Changing Subjects: The Making of Feminist Literary Criticism // Review

Inventing AIDS by Cindy Patton is a tight comprehensive book, that for me, sparked many questions, yet helped me work through many complex notions surrounding the AIDS epidemic. Generally, Patton interrogates how the liberal and scientific discourses of AIDS in social services, education, and research continue to produce further discrimination against gay men, women and people of colour. Specifically, Patton's inquiry focusses on the earlier history of the AIDS epidemic (1980-1988), and offers a complex analysis of a racist/sexist/classist/anti-gay construction of AIDS that has been reproduced and manufactured through these various discourses. Patton examines the interrelationship between systems of discrimination and scrutinizes the dominant role of the West in the construction of AIDS. She challenges essentialist identity-based theories, and points to the necessity of uncoupling identities from practice in order to make safer sex practices and coalition building relevant across communities.The AIDS service industry is organized largely on the basis of identity and community: those with multiple identifications and communities are often fragmented in this system. Attempts to bridge the various services have been unsuccessful. Coalitions of AIDS services have become sites of struggle and resistance, emphasizing divisions among already disenfranchised groups. Patton notes that while the concept of "community" has political potency in the US, it is not reflective of the shifting categories lived by individuals. Also, the investment in community only reinforces the notion that identity rather than practice proliferates the AIDS virus, an idea that is strongly contested by AIDS activists.According to Patton, the AIDS service industry did not take up in their struggle how differences in the social realm produce differences in relation to AIDS, thus marginalizing the experiences of those who are already outside the constructed norm of AIDS. These exclusions became exaggerated when grassroots AIDS activism turned to public funding and formalized the AIDS service industry. For example, the singular focussed AIDS service industry was successful in acquiring private funds that allowed for a higher quality of care, while community health organizations, such as those serving the diverse needs of African-Americans, struggled for financial survival. AIDS services continueto be organized on the basis of these existing inequities and disadvantages within communities, and fail to break down these barriers.Patton outlines the change from grassroots organizing where the roles of activists and people living with AIDS are fluid, to a professionalized industry that uses rigid categories to differentiate between "experts," "victims," and "volunteers." These categories inscribe particular roles that rarely correspond with the lived multiple experiences of the epidemic. In the new AIDS industry, provision of care for people with AIDS replicates the inequities that exist in the delivery of health services in the US. The emphasis on volunteer and charity work in the AIDS industry serves to deepen class and racial discrimination. Compassion positions volunteers as a class with the privilege of being kind to those with AIDS. This practice of "othering" allows volunteers to disregard their own complicity in the system of AIDS discrimination: to position oneself as safe from HIV infection requires positioning others as embodying the virus itself. Altruism and empathy of care in the service industry replace the politics that initially grounded AIDS activists. As Patton states:The new altruism diffuses the political power of community organizing by recasting as "good works" the middle class's effort to help and defend....It ends any society-wide commitment to redistributing wealth, instead allocating resources according to who makes an appealing victim, rather than according to who has been "victimized" by society (p. …