Communication Currents

Just last month, HBO presented an adaptation of Larry Kramer’s award-winning play about the AIDS crisis, The Normal Heart. You might be surprised to learn that HBO’s long-standing commitment to creating HIV/AIDS programming has provided audiences with more than 25 films in the past three decades. The history of these films is largely unwritten, but when viewed together they tell us a great deal about how we’ve come to understand and combat HIV/AIDS.

Beyond just writing a history of these programs, my article demonstrates that these films echo our cultural response to the AIDS epidemic in the United States in the 1980s and 1990s and the broader global pandemic today. That response is one that aligns with a neoliberal political agenda—a shift toward private entities performing duties that once were primarily considered the role of the state. The AIDS epidemic was largely understood through media representations such as film and television, and these HBO programs instructed people how to calm their fears in the face of AIDS, educated the public about safe-sex practices, and taught viewers the importance of compassion and ethical citizenship when it came to caring for people with AIDS.  

I argue that HBO’s HIV/AIDS programming can be divided into two groups. The first group of programs (1987–1999) positions the viewer to deal with AIDS on an individual basis through safe-sex practices and testing for HIV. Films such asAIDS: Everything You and Your Family Need To Know But Were Afraid to Ask (1987),Tidy Endings (1988), And the Band Played On (1993), and Eagle Scout: The Story of Henry Nicols (1995) also encourage viewers to take on sympathetic and ethical responses to those suffering with AIDS. The emphasis is not on the government or a central authority solving the problem of the AIDS crisis, but rather on the individual who can make the most difference by containing and eradicating the virus through his or her own practices.

The second group of HBO programs (2000–2014) considers AIDS to be a global pandemic beyond the realm where individual action can be the ultimate answer. In films such as Pandemic: Facing AIDS (2003), Life Support (2007), and The Lazarus Effect (2010), non-governmental organizations (NGOs) are positioned as the ones who can work to solve this global problem, and individuals are asked to channel their efforts through NGOs. In describing these two groups of HBO programs as representative of broader media discourse about HIV/AIDS, I argue that the national response to the AIDS epidemic was clearly one of governmentality—not direct action, but directing action. The overall response was to educate individuals and direct their practices, have them internalize that education and practice, and then encourage them to share and extend information and practices by monitoring and directing the actions of others.

In the late 1980s, misguided and dangerous misunderstandings of the nature of the AIDS epidemic and widespread beliefs about sexuality often did much to oversimplify the problems and potential solutions expressed in mainstream media. Independent cinema and activist video often were praised for the way in which they handled the complexity of the issues at stake, but network television, Hollywood film, and even PBS have been regularly critiqued for their mishandling of their responses to AIDS. While HBO made mistakes, it did manage to succeed in several important ways:

1.      Given the freedoms of premium cable television, HBO it was not beholden to advertisers wishing to avoid controversy or film studios concerned about box office performance. This provided HBO with the ability to tackle the topic of AIDS early and often without having to be overly careful about offending more conservative sensibilities.

2.      While media discourse about AIDS during the late 1980s and early 1990s treated AIDS exclusively (or at least primarily) as a disease affecting homosexuals, hemophiliacs, heroin addicts, and Haitians (“the four Hs”), HBO made significant efforts to combat that misconception quite early.

3.      Compared with Hollywood cinema and network television, HBO managed to treat the AIDS epidemic with complexity. For example, oversimplified stereotypes of homosexuality were, for the most part, avoided for what many critics considered more accurate and diverse representations. Scientific discourse as well as issues of sexual desire and mechanics were discussed without resorting to the “baby talk” common in network television and PBS.

4.      Long after many media outlets moved on from the issue because of “AIDS fatigue,” HBO continued its commitment for 25 years, following AIDS as it moved from being regarded as a U.S. public health crisis to a global pandemic affecting the economic and political structures of countries around the world.

HBO should rightly be applauded for these efforts, but it is not above criticism. While advancing public knowledge and advocating ethical responsibility, HBO also was falling prey to logics that aligned with a governmental approach to this public health issue. Many of HBO’s HIV/AIDS programs focus on individual rather than collective struggles, and neoliberal rather than more concerted and effective top-down efforts to eradicate AIDS. In these films, private solutions nearly always came before a call for public solutions. That said, over time HBO became a space for the type of HIV/AIDS programming that could not seem to find a home elsewhere. It is no coincidence, for example, that adaptations of three of the most important works of AIDS literature—And the Band Played On (1993), Angels in America (2003), and The Normal Heart (2014)—all were produced by HBO.

The fact that a large number of HIV/AIDS programs were being produced and distributed by HBO rather than public television demonstrates how conceptualizations of public service television were part of broader neoliberal approaches to public service, public health, and social welfare. For example, at the height of public panic in 1987, it was HBO, not public or network television, that produced and distributed a 30-minute question-and-answer special with Surgeon General C. Everett Koop, M.D., titled AIDS:Everything You and Your Family Need to Know… But Were Afraid to Ask. The program’s video release (distributed to schools, libraries, and other organizations) even included a study guide containing up-to-date information about HIV, giving viewers as much information as they needed to be able to manage their health without ever having to consult a physician in person or contact a state-run health clinic.

Beyond the AIDS epidemic, HBO’s engagement with a broader set of social issues is illustrative of how public service has become increasingly privatized. From global efforts to fight disease, poverty, and human rights violations, it appears that private industries and non-profit/non-governmental organizations have taken the lead in many of these causes. While any and all efforts to improve the world we live in should be applauded and supported, the shrinking role of the state (or at least the shift from a traditional welfare state to something of a “corporate welfare state”) is also, for many, a cause for substantial concern and distress. It is clear that there is a place for public and private media to do their part. With both at work, each making up for the failures of the other, maybe there is hope that we can do better next time.