Rumors and Realities: Making Sense of HIV/AIDS Conspiracy Narratives and Contemporary Legends

摘要

The social context of the early HIV/AIDS epidemic in the United States provided fertile ground for rumors about transmission. Today, however, rumors about HIV/AIDS persist only within the African American public. Focus group and public discourse data reveal the content and distribution of HIV/AIDS origin and conspiracy rumors. Rumor and contemporary legend theory allows reinterpretation of rumors as a measure of trust between the African American public and health professionals, not as evidence of ignorance or of historical racial oppression. To improve public health results in the African American community, HIV/AIDS efforts must acknowledge the sources and meanings of rumors, include rumors as a measure of trust, and address the underlying distrust that the rumors signify. Despite major advances in knowledge about the HIV virus, modes of transmission, and treatments that can reduce viral load and extend life, the spread of HIV among African Americans, especially African American men who have sex with men, has remained stubbornly resistant to interventions. As of 2006, 48.1% of new HIV infections in the United States were attributable to male-to-male sexual contact; African Americans had an HIV prevalence rate of 1715.1 per 100?000 (2388 per 100?000 for men and 1122 per 100?000 for women), whereas the rate for Whites was 224.3 per 100,000 (394 per 100?000 for men and 62.7 per 100?000 for women). 1 These persistent high rates among African Americans run counter to the experience of most populations in the United States, for whom better knowledge about HIV/AIDS has led to reductions in morbidity and mortality, as shown in the following diagram: These relationships, however, work only if people trust the sources of official information. This applies equally to prevention and treatment: no HIV/AIDS program that requires action by the public—however valid or well-originated—can succeed when people distrust the program’s sponsors or the sources of information about the disease. Understanding the forces that cause and sustain distrust among African Americans is essential to reducing rates of HIV infection, and this requires recognition of the role of HIV/AIDS rumors—their origins, spread, and capacity to resist contrary information. Initially, AIDS rumors were widespread, because the social context provided what rumor theorists have identified as fertile ground for the growth and persistence of rumors: a dearth of trusted information in conjunction with high levels of social anxiety. 2,3 Furthermore, the trust and knowledge networks that support rumors are typically bound by the same elements of social stratification that constitute racial and ethnic identities and subgroups; people circulate stories to people they know and trust, and only retell stories with meaning or resonance. 3,4 Rumors about HIV/AIDS proliferated throughout US society: only gay people can get AIDS 5 ; you can catch it from a doorknob, a toilet seat, or a swimming pool; flying insects can transmit it; women are tricking men into having sex with them so they can give them AIDS 4 ; AIDS was developed by the Central Intelligence Agency (CIA) to kill off African Americans and gays 6 ; it’s not caused by a virus at all. 7 As the emerging HIV/AIDS crisis forced scientists and health professionals to change their habits and practices, partly because of the science of the virus but largely because of effective social activism by AIDS-affected lay groups, 8 those same groups invested their faith in the health professions community. They demanded action commensurate with the health crisis: scientific knowledge to replace fears, ignorance, and uninformed suppositions. And they succeeded; as solid, official information developed, general anxiety about HIV/AIDS slowly receded, and so did the stories—most HIV/AIDS rumors have disappeared. 9 Within the African American community, however, specific rumors continue to persist, rumors that understand HIV/AIDS as a genocidal government plot against African Americans. Moreover, these HIV/AIDS rumors do more than indicate distrust, they reinforce distrust by positing an explanation that assigns responsibility so explicitly: an illness that can be traced to an intentional (and familiar) actor, instead of a social and health problem that is part of an impersonal modernity with complex causes that can leave the individual feeling helpless and hopeless. 10 I collected data from a systematic survey of public discourse and from a series of 6 focus group interviews that I conducted, organized by race/ethnicity among members of a college community, to examine the ways in which HIV/AIDS rumors distribute themselves in some groups—but not others—and serve to sustain distrust. My goals were (1) to establish the uniqueness and pervasiveness of HIV/AIDS rumors within the African American public, (2) to connect those rumors to the distrust that contributes to continued high HIV infection rates, and with that knowledge, (3) t