Moral Threats and Dangerous Desires

AIDS in the News Media

Deborah Lupton

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9781138468122
• eBook ISBN: 9781135341534
• Topic: Medicine
• Subtopic: Sociology

Since 1981, AIDS has had an enormous impact upon the popular imagination. Few other diseases this century have been greeted with quite the same fear, loathing, and prejudice against those who develop it. The mass media, and in particular, the news media, have played a vital part in "making sense" of AIDS. This volume takes an interdisciplinary perspective, combining cultural studies, history of medicine, and contemporary social theory to examine AIDS reporting. There have been three major themes dominating coverage: the "gay-plague" dominant in the early 1980s, panic-stricken visions of the end of the world as AIDS was said to pose a threat to everyone, in the late 1980s; and a growing routinising of coverage in the 1990s. This book lays bare the sub-textual ideologies giving meaning to AIDS news reports, including anxieties about pollution and contagion, deviance, bodily control, the moral meanings of risk, the valorisation of drugs and medical science. Drawing together the work of cultural and politicaltheorists, sociologists and historians who have written about medicine, disease and the body, as well as that of theorists in Europe and the USA who have focused their attention specificaiiy on AIDS, this book explores the wide theoretical debate about the importance of language in the social construction of illness and disease. This text offers insights into the sociocultural context in which attitudes towards people with HIV or AIDS and people's perceptions of risk from HIV infection are developed and the responses of governments to the AIDS epidemic are formulated.

Chapter 1

AIDS as News

AIDS was first reported to the world in 1981 when five cases of Pneumocystis carinii pneumonia and 26 cases of the hitherto rare cancer Kaposi’s sarcoma, associated with extreme immune deficiency, were reported among young gay men in the USA. By 1982 several articles had been published in American medical journals concerning this mystifying new disease, which already was being described as a ‘serious public health problem’ by virtue of its high mortality rate among young, previously healthy individuals (CDC Taskforce, 1982: 252). In late 1982, when the tally of cases identified worldwide was 788 (Waterson, 1983: 745), medical journal articles began referring to the condition as the Acquired Immunodeficiency Syndrome or its acronym, AIDS. It was during this early discovery phase that AIDS was labelled a ‘Gay Plague’ in the medical literature. Most articles published in medical journals describing the disease included in their title a reference to gay men, despite evidence that women and heterosexual men were susceptible to the disease. Other high risk groups in the USA, including injecting drug users, people with haemophilia, and Haitians were also largely disregarded, as the attention of researchers became more and more centred upon gay men with AIDS.

There is no doubt that in the short space of time AIDS has been ‘known’ in the western world, it has commanded a huge media interest. In 1985 the American news story wire service United Press International reported that AIDS was one of the top four news-making issues, while the Associated Press placed it fifth and Encyclopaedia Britannica rated it sixth on a worldwide basis. In 1986 these sources all ranked AIDS ninth in international news value (Hughey, Norton and Sullivan-Norton, 1989: 56–7). In the quest for profit, newspapers and magazines must try to maximize their readership. Their agenda is not explicitly to disseminate health information per se, but to entertain. Hence, they focus upon drama, controversy, human interest, brevity and simplicity in news stories. Hence too, AIDS has received enormous coverage in the popular media. The news media’s desire to publish sensational and unusual stories to attract consumers’ attention was fulfilled by the association of AIDS with male homosexuality, heterosexual promiscuity, prostitution and injecting drug use: all behaviours which inspire prurience and voyeurism. All of the necessary conditions for ‘good’ news were thus provided by this new disease, and assisted in making AIDS – at least at first – a media sensation.

The ways in which the phenomenon of AIDS has been represented in the entertainment and news mass media have played an important role in the development of shared cultural meanings about AIDS. Weber and Goldmeier (1983) wrote a case note for the British Medical Journal about the hundreds of patients they had recently seen with anxiety about AIDS, of which three had severe psychiatric illness with fear of AIDS as the dominant feature. One man had watched a television documentary on AIDS in April 1983, following which he had developed an irrational conviction that he was incubating AIDS, suicidal thoughts and fear of contaminating others. A second patient complained of acute depression, malaise, night sweats and impairment of concentration. These symptoms had begun when he had read a newspaper article on AIDS. The third patient had seen the documentary also, which he watched on video over 30 times. He developed intense anxiety about AIDS, was unable to work and contemplated suicide. The authors believe that ‘in each case the condition was precipitated by particular media coverage of the AIDS epidemic’ (Weber and Goldmeier, 1983: 420).

These individuals represent extreme cases of reaction to mass media news coverage of AIDS and it is unlikely that many others in the general public have been so affected. However, it has often been speculated that the news media have had an impact upon everyday and popular beliefs about AIDS. The importance of the mass media, most particularly television, newspapers and magazines, as major sources for individuals in western countries for information about AIDS, whether it be accurate or distorted, has emerged in many large scale studies of AIDS-related knowledge, attitudes, beliefs and behaviour carried out in a number of countries (Ross and Carson, 1988; White, Phillips, Pitts et al., 1988; Dolan, Corber and Zacour, 1990; Carducci, Frasca, Matteelli et al., 1990; Herlitz and Brorsson, 1990; Abraham, Sheeran, Abrams et al., 1991). One Australian study (Bray and Chapman, 1991) conducted two randomized telephone surveys of Sydney adults in 1988 and 1989 in which a total of 1352 interviewees were asked to recall, without prompting, any AIDS programmes, articles or advertisements in the print or electronic media; 92 per cent in 1988, and 93 per cent in 1989, could recall at least one advertisement or programme about AIDS on television. While only a minority of interviewees could recall a radio programme or advertisement, approximately half of them recalled articles about AIDS in newspapers or magazines. Those most often recalled were the individual stories of real people whose lives had been affected by AIDS.

It has also been asserted that individuals perceived to be at high risk from HIV infection, or those identified as seropositive, may be psychologically adversely affected by homophobic statements made in the media, or by statements that assume that HIV seropositivity is an inevitable death sentence (M.W. Ross, 1989: 79). Pictorial representations of people (most usually gay men) living with AIDS in the popular media have routinely depicted them as emaciated, disfigured, ashamed, despairing and lacking hope (Crimp, 1992). In response to these images and representations at least one HIV antibody positive man has publicly commented that:

People with HIV disease, and especially people with AIDS, are constantly reminded that they are probably going to die. You turn on the television or open a newspaper and, in the context of an item of AIDS, you will see yourself described in terms which make it clear that, in society’s eyes, you are finished.

Grimshaw, 1987: 256

While quantitative studies routinely refer to the ‘mass media’ as an important source of AIDS information, little attention has been paid by public health researchers to singling out the relative importance of unplanned messages and meanings about AIDS issues disseminated in the entertainment and news media which compete for audiences’ attention with planned education campaigns. Few researchers have specifically attempted to determine the reaction of audiences to the entertainment mass media’s representation of AIDS using small-scale qualitative methods. However audience response research undertaken by Tulloch (1989) investigated the response of the audience to the episode of the Australian television series A Country Practice which depicted the fictionalized story of a young girl who contracts HIV after sharing needles. Small groups of students (178 in all) were shown the episode at school, and were taped talking (without a teacher or researcher present) about the key messages in the text. Tulloch found that the episode had a significant effect on the students’ awareness of needle sharing as a high priority risk behaviour for HIV infection. Many of them mentioned this risk behaviour for the first time after seeing the episode. Additionally, the discussion of the students revealed that they made sense of the episode according to understandings of drug use current within the particular subculture to which they belonged. Tulloch (1989: 123) concludes that ‘the transmission of health messages is a process of negotiation between several different cultures’. In a later paper (1992), he notes that a larger group of students shown the episode lacked identification with the characters and the AIDS education message, even though the intention of the producers of the episode was to generalize the risk of AIDS.

In another study, Kitzinger and colleagues (Kitzinger, 1990; Kitzinger and Miller, 1991) utilized several methods of researching the influence of the British news media in shaping the beliefs of the general public about AIDS. The researchers were particularly interested in how members of the audience interpret what they hear and see in the news media. Kitzinger and colleagues worked with pre-existing groups of people from a wide range of socio-economic backgrounds resident in Scotland. Study participants were invited to engage in such exercises as ‘The News Game’, in which they were asked to play the role of journalist in producing a news story related to a set of pictures, thereby initiating discussion about AIDS and the media, particularly concerning the value judgements, information and narrative structures apparent in the media. One major finding was that the participants’ most popular belief about the origins of AIDS was that it came from Africa. According to the participants, their primary source of information was the news media. Many participants specifically recalled the ways in which early reporting of AIDS linked it to Africa, Haiti or the Third World. The researchers found striking similarities between audience understandings of ‘African AIDS’ and news reports. Kitzinger and Miller (1991: 20) concluded that journalists both drew upon and helped to reproduce certain cultural assumptions about AIDS and Africans in their reports. These assumptions were then reflected in the respondents’ attitudes to AIDS.

The conclusions drawn by researchers engaged in this type of audience response research have therefore suggested that the tenor of coverage of AIDS issues in such popular media products as soap operas and news reports may be very influential in the construction of lay health beliefs and knowledges relating to AIDS. Yet such findings also demonstrate that audiences respond to media products in complex and sometimes unexpected ways, and are not simply passive receptacles for the preferred meanings of the producers.

AIDS in the news media

To add a further dimension to audience response research, it is necessary to document in detail the types of information, messages, meanings and discourses present in such media. There has been very little analysis published which has attempted to go beyond the surface meaning of reportage of medicine, health, illness and disease. One exception is the AIDS epidemic, which has sparked a plethora of creative, critical and insightful responses from media analysts, many of whom centre their attention upon the ways in which the disease has been depicted in the news. As one of the progenitors of cultural studies, Stuart Hall, recently remarked, the advent of AIDS has inspired the field of cultural studies to analyse ‘the constitutive and political nature of representation itself, about its complexities, about the effects of language, about textuality as a site of life and death’ (Hall, 1992: 285).

The vast majority of large-scale research into the media coverage of AIDS has been undertaken of the news media in the USA (Albert, 1986a, 1986b; Baker, 1986; Hughey, Norton and Sullivan-Norton, 1989; King, 1990; Austin, 1990; Clarke, 1991, 1992; Nelkin, 1991; Rogers, Dearing and Chang, 1991; Colby and Cook, 1991) and the UK (Wellings, 1988; Murray, 1991; Beharrell, 1991, 1993; Berridge, 1991), but the news media in France (Herzlich and Pierret, 1989), Puerto Rico (Cunningham, 1989), West Germany (Jones, 1992) and Canada (Clarke, 1991) have also been examined. Others have taken a comparative approach, contrasting news coverage of AIDS in San Francisco and London (Temoshok, Grade and Zich, 1989), Japan and the USA (Dearing, 1992) and a number of European countries (Grube and Boehme-Duerr, 1988). These findings are extremely useful in providing information about the broad patterns of AIDS reporting in the overseas news media. Because of their generally systematic approach, the findings from many such analyses may be generalized to a large body of news media.

Several studies of AIDS as news have shown that there have been important changes in the focus of the coverage over time. Following initial phases of panic reporting and dramatic headlines, AIDS news coverage in western countries by the late 1980s appeared to have been rendered routine, largely losing its dramatic qualities. Herzlich and Pierret (1989) identified four main phases in the French reporting of AIDS. The first they entitled ‘The mysterious illness’, and place between January 1982 and April 1983. During that time, AIDS was first mentioned in the press and underwent a ‘naming process’. Press reports focused upon quantitative data which stated the actual or projected number of cases nationally and worldwide, and concern was expressed about the rapid spread of AIDS. AIDS was perceived in two paradoxical ways: one perception related to its ‘accidental’ nature, the other to its potential to cause a worldwide catastrophe. It was presented as an emergency, about which ‘something must be done’.

Herzlich and Pierret named the second phase in French reporting ‘The construction of a “social phenomenon”’. This phase, spanning May 1983 to May 1984, was bounded by two scientific events: the publication of a report in the medical journal Science about the viral origin of AIDS, and the official announcement by American authorities of the discovery of the virus that probably caused AIDS. During this time, the number of articles in the French daily newspapers increased tenfold. According to Herzlich and Pierret (1989: 1237), it was during this phase that the ‘AIDS social phenomenon’ was ‘constructed scientifically, economically, morally, and culturally’. AIDS had become more than a serious illness: it had become a public issue. In French newspapers the topic of the year in 1983 was AIDS. This period of intense press interest was followed by a phase the authors called ‘A relative calm’, lasting from June 1984 to March 1985, in which fewer articles about AIDS were published. Articles during this time mainly dealt with scientific issues and the spread of AIDS to other countries and groups. Between April 1985 and June 1986, press interest in AIDS revived, and this phase Herzlich and Pierret accordingly titled ‘Gaining momentum’. During this time the first international conference on AIDS was held, the dispute over the identification of the virus had flared up again, a debate about the systematic testing of blood donors occurred, AIDS was appearing in prisons and political interventions in the spread of the disease were becoming explicit. AIDS was no longer a problem of individuals alone, but now was a problem for the government. In addition, Herzlich and Pierret assert, AIDS had by then been fully constructed as a social phenomenon; it was no longer presented as mysterious or novel.

Three peaks in American news coverage between June 1981 and December 1988 can be identified: May 1983, July 1985 and February 1987 (Rogers, Dearing and Chang, 1991). AIDS was initially ignored by the mainstream American news media, which were uncomfortable discussing homosexuality, fearing a negative response from audiences, and which did not consider the disease newsworthy enough while it seemed confined to the gay population. In 1982, for example, although by then there had been 800 reported cases and 350 deaths from AIDS in the USA, there were only six stories about AIDS on the major network news, and few articles appeared in newspapers and magazines (Nelkin, 1991; Cook and Colby, 1992). Indeed, for five years into the AIDS epidemic, the influential New York Times refused to use the word ‘gay’ except within quoted passages (Rogers, Dearing and Chang, 1991). In May 1983, the rise in news coverage followed the publication of an editorial in the Journal of the American Medical Association concerning the possibility of AIDS being ‘transmitted’ through everyday close contact, but interest subsequently declined.

An analysis of all AIDS-related articles which appeared in American national circulation magazines between May 1982 and December 1983 found that people living with AIDS, especially gay men, were portrayed in magazines as ‘experiencing a reign of terror justified by an exponentially increasing death toll’ (Albert, 1986a: 170). Gay men were represented as reaping the rewards of their ‘depravity’, and there was an implicit use of blame as an indicator of social worth. AIDS was thus presented as a problem which affected only a small and deviant group of people. When Rock Hudson’s illness from AIDS was announced in July 1985, there was a dramatic increase in news stories about AIDS in the American media lasting until his death in October, which continued until December that same year with coverage of a boy with HIV infection, Ryan White, and the discrimination he faced in connection with school attendance (Rogers, Dearing and Chang, 1991; Nelkin, 1991; Cook and Colby, 1992). The importance of AIDS as a rapidly growing epidemic was reinforced by Time magazine’s publication of a cover story in August 1985 with the headline

AIDS, THE GROWING THREAT: WHAT’S BEING DONE.

The American news media’s attention dropped again during 1986, but rose to a new height in early 1987 with increasing attention on mandatory testing and privacy issues, the heterosexual transmission of HIV, and Presidents Reagan and Bush’s first public statements on AIDS (Rogers, Dearing and Chang, 1991; Cook and Colby, 1992). In February 1987 Time magazine again published a cover story on AIDS, this time focusing on the threat posed to heterosexuals:

THE BIG CHILL: HOW HETEROSEXUALS ARE COPING WITH AIDS

Testing and privacy issues dominated press coverage in the late 1980s; by then the annual International AIDS Conference in June provided the annual peak of coverage in the American news media (Colby and Cook, 1991).

Berridge (1991) asserts that British media coverage, particularly that of the press, appeared broadly to parallel the chronology of policy development. She identified four stages of reporting: 1981–3; 1983–5; 1986–7; and from 1988 onwards. In concert with other commentators, e.g. Watney (1987) and Wellings (1988), she notes the dominance of the ‘gay plague’ representation of AIDS in the earliest stage of British reporting. However, she suggests that from mid-1983 the focus shifted to questions about the safety of the blood supply and heterosexual transmission in Africa, the latter topic raising the spectre of a possible heterosexual epidemic in Britain. The issues of AIDS in prisons and the death of Rock Hudson dominated coverage in 1985. In 1986 the focus of policy changed again as the key issue became the national emergency posed by the disease to the entire British population. Berridge identifies qualitative differences between television and press coverage of AIDS during this period: according to her, the emphasis of television news coverage was upon minimizing the threat posed by AIDS to the general population using liberal notions of education, while the press adopted a New Right agenda favouring testing and quarantine.

The question of the risk posed by AIDS to heterosexuals was a major issue in British media reporting during 1988–90 (Murray, 1991; Berridge, 1991; Beharrell, 1991). British news accounts were characterized by a heated debate concerning whether or not heterosexuals were at risk from AIDS following a government-sponsored campaign directed at heterosexuals in February 1988. During this period, the tabloid press in particular promoted the view that heterosexual risk had been much exaggerated and alleged that ‘guilty’ AIDS patients were consuming more than their fair share of resources (Murray, 1991: 39). The liberal, ‘quality’ press were more likely to emphasize heterosexual risk and be supportive of the government’s attempts to educate the general public, while the conservative press, both broadsheet and tabloid, was far more negative and critical of the education efforts: ‘often, health education [was] depicted as at best a waste of time and money, at worst a sinister conspiracy’ (Beharrell, 1991: 27).

After 1988, Berridge notes a normalization of AIDS in both British government policy and news media coverage. In this most recent period, she identifies a decline in the intensity of media coverage, accompanied by claims about the ‘myth of heterosexual spread’. One news editor was quoted by Berridge (1991: 181) as stating in late 1989 that AIDS has become ‘a boring story … The only stories now would be a miracle cure or a massive rise in heterosexual spread – AIDS is a buried subject’. ‘Gay Plague’ representations of AIDS were therefore, according to Berridge (1991: 181) ‘a response which was both historically and media specific’. She asserts that the diminishing of such representations in favour of a normalization of AIDS has resulted in the news coverage of gay people living with AIDS being vastly reduced.

In most western countries, we...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• Acknowledgments
• Series editor’s preface
• Introduction
• 1 AIDS as News
• 2 Analysing News
• 3 The Early Years of AIDS Reporting
• 4 The ‘Grim Reaper’ Period of AIDS Reporting
• 5 AIDS Reporting in 1990
• 6 AIDS, Textuality and Ideology
• 7 Epilogue: AIDS as News in the Second Decade
• Appendices
• References
• Index