Mortal Secrets: Truth and Lies in the Age of AIDS

Rating:
Summary: A worthwhile project, but less a Book than a Dissertation
Review: MORTAL SECRETS: Truth and Lies in the Age of AIDS is a book that is much needed as we read about the disheartening upswing of the AIDS pandemic. Now that so many new drugs are available and now that living with AIDS is a reality instead of an unachievable goal (as we all wait for a vaccine and a cure), this is an opportune moment for addressing the psychological and ethical issues faced by both HIV positive and HIV negative persons. What Drs. Klitzman and Bayer (a Psychiatrist/Bioethicist and a professor of sociomedical sciences) set out to do is make observations based on interviews with gays, bisexuals, straight people with histories involving drug use and prostitution (or partnered with one from these groups) on several topics: transmission of the disease, attitudes about getting tested, about being positive, about disclosure to partners, parents, extended family, co-workers, and the public at large, and the painful struggle about making moral judgments as to when to disclose positivity to sexual partners, etc.

The introduction is levelheaded, the interviews are isolated paragraphs instead of two-way conversations, and the presentation of the data and the opinions of the writers is fairly dry and flat. Knowing this is an investigatory, extended paper makes the reader finally absorb the material as though for a class in college. Not that this is at all bad: I think this book will provide a good reference for future works whether they be fact based or novel enhanced. One wishes for more writing like the following sentence in the closing paragraph: "Shame, desire, passion, fear of abandonment, lures of secrecy, vicissitudes of moral character, and qualities of relationships all mold private life and individuals' willingness to talk about HIV. Policy Makers can shape the context of private choice, but the exercise of such choice remains beyond their control."

In writing about this most devastating of diseases one hopes for more passion on the part of the writers. How do these men really feel about the pandemic? There really are no "Conclusions" here. But then, again, this is more a dissertation than a support session.

Rating:
Summary: Disclosure and its meanings
Review: This book is a disppointing read. The data are old: the epidemic has moved on from pre-HAART days so that the narratives about disclosure are distorted by the time warp. The material isn't organized well either, so that the social patterning of disclosure (e.g. by gender, social class, race etc.) is never revealed. The book needed a better and deeper theoretical analysis to elucidate the connections between social patterning, HIV transmission and disclosure. Further, the material presented here is a little too rosy. Many people do not disclose their HIV-positive status in the short term and often not in the long term either. It was difficult to get a sense of the meaning behind the material in a way that would be useful for dealing with issues of disclosure in the field.

Rating:
Summary: Useful insights, not righteous prescriptions
Review: This book is a welcome respite from the "damn or defend" approach usually taken to hot-button issues like HIV disclosure. Rather than inserting themselves as authorities who tell people with HIV what to do, the authors let people who are wrestling with all the complexities of HIV disclosure--with casual partners, with long-term partners, even with parents and friends--speak for themselves . The result is a portrait that won't satisfy those who want to mandate how it is people with HIV who live their lives, but also doesn't pander to people who want to whitewash away the uncomfortable truths about how people infect one other. Many of the voices here capture the complexity that gets lost in sound bites about HIV. This is just how it should be with a book about an issue that is simultaneously so everyday and so freighted with consequence for many of us. Get it. Read it. It will make you feel human, and appreciate the humanity of others.