‘Test Now, Stop HIV’: COVID-19 and the idealisation of quarantine as the ‘end of HIV’

Abstract

The emergence of COVID-19 precipitated varied responses from public health officials in London, England. In April 2020, clinicians at 56 Dean Street sexual health and advice clinic in central London described social isolation as ‘a unique window of opportunity’ to ‘break the chain’ in HIV transmission. This was followed by critical responses within HIV prevention circles. Drawing from these responses, this article examines the implications of the clinic’s ‘Test Now, Stop HIV’ campaign by asking how has the early COVID-19 pandemic reshaped institutional responses and strategies to end HIV transmission in England? We assess how campaign messages developed between April and May 2020. We analyse materials related to the campaign, including the clinic’s Twitter account, the campaign website, and journalism in mainstream media. Based on this information, we discuss three themes: testing and issues of access; the biopolitics of testing; and the idealism of quarantine. We draw on sociology, cultural theory and science and technology studies to describe how the ‘end of HIV’ was constructed through the link between COVID-19 and HIV. We suggest the campaign reinscribes historical perceptions of abstinence and quarantine as idealised HIV prevention strategies, and thus fails to address safer sex in the time of Coronavirus.

Keywords:

• Biopolitics
• COVID-19
• HIV
• public health
• quarantine

Notes

1 THT later stepped away from the message of the ‘No Hook-ups’ campaign, instead encouraging men to have sex more safely during the COVID-19 pandemic (see Brady 2020a). Accordingly, the original campaign page was pulled from the website but references to it could be found in a blog written by THT’s Medical Director, Michael Brady, in March (see Brady 2020b) or as an archived webpage (see Terrence Higgins Trust 2020b).

2 We define ‘abstinence’ here as the eschewing of sexual contact between individuals.

3 The abstinence imperative holds great moral influence in Western history as a tool for hygienist separation of “healthy” and “diseased” bodies. As Jones (2020, 1682) writes: ‘Syphilis, one of the great scourges of the early 20th century, could have been ended, in theory, had everyone adhered to a strict regimen of abstinence or monogamy. But as one US Army medical officer complained in 1943, “The sex act cannot be made unpopular.” When penicillin became available, syphilis could have been eradicated more easily, but some doctors cautioned against its use for fear that it would remove the penalty from promiscuity. [HIV] could, in theory, have been contained in the 1980s, but it was not—and although the advent of effective antiretroviral therapy in 1996 dramatically reduced AIDS-related mortality, it did not end it. Striking disparities in AIDS outcomes persist, following familiar lines of race, class, and gender. As historian Allan Brandt (1985, 161) famously concluded, “the promise of the magic bullet has never been fulfilled”’. Similarly, the idealisation of abstinence - through the COVID-19 quarantine - cannot manifest a ‘magic bullet’. Indeed, it will only reiterate the unsuitability of this intervention strategy since ‘sex cannot be made unpopular’.