featured gallery for September 2014

HAART in Art: Temporal Reflections on Artistic Representations Of HIV Medication

It’s been over four months now since my last archival visit to Visual AIDS, and yet acute, pristine visions of artwork still flash in my mind’s eye. Over the last year, I’ve been gathering archival material for my dissertation research on adherence in HIV treatment. Specifically, I am collecting artwork created by people living with HIV/AIDS to trace the changes in representations of HIV medication over time. With artistic appreciation and an academic eye, I approach these pieces of art, first and foremost, as works of art, but also as expressions of the complexities of living with HIV in the age of highly active antiretroviral therapy (HAART). As a photographer, I value the critique art presents to its viewer. In my doctoral work, I engage with works of artists living with HIV to consider their critiques of HIV medication as well as to emphasize their shifting relationships with treatment. What are particular themes in artwork that arise with the release of HAART? What does HIV medication say about people’s relationships to their bodies? But also, in this new post-HAART era—steeped in HIV criminalization, intensified surveillance, medicalization of prevention, and neoliberalization—how is medication represented in art created by people who often are targets of HIV medication adherence practices? As a surrogate marker of adherence to HAART, how is viral load represented? In short, what are the differences between artistic representations of HAART in the late 1990s versus now? I believe artwork by positive artists articulates not only the fulfilled desire for treatment, but much more nuanced relationships between people and HIV medication, which include hope, promise, suspicion, distain, resentment, hardship, critique, obsession, resistance, and tenacity.

So my curatorial statement is more of my own thoughtful reflections on what I see rather than a totalizing academic commentary on artwork produced by positive artists. I should also say that my humble beginnings as an advocate are framed by working at a community HIV clinic shortly after HAART was released. I remember clearly friends who made miraculous recoveries thanks to HAART. Yet, I also remember the skepticism about the panacean promises of this pharmaceutical advancement. This is all to say that I draw not only from my academic cultural and feminist study of HIV, but also my first-hand experiences as a longtime AIDS activist. People’s relationships to medication are complex and shift temporally, which is what I hope to echo in this online gallery.

Given the heroic efforts of AIDS activists to gain access to treatment in the late 80s and early 90s, it’s no wonder that HIV medication figures so prominently in the work of artists living with HIV/AIDS after the release of AZT in 1987 and, more intensely, after HAART in 1996. Artists’ representations of their relationships to HAART from the 90s to the present day show a subtle, but telling shift in how people relate to these drugs—biologically, medically, culturally, and politically. The continued artistic use of HIV medication in the works included in this online gallery reflects an intensified, yet complex critique of pharmaceuticals. Critiques of HIV medication does not recede into the quiet, private life mirroring the dissolution of ACT UP. Rather, these works remain at the forefront of cultural and political critiques on AIDS, responding to the shifting medical, political, economic, and social discourses; a critique that clearly extends through to present day.

Early works show us how pills and bottles are used to create particular images. Talisman (1994) by Barton Lidice Beneš reflects the predicted mystical qualities of AZT as well as it critiques the profits made in this sacrosanct medical venture. In two of Max Greenberg’s works–AIDS 101–An Intensive (1997) and Medicine Man (1997), pharmaceutical objects spill out to create things. In the first piece, they construct the acronym ‘HIV;’ while in the second they are shaped into a body with a heart not unlike a body positioned strategically at a die-in demonstration demanding access to these very same drugs. These three pieces represent the tensions of the early days of HIV medication: a critique of the profits made off pharmaceuticals by those often far removed from the bodily experiences of living with HIV as well as the precarious, but promising ways HIV medication would affect, shape, and become people’s bodies and lives.

Yet, several years later, shortly after the turn of the second millennium, Greenberg’s works— Cocktailed (2001), Bondage (2001), Non-Compliance Plays Russian Roulette (2001)—show an important shift in the artists’ relationship to his subject matter. These later works render an increased urgency; Greenberg creates stark depictions of what medications do to people: fuck them, bind them, and also place them in life-threatening situations of chance. These three pieces reflect the various ways medications actively shape people’s bodies and lives. The distinction between these and earlier works is the personification of HAART, enabling medications to act upon people. The problem of adherence to HAART is directly represented in the last of these three images by equating the development of viral mutations and replication to Russian roulette. This last piece highlights the deadly game of chance people engaged in when deciding to take HAART for either reasons of life-saving necessity or chronic illness management. In the early 2000s, those two reasons were the prominent rationale as to why someone would start medication. But today, as we see with pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP), taking HIV medication for primary prevention purposes also now heavily factors into people’s HIV medication initiation decisions.

What strikes me about artwork produced between 2007-2014 is the more intimate relationship people have with the instructions accompanying HAART prescriptions. These clinical directives constitute the body as a site of both self-disciplining and regulatory techniques, thus complicating the relationship between medical control, desire for health, pharmaceutical technologies, and people. Fredrick Weston’s series, Blue in the Face (I, II, and III; 2007) portrays representations of human faces made from pill bottle instruction stickers. While the first two pieces in this series are two-dimensional, the difference in the third work points to the way these instructions shape people. Not only is this last piece three-dimensional, but also it is given human form. It is a mask. It is something to be worn. Medication instructions line the contours of the face, giving it its shape. Echoing this nexus between technology, clinical instruction, and identity, Grahame Perry’s Am I Blue? (2013) expresses the repeated, minute, ceaseless effects of HAART and its instruction. Joe Munroe’s Nightly Ritual (2010) characterizes the way HAART regimes require multiple interventions and surveillance as numerous hands flail to feed this person pills. Man’s best friend watchfully presides over this repeated nocturnal ceremony, mimicking clinical surveillance and dispensation. Pills swirl into the character’s heart while the second mouth also swallows its share of medication. The lines between what are pharmaceutical invention, medical directive, and human becomes more blurred than earlier artwork depicting HIV medication.

Joe Munroe’s and Chloe Dzubilo’s work reflects the long-term effects of HAART. Me after AIDS (2011) points to the specific and distinct ways the continuous use of HAART shapes his body reminiscent of medical textbook diagrams of human cadavers. While the bodies in those medical texts are dead, this body is clearly alive with its heart calling for discussion and its active voice describing present symptoms and ailments. A similar taxonomy of afflictions, but one focusing on bones and cardiovascular health, is written underneath the image of a woman made of hearts in Untitled (I Ask Myself; n.d.). Her mermaid-like heart body replaces her bones, standing her up to face the relentless politics of HIV medication.

More recent artwork produced after 2010 has another notable feature: the way HIV medication is depicted as regal, strategic, and meticulously organized. Benjamin Fredrickson’s Atripla (2011) trumpets the royal arrival of the first one-pill-a-day released in 2006, marking a significant pharmaceutical shift from complex to more simplified regimens in order to address pill burden and adherence issues. Hector Tascano’s pieces, Domino (2013) and pill o the game (2013), exude the tactical nature of prescribing HIV medication today; the ways medications are specifically paired together in fixed-dose combinations as well as the order in which particular pills are called into played to decrease drug side effects. Obsession (2012) and Memories of Medication (2012) by Grahame Perry illustrate the intensely intricate structure of today’s HIV medication. Aligned perfectly, present day HAART regimens can manifest in the “obsessional” quest for immaculate health as Perry himself describes.

Representations of viral loads feature more prominently in works by artists living with HIV roughly after 2005. As a clinical marker of virological success as well as of adherence to HAART, one’s viral load becomes a way to know oneself more fully on a smaller scale while also self-monitoring one’s health. Joe De Hoyos discusses his series Viral Load in the February 2003 issue of HIV Plus noting that the dots represent the virus while the objects symbolize the ‘load.’ In his piece, Black Viral Load Series (Panel 2; 2005), objects of various scales pepper the collage, representing aspects of everyday life all while the punctuated dots become the surface on which life is lived. Akin to this work is Hector Toscano’s bodies + virus (2012), where the virus, in its repeated pattern, is overlaid on the naked body. Artwork produced after 2005 reflects life and bodies that are patterned and complicated by viral loads.

Depicting viral loads and dildos, Paul Chisholm’s work is particularly interesting. In VIRAL LOAD (2010), straight pins puncture this phallus with a congregation of red pins, signaling danger, concentrated at the very tip of the cock. In this era of neoliberalism, where people are held more individually responsible for personal and public health, viral load also becomes a way to know how infectious one is; viral load becomes a (re)markable way to predict transmission rates as we see in new prevention technologies such as community viral load mapping. Now, having a viral load is not only potentially damaging to one’s own health, but also dangerous for those uninfected. Purity and Danger (2010) more pointedly remarks on the threat not only of the virus in semen, but also on positioning subjects in oppositional stances within debates on barebacking and HIV prevention. Now more than ever, one who has a viral load is marked as dangerous and criminal, at least in Canada with the 2012 Supreme Court non-disclosure ruling. L. Robert Westeen’s Criminalization Is Not A Cure (2013) reminds us that criminalizing people living with HIV is counterproductive to stopping AIDS by highlighting the continued, but revised medicalization of HIV prevention. The rusty nails in Rusting AIDS Compassion 1 (2010) by Joe Munroe signals the weather-beaten, but persistent heart of AIDS activism. While the fight for access to HIV treatment was laid to rest sometime ago now (although other problems remains such as lack of resources), (re)new(ed) challenges emerge for those affected and living with HIV on the various fronts of neoliberalized medical care, heightened minute and magnified surveillance, obsessive quests for health, compounding long-term side effects of HAART, and HIV criminalization. What the works presented in this gallery exemplify is that AIDS activism and critique is not dead, but continues in various cultural and political ways. Take heart. We persevere.

I would like to acknowledge the financial support of the CIHR Social Research Centre in HIV Prevention in making this research fieldwork possible.