HIV Unplugged

HIV Unplugged

San Francisco resident Martin Hollick, who has lived with HIV for 17 years, had high hopes when Showtime's TV drama Queer as Folk added an HIV-positive main character during its second season. Despite eventually including story lines involving three seropositive men (college professor Ben Bruckner; Hunter, a teenage hustler; and sage elder Uncle Vic) on the program, though, it proved a disappointment to Hollick, who saw little of his own reality on the show'or nearly anywhere else on TV, for that matter.

'No one on earth looks as good as Ben,' says Hollick of the hunky Queer as Folk professor, TV's only HIVpositive lead character. 'And certainly no one I know with HIV looks like that. He was on his deathbed at the hospital, and he looked better than I do after a week at the spa. OK, it's TV'no sunken cheeks.'

Sadly, it is not just lipoatrophied faces that are missing from today's television programs. While once cropping up routinely, even if for just a single AIDS-themed episode, on network sitcoms, dramas, talk shows, and soap operas, HIV-positive characters have become so scarce that only the most dedicated couch potato can find them.

'There have been some notable moments on television' that address HIV, says Eric Rodriguez, the HIV-positive executive director of Body Positive, a New York'based AIDS service organization. 'But you're kind of talking about flashes in the pan that happen once in a blue moon, and that's basically it. And a lot of them were many years ago, when AIDS was a lot more prevalent in the general population's mind-set than it is now.'

There was a time when shows like ER, Life Goes On, Thirtysomething, The Real World, and several daytime dramas all had major characters infected with the virus. And made-for-TV movies on the major broadcast networks, such as 1989's The Ryan White Story, once tackled the topic for a full two hours. The major sitcoms Mr. Belvedere, Designing Women, A Different World, and The Golden Girls all had 'very special episodes' devoted to HIV. But today, AIDS is usually treated as more of a thread woven into the show's larger fabric'when it is included at all.

For example, recent television movies have incorporated HIV into their plots but have not focused on the subject. A decade after HBO aired And the Band Played On, which addressed AIDS and AIDS only, the network in 2003 produced Angels in America, which dubs itself a 'gay fantasia on national themes,' with AIDS as only one of many complementary subjects. Also in 2003, Lifetime's Homeless to Harvard told the success story of a girl orphaned by her mother's death from AIDS-related complications'standing in contrast to the 1992 ABC movie Something to Live For, which starred Molly Ringwald as a doomed HIVer.

Even the controversial miniseries The Reagans, which covered the period in U.S. history when AIDS first emerged and began killing thousands of gay men, hemophiliacs, and injection-drug users, barely touched on the topic. The most controversial element of the imbroglio over CBS's attempt to air the miniseries in 2003 was over whether President Reagan might actually have said of people with AIDS, 'Those who live in sin shall die in sin.' When the program'banished from broadcast TV'finally aired on Showtime, the line was excised.

Poor Reception
With the introduction of antiretroviral drugs in 1996 leading to a dramatic drop in the number of people dying of AIDS, the disease'from the perspective of television producers'simply lost its status as a hot-button issue that could grab the attention of potential viewers. That is likely why daytime soap operas General Hospital, As the World Turns, Another World, and The Bold and the Beautiful have long since sent their HIV-positive characters to their graves'or occasionally just off the airwaves. After all, in the emotionally charged world of soaps, a relatively manageable disease provides far less dramatic fare than a ghastly fatal one.

The lack of HIVers on soaps today is a radical shift from the 1990s, when the annual Day of Compassion was organized by the now-defunct group Hollywood Supports to include HIV messages and, ideally, HIV-positive characters on nearly all the major daytime dramas as well as several talk shows and prime-time programs. The first Day of Compassion was held in June 1993, while AIDS death rates were still rapidly climbing, says Glennda Testone, regional media director for the Gay and Lesbian Alliance Against Defamation. After the 1998 event, though, as the mistaken notion began to set in among the American public that protease inhibitors had defused the domestic AIDS crisis and after control of the Day of Compassion event changed hands twice, the project fizzled out.

The end of the 1990s also saw the departure of TV's first and to date only lead character who was an HIV-positive woman of color'ER's physician assistant Jeanie Boulet, played by Gloria Reuben, who appeared on the program for five years. For many women HIVers, Jeanie's inclusion on the show and struggles with her anti-HIV treatment, hepatitis C coinfection, and even the near-loss of her job because of her infection provided the only opportunity they had to see their lives and concerns reflected on television.

But Reuben quit ER in November 1999'because, she says, she felt HIV issues were being swept into the background on the show'leaving a still-unfilled void as far as TV portrayals of HIV-positive women, particularly women of color, are concerned. 'We're not seeing ourselves at all anymore,' notes Precious Jackson, treatment adherence and education coordinator for the Los Angeles'based AIDS group Women Alive. 'The epidemic has changed and women of color are becoming infected at a growing rate, but I think the only time at all that I see HIV-positive women on TV'even Caucasian women'is when there's a major campaign going on to get awareness out, and then that's it. There's nothing ongoing to continue to keep us in mind.'

HIV-positive men are only slightly better represented, especially on noncable programs, leaving some to wonder why TV writers and producers are not devoting more attention to the epidemic.

'I think the times we did see AIDS on TV in the past were mainly as part of the 'special episodes' about the disease, but because AIDS isn't considered to be as special anymore in terms of it being an important subject for an episode of any show, we're just not seeing it anymore,' says Stephen Tropiano, author of The Prime Time Closet, which looks at the history of gays and lesbians'and, adjacently, AIDS issues'on TV. 'The drama has kind of gone out of it. In order to include AIDS on TV now, you have to put a new spin on it'do something that hasn't been done before.'

Adjusting the Contrast
HIV-positive Chicago resident Chris Bell sees the decreasing focus on HIV as discriminatory. 'This marginalization of HIV-positive characters is, I think, indicative of the larger cultural marginalization of the same,' he says. 'We know they are there but choose to deal with them only in sound bites or at certain times of the year,' he adds, referring to the annual onslaught around World AIDS Day each year of HIVrelated story lines in entertainment programs as well as news shows.

The proliferation of cable television, the explosion of reality shows (which, since Pedro Zamora announced he had AIDS on MTV's The Real World in 1994, have virtually ignored HIV), and the death of the broadcast-TV movie also have all played a part in the diminished visibility of HIVers on the tube. The increased influence of cable TV, for example, has led to riskier programming, especially on HBO, which has touched on AIDS issues in Sex and the City, Oz, and Six Feet Under. Yet even on these cutting-edge shows, which can delve deeper and more frankly into controversial topics than their broadcast brethren, HIV issues are rarely dealt with beyond an episode or two'or even a single subplot.

One silver lining as of late is that although HIV is rarely brought up, when it is discussed it is no longer 'couched in a death knell' the way it once was, says Melissa Havard, director of the Media Project, a nonprofit group that helps the entertainment industry produce programming that addresses sexual health issues. NBC's An Early Frost, which aired in 1985 and was the first television movie about AIDS, established the 'coming home to die' genre, which continued into the late 1990s.

'What we're seeing today is different,' Havard says. Characters are 'managing the disease'women, young people, people of all ethnicities. It's more normalized. It might not be the entire focus of a story.'

And there are significant exceptions to the general lack of HIV-positive characters on the tube. Media giant Viacom has spent nearly $400 million so far on its ongoing 'Know HIV/AIDS' health education campaign, which in addition to educational spots includes HIV-related story lines in programs on Viacom's numerous networks, including Showtime, MTV, Nickelodeon, VH1, BET, UPN, and CBS.

To date, more than 85 million people have seen the 20-plus HIV-themed episodes, and Imara Jones, director of Viacom's Initiative on HIV/AIDS, says the shows have been resoundingly successful in getting their message across. He cites a woman who approached him to say that after seeing an episode of UPN sitcom Girlfriends, she was inspired to get tested for HIV. Other shows within the campaign that have tackled the issue'usually only for a single episode'include Becker, Star Trek: Enterprise, The District, Half and Half, One on One, The Parkers, JAG, Presidio Med, and Queer as Folk.

Critics have not always reacted graciously to Viacom's good intentions, though. Reviewing a February 2003 episode of Star Trek: Enterprise in which a Vulcan woman gets an AIDS-like disease, Boston Herald writer John Ruch lambasted the show for following the 'grand entertainment industry tradition of speaking out bravely on hot social issues 20 years too late. (And puffing itself with a self-congratulatory publicity blitz.)'

To Be Continued...?
One might wonder if it's really the responsibility of television programs to promote public health. But the evidence is solid: TV can be a powerful tool to educate the public about health matters. According to a Centers for Disease Control and Prevention survey in 2000 of prime-time television viewers, 52% said they obtained health information they trust from TV, and 26% said the programming is among their top three sources of health education.

The same study found that ER stands at the apex as the 'school nurse' of television. A third of all viewers said the show helped them make health decisions for their families. The CDC found, however, that if health information is not repeated in subsequent episodes, viewers will quickly forget what they have learned; therefore, it's important to return to the topic of AIDS with regularity.

ER had four HIV story lines in its 2003'2004 season, including an entire episode set in HIV-ravaged Africa. Says Joe Sachs, a supervising producer and writer for the show: 'We want to present current issues in health care that are controversial, that are cutting-edge, that reflect what's going on in America. But we never say, 'Hey, the world needs to know more about prostate cancer.' If the story, wherever it comes from, fits the dramatic needs of the character, we will do it.'

However, Ron Cowen, who along with Daniel Lipman created An Early Frost, Sisters, and Queer as Folk, points out, 'Given the fact that there seems to be a lot of irresponsible behavior going on and a lot of misinformation regarding the medications'that they seem to be a magic cure-all'I think we do have a responsibility to address HIV.'

And Queer as Folk is unusual and commendable in that it approaches HIV from all different angles with an unapologetic frankness. The show portrays not only drugged-out sex parties but also romantic safer sex. Each of the three recurring positive characters has served as a spoke in the program's HIV wheel. Ben is the usually healthy stud who grapples with fears of wasting when his medications are not working. Hunter is a sexually confused former teen prostitute who has only recently learned he is infected. And Uncle Vic was the age-old survivor on disability until he died of a heart attack brought on by the high blood pressure he suffered as a side effect of his antiretroviral therapy.

Cowen and Lipman say their research convinced them that it was important to have Vic die from his meds' side effects rather than from AIDS itself because they felt the approach better portrayed the reality of what the disease has become in the 21st century.

But like a variety of story lines that make it to the airwaves, this one made some of the show's fans livid. 'You wouldn't believe the e-mail, the mail, the response: 'He should've been dying in a hospital of AIDS,''' Lipman recalls.

Like Hollick, those viewers perhaps expect too much from television. Tropiano says the main reason that realistic depictions of HIV-positive people'and in a larger sense, other minority groups, such as African-Americans, Latinos, Asians, and gays and lesbians'are so rare is that television networks deliberately use as broad a brush as possible when crafting their programs so as to not turn off any potential viewers.

'It really comes down to selling advertising time and ratings, and as a result of that, everything is pretty mainstream,' Tropiano explains. 'You don't see [HIV-positive people] because there's no money in it and because they want to stay as far away from controversy as they can.'

While that approach leaves many HIVers upset at their absence from the airwaves, it is just fine for others who would rather not watch TV characters on their favorite shows continually grapple with the same issues they struggle with. 'I live in reality every day,' Rodriguez says. 'I don't need to entertain myself with it also.'

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