Notes on Proximity this World AIDS Day

Pissing boxes

December 1st is World AIDS Day. What does that mean? Red ribbons, advocacy, awareness, pride, remembrance, some sorrow, and, yes, an advertising opportunity for a private, ‘mail-your-sample-in’ STI service. The STI Clinic, as it’s called, is located on prestigious Harley Street (where football players get hair transplants). But that’s really irrelevant because the whole point of their service is that you don’t have to go anywhere: receive box, pee in box, send box, and check results online.

Now, I’m going to go out on a limb here and guess that an STI screen that provides test results without any personal interaction whatsoever with qualified health care professionals is probably not the best route to achieving the aims that most HIV/AIDS campaigners are seeking, namely better, more equitable health care.

Of course, The Clinic couches its business model in the language of innovation and customer service benevolence: ‘The STI Clinic was created to make it easier for people to access tests and treatments for sexually transmitted infections.’ £30 gets you a Gonorrhoea test. And the price of other services ranges – up to £140 for a ‘full screen.’ That being said, they do not offer mail order HIV tests, nor do they test other sites of the body where infections such as Chlamydia can be present, so ‘full’ isn’t exactly full.

According to the website, physical examinations ‘can, in many cases, be unnecessary.’ As it happens, this sort of interaction also cuts into profit margins. At The STI Clinic, they’ve found a way to make an impoverished service marketable as an asset – just like those self-checkout machines at the grocery. It’s an instance of the private sector excelling in making a buck on a service that would be liable to create scandal in the public sector.

Choice and privacy have become bywords of the ‘luxury’ shopping age and The STI Clinic taps into those values. But asking people to guess which infection they may have in order to click purchase a urine test kit, when accurate tests require other types of samples, isn’t a method pathologists or AIDS activists would recommend. So why does World AIDS Day have The STI Clinic as its major sponsor?

‘AIDS is a political crisis’

Of course, access to services is a genuine concern. For a variety of reasons, getting into an STI/GUM clinic can indeed be difficult. Mobility issues, homelessness, language barriers, privacy concerns and even emotional fears can prevent people from accessing sexual health care. But let’s be clear, this standardised mail-in service isn’t about addressing individual health care needs; it’s about paving over them. Such a service compartmentalises the burden of illness, both financially and culturally, on the individual, while at the same time reducing their health care into a series of consumer transactions.

AIDS campaigners should be challenging the insidious growth of privatisation and the individuation of disease, rather than providing a media platform for it. As the famous ACT UP mantra goes: ‘AIDS is a political crisis’. Campaigns such as World AIDS Day work hard to address stigmatisation and to support people and communities, which reflects the proud and radical history of AIDS activism. Challenging and questioning the complicity of the institutions that have come out of that legacy, however, is an aspect of the current AIDS crisis, as well the current sociological (or so called economic) crisis.

World AIDS Day comes on the heels of the biggest strike action the UK has seen in generations. The welfare state is being discredited and dismantled at a time when a re-imagination and expansion of the aims of ‘the commons’ is needed most. Rather than more packaging, what we need are boxes of a larger variety, boxes called places, places of all kinds where people can move around together, touching and pissing together.

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