HIV/AIDS on screen: by focusing on history, we ignore the present

Matthew McConaughey won an Oscar for his performance in Dallas Buyers Club – but films about the contemporary experience of life with HIV/AIDS are in short supply. EPA/ETTORE FERRARI

Consider the last three major films gracing our screens that explicitly deal with HIV/AIDS – the Academy Award-winning, highly acclaimed Dallas Buyers Club in 2013, followed by Ryan Murphy’s much-hyped HBO television film rendition of Larry Kramer’s play The Normal Heart and the festival circuit darling Test, both in 2014. A picture begins to emerge of HIV/AIDS as something from a distant time.

Each of these films are pointedly set in the early 1980s, at the dawn of the AIDS epidemic in the United States. They recall the AIDS crisis years in ways that are undeniably important to an ongoing archival project.

But their existence and widespread reception run the risk of contributing to a broader cultural illiteracy when it comes to the contemporary lived realities of HIV in high-income countries such as the United States or Australia.

Trailer for Dallas Buyers Club.

How the meaning of HIV has changed

Since the introduction of highly-active antiretroviral therapy (HAART) in 1996, and subsequent improvements and innovations in the decades following, the meaning of HIV has undergone a radical shift for those with access to affordable healthcare.

HIV is increasingly being seen as a chronic health condition, manageable in most circumstances with the right medication and access to services. HIV-positive people on stable medication are reducing their viral load – the number of copies of the virus in their bloodstream – to a level that is known as “undetectable”.

The ongoing PARTNER Study of 767 serodiscordant couples has reported zero transmissions from the “undetectable” HIV-positive partner to the HIV-negative partner so far, suggesting that an end to HIV transmissions in the near future is highly possible.

Trailer for The Normal Heart.

The introduction of preventative medications is also playing an important role in reshaping the lived realities of HIV in high-income countries. Post-exposure prophylaxis (PEP) is successful in preventing HIV infection within 72 hours of exposure. Pre-exposure prophylaxis (PrEP) is now available in the United States and is currently being trialled in Australia, a once-daily HIV prevention pill whose introduction has been compared to that of the contraceptive pill in the 1960s.

HIV/AIDS onscreen

Yet there remains a stark discord between the representations of HIV/AIDS we see onscreen, and the experiences and challenges of HIV today.

This week (July 20-25), thousands of HIV/AIDS researchers are convening in Melbourne for the 20th International AIDS Conference. The affiliated cultural events, including a number of theatre and dance performances and a film festival, demonstrate the tensions in HIV/AIDS representation between the past and the present.

James Welsby’s contemporary dance piece HEX engages with the shared memory of the 1980s AIDS crisis years from the perspective of a younger generation growing up in the shadow of the “Grim Reaper” PSA.

Similarly, the “verbatim documentary theatre” piece The Death of Kings, directed by Colette F. Keen, revisits the early 1980s, based on interviews conducted with gay men who lived through and survived the crisis. Both pieces do important work in the preservation of the memories and histories of a significant moment.

Yet much like The Normal Heart, Dallas Buyers Club and Test, they risk proliferating the idea that HIV/AIDS is purely historical. That is a problem, because the gap between HIV representation in culture and the lived realities of HIV influences the community’s comprehension of what HIV and AIDS mean today, in real terms.

An excerpt from HEX by James Welsby.

The cultural program for AIDS2014 also offers some works that engage directly with the contemporary lived experience of HIV.

Living with it – through art

BalletLab’s Live With It: We All Have HIV is a multi-disciplinary performance produced through workshops with people living with HIV across Victoria, promising “choreography, written and spoken words, video and other visual media … used in interpreting the ideas expressed by the participants, which define their personal relationship with the virus”.

Similarly, the play STATUS, emerging from the ENUF campaign, aims to address HIV stigma by transcribing the accounts of HIV positive people’s experiences onto the stage with professional actors.

Both are examples of the efficacy of using cultural works as an element of broader campaigns for public health and justice outcomes: Live With It was created in partnership with the Victorian AIDS Council/Gay Men’s Health Centre and STATUS in partnership with Living Positive Victoria.

Onscreen, the many hard-hitting documentary films in the program for the Outrage HIV Justice Film Festival are complemented by a screening of Being Brendo, an Australian web series developed with the VAC/GMHC portraying many realities of contemporary gay Australian life, including living with HIV.

Trailer for Being Brendo.

In the United States, Unsure/Positive is a new quality dramedy series currently in production that centres the experience of HIV positive people. In the creator Christian Daniel Kiley’s own words:

I’ve searched for other comedic and dramatic narratives about life with HIV, and I haven’t found much. Other AIDS-related narratives in film and television usually treat HIV positives as the “other,” and often include the seemingly inevitable death of those characters. I’m telling a different story, about what it is like to be given an HIV positive diagnosis today, what it is like to deal with that information today, and the ongoing (and not well understood) self-stigmatisation that many people from similar walks of life experience.

While the biomedical innovations and interventions of the past two decades have transformed HIV from a death sentence to a manageable chronic disease, they are no silver bullet.

Ending new infections and ending stigmatisation of HIV positive people will only come through improving community awareness and dialogue about the realities of HIV. Disseminating these narratives through culture – on screen and on stage – is a commendable start.

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