Chapter Five AIDS and the Pathogenesis of Metaphor

Christopher C. Taylor

As AIDS continues to spread its way from one part of the world to another and from one sector of the U.S. population to another, it is becoming increasingly clear that societies are being forced to come to grips with two aspects of AIDS pathology, one which is directed toward AIDS the "disease" and another which is oriented toward AIDS the "illness. " This disease/illness distinction ( Kleinman, Eisenberg & Good, 1978: 251-52) differentiates between "disease," the biological and psychophysiological malfunctions occasioned by sickness,1 and "illness," the manner in which a specific sickness is experienced by the sufferer ( 1978: 251-52) and culturally labeled, explained, and valued ( Kleinman, 1980: 72). While biomedical practitioners generally concern themselves almost exclusively with the "disease" component of AIDS, it is apparent that for sufferers and society the "illness" component of AIDS is also important. AIDS as "illness" incorporates judgments about its meaning for sufferers and society, judgments that are culturally specific and receive expression through the medium of metaphor.

For example, we know that HIV suppresses the immune system, that in its later stages it invites "opportunistic infections," and that AIDS is almost always fatal; these are characteristics of the "disease," AIDS. However, many Americans fear and detest AIDS more for its perceived association with a "debauched" life-style, most notably, homosexuality and intravenous drug use, than for any direct health threat to themselves. The moral judgments leveled against gay men and IV drug users by certain segments of the American population have become part of AIDS as "illness," part of AIDS as a "social construct" (cf. Berger & Luckman, 1967). This construct, I maintain, has influenced the response that American health authorities have taken against AIDS as much as, if not more than, scientific thinking about the "disease" component of AIDS.

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Culture and AIDS
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Preface vii
  • Chapter One - Introduction: Culture and Aids 1
  • Chapter Two - Aids in Cultural, Historic, and Epidemiologic Context 9
  • Notes 23
  • References 24
  • Chapter Three - the Sick Role, Stigma, and Pollution: the Case of Aids 29
  • Notes 42
  • References 43
  • Chapter Four - Assessing Viral, Parasitic, and Sociocultural Cofactors Affecting Hiv-1 Transmission in Rwanda 45
  • Note 51
  • References 51
  • Chapter Five - Aids and the Pathogenesis of Metaphor 55
  • Note 64
  • References 65
  • Chapter Six - Aids and Accusation: Haiti, Haitians, and the Geography of Blame 67
  • Notes 88
  • References 89
  • Chapter Seven - Prostitute Women and the Ideology of Work in London 93
  • Notes 108
  • References 109
  • Chapter Eight Minority Women and Aids: Culture, Race, and Gender 111
  • Notes 128
  • References 131
  • Chapter Nine Language and Aids 137
  • Notes 157
  • References 158
  • Chapter Ten Aids and Obituaries: the Perpetuation of Stigma in the Press 159
  • References 168
  • Chapter Eleven Sex, Politics, and Guilt: A Study of Homophobia and the Aids Phenomenon 169
  • Note 181
  • References 181
  • Chapter Twelve Increasing the Cost of Living: Class and Exploitation in the Delivery of Social Services to Persons with Aids 183
  • Notes 198
  • References 201
  • Chapter Thirteen Postscript: Anthropology and Aids 205
  • Note 208
  • References 208
  • Index 209
  • ABOUT THE EDITOR AND CONTRIBUTORS 215
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