[Kendall Thomas, in continuation from “Cc…: CCC, part 14]
My point here is that the landscape of “international AIDS” in the U.S. is, first and foremost, a psychic space whose field of action is the interiorized projection (Rorty’s “sentimental education”) that allows Americans to “feel” that they are part of the global culture of concern about the HIV pandemic. Needless to say, the heightened sensitivity of the American public to the imagined pain of those who are living with (and dying from) AIDS in other parts of the world has yet to take the form of a collective public demand that the U.S. government increase its support for international treatment and prevention efforts. (Tellingly, the Kaiser Foundation survey I mentioned earlier found that nearly half of those polled doubted that more money would result in any meaningful progress in the struggle against AIDS in Africa.) If anything, the “international turn” in the U.S. domestic discourse on HIV/AIDS has served as an alibi for not addressing the intranational scandal of HIV infection and illness on our own shores. Consider the following state of affairs. The U.S. continues to record about 40,000 new infections each year. Roughly one-half to two-thirds of the 800,000 to 900,000 Americans with HIV/AIDS do not receive regular medical care. Up to one third of Americans do not know that they are infected. African Americans, who represent 12% of the U.S. population, make up 47% of new AIDS cases. African American women account for nearly two thirds of the new AIDS cases among women in the U.S. Some 56% of the African Americans living with HIV are not on combination drug therapy. They are 1.5 times more likely not to get preventive treatment for PCP. Although they represent only 15% of the total U.S. population under the age of 13, African Americans make up 62% of the nation’s pediatric AIDS cases. Half the new AIDS cases among young people between the ages of 13 and 19 are among African Americans. AIDS continues to be the leading cause of death for African Americans between the ages of 25 and 44. A recent study of young men who have sex with men suggests that in parts of the U.S., one in three gay African Americans are infected with HIV, a rate fully comparable to that of the hardest hit African countries.
Does this mean that AIDS analysis and activism in the U.S. should turn inward and cut itself off from the rest of the world? Not at all. I am not urging a narcissistic return to the isolationism that has characterized too much of the history of the U.S. response to HIV/AIDS. I am saying that in engaging with the question of where to act now, we in the U.S. have a responsibility to continually think the global around the axis of the domestic. We have a responsibility, too, to develop and defend a radical vision of solidarity across the mental borders that AIDS sentimentalism has drawn between the international pandemic and the intranational epidemic. In my view, the measure of those of us who live in the U.S. must be taken by our willingness to fight AIDS as fiercely at home as we do abroad.