A study found that images in safer sex material reinforce the social construction of men as sexually active and adventurous and of women as sexually uninterested and passive. But the images were rejected by the publisher. Study author Tamsin Wilton believes such actions stifle academic debate.
Since 1987 I have been an active member of a small but rapidly growing group of people with a deep interest in other people's sex lives. More specifically, in how an entire planetary population can change the various ways in which they have sex, in order to prevent the continuing spread of HIV infection.
If we were in any sense Homo sapiens, if we were the thoughtful, wise animals we believe ourselves to be, HIV would present far fewer problems than it does. It is not easy to transmit, unlike other great epidemic diseases. You generally become infected with the virus by having sex with someone who is already infected (other transmission routes, according to the World Health Organization, account for less than 25per cent of global infections).
Avoiding infection is, in theory, ludicrously easy. "Don't get semen in your anus or vagina," cautions long-time Aids activist and writer Cindy Patton, effectively side-stepping the dangerous red herring of sexual orientation and offering what must be one of the most unambiguous pieces of health educational advice on record.
The physiological simplicity of this defensive strategy cannot, of course, hold up against the complexities of human social organisation. The Roman Catholic Church, the entrenched homophobia of the (presumptively) heterosexual mainstream, the material and cultural inequalities that give rise to prostitution, the legacy of colonialism - a moment's thought will explain why Patton's advice, although sound, is about as useful as heartily recommending that we all "just say no" to drugs. HIV may be a virus, but the epidemic is primarily a social phenomenon.
The particular social aspect of Aids that I have been studying is how safer sex has been promoted; in particular the complex social factors influencing the promotion of safer sex to different social groups and the unintended consequences of the ways in which sex and sexuality are represented in safer sex materials. The whole question of promoting safer sexual behaviour has become taken for granted in this age of Aids, and it is easy to forget just how much of a leap into the dark it is. In the perilously innocent days of the late 1970s the very idea of Her Majesty's Government urging people to masturbate for the good of their health would have been inconceivable. Combine the stultifying British "reserve" about sex and sexuality with the political ascendancy of a New Right determined to halt the steady liberalisation of social attitudes and reinstate a punitively narrow, familial moralism, and you have a social climate tailor-made to ease the passage of a sexually transmitted virus.
In Britain there are two key sociopolitical factors impeding the effective promotion of safer sex (there are many others impeding its widespread adoption, of course, but that is a different question). First, political expediency inhibits governmental agencies from being seen to promote non-penetrative sexual practices. Everything from oral sex to bondage, from golden showers to voyeurism is much safer than "normal" penis-in-vagina sex, with or without a condom, but such activities come under the heading of kinky sex, perversion or at best "foreplay", and as such are outside the remit of an ideology that remorselessly attaches heterosex to marital reproduction and does not respect homosex at all. This means that safe sex materials, which need to be clear, unambiguous and explicit, are among the most densely coded information-giving texts available. It is as if the instructions you receive with your self-assembly wardrobe advised "metal-to- metal contact" instead of telling you to use a cross-head screwdriver with your cross-head screws.
Second, safer sex materials cannot spring into existence, detached from the wider cultural context. Such materials are carefully targeted, following "sauce for the goose" principles: at "gay men", "women", "drug (ab)users", "lesbians", "young people" and so on. The problem is that these discrete target groups are themselves fictions, culturally constituted by a range of discursive practices from advertising to medicine. What is more, safer sex materials themselves contribute to the cultural construction of these groups.
A comparative study of the safer sex materials available in Britain reveals that gay men are offered material that represents safer sex as fun, highly erotic, imaginative and pleasurable. This tendency is present whatever the origin of the material (whether from the Health Education Authority, the Terrence Higgins Trust or Gay Men Fighting Aids). Moreover, materials originating in gay community organisations represent safer sex as an intrinsic component of a politically assertive, responsible, sex-positive gay identity. In utter contrast, safer sex materials for "women" are devoid of any suggestion of erotic excitement, pleasure, desire or fun. They are weighed down with questions of family responsibility and often suggest that women (should) find sex unpleasurable, difficult or offensive. Typical is one safer sex leaflet for women produced by a local healthcare trust which carries a warning on its cover: "The advice in this leaflet is explicit. Please do not read it if you are easily offended."
Thus the social construction of men as sexually active and adventurous, and of women as sexually uninterested and passive is being reinforced and reaffirmed by safer sex materials themselves. This is highly dangerous and irresponsible, since it is colluding with precisely those gendered inequalities that - as much research has demonstrated - make it so difficult for women and men to negotiate safer sexual practices.
I have just completed a book about all this, En/gendering AIDS. Needless to say, since it is about the unintended consequences of representing sex, I submitted a selection of illustrations to Taylor and Francis, my original publisher, as an integral part of the book. I also submitted a drawing for a cover illustration, showing a muscular female version of Leonardo da Vinci's famous Vesallian man; intending to make the point that man (in this case, specifically gay man, so Leonardo's sexuality was a nice bonus) is the measure of human society and that women are marginalised in consequence. Aware of the Obscene Publications Act - no researcher in the field of HIV/Aids can avoid being aware of this Act - I was careful to select images that were widely available in the public arena from legitimate sources and were well within the law. It was, after all, not my mission to deprave and corrupt my colleagues in academe, merely to encourage debate about the representational practices of health education. To set my deconstruction of safer sex materials in the wider sociocultural context, I selected a page of telephone sex-line advertisements from a soft porn magazine aimed at women. To demonstrate the high quality of the erotic safer sex materials produced by and for gay men, I chose a nicely photographed illustration from a Terrence Higgins Trust leaflet.
A few weeks after I had despatched the manuscript and the illustrations to Taylor and Francis they sent me the originals of my illustrations, together with a letter from my editor. She thanked me for the manuscript, saying she was sure the book would be 'well received', and went on to discuss the proposed illustrations. With regard to the cartoon of "Vesallian woman", she "liked the concept very much" but - and it was here that my jaw began to drop - "We cannot depict nudity, even in this symbolic fashion, on the cover of the book". Her suggestion was that I "find a way to take out the detail of the 'essentials' as it were, or clothe the figure in some way". Worse was to come as I read on, there were apparently similar problems with the textual illustrations: "We certainly cannot publish any of the proposed illustrations depicting nudity and various sexual acts. We do not believe it is in keeping with the series (Gender and Society: Feminist Perspectives), or the kinds of text we publish.' My initial reaction was one of amused disbelief. I had just attended the London launch of Pandora's coffee-table lesbian sex book, Making Out, copiously illustrated in full colour with Laurence Jaugy-Paget's photographs, and had not picked up any signals that this was regarded as an especially risky or unwise thing for a publisher to do. More or less explicit photographic representations of nudity - male and female - and of sexual acts have quite clearly shifted out of the province of the pornographer and into the mainstream. Such images are produced and consumed within and outside the academy, and (whether in the context of health education or not) it is the proper business of the academy to research and debate their social position, their cultural meaning, their impact and implications, and to chart the wider, sociopolitical shifts that they mark. Serious journals from Feminist Review to New Formations have published explicit sexualised imagery, and my own piece setting safer sex promotion in the context of the pornographic vernacular was unproblematically accepted for publication in a prestigious collection, edited by Dr Lisa Adkins of the British Sociological Association (to be published later this year by Macmillan), together with several accompanying illustrations.
Moreover, Taylor and Francis had themselves published an earlier piece of mine on the same topic with illustrations that included a naked gay man reclining on a bed and two wet naked lesbians embracing in a shower/sauna. As far as I was concerned, the illustrations were an integral part of the book - indeed, its raison d'etre - and I was not prepared to withdraw them.
I rang the series editor, June Purvis, professor of sociology at Portsmouth University, whose advice was to try to resolve the situation by compromise. I thought the cover illustration of the Leonardo original in a bikini might make the point. We would try to get the text illustrations through in return.When I finally spoke to my editor at Taylor and Francis and told her that my bottom line was "no illustrations, no book", she promised to take it to an internal meeting for a final decision. That my earlier naked lesbians had got through was, she said, a mistake "that should not have happened". She was not, she warned me, hopeful of the outcome, saying that they did not want to follow in Cassell and Routledge's footsteps.
My editor rang me back after the meeting with their decision to lose the book and release me from my contract. "You are free to take it to anyone else" was how she put it, so of course I did.
Who gains by Taylor and Francis not publishing my book? They certainly do not. Their editor is put in the difficult position of having to restructure her publication schedule, the series editor is now aware of very serious restrictions pertaining to her editorial judgement, I have to scrub from my CV the line that reads "En/gendering AIDS: Sex, Texts, Epidemic, Taylor & Francis, forthcoming" and write in something vague about "under review". Whichever publisher takes it on (it is currently with readers at Routledge) will get the benefit of a completed manuscript, but will have to juggle publicity and publishing schedules to take account of this.
It also throws light upon under-discussed and difficult questions about the relationship between academic writers and their publishers. Given that publishers have the right (and obligation) to ensure that they do not fall foul of the law, what further rights should they exercise to determine what may and may not be exposed to the academic gaze? When students complain, as they sometimes do, about the books stocked in our university library (they are almost always the lesbian and gay books that are attacked - indeed, two male members of staff from our humanities faculty complained about the library stocking Gay Times) they are told that this is an academic institution whose very existence is founded upon encouraging and facilitating open and informed debate. Images and words constitute the medium through which academic debate takes place, they are in a very real sense the lifeblood of the entire academic enterprise. What does it mean that publishers can control what may and may not be seen within the academy?
But looming large in this story is the pungent irony of it all. En/gendering AIDS is about the dangers of censorship, prudery and homophobia, the unnecessary deaths to be laid at the door of those for whom imposing their moral certainty on others takes precedence over saving lives. I believe that, in the context of HIV/Aids, the clear and present dangers of censorship, prudery and homophobia emerge with a clarity that demands recognition. Aids has given rise to a crisis in representation with lethal consequences, and my object in writing En/gendering AIDS was to urge the academic community to get involved in this crisis. It is also essential that health education is reflexive and responsive to criticism, and if debate about health educational imagery cannot take place in the public arena provided by academic publication, how else can we develop reflexive and effective practices? Never mind that the images in question are freely available to anyone who cares to visit a newsagent or the local Aids service organisation; for Taylor and Francis to determine what may be shown to academics and professionals in the context of a debate about censorship is both painfully ironic and, in a wider context, unhelpful to those trying to stem the advance of this miserable pandemic.
Tamsin Wilton is senior lecturer in health and social policy, faculty of health and community studies, University of the West of England at Bristol. She has published widely on HIV/Aids and sexuality.