Contextualizing Crisis: Histories of the AIDS Epidemic in the Age of COVID-19

Endorsed by the OAH Committee on the Status of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Historians and Histories and WHA

Saturday, April 1, 2023, 10:30 AM - 12:00 PM

Type: Paper Session

Tags: Race; Science, Medicine, and Public Health; Sexuality

Abstract

Two years into the pandemic, COVID-19 continues to wreak havoc on the United States. The crisis has exposed—and, indeed, exacerbated—the inequalities and injustices that have long defined the American experience. The pandemic’s disproportionate impact on marginalized communities—namely people of color, poor and working-class communities, undocumented people, and uninsured people—has invited comparisons between COVID-19 and HIV/AIDS, the latter of which has now ravaged poor, Black, and queer communities for over forty years. Taking comparisons between COVID and AIDS as its point of departure, this panel excavates histories of the 1980s HIV/AIDS crisis. It reveals how culture (broadly conceived) helped shape health outcomes during the height of the AIDS epidemic. First, George Aumoithe demonstrates how the AIDS “crisis” at St. Vincent’s Hospital in New York City was rendered exceptional, while the latter years of the pre-pharmaceutical epidemic was normalized in Harlem. Aumoithe traces how over the course of the 1980s and into the 1990s, New Yorkers debated where to locate a dedicated AIDS care ward that would serve a majority of AIDS patients in the city. Next, Salonee Bhaman shows how insurers sought to deny coverage to people living with HIV/AIDS by operationalizing the language of risk management, choice, and personal responsibility. These maneuvers disproportionately affected people of color, poor and working-class individuals, and queer people, many of whom were already wholly (or mostly) divorced from the medical establishment. Bhaman also spotlights the challenges to insurers mounted by disability rights and LGBTQ activists, who demanded more equitable and generous healthcare for people with HIV/AIDS in the mid- to late 1980s. The next two papers look specifically at the hierarchies of “deservingness” and “victimhood” that structured understandings of AIDS in this period. For his part, James Chappel considers the distinctions drawn between AIDS and Alzheimer’s by policymakers and journalists in the late 1980s and early 1990s. Alzheimer’s served as the “anti-AIDS,” Chappel illustrates, because it supposedly afflicted the “innocent,” while, according to dominant media and political narratives, HIV/AIDS primarily targeted those who engaged in criminalized and stigmatized behaviors. These divergent ideas about “culpability” and “deservingness” worsened disparities in funding and health outcomes and ultimately allowed Alzheimer’s to eclipse AIDS as the disease du jour in media and political discourse. In a similar vein, Paul Renfro examines the media and political narratives that coalesced around Ryan White, a teenage hemophiliac who contracted HIV through contaminated blood products and eventually died of complications from AIDS in 1990. White became a household name after he was prohibited from attending his Russiaville, Indiana, middle school in person. His story generated sympathy for particular people with AIDS while reinforcing the stigmas surrounding other populations associated with the disease, especially gay men and people who used intravenous drugs. Together, these papers complicate facile comparisons between HIV/AIDS and COVID-19 while also drawing meaningful linkages between the two. In so doing, the panel brings historical knowledge to bear on our present moment, one defined by inequality, illness, and fraught debates about state power and state capacity.

Papers Presented

How Crisis became Familiar: Locating AIDS Care from St. Vincent’s Hospital to Harlem’s Business Improvement District

The intensifying AIDS epidemic in New York City in the late 1980s and early 1990s challenged norms about where to place AIDS care. Famous in the early years of the epidemic as a uniquely situated place to handle what public health experts perceived to be a disease disproportionately targeting white gay men, St. Vincent’s Hospital, located a stone’s throw from the Stonewall Bar in Greenwich Village, New York, served as an epicenter of AIDS triage care. By the early 1990s, however, and as the demographic impacts of HIV increasingly consumed Black communities, city officials and private entities suggested that Harlem served as the best locus for the city’s future AIDS care. This paper argues that cultural frames of normality posed an emergent epidemic in downtown New York as exceptional while labeling later manifestations of the epidemic as “chronic” and most logically based uptown. By comparing popular coverage of St. Vincent’s experience with controversy over the construction of a proposed Mt. Sinai AIDS ward in the center of Harlem’s Business Improvement District on Central Park North/110th Street, this paper argues that the shifting demographic burden of HIV/AIDS also entailed a geographic racialization of the disease in ways that sharpened the boundaries of where best to locate AIDS care.

Presented By
George Aumoithe, Stony Brook University, Department of Africana Studies

Uninsurable Risks: AIDS and Public/Private Insurance

When the ELISA test for HIV first became widely available in 1985, insurers scrambled to assert their rights to screen potential subscribers for infection before covering them under medical and life insurance plans. Meanwhile, state governments feared that such screening practices would catastrophically strain already overburdened Medicare and Medicaid programs. This paper will explore the discourses of risk management, healthcare access, and equity that produced an understanding of AIDS as an exceptionally expensive ailment. It will delve into debates between private insurance providers and state governments and the work of activists who built solidarities across the disability rights movement.

Presented By
Salonee Bhaman, Yale University

The Other Syndrome of the 1980s: Race, Gender, and the Rise of Alzheimer’s Disease

While Ronald Reagan is renowned today for his failure to publicize or fund the fight against AIDS, to most observers in the 1980s and 1990s he was more well-known for his decision to publicize and fund the fight against a different syndrome: Alzheimer’s disease. He had declared November to be Alzheimer’s Awareness Month as early as 1983, a decade before he came down with the disease himself and established the Reagan Research Institute, which focuses on Alzheimer’s. In the interim, Alzheimer’s became a household word, and the National Institutes of Health funneled untold sums in a race for the cure. This paper will explore the Alzheimer’s Industrial Complex, arguing for a connection between the rise of Alzheimer’s and the eclipse of AIDS. Alzheimer’s, I contend, emerged in this period as the “anti-AIDS.” For while AIDS was viewed as a disease that affected stigmatized populations because of their own sins, the victims of Alzheimer’s were portrayed as polar opposites: white, elderly, and noble folks who did not engage in sex or drugs, and who faced a complex syndrome through no fault of their own.

Presented By
James Chappel, Duke University

Ryan White, Hemophilia, and the Politics of "Normality" in the 1980s AIDS Crisis

Ryan White was diagnosed with AIDS in December 1984, just after his thirteenth birthday. He had contracted HIV through contaminated blood products, which he used to treat his severe hemophilia. The following year, Ryan became a household name after he was barred from attending his middle school in Russiaville, Indiana. National news media accounts generally affirmed Ryan’s right to attend school in person by emphasizing his seeming “normality” as a white, midwestern, heterosexual, superficially ablebodied teenager. Often freighted with the notion that Ryan had acquired HIV “through no fault of his own,” news media reports not only ginned up popular support for Ryan; they also distinguished him from other, more “deviant” populations generally associated with AIDS in the 1980s, particularly gay men and intravenous drug users. This paper grapples with the politics of “normality” in the 1980s AIDS crisis by focusing on Ryan White, his hemophilia and AIDS, and the ways in which journalists, politicians, and other individuals conceived of him and his interlocking disabilities. The paper begins by tracing the history of hemophilia, spotlighting the revolutions in blood-clotting technology that reshaped hemophiliacs’ lives following World War II. It then shows how these same medical advancements subjected Ryan White and thousands of other hemophiliacs to the virus that would soon be called HIV. While Ryan’s AIDS diagnosis complicated his pursuit of “normality,” his race, age, diminutive stature, midwesternness, non-threatening sexuality, and perceived “innocence” rendered him a relatively “normal,” destigmatized subject among people with AIDS and people with disabilities, more generally.

Presented By
Paul Renfro, Florida State University

Session Participants

Chair and Commentator: Eileen Boris, University of California, Santa Barbara
Eileen Boris is the Hull Professor and Distinguished Professor of Feminist Studies, History, Black Studies, and Global Studies at the University of California, Santa Barbara, specializing on home-based work and the racialized gendered state. Her books include the prize-winners Home to Work: Motherhood and the Politics of Industrial Homework in the United States [1994] and Caring for America: Home Health Workers in the Shadow of the Welfare State, with Jennifer Klein [2012, 2015]; and the co-edited collection with Rhacel Parreñas, Intimate Labors: Cultures, Technologies, and the Politics of Care [2010]. Her latest books are Women’s ILO: Transnational Networks, Global Labor Standards, and Gender Equity [2018], co-edited with Dorothea Hoehtker and Susan Zimmermann; Making the Woman Worker: Precarious Labor and the Fight for Global Standards, 1919-2019 [2019]; and co-edited collections, Engendering Transnational Transgressions: From the Intimate to the Global [2021] with Sandra Dawson and Barbara Molony, and Global Labor Migrations: New Directions [2022, forthcoming] with Heidi Gottfried, Julie Greene, and Joo-Cheong Tham. She currently is writing a microhistory on US vs. Ingalls, tentatively called, Dora’s Story: The 1947 Slavery Case that Fractured a Family and Shook the Nation, and a broader study, “Less Than Free Labor: Migrant Domestic Workers Fight for Recognition and Recompense.”

Her articles have appeared in the Journal of American History, Signs, Feminist Studies, Journal of Women’s History, Journal of Policy History, Labor, ILWCH, and numerous collections. Her public writings have appeared in New York Times, The American Prospect, Time, the Nation, Al-Jazeera America, Huffington Post, New Labor Forum, Dissent, Gender Policy Report, and Labor Notes. She was principal investigator for “Working at Living: The Social Relations of Precarity,” for “Enforcement Strategies for Empowerment: Models for the California Domestic Worker Bill of Rights,” and “The Labor of Care.”

Boris is the past-President of the International Federation for Research in Women’s History, 2015-2020, and has held the Bicentennial Chair in American Studies at the University of Helsinki as well as visiting professorships at Paris VII, the University of Melbourne, Tokyo Christian Women’s University, and University of Toulouse. She has served on the executive boards of the Labor and Working-Class History Association (LAWCHA) and the Social Science History Association and on prize and other committees for the Organization of American Historians (OAH), American Studies Association, Social Science History Association, American Historical Association, and Berkshire Conference. She is an OAH Distinguished Lecturer. Currently she is on the editorial committee of Labor: Studies in Working-Class History and Gender and History, the board of Journal of Policy History, and the consultant board of Feminist Studies. She has received the Distinguished Service Award from LAWCHA (2017) and the Rachel Fuchs Memorial Award from the Coordinating Council for Women in History for Mentoring LGBTQ/Women (2019). She is part of the research network on domestic work connected to the International Federation of Domestic Workers and active with the California Domestic Workers Coalition and Scholars for a New Deal for Higher Education.

Presenter: George Aumoithe, Stony Brook University, Department of Africana Studies
George Aumoithe is an assistant professor of global health in the Department of Africana Studies and the inaugural director of the Global Health and Health Inequality Mapping Lab at Stony Brook University. His book manuscript-in-progress is Medical Scarcity: The Political Economy of Healthcare Rights in America. He organized the 2019 national Law, Difference, and Healthcare: Making Sense of Structural Racism in Medico-Legal History conference at Princeton. His scholarship has been published in the Journal of Urban History, and his public writing has appeared in Social Difference Online, Legal History Blog, the Washington Post, and The Nation.

Presenter: Salonee Bhaman, Yale University
Salonee Bhaman is a Ph.D. candidate in the Department of History and program in Women, Gender, and Sexuality Studies at Yale University. Her research interests focus on intersecting histories of race, gender, social welfare, migration, and labor in the twentieth-century United States. Her public writing has appeared in Truthout, The Washington Post, Boston Review, and the Asian American Writers Workshop.

Presenter: James Chappel, Duke University
James Chappel is the Gilhuly Family Associate Professor of History at Duke University. He focuses on the intellectual history of gender, religion, and the family in the United States and Europe. His first book, Catholic Modern: The Challenge of Totalitarianism and the Remaking of the Church (Harvard University Press, 2018), explained the shifting Catholic attitudes towards politics, family, and race. He is currently writing a book on the history of old age in America, asking how Americans have morally and politically grappled with the massive extension of the lifecourse. His writings on these themes have appeared in scholarly venues like The Journal of Modern History along with more popular ones like The Nation and The New Republic.

Presenter: Paul Renfro, Florida State University
Paul Renfro is an assistant professor of history at Florida State University. He is the author of STRANGER DANGER: FAMILY VALUES, CHILDHOOD, AND THE AMERICAN CARCERAL STATE (Oxford University Press, 2020) and the coeditor of GROWING UP AMERICA: YOUTH AND POLITICS SINCE 1945 (University of Georgia Press, 2019). Renfro’s next book, tentatively titled YOUNG BLOOD: RYAN WHITE AND AIDS, is under contract with the University of North Carolina Press. His public writing has appeared in the New Republic, TIME, the Washington Post, Slate, Teen Vogue, and Dissent. Before arriving at Florida State, he served as a postdoctoral fellow in the Center for Presidential History at Southern Methodist University in Dallas.