Published in the context of the unfolding COVID-19 pandemic and the Black Lives Matter Movement, Karma Chávez’s monograph, The Borders of AIDS: Race, Quarantine, and Resistance is a timely and well-executed contribution to the social history of American public health. In this work, Chávez writes a rhetoric history of the HIV/AIDS pandemic that critically examines race through the lens of disease, interrogating associated immigration laws and policies as a means of analysing the systemic racism present at a foundational level in the United States and refocussing this narrative to prioritise Black and Brown experiences of the AIDS crisis. Chávez uses this moment as an opportunity to remind readers that in the US, disease has long been used as an opportunity to “further marginalize the marginalized” (p. vii) and to target those perceived as Other for political ends, reminding us of the ongoing way in which the past continues to inform the present.
The central thesis of The Borders of AIDS is that the US was founded on an “alienizing logic” (p. 4-7) of exclusion, and disease represents one of many opportunities to express this logic. Chávez tells the story of how this “alienizing logic” manifested in quarantine and travel bans for HIV-positive people, exploring how public health officials, politicians, and the media applied this logic in the early years of the AIDS crisis. The phrase “alienizing logic” is used by Chávez to articulate a specific type of Othering in which the boundary between belonging and non-belonging remains in flux as what is considered “alien” is continuously redefined. This thought-structure makes it possible for some people to belong, and others to not belong, even when they reside within the same community, and Chávez argues that disease, or fear of disease, has historically been used as an opportunity to exercise racialized alienizing logic in the US.
The book is divided into two distinct sections, comprised of five chapters, throughout which Chávez addresses the relationship between disease, race, and state power. In part one, Chávez outlines how public health officials and politicians used AIDS as an opportunity to enact alienizing logic. Chapter one offers a history of US quarantine laws from the late 18th century onwards, while chapter two explores calls within the US for public health officials to address the AIDS epidemic via quarantine mechanisms. This section concludes with chapter three, a documentation of the transition from the alienizing logic of quarantine of people already in the US, into “national common sense” immigration law and the ban on HIV-positive immigration in 1987. In part two, Chávez shifts gears and explores how mostly queer AIDS activists resisted this alienizing logic regarding migrant communities. Chapter four explores boycotts of the International AIDS Conferences in 1990 and 1992 because US immigration law excluded people living with AIDS from attending. Finally, chapter five provides a consideration of Haitian peoples’ relationship with HIV/AIDS through AIDS activist media. Chávez concludes with an impassioned conclusion and epilogue that situate this work in the present pandemic context and address the importance of writing history in these urgent times. The epilogue in particular captures the passion, emotion, and anger of 2020 and provides an opportunity to let go of the academic restraint demonstrated in earlier chapters.
Through this monograph, Chávez broadens the scope of existing social histories of the AIDS crisis in the US by prioritising themes of race and immigration, rather than sexuality, which has previously occupied focus. She successfully demonstrates the centrality of citizenship and immigration status as essential components of the AIDS crisis, both in the framing of Haitian and African communities, and in the laws around immigration, travel, and quarantine that were applied to non-citizens. Furthermore, Chávez intentionally challenges the perceived temporality of the AIDS pandemic, choosing to end her volume in 1993, rather than 1996, the year which is often considered to mark the end of the “early years” of the crisis, not just in the US but in other Western countries. In choosing to conclude in 1993, a year that signifies the codification of the US ban of HIV-positive migrants, Chávez effectively decentres the experiences of middle-class, white, male, US citizens as the main protagonists of this narrative and invites a more diverse and inclusive reading of the multiple temporalities of the AIDS crisis.
Use of sources is one of the key strengths of this work and primary sources utilised consist of news reports, congressional records, public health records, mainstream news media reports, and mostly queer AIDS activist archives. Within this, Chávez does an excellent job of interrogating this archival material with the critical lens of race and immigration, effectively reading against the grain to locate and extract Black and Brown experiences and Black livingness from the ephemera of these archives that so obviously prioritise the experiences of white, male, US citizens. For example, we gain insight into the experience and impact of Black sex workers, with chapter two revealing how a select number of high-profile, sensationalized cases of Black sex workers fuelled the demand for quarantine laws and laid the foundation for laws that criminalized HIV. However, The Borders of AIDS operates within a US-centric understanding of race, ethnicity, and disease and discussion focusses on the use of alienizing logic as it relates to those denied entry to the US or within the context of the US. This concept has the scope to be pushed further and it would have been interesting to consider how Western culture more generally applies an alienizing logic to experiences of disease that exist in geographically “Other” locations.
In this important monograph, Chávez eloquently interrogates the concept of national belonging as it relates to race, disease, power, and morality in the US. She clearly and articulately expresses her core thesis of the alienizing logic of exclusion and offers a fresh and insightful contribution to existing histories of the early years of the ongoing AIDS crisis by repositioning themes of race and immigration into the central frame of this narrative.