Mortal Secrets: Truth and Lies in the Age of AIDS

By Ronald Bayer and Robert Klitzman

Book Overview

In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental, and rarely discussed questions about truth, lies, sex, and trust. Drawing from interviews with over seventy gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social, and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, despair, and fear that shape individual dilemmas about whether to disclose to, deceive, or trust others concerning this disease. Some of those interviewed revealed their diagnosis widely; others told no one. Some struggled and ultimately told their partners; others spoke in codes or half-truths. One woman discovered her husband's diagnosis in a diary; when confronted, he denied it. Each year in the United States, 40,000 new cases of HIV arise, yet approximately one-third of the 900,000 Americans who are infected do not know it. As treatments have improved, unsafe sexual behavior has increased and efforts at prevention have stalled. Many of those infected continue to fear and experience rejection and discrimination. Addressing broad debates about the nature of secrecy, morality, and silence, this book explores public policy questions in the light of the nuanced, private decisions that are shaping the course of an epidemic and have broader indications for all.

• Format: Paperback
• Language: English
• ISBN: 0801881919
• ISBN13: 9780801881916
• Release Date: April 2005
• Publisher: Johns Hopkins University Press
• Length: 232 Pages
• Weight: 0.69 lbs.
• Dimensions: 0.5" x 6.2" x 9.0"
• Age Range: 18 years and up
• Grade Range: Postsecondary and higher

Customer Reviews

Useful insights, not righteous prescriptions

This book is a welcome respite from the "damn or defend" approach usually taken to hot-button issues like HIV disclosure. Rather than inserting themselves as authorities who tell people with HIV what to do, the authors let people who are wrestling with all the complexities of HIV disclosure--with casual partners, with long-term partners, even with parents and friends--speak for themselves . The result is a portrait that won't satisfy those who want to mandate how it is people with HIV who live their lives, but also doesn't pander to people who want to whitewash away the uncomfortable truths about how people infect one other. Many of the voices here capture the complexity that gets lost in sound bites about HIV. This is just how it should be with a book about an issue that is simultaneously so everyday and so freighted with consequence for many of us. Get it. Read it. It will make you feel human, and appreciate the humanity of others.

A worthwhile project, but less a Book than a Dissertation

MORTAL SECRETS: Truth and Lies in the Age of AIDS is a book that is much needed as we read about the disheartening upswing of the AIDS pandemic. Now that so many new drugs are available and now that living with AIDS is a reality instead of an unachievable goal (as we all wait for a vaccine and a cure), this is an opportune moment for addressing the psychological and ethical issues faced by both HIV positive and HIV negative persons. What Drs. Klitzman and Bayer (a Psychiatrist/Bioethicist and a professor of sociomedical sciences) set out to do is make observations based on interviews with gays, bisexuals, straight people with histories involving drug use and prostitution (or partnered with one from these groups) on several topics: transmission of the disease, attitudes about getting tested, about being positive, about disclosure to partners, parents, extended family, co-workers, and the public at large, and the painful struggle about making moral judgments as to when to disclose positivity to sexual partners, etc. The introduction is levelheaded, the interviews are isolated paragraphs instead of two-way conversations, and the presentation of the data and the opinions of the writers is fairly dry and flat. Knowing this is an investigatory, extended paper makes the reader finally absorb the material as though for a class in college. Not that this is at all bad: I think this book will provide a good reference for future works whether they be fact based or novel enhanced. One wishes for more writing like the following sentence in the closing paragraph: "Shame, desire, passion, fear of abandonment, lures of secrecy, vicissitudes of moral character, and qualities of relationships all mold private life and individuals' willingness to talk about HIV. Policy Makers can shape the context of private choice, but the exercise of such choice remains beyond their control." In writing about this most devastating of diseases one hopes for more passion on the part of the writers. How do these men really feel about the pandemic? There really are no "Conclusions" here. But then, again, this is more a dissertation than a support session.