Viral times, viral memories, viral questions

We started to develop the idea for this special issue based on a shared sense of familiarity in the early days of the pandemic. We know it was early on because two of us (JG-I and MN) were sitting in a coffee shop in Manchester, mask-free, wondering how many weeks it would take for the hype to blow over. Facebook tells us this was 6 March, 2020. Looking back, it feels like ages ago.

As we sat there, two scholars with a particular interest in HIV and AIDS, we felt, perhaps eerily and with trepidation, that there was a lot to say, even if we did not know exactly what that would be. Every day that same month we woke up to new similarities and differences between HIV and the growing threat of COVID-19, to new angles from which to approach the viral conditions, and to new source materials being available (newspaper articles, Twitter threads, the use of HIV medication to treat COVID-19, masks vs. condoms, etc.). We wanted to write something together that gave voice to our torrent of ideas (and we did, see García-Iglesias and Nagington 2020) but we were just as interested in developing space for critical engagement with discussion about HIV and COVID-19, their possibilities and their limitations. We wanted to move beyond the ‘hot takes’ of a few pundits and Twitter academics to produce a body of work that might stand the test of time. By late March, we had put together a call-for-papers and found a journal that wholeheartedly welcomed it. We had also started working from home, stocked up on hand sanitizer and face-masks, and realised COVID-19 would not blow over anytime soon.

Around the same time, the third of us (PA) was travelling to the UK from Sydney, for what he thought would be a short stay in London, only to find himself ‘locked in’, ‘locked out’ and ‘locked down’, unable to return to Australia as national borders closed. As someone with a long-term commitment to critical social research on HIV, he too had spotted the similarities between national responses to HIV and COVID-19 in terms of the interplay between the political, moral and public health concerns that motivated the national and international response. Between the three of us, we knew that a forum was needed for discussion of the parallels (and differences) between COVID-19 and HIV – both in the popular imagination, but also in the ways in which politicians and ‘experts’ sought to construe and promote public understanding of the epidemic.

That call-for-papers, the many abstracts received, and the papers that followed are necessarily the products of their time, a time that feels distant, but in many ways is not: a time of major uncertainty, when vaccines were but a distant hope maybe years ahead; of corpses piling high in hospital morgues and care homes; of PPE (personal protective equipment) being unavailable even to hospital staff; of home confinement, and so on. In the rich countries of the West, these horrific images and the lack of vaccines are quickly becoming history, yet they remain a distressing and present reality for most people in many parts of the world. These papers are therefore the product both of time and of geopolitical relationships: so much has changed so quickly (vaccines, treatments, etc.), yet so much remains to be done. As such, the articles in this special issue of Culture, Health & Sexuality risk becoming fast-tracked fossils: both individually and collectively they demonstrate the speed at which the socio-political aspects of COVID-19 have evolved, and for whom. And yet, like fossils, they remain valuable in helping us understand just how and why things do, or do not, change.

Memory, and how we remember what feels like ages ago but perhaps is not, is a key framework through which to understand these issues. Throughout the entirety of the COVID-19 pandemic, there has always been a personal sense of memory. Sometimes, this may take the form of second-hand memories (since some of the authors in this issue do not have first-hand experience of the AIDS crisis of the 1980s and 90s) but also questions about who and why we remember. There is also the opposite, of course, in the form of forgetting: at moments a conscious effort to ignore the past with its painful lessons; at other times, a sort of amnesia as if that which happened and those who died decades ago are not worthy of remembrance. As Peter Hegarty and Joe Rollins write in their paper in this collection, COVID-19 is a spectacle of memory and amnesia.

This is also a spectacle of questions: a few of the papers in this special issue aim to answer some of these; others embark in the equally difficult task of finding the right question to ask. What do we learn from comparing these pandemics? How can such reflections enlighten our recent history and hint at possible futures? Will COVID-19 become endemic to certain people and places, just as HIV has? Will long-COVID come to resemble chronic HIV? Will we ever arrive at a moment of reckoning and accountability in the mismanagement of the epidemic (like we have not done for AIDS)? What if any, will be the long-term social, emotional and intimate consequences of COVID-19? How has COVID-19 changed how we remember and experience HIV?

Over the past sixteen months, we have been honoured to work with a group of wonderful scholars and colleagues in attempting to tackle these questions. Amidst the multitude of big and small crises that have enveloped each and every one of us during this time, such as increased work-load, job uncertainty and personal illness, the authors in this issue have shown a deeply-held sense of personal curiosity, paving the way for what we hope will be a sustained, long-term inquiry. Working on this issue, reading the drafts and reviews that so many peer reviewers generously contributed, has made us feel, at times, less useless, more hopeful, or more hopeless, but above all it has enhanced our certainty in the need to reflect on, and discuss, the many ideas we have had about COVID-19 and HIV.

Quarantine

The first three papers in this issue concern themselves with how power operates in society during viral times. The first paper, by Chase Ledin and Benjamin Weil, offers a close and critical reading of a campaign by 56 Dean Street (a London based sexual health clinic primarily serving gay man), ‘Test Now, Stop HIV’, which suggested that HIV transmission could be brought to a halt during COVID-19 home confinement. Addressing the idealisation of quarantine as a piggyback strategy, the authors highlight the (unintentional) historical synergies between this, related campaigns in other countries, and earlier homophobic attempts to force HIV positive people into quarantine. Alongside this, they demonstrate how the prohibition of sex via criminal means has historically hindered harm reduction strategies. Their paper calls for critical reflection on the resonances that public health strategies may play to and create, and how these may be (un)helpful to the communities they address.

The second paper by Max Morris is a UK-based autoethnography that examines the representation of pandemics from a personal perspective. Morris wonders why many existing actions to end the HIV pandemic (among them, testing, treatment and chemoprophylaxis) have failed to be implemented to their fullest, and criticises public health strategies that enthusiastically embrace quarantine. Morris uses this as a point of departure to highlight how conceptualisations of risk are related to normative social moralities as well as rational scientific judgements. In this way, through his autoethnography, Morris traces the emergence of sexual conservativism amplified by COVID-19. Thus, hegemonically embraced festivals such as Christmas, during which the Government in England initially planned to relax social distancing measures for friends and families, become a socially acceptable reason to break quarantine, whilst the sex lives and freedoms of queer and non-monogamous people remained restricted.

Moving on from this very personal autoethnography, the third paper by Amy Braksmajer and Andrew S. London examines social responses to other complex relationships between HIV and COVID-19. Drawing on interviews with 30 men who have sex with men in the USA about their experiences of COVID-19, Braksmajer and London deploy Rosenberg’s theory of pandemics to explore how participants’ perceptions of the seriousness of the COVID-19 pandemic progressed and how they managed uncertainty. In particular, they highlight how many of the men in their sample relied on experiences of HIV to help them understand and respond to the COVID-19 pandemic. This trans-pandemic awareness influenced both their responses to COVID-19 and their perception of government actions.

Collective action and care

Three papers offer an analysis of how care is enacted in viral times. In his wide-ranging paper, Adrian Guta returns to the AIDS crisis to explain how, in the face of state indifference to AIDS-related deaths (particularly in the USA), collective action by members of the most heavily impacted communities resulted in culturally embedded strategies of prevention, treatment and care. However, while HIV led initially to collective action, in more recent times individual responsibility has become a narrative for viral containment – with people being encouraged to discipline their bodies through biomedical means such as by achieving an undetectable viral load or taking PrEP. This individualisation of desire in pursuit of public health has also informed approaches to managing the COVID-19 pandemic, particularly in how masks and vaccination have been presented as personal choices, rather than acts of collective solidarity.

Ally Day’s paper explores the making, in the midst of COVID-19, of a documentary film about a long-closed HIV hospice. Where Guta’s critique highlights the loss of collective action, Day uses critical theory of HIV to breathe life back into the value of collectivity. Drawing on crip theory and Barounis’ formulation of antiprophylactic citizenship, Day suggests that what matters most in collective action during viral times is an openness to ‘contaminated outsiders’ whereby people take ‘risks in [the] service of safety’. Doing so provides the basis for an ethical form of care, in which comprehensive ‘webs’ of support ensure justice where the state fails. Such forms of care is counterposed against the more individualised forms of treatment typical of state management of bodies and disease. Day traces how the former can often slowly morph into the latter, and how forms of ‘messy and wild’ care remain needed in COVID-19 times.

The final paper in this section comes from Peter Hegarty and Joe Rollins. Their work demonstrates, in a particularly lucid way, how a focus on ‘flattening the curve’ or ‘staying at home’ generates individual responses to COVID-19 that both preclude remembering of the lessons of the first decade of the AIDS crisis and obscure how communities may be the source of effective care structures. Furthermore, they evidence how the biggest spectacle of all in the context of COVID-19 has been one of amnesia. This is based on the willing forgetting of the lessons from the AIDS crisis but also, and just as importantly, how quickly we will likely forget much of what we have learned during COVID-19: including what is an ‘essential’ job or worker, the need for universal healthcare, the importance of engaging with deep-seated inequalities, and so on.

State sanctioned heterosexuality

The final two papers by Barbara Rothmüller, and Chris Ashford and Gareth Longstaff, remind us of the continued valorisation and cultural force of the monogamous, heterosexual, co-habiting couple in the modern nation state. In a similar way to Day, who highlighted how the basis for an ethical approach to care lies in being personally open to risk, Ashford and Longstaff focus on the glory-hole to explore how COVID-19 has triggered a drastic criminalisation and regulation of intimacy in the UK. Delineating a rich cultural and historical framework around the regulation of queer desire and sexuality, they argue that gloryholes (small openings often in public toilets through which a penis can be inserted for sexual purposes) have become important sites to negotiate the intimate and the impersonal, and thus offer a strategic device through which to understand the regulation of sex in pandemic times.

Picking up on similar themes, Rothmüller’s paper draws on findings from the Love, Intimacy and Sexuality in the Time of COVID-19 survey undertaken in Austria and Germany. She discusses how, throughout the epidemic, the monogamous co-habiting couple has remained largely untouched by state-sponsored attempts to regulate bodies. While in both countries severe restrictions have been placed on sexual relationships outside the home, close contact was allowed for other activities defined as culturally normative, such as family visits to Father Christmas. Together, these papers highlight how state efforts to manage COVID-19 transmission have their roots in long-term, monogamous, co-habitation as the foundation for viral containment, and how the enactment of viral containment disproportionately impacts gender and sexuality minority communities and queer sexual sub-cultures.

COVID-19 and beyond

Like any collection of papers, this one has its limitations. All of the articles present a largely Western perspective. However, both HIV and COVID-19 are deeply implicated in global as well as identity-based health inequalities, as evidenced in vaccine distribution and morbidity and mortality rates. This special issue is limited therefore with regards to its geographical reach – an issue we intend to engage with in future work.

Despite this weakness, we remain convinced that the familiarity we first felt between COVID-19 and HIV is important, and understanding its roots is a fruitful pursuit. In contrast to the ‘newness’ about COVID-19 we felt back in March 2019, we hope that the papers published here offer substantive and sustained critique. We hope too that they will assist scholars and researchers in thinking about how to make sense of HIV and COVID-19 in other socio-political contexts.

As we go forward together, and despite continued uncertainty and newness, one thing is certain: both HIV and COVID-19 will continue to shape our lives for many years to come. By creating space for critical reflection, we hope to encourage others to do the same. The academy played a key role in the struggle for social justice during the HIV and AIDS crisis and will be vital in ensuring fairness, inclusion and equality for COVID-19 and beyond.

Acknowledgement

Elements of this work were supported by the Mildred Baxter Postdoctoral Fellowship from the Foundation for the Sociology of Health and Illness and the Wellcome Trust.