Susan Sontag, HIV/AIDS Handout

AIDS as Metaphor: Body Politic and Culture of Surveillance

By Desi Wimberly and John Wilkinson

Susan Sontag: (1933-2004)

Born in New York, raised in Tuscon, AZ and Los Angeles, CA. Sontag is a celebrated writer and academic who, among her credentials, taught Freshman English at Uconn, 1951-1952. She identified as bisexual and wrote extensively about cancer, HIV/AIDS, and illness. She died from complications of cancer

HIV/AIDS Definition

HIV is an acronym for Human Immunodeficiency Virus. The virus destroys important cells that fight disease and infection. The virus can stay hidden for prolonged periods of time (approx. 6 months) and it attacks “T-Cells,” which are key part of the immune system used in fighting infections and disease. The virus invades “T-Cells,” using them to make copies of itself before destroying them, effectively destroying the immune systems capabilities of combating the virus.

AIDS is an acronym for Acquired Immunodeficiency Syndrome. AIDS is a condition that is acquired once the virus has killed enough “T-Cells,” so that the immune system can no longer fight infections and disease. The body is then attacked by “Opportunistic Infections” that it cannot fight off. Those who have this syndrome demonstrate the symptoms of the attacking infections and are subject to the worst effects of the infections, being unable to fight them off with their immune system. AIDS is the final stage of HIV

Current HIV/AIDS Trends (Information Gathered from the Center for Disease Control and Prevention)

Lower Transmission Rates: The majority of people infected with HIV do not transmit the virus to others. CDC estimates that there were 5 transmissions per 100 persons living with HIV infection in the United States in 2006, meaning that 95% of those infected did not transmit HIV, an 89% decline in the estimated rate of transmission since the peak of the epidemic in the mid-1980s. This decline is likely due to prevention efforts and availability of improved testing and treatment.

More Awareness: The estimated proportion of persons in the United States with HIV who know they are infected increased from 75% in 2003 to 82% in 2009. This is a sign of progress for HIV prevention because research shows that most individuals reduce behaviors that could transmit HIV when they learn they are infected.

Cause of Death: More than half a million people with an AIDS diagnosis in the United States died from the beginning of the epidemic through 2007, the most recent year that death statistics are available.

Late Diagnosis: Too many persons continue to be diagnosed with HIV late in the course of their infection and miss opportunities for treatment and prevention. In 2008, one-third (32%) of individuals with an HIV diagnosis reported to the CDC received a diagnosis of AIDS within 12 months of their initial HIV diagnosis.

Disproportionate Impact: Men who have sex with men (MSM), blacks/African Americans, and Hispanic/Latinos are the groups most affected by HIV infection. Geographically, urban areas are the most heavily impacted:

MSM represent 2% of the population; however, their HIV diagnosis rate is more than 44 times that of other men and more than 40 times that of women. MSM account for more than half of all new infections in the United States each year.

Blacks/African Americans are the racial/ethnic group most affected by HIV. They represent about 14% of the population but but accounted for 44% of new HIV infections in 2009. Over the course of their life, 1 in 16 black/African American men will receive a diagnosis of HIV, as will 1 in 30 black women. HIV infection rates are higher among black MSM compared to other MSM. More new HIV infections occurred among young black MSM (aged 13–29) than among any other age and racial group of MSM.

Hispanics/Latinos represent 16% of the population but account for an estimated 20% of new HIV infections in 2009.

Women of color continue to be disproportionately affected by HIV infection. The rate of new HIV infection for black/African American women is nearly 15 times the rate for white women. The rate of new HIV infection among Hispanic/Latina women is over four times that of white women.

Specific locations are more affected, although HIV and AIDS have had a severe impact on all regions of the country. AIDS remains mainly an urban disease, with most individuals diagnosed in 2009 living in cities with more than 500,000 people. Areas hardest hit based on ranking of AIDS cases include Miami and Jacksonville, Florida; Baton Rouge, Louisiana; New York City, New York; and Washington, D.C.

Body Politic and Language

Rudolf Virchow (1850), the founder of cellular pathology, referred to the body as being like a society (Sontag 94f.) The term “body politic” is defined as “a nation regarded as a corporate entity; a state” (OED). The term “body politic” is often utilized to describe the representation of a body in terms typically associated with a state. “Body politic” and metaphor in regards to illness emphasize the relationship between a condition and the language used to describe the condition and the perception of those with the condition. The heavy use of militaristic diction and metaphor (Sontag 99) throughout the language of illness establishes a connection between disease, invasion, and foreigness (Sontag 136). Upon thinking he was fatally ill, poet John Donne “[described] illness as an enemy that invades, that lays siege to the body-fortress” (Sontag 195). Sontag herself states that “disease is seen as an invasion of alien organisms, to which the body responds by its own military operations” (156).

Myths and Misconceptions

Myths and misconceptions about the origins and spread of HIV/AIDS include the following: it comes from sex with monkeys and bestiality, only homosexuals or minorities can contract it, it is spread by homosexuals, it is a government conspiracy and form of eugenics, it is divine retribution for hedonism. In reality, it is believed that hunters in West Africa killed and ate infected chimpanzees and may have been spread from infected chimpanzees as far back as the late-1800s ( HIV/AIDS is primarily transmuted through the exchange of bodily fluid (blood, semen, vaginal fluid, and breast milk), but can also be transmuted through procedures such as blood transfusions and the reuse of needles. AIDS is an acquired medical condition, not an illness in and of itself and is diagnosed in temporal stages. The language of HIV/AIDS has a “dual metaphoric geneology” (Sontag 105): micro-process is equated with invasion and transmission is equated with pollution.

Perception of HIV/AIDS Diagnosis

“Fictions of Responsibility” (Sontag 100) has historically been associated with Tuberculosis, Syphilis, Cancer, and now HIV/AIDS. HIV/AIDS is perceived as a violation and invasion of the body, being contracted from outside (without) rather than coming from the body itself (within), and it kills cells, whereas cancer (typically) comes from within and mutates and proliferates. Cancer can be a cause of an external influence, but it is view as a consequence of excess or weak will. In contrast, HIV/AIDS is primarily linked with sexual deviance, hedonism, and drug abuse.

Body Politic and Literary Representation

“All these and security were within. Without was the ‘Red Death’;” “[T]here came yet another chiming of the clock, and then there were the same disconcert and tremulousness and meditation as before.” – Edgar Allen Poe, “The Masque of the Red Death”

Causality and Perception

Those with the condition of HIV/AIDS are grouped as a“Member of a certain ‘risk group’” or having “[flushed] out an identity” or “[confirmed] an identity.” HIV/AIDS is associated with hedonism, indulgence, and delinquency (Sontag 112f.)

Culture of Surveillance

“Surveillance based on a system of permanent registration;” “The relation of each individual to his disease and to his death passes through representatives of power, the registrations they make of it, the decisions they take on it” – Michel Foucault, “Panopticism” 196f.

Pedro Zamora: 1972-1994

Pedro was declared HIV/AIDS positive at 17 and died of related complications at 22. He was one of the first openly gay, HIV/AIDS positive individuals in media and garnered attention through MTV’s The Real World: San Francisco.

Sources: “What is HIV/AIDS?”

”body politic, n.”. OED Online. Oxford University Press. 26 March 2013.


Foucault, Michel. “Panopticism.” Discipline and Punish: The Birth of the Prison. Trans. Alan Sheridan. New York: Vintage Books, 1979. Print.

MTV. “A Tribute to Pedro Zamora.”

Poe, Edgar Allen. “The Masque of the Red Death”

Sontag, Susan. Illness as Metaphor and AIDS and Its Metaphors. New York: Picador, 1989. Print.

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