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Sot. Ser. Med. Vol. 29. No. I I . pp. 1235- 1242.

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Abstract-The analysis of articles about AIDS published from 1982 to 1986 m 6 national French dailies
sheds light on how the AIDS social phenomenon was constructed during this period. The press passed
information about this new disease from the medical domain into the pubhc sphere. As the press circulated
AIDS news (information) among various groups and emphasized the rapid extension and catastrophic
proportions of this unforeseen epidemic. AIDS became an issue around which social relations polarized.
The processes at work during the four phases of the construction of this social phenomenon are described:
naming. comparisons with past epidemics. popularization of medical knowledge and symbolic values
attributed to it. competition over claims to discoveries and patents. discourses about the other (in
particular. homosexuals). During each phase, a concept or fact related to progress in the medical sciences
served as the basis for attempts to make a meaning out of this new disease.
Key W&~-AIDS, social phenomenon. mass communication. sociology. pubhc opinion. epidemics, press
Whenever a new disease breaks out, a rare event
indeed, it draws the attention and energy not only of
scientists and clinicians but of the whole society. As
shown elsewhere [I], an epoch and a society can, in
general. be characterized by the nature and distribu-
tion of its illnesses, certain of which have had unset-
tling consequences on the social order. Campaigns
against such diseases as well as the treatment of
victims have mobilized a major part of societys
human and financial resources. Symbolically. illness
is a prevalent way to embody collective and individ-
ual misfortunes of all sorts; it cries out for an
explanation that goes deeper than the search for its
causes, an explanation that tells the truth about both
the sick body and the world order. In this sense.
illness can be called a metaphor: the attempt to
understand it, the quest for the meaning of misfor-
tune, always has as subject the world and society [2].
Sociological research has not. however, generally
taken up this conception of illness as a total social
phenomenon. Illness is still nearly always considered
to be a state of an individuals body to be analyzed
in terms of the relationship with medicine. This holds
for the Parsonian approach to illness as deviance that
has to be-by means of a set of roles and statuses (the
rights and obligations of physicians and patients)-
identified and treated. This view is also held by critics
of the foregoing approach, for instance: Gallagher [3]
and Gerhardt [4].
Anthropology, by giving illness a place in the set
of cultural phenomena specific to a given society.
has undeniably helped bring social theory clear of
*A first version of this article was submitted as a paper at
the Tenth Social Scietwe and Medicine Conference held
26-30 October. 1987. at Sitges.
biological reductionism. Anthropologists have drawn
up explanatory models that. in Benoists words
15. p. 541.
take as starting pomt the fact that illness is a meaningful
whole. which chmcal practice must begin by decod-
mg These studies concentrale on the social and symbolic
context that gives a particular semantic configuration IO
medical categories
But how does illness. an illness, become an issue of
concern for certain sociaI groups? Why does debate
about this issue then take place in public. rather than
staying confined to the professional categories re-
sponsible for providing health care? The foremen-
tioned models provide scant lead to explaining how
an illness enters the public sphere [6].
When AIDS (Acquired Immuno-Deficiency Syn-
drome) broke out. social scientists faced an event. the
spreading of an unheard-of disease, that could be
analyzed in order to understand how a social phe-
nomenon having to do with various fields of reality.
notedly medicine. is constructed: for as Berger and
Luckman [7] have pointed out, reality, whether bio-
logical or social, has to be constructed. Strikingly, in
the case of AIDS. a new reality that crystallized
intense feelings and polarized social relations has
been built up over a very short period of time. This
reality has been constructed through medical knowl-
edge (itself progressing) and, almost simultaneously.
in public opinion. This is perhaps the first time that,
as a new phenomenon arises, we have been able to
observe such evident interferences between science
and common sense, such visible feedback between
medical knowledge and public opinion. The attempt
to see into this process led us to examine how 6
national dailies published in Paris [8] have, from
January 1982 (the date of the first article) to June
1986 (the date of the Second I nrernafional AI DS
Conference), helped construct the event (Table 1); for
The mvsterious
illness: 16 months
(January 1982-April 1983) 2 4 0 I I 0 8
Construcuon of the
social phenomenon:
I3 months
(May l983-May 1984)
A relative calm:
IO months
(June 1986March 1985)
28 I9 I8 8 5 5 83
II I3 13 6 3 I 47
Gaming momentum:
I5 months
(April l985-June 1986)
83 73 44 30 30 I4 274
124 109 75 45 39 20 412
(30.1%) (26.4%) (18.2%) (10.9%) (9.5%) (4.8%) (100.0%)
When a dally placed, in a smgle issue. several articles under the same heading havmg to do wth AIDS. the whole was counted
When an art& was published m a series. parts of which were run on separate days. each part was cowled once.
the news media are the place where industrial soci-
eties produce our reality (9. p. 81. Without the press.
AIDS would have. for a rather long time, concerned
at most but a few thousand persons worldwide.
Despite this limited scope, the press made AIDS
come into being for all of society and, by shedding
light on related political, economic and scientific
issues, revealed the meaning of this disease to the
general public. The aim herein is not to review the
thematic contents of newspaper articles but rather to
analyze how the French press started and abetted this
process of social construction.
This construction of AIDS has two aspects. First
of all. the press announced and gradually described
a new disease phenomenon. Furthermore, it passed
information about this disease from the medical
domain to society, from a level of scientific inquiry
in the laboratory to a level of social concern. AIDS
was no longer treated like a problem limited to a
specific field. The media presented AIDS in terms that
had to do with fundamental social processes and
transformed this individual event into a collective
reality, into what it called a social phenomenon.
Secondly. the press circulated information about
AIDS among social groups that would. little by little,
feel concerned and mobilize. It polarized relations
around AIDS. For example, through the declarations
that newspapers reproduced, AIDS became a topic
about which people took sides and groups fought. In
this way, opinion-this not very clear category that
exists at first in the representation or image formed
about it-has continually played a role with regard to
AIDS, and the disease was forced into the public
press, radio and television-has its place. Further-
more, each newspaper or news broadcast has its own
strategy for covering the news, a strategy based on
economic, organizational and technical determinants
as well as on social norms and ideological consider-
ations. These factors condition how a given daily will
deal with a specific event. Ideally, the comparative
analysis of how each daily constructed the AIDS
social phenomenon would require studying. before-
hand, all these production constraints 19. p. 8] and
their effects on the dailys discourse. The propor-
tions that such a study would take were too large to
fit within a preliminary study.
The present analysis, however, does not consist of
a systematic comparison of how each of the 6 dailies
has covered AIDS. To have done this would have
necessitated overcoming several difficulties, in partic-
ular, the problem of controlling the set of factors that
could explain all aspects of discourses about AIDS.
The news media form a system wherein each media-
Given the importance of the media with respect to
the phenomenon under study, another difficulty was
the temptation to judge the quality of reported
information and evaluate the validity of proposed
interpretations. This could seem all the more neces-
sary in that the press itself has raised questions about
its role in this matter. How has the press affected
opinion? Or more generally, how has it affected
public consciousness of AIDS? All earlier studies of
this question have emphasized the complexity of
measuring the presss influence. especially in matters
of health [IO]. Before attempting such an evaluation,
we felt that it was important first to recognize the
fundamental role of mass communication, namely it
brings an event into the awareness of social actors
and crystallizes relations about it. In this respect, our
analysis is based on one of the main characteristics of
the AIDS phenomenon: its temporal dimension. Dur-
ing the period studied herein (1982-1986) the AIDS
social phenomenon was, in our opinion, fully con-
structed. Since the summer of 1986, AIDS has,
regardless of subsequent developments, a fixed place
in social life. Its boundaries have been set. The period
in question, though limited, is long enough that we
can discern phases. We invite the reader to follow
us throughout these phases as various mechanisms
are put to work to construct the AIDS social
AIDS in the French press 1237
Six months went by before French dailies followed
up on a series of articles. in the Nero England J ournal
qf Medicine [ 1 I], about a mysterious illness observed
during the spring of 1981 in the United States. During
this initial phase of press reactions, which lasted until
late April 1983. the very few articles-less than 10 for
all 6 dailies-devoted to this mystery related the
medical professions questions and perplexity. The
tone was one of uncertainty, even stupefaction, given
this unknown. unexplainable. accidental event. By
relaying information from doctors and scientists [ 12,
pp. 32-341, the newspapers handled this topic in the
way they normally popularize scientific findings. This
mystery, first signaled in the systematic surveys of the
Center for Disease Control (CDC) in Atlanta,
Georgia, was said to be a deadly, new disease that
attacked young homosexual men and was transmitted
through sexual contact and the blood. These themes,
which would later make AIDS into a social phe-
nomenon, were present from the start; but for the
time being, they served only for description and
were not yet brought together so as to set up an
interpretative framework, to paint a bigger picture.
Ethical, social and cultural interpretations were,
however, being printed about another sexually
transmissible disease. namely, genital herpes. In
1982-1983. newspapers reported on the herpes psy-
chosis. The themes of contagiousness. panic and
divine punishment, all related to sexuality, were being
voiced. The articles about this epidemic both
pointed to infected persons who had been stigmatized
and made the point that sexual practices were being
moralized as people began changing behavior. Gen-
ital herpes seemed to have been the forerunner of
AIDS, especially in the United States. Although
reactions were not as intense as they would be in the
case of AIDS. the forementioned themes already
composed a strong symbolic configuration that
would, when the new disease was discovered. be
quickly and easily updated.
This new medical mystery gradually became a
clearly identified. though still unexplained. object.
This identification took place in two ways.
The first was the naming process. The mysterious
illness was called homosexual pneumonia, homo-
sexual cancer. gay cancer or, more frequently. the
homosexual syndrome even though the newspapers
did mention that it was not a cancer and, according
to epidemiological statistics (reported in the papers
since the summer of 1982). homosexuals were not the
only persons affected. Clearly, the association that
was immediately significant in symbolic and social
terms was prevailing. Although several dailies began
in March 1983 using the descriptive medical term or
its abbreviation (SIDA in French). they continued
juxtaposing AIDS and the homosexual syndrome,
associating the one with the other until July 1983.
The second way that AIDS would become not
merely a biological but an epidemiological reality
was, as of February 1982, through statistics. As the
number of articles increased, quantitative data would
be more frequently reported so as to emphasize that
the disease was spreading fast. French dailies would
base their articles upon, or even center them around,
statistics released by the Center for Disease Control
(CDC), the World Health Organization (WHO) or
the French Ministry of Health. Statistics about the
United States, France and an ever lengthening list of
countries tallied the number of cases and of deaths;
sometimes actual figures were cited, and sometimes
As a consequence, the focus of concern shifted to
the spreading of AIDS, its geographical extension
and the increasing number of cases. The absolute
number of persons affected was of little importance;
for in December 1983, the highest figure, provided by
the WHO, stood at about 4000 cases worldwide. The
disease. as it spread, forced recognition of a reality
that had been. until then, considered to be an acci-
dental event that would go away. But in fact, the
accident was lasting. Given this image of a high-risk,
hardly controllable disease (regardless of how it was
spreading), the notion of an epidemic was, inevitably,
brought up: it provided the only intelligible model of
the event under way.
AIDS. along a temporal dimension, was being seen
in two ways, each of which was paradoxical. On one
hand, this accidental event that had broken out so
suddenly and so unforeseeably was lasting, even
though accidents do not last. On the other hand.
although AIDS was-when initially observed-lim-
ited in comparison with the many other health risks
threatening various populations, it was anticipated in
apprehension of its potentially unlimited extension:
the accidental event was not only lasting but could
bring about a worldwide catastrophe. This anticipa-
tion created an emergency. Given a so serious situa-
tion that would apparently go on worsening,
something must be done despite both the stupefac-
tion and lack of knowledge-something had to be
done even though no one was sure of what.
The second phase in the newspapers, from May
1983 until May 1984, was bounded by two scientific
events: the publication in Science of the first articles
about the viral origin of AIDS, and the official
announcement by American authorities of the discov-
ery of the virus that probably caused AIDS. Articles
in the 6 French dailies multiplied tenfold; they were
more varied (scientific but also economic pieces,
reportages. interviews, commentaries); and many
were signied by new names. During this phase, what
we have called the AIDS social phenomenon was
constructed scientifically, economically, morally, and
Full attention was focused on scientific break-
throughs In the history of AIDS, research had, more
than ever before, the value of an event [12, pp.
20-241. As the information provided by medical
research was worked up, as symbolic associations
were aroused, as various groups (and even the nation)
became aware of the situation, AIDS became some-
thing other than a medical mystery. It was more than
an illness, a serious illness: it was becoming a public
AIDS and related scientific discoveries were used to
develop a picture of science and of the scientific
community different from the usual group portrait of
disinterested scientists maintaining intellectual rela-
tionships with each other. As Roqueplo has pointed
out [ 121, when scientific findings are popularized so as
to make intelligible and meaningful for as many
people as possible what is considered to be a scientifi-
cally objective knowledge, the scenes conveyed to the
public in order to legitimate this knowledge depict
scientists at work in their laboratories. In the case of
AIDS however, the conveyed image would, more
quickly and more clearly than ever before, be of a
battle over two viruses, a battle that divided the
scientific community into opposing sides and even set
at odds two countries. their interests and economic as
well as scientific policies. While the dailies, by regu-
larly diffusing the contents of articles published in
international academic journals and the debates dur-
ing scientific congresses, were reporting on the pro-
gress being made in research, their popularization of
scientific findings dealt with controversies in a way
that highlighted the civil war in the scientific commu-
nity rather than shedding light upon the findings
themselves. Articles were devoted to what the
newspapers dubbed the virus quarrel. The French-
American scientific battle, as it would be depicted
with respect to AIDS. was motivated not only by the
quest for intellectual prestige but also, and essentially
(as the newspapers did not fail to point out), by the
economic stakes.
Before the virus quarrel. readers had learned
about the patent war and the risks of spreading
AIDS through the blood products used for making
the hepatitis B vaccine. Journalists were not simply
popularizing science: they were actively investigat-
ing, asking questions in appropriate circles and
opening the files. The heated controversy from May
to July 1983 about the hepatitis B vaccine produced
by Institut Pasteur matched industrialists, scientists,
and public officials against each other-a match
organized through journalists, who would be taken to
task as these various actors, to avoid questions,
became indignant or evasive. Thereafter, the eco-
nomic spin-offs of AIDS-the patents for tests or
future vaccines. the competition for shares of the
market-would be a definitive part of the news,
although the tone of such articles was less polemical
than during the virus quarrel. The AIDS phe-
nomenon thus came into being in the economy.
AIDS was also constructed as a cultural and moral
phenomenon upon the basis of concepts borrowed
from epidemiology. Placed between quotation marks,
terms such as risk groups (or also risk categories,
individuals, persons, and populations) were diffused
by the various dailies from May 1983 onwards. By
this means of referring to persons who ran the most
risks of catching the disease, a new theme arose that
would soon be foremost among the many associated
with AIDS. In the summer of 1983, AIDS ceased
being a mere medical mystery similar to, for in-
stance. the American Legion disease, which had made
the front pages a few years earlier. It was not only
treated as a subject of intense research, as an issue in
an economic and scientific battle of which the general
public had never seen the likes: it also became, owing
to the identity of its victims, a topic about which
questions were asked and moral judgments made.
Those persons who pushed this theme to the utmost
took the spreading of AIDS to be the driving force
behind thoroughgoing changes that would. as the
twentieth century draws to a close, affect values.
life-styles, and particularly sexual freedom. AIDS
thus marked a turning point in social trends: the
period after AIDS would be lived not only under the
physical threat of the disease but also under the sign
of a global transformation of society. By late 1983.
this set of meanings and associated themes had been
How could such a reality be constructed while
there were still so few actual cases of AIDS? Com-
ments of the forementioned ilk were formulated with
reference to science. specifically epidemiology. a
branch of medicine of which the general public had
been unaware but that would now become part of the
stock of common-sense knowledge. It provided the
concepts of risk. risk factor, and high-risk groups.
This last term, condensed into risk groups (groupes
d risque) and diffused by the press, was used along
with statistical reports to justify anticipation and
apprehension about contamination. i.e. contagion.
From the first time it was mentioned. the term
epidemiology strengthened. through linguistic prox-
imity, the cognitive pattern that articles had already
been shaping, namely the catching awareness of a
spreading epidemic. Yet. references to risk groups
implied that not all persons were as likely to be
These concepts are a recent acquisition in epidemi-
ology. This branch of medicine was initially con-
cerned with epidemics. a term that eventually had to
be reworked in terms of probability so as to take into
account the many factors related to noncommunica-
ble diseases and chronic ailments. Causality thus
yielded to notions that were harder to define. such as
risk and risk factor, which imply statistical correla-
tions. When handling AIDS. French dailies, by fre-
quently indiscriminately shifting back and forth from
cause to risk factor, gave the impression that this
illness infected specific groups characterized by what
was considered to be their deviant sexuality. Several
articles stuck to the probabilistic concept of risk
group much broader labels such as homosexual
community or homosexual life-style. as though
these referred to a homogeneous reality [13]. These
labels were thus intrinsically tied to AIDS through a
sort of causality.
Two conceptions. with different meanings, of how
illness is transmitted were mixed up through this
ambiguous usage of causality. The conception that
AIDS was caught by a specific group. homosexuals.
was bound to the idea that a curse had befallen the
victims, who were themselves responsible for this
unheard-of misfortune. At the same time. AIDS was
taken to be an epidemic so contagious there were no
limits to its extension. no way to keep it from
spreading. This most striking characteristic of the
disease implied a soon to come catastrophe as even
more people would be killed off.
So were homosexuals victims of AIDS? Or respon-
sible for it? Or for what exactly-for catching it, or
spreading it? What was really being alleged? A mor-
alizing discourse arose about the origin of the curse
and the responsibility for a coming catastrophe. Risk
group came to mean both the risk of catching AIDS
AIDS in the French press I139
and especially the danger of spreading it. An implicit
procedure for imputing responsibility brought to-
gether the two forementioned conceptions: the curse
that had befallen this specific marginal group was
menacing all of mankind.
As a consequence, French newspaper readers be-
gan, in the spring of 1983. learning, through reports
from American cities, about homosexuals, their com-
munities and life-styles. These reports furnished the
notion of risk group with the purportedly corre-
sponding social reality. In this way, newsworthy
information about AIDS was diversified. In formal
terms, these reportages stand apart from the popular
approach. which had prevailed until then. AIDS was
thus brought off the medical and scientific pages and
became, in the sense of the term used in French
journalistic jargon, a fact of society (.fair de sociPtP).
Sources became more numerous and diverse; re-
porters and foreign correspondents began handling
the topic. The forementioned reports were printed
along with interviews and viewpoints. wherein not
only doctors but also representatives of homosexual
organizations as well as other persons made their
voices heard.
These reports were put together following a single
model. They started by describing, along with the
spread of the disease, the psychosis, paranoia and
panic of, at first, American gays and then the
whole population. They continued in two directions:
the rejection or stigmatization of AIDS victims by
normal society; and the organization and mobiliza-
tion of homosexuals who had decided to fight back.
This news picture was. indeed, of a fight: the fight
against the disease but also the fight between groups
holding different moral positions.
These reports also provided the occasion to dwell
upon the prevailing interpretation of AIDS as a
divine punishment or curse that. as did certain
sicknesses in the past (the plague was usually men-
tioned). befalls the guilty. Some dailies emphasized
that this punitive interpretation had. like AIDS itself,
developed in the United States; they related it to
Anglo-Saxon Puritanism. to Reaganism or. besides
these religious and political explanations, to the
Moral Order movement, which was spreading over
the United States in the early 1980s.
What did these reports intend? Were they merely
informing the public about a doubly different-ho-
mosexual and American-reality and reflecting the
effects of French-American rivalry (particularly in
the scientific battle over AIDS-related findings) on
the everyday lives of concerned persons and groups?
Several articles insisted upon how different situations
were in these two lands; and many of them avoided
or even averted the moralizing. irrational attitudes
revealed by reactions in the United States. However
the newspapers also adopted another, basically peda-
gogic, stance: the situation in New York and San
Francisco should make French homosexuals think
twice. The dailies relayed the advice of physicians and
suggested that French homosexuals imitate American
gays by modifying sexual practices.
Whether voiced by doctors or relayed by journal-
ists, this concern for public health was often voiced
explicitly along with the desire to respect individuals
private lives. But in fact, statements intended to be
informative or pragmatic were continually embedded
in articles describing. along with the spread of the
disease. punitive interpretations as well as reactions
of anguish, panic and rejection. The dailies reported
on the hysterical attacks of American preachers. the
obsessions of the man in the street, the denial and
anger of homosexuals. Through the confused report-
ing of such stories, the responsibility for AIDS and
the blame for stigmatizing remarks were being placed
on others. In early summer 1983, prevailing themes
were the rejection. accusation and guilt of the other.
and the menace of his presence. These accusations
had no author. It was implicitly understood that
others had made them. Were journalists simply relay-
ing the opinions of their sources (sources who were
not clearly identified)? Or were they professing their
own views? No one would stand by such a discourse;
and yet everyone, regardless of his stance. would be
caught up in it.
One more step was being made towards turning
AIDS. as Sontag has shown for cancer, into a
metaphor. As a warning. punishment or curse,
AIDS was being constructed with a meaning that was
taken for granted even if one did want to deny it.
Moreover, the disease was threatening no longer
homosexuals alone but now everybody. This threat
was being made not only against bodies but also
against late twentieth century culture and values.
Because of AIDS, nothing would be the same, every-
thing was going to change: the life and sexuality of
everyone was at stake. As a biological disavowal of
bodies that were believed to be free, AIDS was not
only a cause that led people to give up risky practices
but also a reason that they should adopt certain
values; it was a means for making obvious the
necessity of reversing values.
At this point, a metadiscourse [9. p. 621 was
taking shape that no longer had to do with the
event-the disease itself-but with reactions toward
and discourses about it. The press referred to this as
the e&t Sif)A (AIDS effect) distinct from the disease
itself, which, whether one accepted or not moralistic
interpretations, was said to have symbolically
marked this history of medicine. The topic of the
year in 1983 was AIDS.
During the next IO months, articles devoted to
AIDS in the 6 dailies mostly dealt with scientific
issues and the spread of the disease to other countries
and groups. Following the discovery that some sub-
jects produced antibodies against the virus, the press
would, as of April 1984, dub these persons healthy
carriers @Orteurs suins), an ambiguous label refer-
ring to people rather than, like the corresponding
English term (HIV-positive), to test results. From
June 1985 onwards. as this term was widely diffused
by the various dailies, its emphasis shifted from
contaminated blood to seropositive (shpositf)
subjects while its meaning slipped from testing
positive for AIDS antibodies to having AIDS.
The AIDS phenomenon gained momentum as
discourse picked up and carried along this weighty
By the time of the April 1985 international confer-
ence in Atlanta, more and more articles were being
printed about AIDS. and the whole French press-
local and national, dailies as well as weeklies-was
now interested in the story. Not only were scientific
breakthroughs and the French-American quarrel
(which was again flaring up, this time over the
antibodies test) mentioned; not only were accounts
run of how homosexuals were responding; but also
reactions, including movements of fear and panic,
were related. Interventions by political and scientific
authorities did not suffice to calm rising fears. The
widespread diffusion of, this time, a biological instead
of an epidemiological concept, the extensive usage of
healthy carrier, would make the AIDS phenomenon
pick up momentum despite what became the key
word that summer: informer. This word is so capa-
cious that all intentions fit into it. In effect, it can
mean: (a) to inform. i.e. communicate knowledge of
a fact or circumstance; (b) whence, by way of infor-
mations (= the news), to give news of; and (c) more
broadly, to educate.
when an experimental treatment with cyclosporine
was announced during a press conference organized
by doctors from Laennec Hospital with the Ministry
of Healths backing. To date, this announcement was
the AIDS event most covered by the French press.
The 6 dailies wrote about it 22 times between 30
October and 15 November: it made the front page 5
times and was the subject of m-depth pieces twice.
The newspapers tried to keep their distance as they
attentively reported this hypothetical scientific break-
through that political officials were appropriating.
Journalists raised questions about their proper role in
handling this announcement. and they even went so
far in their criticism as to remind doctors and scien-
tists of the rules of conduct that should be applied in
The phenomenon gained momentum from the first
international AIDS conference held in Atlanta,
Georgia (14-17 April, l985), which brought together
2000 scientists from 30 countries. Holding such a
conference, even though no important findings were
released, was evidence that physicians and scientists
were interested in, and concerned about, the disease.
Although French dailies did not all devote the same
space to this event, they all did describe the anxious
concern, the apprehension spreading throughout the
world of medicine as a result of the international
extension of AIDS. Homosexuals were not the only
victims, for contamination was also occurring
through the blood.
The debate about systematically testing blood
donors was heating up. Newspapers pointed out that
setting up a system for testing blood donations was
taking too long even though, technically and ethi-
cally. such testing was possible. On I9 June, Prime
Minister Fabius told the National Assembly that
blood donors would be subject to obligatory testing
as of I August. In a letter (dated 24 August) to the
undersecretary of Health. the Prime Minister laid
down the major lines of his governments AIDS
policy: To avoid excessive and unjustified drama-
tization. public authorities must adopt a global
strategy of public health based upon research,
information and prevention.
As the scientific community was being mobilized.
as politicians were intervening. fear was rising. Con-
sequent both to the ambiguity of porreur sain (healthy
carrier), and to the abuse of the biological concept of
sPropositif (HIV-positive). there was more and more
confusion-for instance. about the spread of AIDS
through blood transfusions and by blood donations,
as well as about the difference between testing posi-
tive and having the disease-a confusion that would
peak in late summer 1985. The press was overexcited,
and panicked. In spite of the key word that summer,
informer, the more news circulated, the more fears
seemed to be aggravated. As of mid-June. newspapers
began citing examples of persons or groups in contact
with the virus; articles were run on French hemo-
philes and about Belgian prisoners who had tested
positive. When it was announced that 6 inmates had
tested positive at Gradignan in France. the prison
guards panicked and demanded that such prisoners
be segregated and special protective facilities set up.
Whether handling the prison situation or reporting
the first estimates of how many people had tested
positive in France. the whole press unreservedly used
the term healthy carrier throughout the summer. In
the following months, doctors would criticize the use
of this concept and replace it with shpositi&P. but
it was too late. The culturally inhabitable notion of
healthy carrier, used to mix up in a single category
both the contaminated (persons with AIDS anti-
bodies) and the sick (persons with AIDS itself). had
created the conditions for labeling and stigmatizing
certain groups. It also aroused mistrust. even distrust,
and, in some cases. stirred up panic.
Political interventions were4 yr after the first
AIDS cases in the United States, 3.5 yr after the first
ones in France-becoming explicit. This disease
would no longer be the private problem of infected
persons or the professional problem of doctors: it
would be a concern of the government, a problem on
which public authorities should act. AIDS was enter-
ing the public sphere, as people became clearly aware
that the disease might be spreading beyond the
specific groups of its initial victims and throughout
the whole population. Thenceforth, AIDS was a
public issue to which politicians would pay attention.
The topic of concern was not really AIDS itself but
reactions toward it-as mentioned. those of French
prison guards and. in September, the demonstrations
by American parents trying to keep a pupil with
AIDS from attending school. Several French papers
ran photos of the latter event. Emotion in France was
intense when, to calm feelings. Professor Griscelli
announced that several dozen children were contam-
inated . and attending school. Induced by the fore-
mentioned confusion of categories, this paroxysm
was evidence that information/news/education
about AIDS was having the opposite effect of what
had been intended.
The relationship between political officials and Paradoxically, the major theme at the time was
scientists (such as had developed as early as April
informer, a theme that ran through the various
1984 in the United States when the HTLV3 virus was dailies, whether in articles by journalists or in inter-
discovered) would be exposed in late October 1985, views with politicians and health-care professionals.
AIDS in the French press 1241
In a report submitted to the government in June 1985.
34 specialists on blood transfusions recommended
both informing blood donors of test results and
setting up as quickly as possible a system of informa-
tion and prevention. To provide information about
the illness and help persons suffering or dying from
AIDS was the twofold objective of AIDES. a non-
profit organization whose creation was reported in
the press. In early August. the official report to the
Prime Minister about how to treat AIDS patients
confirmed the recommendation to inform blood
donors of test results. Inform without deforming
was the title of an interview in Le Monde of 18119
August with Dr Rozenbaum, an AIDS specialist.
In this context, AIDS put on a human face: in late
July, the press reported that Rock Hudson was
coming to France for treatment. Whereas the news-
papers had been silent about French AIDS patients
and victims, the American actor would come to
symbolize, in France, frankness and courage. In
previous instances when the press focused on a
famous sick person or when doctors brought forth
star patients to meet the public-recall the first heart
transplant recipients and, in particular, Barney Clark
whose case, widely covered by the international news
networks, had fueled fiery scientific, economic and
ethical arguments [14]-the leading, critical role had
been played by medicine as a branch of knowledge;
the patient, though praised for his courage, seemed to
be the occasion for medicine to make a break-
through. The case of Rock Hudson was different: it
was known and said that he was going to die, and
that he had had homosexual relations. The prime
topic was his illness and approaching death. themes
that, owing to his fame, could be associated with a
message about homosexuality and tolerance.
Rock Hudsons case, and its repercussions fohow-
ing his death, shed light for the first time upon
another facet of the AIDS phenomenon: what was
visible about this disease was that it was especially
affecting persons who belonged to socially or cultur-
ally privileged categories or who had contacts with
the media. During the summer of 1985, artists began
mobilizing to oppose discrimination against AIDS
patients. Personalities such as Liz Taylor in the
United States and Line Renaud in France took the
lead in this movement of solidarity. AIDS became a
cause. The press was. once again, in the forefront of
a trend that it had helped create through its reporting
on AIDS and that now it would sustain through its
coverage of these new militants and of their actions
on behalf of AIDS patients.
AIDS had now been fully constructed as a social
phenomenon; it was no longer a mysterious event
affecting a minority group. For all the press, it
became the subject of a regular heading, a major
problem facing society. In 1987, AIDS was declared
to be a national cause in France. It has been the
subject of legislation in several countries, and politi-
cians are now almost inevitably asked to take a stand
on it. In effect, AIDS is a litmus test for detecting
fundamental ideological cleavages and conflicts. This
is not something new. Most major epidemics, owing
to their contagiousness, have challenged conceptions
of individual freedom, responsibility and solidarity.
Every health policy is political in the strongest sense
of the word. It is not an accident that. in France
during 1987. AIDS served as the basis of an extreme
right-wing discourse founded on racist themes and
the desire to exclude unwanted others. Individually
and collectively. the question is, from now on, how
to live with AIDS.
Given this new disease about which little was
known, it is fascinating to observe how the construc-
tion of the AIDS phenomenon was bound up with the
progress of scientific knowledge. The articles in May
1983 about initial research on the virus put an end to
what we might call the discourse of ignorance; but
at the same time, the first reports were being made on
American homosexual communities struck by this
curse. During each phase of this social construction,
a concept or fact having to do with the progress being
made by science served as the basis for attempts to
make a meaning out of the disease. As Holton [IS]
has brilliantly shown, the history of science should
not ignore the role of the imagination in scientific
creativity; fundamental preconceptions that are
richly suggestive-themata-are essential to develop-
ing theories, for concepts have a thematic compo-
nent. AIDS reveals how this component can be
important in another way-for socially constructing
a reality and defining political issues out of scientific
facts and concepts. This analysis of articles in French
dailies proves that terms such as risk group or
seropositive are, to borrow Roqueplos words, cul-
turally inhabitable [12, pp. 91-921, and thus come to
serve as the dwelling-place of social meaning, the
bode where issues are shaped and dwelt upon.
As an instance of this, let us examine the likening
of AIDS to cancer, the plague, syphilis, and leprosy.
Such comparisons give rise to what can be called a
system of second degree metaphors. AIDS was asso-
ciated, successively or simultaneously, with ail these
diseases. each of which had served as a metaphor at
a certain epoch. Although AIDS condensed all of
these into a single metaphor, it would, during its
construction, tend to be most likened to the oldest of
them, the diseases most distant from and strangest to
us. Although the first articles in 1981-1982 mainly
compared it to cancer, the prototype of modern
illnesses. it would then be likened to diseases-usually
the plague-that have vanished in the West. In fact,
the comparison was more frequently made with the
plague than with syphilis, a disease more like it and
closer to us. AIDS thus represented the irruption of
a vanished reality. By stirring up memories of a
distant past, it reveals, in fact, how very well we have
forgotten that epidemics have disappeared recently in
industrial societies, but still threaten the Third World.
Another lesson can be drawn from the foremen-
tioned comparisons. AIDS, as stated, has been the
subject of a discourse about the other, who is as far
as possible from ourselves, as foreign and strange as
possible. This discourse works by repeatedly making
a cleavage between ones self and others. This is not
new: foreigners have always been accused of bringing
epidemics. In this regard, AIDS sheds intense light on
the possibility of linkages between biological and
social phenomena.
Pushing this encounter with the other from the
general to the particular level. we can ask how specific
others--the sick themselves-perceive this collective
discourse. As Frankenberg [16] has pointed out. the
illness experience always involves an encounter with
metaphors produced and imposed by society. What
do persons with AIDS hear when an impersonal you
or one seems to be voicing his views everywhere?
What do they hear when this someone. who cannot
be precisely identified. talks about them in terms
having to do with sex. blood. death, calamity, and
AIDS, a disease that the press helped to make into
a social phenomenon. has entered the public sphere.
This brings to mind Gersons proposal [I 71: to
understhnd illness as a political process and to inves-
tigate not patients individual characteristics but to
inquire into the situation-meanings, issues, conflicts,
interests and constraints-wherein such persons are
AcX-no,c/edRem~nl--Translated from French by Noal
Mellott, CNRS. Paris.
I. Herzlich C. and Pierret J. Malades dhier, Malades
daujourdhui. De la Morr Collectire au Deroir de
G&son. Payot. Paris. 1984 (translated as I llness and
Se!f in Socierj,. John Hopkins University. Baltimore,
Md., 1987). See also Herzlich C. and Pierrer J. The
social construction of the patient: patients and illnesses
in other ages. Sot. Sci. Med. 20, 145-151, 1985.
2. Sontag S. Illness as Metaphor. Farrar, Strauss &
Giroux. New York. 1977. At@ M. and Herzlich C. Le
Sens du Mal. Editions des Archives Contemporaines.
Paris. 1984.
3. Gallagher E. Lines of reconstruction and extension in
the Parsonian sociology of illness. Sot. Sri. Med. 10,
207-218. 1976.
4. Gerhardt U. The Parsonian paradigm and the identity
of medical sociology. So&i. Ret. XXVII-2, 229-251.
5. Benoist J. Quelques reperes sur l&olution ricente de
Ianthropologie de la maladie. Eu/l. derhno-mid. 19,
51-58. 1983.
6. We have thus borrowed the notion of espace public from
Habermas J. Strukturwandel der Ossenrlichkeit.
Luchterhand Verlag. Hermann. 1962 (translated in
French as LEspace Public. Payot. Paris. 1986).
Berger P. and Luckman T. The Social Consrrucrion o/
Realirj,. Doubleday. Garden City. N.J.. 1966.
We have studied the construction of the AIDS social
phenomenon by analyzing the 412 articles. or grouped
articles. printed m 6 national dailies (see Table I) in
France from January 1982 until July 1986. a period
bound by the first publication of an article on AIDS and
by the date of the Second International AIDS Confer-
ence in Paris (23-35 June. 1986). These 6 newspapers
were chosen for several reasons. Each has a national
circulation and provides regular coverage of medicine
by a specialized Journahst. who may be a doctor.
Furthermore. these 6 dailies cover most of the political
spectrum; only LHumanirP is explicitly ried to a
political party.
Veron E. Consrruire Lt+Pnemenr. Editions de Minmt.
Paris. 1981.
About this question in general. see: Bostrom R. N.
Persuasion. Prentice Hall. Enelewood Cliffs. N.J.. 1983:
Roloff M. E. and Miller G. B. Persuasion: Nears Direc-
rions in Theor!. and Research. Sage. Beverly Hills. Calif..
1980; and Nelkin D. Selling Science: HUN rhe Press
Corers Science and Technolog?,. pp. 70-84. Freeman,
New York, 1987; and specifically about AIDS: Nelkin
D. AIDS and the social sciences: review of useful
knowledge and research needs. Rev. I ~f~cr. DI S. 1X-5,
980-986. 1987.
Near Engl. J. Med. 305. I 98 I.
Roqueplo P. Le Parrage du Saroir. Science, Culrure.
Vulgarisarion. Editions du Seuil. Paris. 1974.
Pollak M. and Schiltz M. A. Identiti sociale et gestion
dun risque de santt!: les homosexuels face au SIDA.
Actes recherche SC,. sot. 68, 77-101. 1987.
Fox R. Its the same but different: a sociological per-
spective of the case of the Utah artificial heart. In A.fier
Barney Clark (Edited by Shaw M.). pp. 67-90. Univer-
sity of Texas Press. Austin. Tex.. 1984. See also Swazey
3.. Watkins J. and Fox R. Assessing the artificial hearth:
the clinical moratorium revisited. In,. J. Technol.
Asse.rsmt Hlrh Care III-2, 387-410. 1986.
Holton G. Linwnfion Seieni$que: Th+mara ef I nrerprG-
tation. Presses Umversitaires de France. Paris. 1982.
This is the French translation both of Themafic
Origins qf Scientific Thought. Harvard Umversity Press.
Boston. Mass., 1974. and of ScienrQ%- I magination.
Cambridge University Press. Cambridge, Mass.,
Frankenberg R. Sickness as cultural performance:
drama, trajectory and pilgrimage. root metaphors and
the social making of disease. Inr. J. Hlrh Sew XVI4
603-626. 1986.
Gerson E. The social character of illness: deviance or
politics? Sot. Scl. Med. 10, 219-224. 1976.