality of HIV infection and AIDS (p. 35). In the opening essay Treichler draws particular attention to the intransigent mythic construction of the gay male body as the "not-self," a binary division that attempts to contain or "barricade" the pathogenic potency associated with homosexuality in order symbolically to protect the self, and by extension, the social body, from contamination (pp. 35-37). But Treichler's argument reaches beyond this specific insight to contend that, especially in the context of HIV infection and AIDS, medicine and science, along with the corresponding popular discourses of illness and disease, urgently need to be analyzed along cultural lines in the interests of working against such dichotomies and advocating for social justice. [End Page 306]