Fatal Advice: How Safe-Sex Education Went Wrong

Fatal Advice: How Safe-Sex Education Went Wrong

by Cindy Patton

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The American public responded to the first cases of AIDS with fear and panic. Both policymakers and activists were concerned not only with stopping the spread of the disease, but also with guiding the public’s response toward those already infected. Fatal Advice is an examination of how the nation attempted, with mixed results, to negotiate the fears and concerns brought on by the epidemic. A leading writer on the cultural politics of AIDS, Cindy Patton guides us through the thicket of mass-media productions, policy and public health enterprises, and activist projects as they sprang up to meet the challenge of the epidemic, shaping the nation’s notion of what safe-sex is and who ought to know what about it.
There is the official story, and then there is another, involving local groups and AIDS activists. Going back to early government and activist attempts to spread information, Patton traces a slow separation between official advice and that provided by those on the front lines in the battle against AIDS. She shows how American anxieties about teen sex played into the nation’s inadequate education and protection of its young people, and chronicles the media’s attempts to encourage compassion without broaching the touchy subject of sex or disrupting the notion that AIDS was a disease of social and sexual outcasts. Her overview of the relationship between shifting medical perceptions and safe-sex advice reveals why radical safe-sex educators eventually turned to sexually explicit, including pornographic, representations to spread their message—and why even these extreme tactics could not overcome the misguided national teaching on AIDS.
Patton closes with a stirring manifesto, an urgent call to action for all those who do not want to see the hard lessons of AIDS education and activism wasted, or, with these lessons, the loss of so many more lives.

Product Details

ISBN-13: 9780822396727
Publisher: Duke University Press
Publication date: 04/24/1996
Series: Series Q
Sold by: Barnes & Noble
Format: NOOK Book
Pages: 192
File size: 3 MB

About the Author

Cindy Patton is Associate Professor, Graduate Institute for the Liberal Arts, Emory University. She is the author of several books, including Sex and Germs and Inventing AIDS.

Read an Excerpt

Fatal Advice

How Safe-Sex Education Went Wrong

By Cindy Patton

Duke University Press

Copyright © 1996 Duke University Press
All rights reserved.
ISBN: 978-0-8223-9672-7


Around 1989

In 1989, an attentive gay male student helped me cue the video for a paper I was about to give on heterosexual pornography. As a closeup shot ended, and the camera panned back to lovingly capture the come shot, the young man shrieked in distress.

"It's a man and a woman!" he exclaimed. "And they're practicing safe sex!"

I began to explain that "pulling out" was necessary to the "come shot," the cinematic mark of male orgasm that has been conventional in pornography since the 1970s. Predating the very idea of safe sex by more than a decade, the come shot was meant to signify the truth of male orgasm, not the distance of the event from "coining inside." For me, the idea of fucking without a condom was antithetical to the safe sex messages I had worked for some years to perfect. For my young friend, the practice he observed met the minimal requirement of at least one safe sex dictum: on me, not in me. For him, two men performing the come shot were not only practicing safe sex, they were demonstrating it: what ostensibly gay men did in films was not only real, but didactic. His only surprise was that heterosexuals had somehow copied gay men, now America's safe sex trendsetters.

Not long after this experience I had a second collision with variant intra-community interpretations, this time writ large as a controversy over a sexually explicit safe sex advertisement that had been placed in GO, the gay and lesbian community newspaper of Ottawa. The ad (which was, in my view, tasteful in the extreme) featured a frontally nude male sporting a condom on his not very hard cock. The ad had been produced by a local gay male photographer in conjunction with Ottawa's AIDS education council. The photographer's work – portraiture, erotica, news photography, and, by 1989, safe sex posters – was widely recognizable in the local community: a Phillip Hannan photograph was as natural in queer Ottawa as a Keith Haring drawing in New York City.

But this particular photograph created controversy on two fronts: in order to make the ad more acceptable in the pages of a community newspaper – in order to make the ad visually distinct from, say, pornography or bar ads – Hannan had agreed to photograph the model at half mast. Radical feminists were outraged by the appearance of even a didactic dick in the pages of their local rag, and safe sex pedagogues were concerned that the dick wasn't hard enough. They feared that novices might try to apply a condom before a proper erection. Poor Phillip was caught in the middle.

The group of lesbians who levied the strongest accusations deemed the ad pornographic, invoking the wealth of controversial analysis about the role of such representations in the oppression of women. As a depiction of male sexuality, they argued, the ad was assaultive to women, especially to female victims of male sexual violence. Although this hard-line antiporn position was only a small voice in the larger lesbian and gay community, other women felt torn by a more inarticulate discomfort with the ad. Some wanted to maintain their allegiance to their sisters, and yet other women simply weren't interested in having naked men in their community newspaper. The women who had approved the ad had initially believed that it constituted valid risk reduction education. Now they wondered if they had gone too far.

The controversy centered on variant theories of representation and their political implications for promoting safe sex. In a conversation with one of the women who took the radical feminist position, I discovered how the conviction that Pornography causes negative behaviors aligned with the view that multiple partnering is a slippery slope to high-risk sex. The woman emphasized that objecting to the ad did not mean that she opposed risk reduction education. Quite the contrary, she equated monogamy with safe sex and believed men should work toward "deeper," "committed" relationships. Far from eroticizing safe sex, she argued, viewing pornography (including Hannan's safe sex photos) leads to uncaring, promiscuous relationships.

"What exactly did you feel was wrong about this ad," I asked.

"It had exposed male genitals," she said.

"Oh," I said, with an air of confusion. "I thought you said he was wearing a condom."

On one hand, I understood these women's interpretation of the penis as a potential weapon: a brandished penis signified the danger of misogynist violence. But after years of working on safe sex projects, I now understood that danger lurked in the body fluid that the erect penis foretold: a penis dressed in a condom was a penis made safe.

I do not retell these stories in order to suggest that gay men's lives are more at risk than the lives of the women whom the radical feminists were concerned to protect. Nor do I mean to sentimentalize my young friend's complicated misrecognition. But these incidents, in different ways, brought home the stakes in and complexities of representations of sexuality. As both stories suggest, a range of groups, for nearly opposite reasons, have placed great stock in pornography's power to direct human behavior. One branch of feminists concerned about violence against women hoped to link pornography watching with the propensity to commit Sexual violence. Equivalently, HIV prevention workers hoped that gay men would shift their desires and practices toward non-HIV-transmitting activities after imitating the "good" parts of safe sex pornography. But if the vast majority of heterosexual men who use pornography have never engaged in acts of sexual violence, then neither does safe sex pornography seem to impel audiences to commit acts of transmission disruption. Heterosexual men have not embarked on mass rampages of sexual violence after viewing the typical pornographic offerings, nor have anguished gay men found their sexual future in the lifesaving, utopian safe sex pornography. And yet, accusations based in the supposed power of pornography abound, despite the difficulty in claiming direct harms or benefits from viewing pornography.

There may well be a complex relationship between the genre of Pornography and the systematic, largely negative representation of women in mass culture, just as there may well be imitative responses to countercultural or interventionist sexual representations. But, personal testimonials notwithstanding, it seems unlikely that people widely imitate pornography in any straightforward way. If that were true, analysts would have to explain why some, but not all, pornographic images are imitated: in the de rigueur come shot of pornography, the insertive male pulls out of his partner to spew his semen. In "real life," few heterosexual men imitate this most basic and consistent feature of pornography. And, tragically, neither do many gay men. Moreover, Condoms appear to have made only modest gains despite their visibility in mainstream gay porn and their status as the most common symbol of safe sex educational campaigns aimed at gay men. It is hard to make good on the strong claims that pornography is the hope for safe sex education or the cornerstone of misogyny. Pornographic safe sex projects may be worth pursuing, but not for the reasons usually proposed. In the last chapter I will suggest some of the ways radical safe sex projects might navigate the complex and variable interpretation of Sexual representation in ways that shift the focus of discussion away from producing safe sex advice and toward interrogating the means of experiencing and reworking sexuality.

This book is particularly concerned to link varying ideas about safe sex through the early 1990s, especially as these imagined a sharp division between those who were continuing to become infected and those who believed they could never be infected. A word or two about some of the concepts will be useful here: the idea of a national public is meant to indicate the collective who are represented as the proper citizens of a nation – here, the United States – an image that people may strive for or reject, but that is, evolving though it may be, the representational site of a struggle or negotiation over who it is that a government is supposed to govern. The Citizen is the individual case of the proper subject of the government, especially insofar as the Citizen is the individual who responds to being governed without much fuss or clear policing. Safe sex is a term that I will constantly problematize. Although I will indicate from time to time the kinds of epidemiologic information that I believe accurately reflects the process of HIV transmission, I will use safe sex descriptively to refer to whatever different campaigns were promoting under the term. I want to make clear how variable were the meanings of "safe sex," not just as epidemiologists disagreed on their transmission data, but more important, as the various strategies for policing, reshaping, and politicizing sexuality converged under this initially innocent enough term. Finally, I distinguish between a national pedagogy, education, and organizing. The first is the mechanisms and logics that frame the evolving concept of citizen. Education refers to practices that make relatively sharp distinctions between those who know and teach and those who do not know and learn. Organizing refers to practices aimed at shaping and directing communities or subcultures in an effort to increase collective and individual viability.

Red Ribbons versus Safe Sex

As my opening stories suggest, by 1989 there were competing interpretations of what constituted safe sex and of who was supposed to practice it. But the multiple meanings available in pamphlets, films, even in the words "safe sex" (as opposed to... ?) and their interpretation by specific subcommunities were not merely intellectual fodder for the growing little industry of AIDS cultural critics. This play of meanings had dire consequences for those people who did not think that this advice applied to them, who deduced that they need not engage in transmission-interrupting techniques. Confusion about safe sex was bound up with the instability of sexual meanings more generally. "Safe sex" held symbolic utility for a country salvaging its failing identity in the face of a transnational, capitalist, global village culture that threatened (and still threatens) to make the very idea of a nation obsolete. If post-1960s America was in crisis already, the AIDS epidemic became a vehicle through which to renegotiate the meaning of being a good American.

The meaning of citizenship, who are to be counted as the true bearers of America's destiny and promise, undergoes revision as society and the state fail to make good on the complex, and also evolving, fantasy of what America is. The crisis surrounding the HIV epidemic exposed America's racism and homophobia in new ways, laying bare the ugly truth that the structure of benevolence – social programs, especially health care – simply were not meant for everyone. America needed a new model for the citizen, a tough love Citizen who could be resolute about cutting federal funding without seeming cruel toward the burgeoning and increasingly organized group of people concerned about HIV whose only hope for treatment and care lay with a coordinated, well-funded federal response. By 1990, this new citizen of the national public had congealed as the opposite of the dangerous deviants who had become visible as "communities." At first, the new idea of citizen seemed only to apply to issues surrounding AIDS. However, as debates about health care and social welfare reform heated up in the 1992 presidential campaign, it became clear that the once liberal, now tough love citizen would be the inheritor of a mantle of conservatism from the 1950s: the tough love citizen recognized fraudulent bids for "special rights" and believed that middle-class life would be nice for everyone, but only if they earned it. Times were hard, but the tough love citizen could vote for the measures that dramatically expanded the underclass, even while they felt sorry for the homeless their detached compassion created.

The emergence of the new citizen was rather quick: the initial social response to the new epidemic was, it seems, widespread, if passive – sex-phobia and panic toward gay men, drug injectors, homeless people, blacks, and sex workers. America capitalized on this initial response not by helping the needy, but by offering a new paradigm for citizenship: the compassionate, tolerant individual who, while never viewing him- or herself as susceptible to contracting HIV, could nevertheless recognize that "some of my best friends have HIV." Rock Hudson, Ryan White, Ali Geertz, Magic Johnson, and dozens of less extensively exposed local and national figures allowed compassionate citizens to form mediated relationships with people living with HIV. Alongside the citizens and their favorite "friend" were constructed not homosexuals or even queers, but deeply obscene bodies, densities that could be the object of research, treatment, discrimination, hatred, and even compassion, but that were inadmissible to the new body politic.

Thinking of these public Information campaigns and media stories as a national pedagogy suggests that the idea of citizenship that pertained was not just an example of interpellation, but evidence of a new procedure of subject formation, one in which the formal moments of "teaching" are only a part. America of the 1980s and 1990s is less the patriarchal, policing state imagined in Louis Althusser's classic example of the policeperson-citizen interaction than it is an avuncular nation of Bill Clintons and Ross Perots, who teach us what it means to be an American, of 20/20 and Moneyline, which teach us what an American is supposed to know and care about. For Althusser, Power is structured domination by a state that protects class interests. Here, pedagogy's power arises through the invocation of a knowledge that simultaneously precedes and seamlessly becomes the possession of the hailed subject. For Althusser, education is just the state operating through less visibly violent ("ideologic") means. The complex interplay between medical and policy institutions and the forms of knowledge they produced highlighted the extent to which this nation does not exercise the form of control envisioned by Althusser: coming to think of ourselves is a much more fragile process. Thus, in the United States of the late 1980s, teaching the nation, threatening the citizen with stupidity rather than violence, is the central form of power: being an American requires extensive and overt lessons in politics, economy, world affairs, but most important, in cold compassion. The concept of national pedagogy suggests that power-knowledge is not statically held in a state comprised of both brute and sublime apparatuses, but is a procedure for bringing bodies into positions of duty and obligation that are constitutive of identity.

Michel Foucault called various modes of relating bodies, space, and their administration "governmentalities." My main concern in this volume is the production and contestation of a particular form of govemmentality – the national AIDS pedagogy. I want to suggest that if the state is more diffuse than activists of the 1980s imagined, then the efforts and effects of their projects must have been less clearly oppositional than neo-Marxian analysis suggested, less predictable than neopositive sociologies hoped. Power works differently than we had imagined; power is far more productive than our critiques of the 1980s recognized. Thus, instead of suggesting that the state "won" when it secured a national pedagogy, I will argue that the persistent contestation of that pedagogy through a variety of safe sex educational efforts coming from within gay communities (detailed in chapters 4 and 5) resulted in the constitution of two zones of information. Our contestations partially secured the national pedagogy (in a series of ways I will discuss in chapter 4), but (as chapters 3 and 5 will suggest) the national pedagogy also left open a space for dissident projects, but only by balkanizing the bodies whose safety depended on their ability to signify and ensure antinational practices of sex.

This jockeying founded the national pedagogy as a paradox: the gap between this new Citizen and the dangerous bodies from which they were distinguished widened, even as average Americans were apparently increasingly concerned about the plight of people living with AIDS. Witness, for example, the way in which the red ribbon campaign so uneasily doubled the yellow ribbon campaign meant to demonstrate patriotism during the Gulf War, and how other ribbon colors have now proliferated as emblems of the citizen who cares deeply about victims (pink for breast cancer, purple for the people of Oklahoma City) but is ultimately unwilling to recognize or fund solutions. The sick within the national borders could be recognized as objects of American's compassion, but they could no longer fit into the ideal of citizenship. This paradox of separation and incorporation occurred through the slow production of a national pedagogy of AIDS, which attracted to itself systems of policing that rearticulated a "normal sexuality" in order to reter-ritorialize bodies that had gone ballistic in the 1960s and 1970s. The "sexual revolution" crashed in a heap, but citizens emerged from the wreck as self-consciously austere heterosexuals.


Excerpted from Fatal Advice by Cindy Patton. Copyright © 1996 Duke University Press. Excerpted by permission of Duke University Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents

Acknowledgments 1

1. Around 1989 3

2. Between Innocence and Safety 35

3. The Erotics of Innocence 63

4. "The Only Weapon We Have . . ." 95

5. Visualizing Safe Sex 118

Conclusion: From Visibility to Insurrection: A Manifesto 139

Notes 157

Bibliography 171

Index 177

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