The Infrapolitics of Care: Welfare, Intimacy, and Regulation in the Era of AIDS
Date of Award
Spring 2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
History
First Advisor
Meyerowitz, Joanne
Abstract
Beginning in the early 1980s, this dissertation investigates the political economy of care labor, risk, and racial equity during the first decades HIV/AIDS epidemic in twentieth-century United States. Through an interrogation of the work of state administrators, activists, and people with AIDS, I examine various sites where public and private provision overlap—including housing, health insurance, and non-profit service agencies—to show how the racialized and gendered policing that had long characterized welfare programs in the United States changed in response to the particular demands of the AIDS crisis. Juxtaposing the work of prominent organizations and interest groups with the writing and advocacy of people living with HIV/AIDS, I analyze the epidemic both structurally and granularly. The activists, institutions, and everyday people at the heart of this story negotiated the meaning of care using strategies that included litigation, direct action protest, institution building, and political lobbying. In response to the unique challenges of the epidemic, they embraced policies and programs like home care and harm reduction that would alter the contours of Americas care infrastructure and influence arenas from drug policy to labor politics. Over the course of a decade, grassroots responses that had been conceived of in a time of emergency would become entangled with the demands of the welfare state, insurance professionals, private foundations, and influential donors. It was through struggles over the right to privacy, shelter, and recognition, people living with HIV/AIDS made bold claims about their continued right to the city that reverberated across borders. Over six chapters divided into two parts, this project chronicles the ways that state inaction and retrenchment became translated into programs that responded to the rising cost of care through healthcare marketization, non-profit contracting, and new forms of labor arbitrage. Chapter One: First Responders traces the development of an ad-hoc care infrastructure created by gay political and community-based organizations, including the Gay Men’s Health Crisis and the National Gay Task Force. Chapter One is followed by a brief interlude that examines the politics and stakes of HIV testing. Chapter Two, “Living Rooms” takes a look at three sites of community organizing around education and social support: the work of the People with AIDS Coalition, the AIDS Counseling and Education Program at Bedford Hills Correctional Facility, and an online forum known as SURVIVORS. Much like disability scholars delineate “medical” and “social” models of disability, I argue that the PWA movement that emerged from this moment produced a model of what it meant to live with AIDS that was rooted in the body while simultaneously accounting for the social and political conditions that structured daily life. Chapter Three, “Sex, Drugs, and The Politics of Space” examines the experiences of sex workers and drug users during this period, with attention towards conflicts over harm reduction and the use of public space. Part Two delves into the tactical power struggles between the private and public sector. Chapter Four, “Uninsurable Risk” explores the regulation of private health insurance and the creation of new technologies of risk management that foreshadowed later attempts at health care reform. Chapter Five explores the politics of housing provision through an examination of how rent regulation, public housing, and care provision intersected with the housing and care needs of PLWHA, highlighting the ways that both AIDS activists and government officials produced new legal categories of inclusion and exclusion throughout the crisis through the expansion of “functional family” jurisprudence, debates about competing rights to privacy and safety, and the incorporation of “harm reduction” policies within AIDS-care programs. Chapter Six, “Reproduction and Risk” considers the reproductive questions at the heart of debates about prenatal HIV testing and the struggle to expand the definition of “AIDS” to include symptoms experienced by women. The project concludes with a coda exploring the passage of the Ryan White CARE Act in 1990.
Recommended Citation
Bhaman, Salonee, "The Infrapolitics of Care: Welfare, Intimacy, and Regulation in the Era of AIDS" (2023). Yale Graduate School of Arts and Sciences Dissertations. 1054.
https://elischolar.library.yale.edu/gsas_dissertations/1054
