AIDS, risk and social governance

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Abstract

This paper considers the discursive properties of public health literature produced around AIDS in the 1980s and early 1990s. Attention is focused upon the role of health promotion in the UK government's response to the epidemic and on the language used in the educational campaigns conducted by the Health Education Council and its replacement the Health Education Authority. Using an analytical approach influenced by the work of Michel Foucault, the paper argues that the knowledges of AIDS produced by these various public health institutions constructed discursive boundaries between the idea of ‘normal’ and ‘abnormal’ behavioural practices. The notion of risk, produced as it is from epidemiological knowledge, is a central mechanism in this process. It is through the production, articulation and normalisation of ‘at risk’ groups that society is fragmented and hence subject to the governance strategies of late-modern liberal economies.

Section snippets

Introduction

The advent of AIDS as a socially meaningful fact in the West has generated an enormous outpouring of words. Across journalistic, political, and medical discourses, a number of terms recur with such regularity that we might be tempted to conclude that AIDS has brought the worlds of the scientist and the humanist closer together. However, we might also — and with greater plausibility — explain this phenomenon as an indication that certain shared assumptions are already embedded in these discourses (Grover, 1987, p. 17)

As this quote from Grover suggests, submerged within the many languages of AIDS were discourses that carried with them a host of malign assumptions about those individuals who found themselves to be ‘at risk’. Interestingly, and still with only few exceptions (Brown, 1995, Brown, 1997, Wilton, 1996), geographers have chosen not to explore this other side of the epidemic. Instead, the geographical lens has tended towards the production of spatial accounts which map the spread of AIDS through

AIDS, risk and social governance

In a recent edition of ‘Geoforum’ dedicated to the issue of social exclusion, Rob Wilton employs the Freudian concept of unheimlich and the Kristevan notion of the abject to explore the structuring of the individual psyche and the impact that this process has on the spatial organisation of the social world (Wilton, 1998, pp. 173–185). Wilton's is a powerful argument, made the more so by his examination of local resident responses to the siting of an AIDS hospice in their Los Angeles

Health promotion: risk, danger and difference

When raising the issue of public good versus individual liberty vis-à-vis state responses to AIDS, Porter and Porter (1989, p. 97) focused attention on a key concern surrounding initial reactions to the epidemic: how to prevent the spread of a lethal disease which constituted a threat to individual rights to health while maintaining individual rights to liberty. As noted elsewhere this was no ordinary epidemic (Nelkin et al., 1991), it largely affected individuals already positioned within

Expanding the boundaries: health education leaflets in the UK

In the UK, two bodies were given primary responsibility by the Government for the production, articulation and evaluation of AIDS-related health promotion material: the Health Education Council (HEC) and the Health Education Authority (HEA). The former being replaced by the latter which took over responsibility for AIDS/HIV health education initiatives from the autumn of 1987, following the Department of Health's ‘AIDS: Don't Die of Ignorance’ advertising campaign. Of course, these were not the

Selling AIDS: mass media campaigns in the UK

Having examined some of the health promotion leaflets produced by the HEC and the HEA I now wish to turn to the language employed in the mass media campaigns. As such, this analysis will cover the same temporal ground as the previous section. However, it should be recognised that the mass media campaigns represent a distinct form of health promotion activity, as the scope of this discursive practice extends far beyond the limited range of the clinic. As Bunton and Burrows suggest, health

Conclusion

In this paper, I have sought to relate the notion of social governance to the analysis of health promotion discourses surrounding AIDS and HIV. In particular, questions have been raised as to the role of risk in the production and articulation of a knowledge of ‘good’ health practice. As argued throughout the paper, the surveillance techniques of epidemiologists acted to fragment the population according to its ‘risk group’ status. Once established as a ‘problem’, such heterogeneously imagined

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