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Conclusion (Second Edition) "The long habit of living indisposeth us to dying". Sir Thomas Browne, Urn Burial, 1658. Whether we like it or not, we inhabit societies in which other people's diseases are generally held to be about as fascinating and involvingas other people's holiday photographs. Even in countries such as Britain and Canada that have socialized medicine, disease is widely regarded asoverwhelmingly private. Yet the supposed privacy of disease is always strangely contradictory. For its experience is generally dependent on large-scale institutions, and "experts" whom we trust precisely because of their public reputation and practice. Aids has proved a strong exception to this rule, both because it has come to play such a central role in the ideological foreground of most Western societies and because of the general unavailability of adequate treatment care to so many people with HIV disease or Aids. This has led to the emergence of a strong collectiveidentity, founded on the twin recognition of mutual needs and shared oppression: the identity of the Aidsactivist. In all of this it is important to establish the precise nature of the forces that continue to define HIV and Aids as problems for "other people" rather than the "general population" that is constituted as the locus of public Aids commentary. In this respect at least, the structures of Aids commentary that I attempted to describe in the first edition of Policing Desire have evidently remained stable since the book was written in 1986. This in itself is remarkable, given the tremendous changes that have taken place at every level of the direct experience, and management, of the epidemic. As Dr June Osborn has pointed out: "it is unsettling to note that much of the Aids dialogue these days seems to be detached from the realities of the situation. Although prevention is our only availablestrategy, the public frets about the tastelessness of condom advertising; many politicians seem to operate on the notion that Aids is a short-term problem - that the 'good old days' will return by 1991 or soon thereafter." However, as she points out in the 146 CONCLUSION (SECOND EDITION) strongest terms: "Aids is here to stay. It is like the day after Hiroshima - the world has changed and will never be the same again".1 Her conclusion is echoed by Dr Allan Brandt, who makes the equally important point that "diseases are complex bio-ecological problems that may be mitigated only by addressing a range of scientific, social, and political considerations, no single intervention - not even a vaccine - will adequately address the complexities of the Aids epidemic".2 The most fundamental concern three areas: health education, health care provision, and community development. Health Education Health education has emerged as the central discursive site in which the "meaning" of Aids is established and contested. In this respect we can begin to distinguish between "official" government sponsored Aids education, and the primary prevention campaigns developed within the social constituencies first affected by the many consequences of HIV, which far exceed disease symptoms. Such campaigns have constantly emphasized that safer sex is necessary as the sine qua non of effective preventativehealth education, and that this involves everyone regardless of their known or perceived HIV antibody status. In the social groups most directly affected by Aids it has been widely recognised that safer sex is a strategy which requires an understanding of the possibility not only that one might contract HIV from another person, but that one might already be infected. Safer sex has thus become established as a cultural practice among gay men inparticular. As Dr James D'Eramo has argued: "The idea that gay men have no option for sexual expression left is a common appraisal, but it simply is not true. . .. Safer sex itself cannot motivate us unless we eroticizeit and make it more than a mere technique. Safer sex, as a motivator, without self-esteem a mix of self-love and caring (gay pride included) - is very limited at best and, at worst, doomed to failure. . .. The crux is what you do and why. And what you do is your choice. . .. Abstinence doesn't work because when people abstain, they don't learn about Safer sex techniques, and when they get horny enough, they'll go out and break every rule in the book".5 Explicit sex videos and magazines have a major role to play in sustainingthe cultural practice of Safer sex, often providing a surrogate peer-support that is such a central...


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