On Women, Red Shoes, and Public Healthcare Blues

A short while ago I made a short post talking up the Red Pump Project. I was really pleased that the lovely people at the Project actually saw my shoutout, and stopped by to say hello, hoping that in the run up to March 10, which is National Women & Girls’ HIV Awareness Day over in the USA, we’d share some photos of ourselves rocking red shoes as a gesture of solidarity.

This post is delivering on that request – I got several of our mixed gender team on board, so you can see some of our feet here rocking various shapes and styles of red shoe from the subtle to the spaceboot. (Yeah, those are mine. I have no taste and proudly revel in it.)

But I also wanted to scribble a few notes about HIV as a feminist issue and our own battle to save our National Health Service. I have much less know-how about HIV in the USA, so I’ve bolted on some UK-based rambling to go with my more general cheerleading.

Shoes, Shoes, Shoes

On the most basic symbolic level, shoes are about Going Places. Michele Roberts’ short story Your Shoes, so beloved of GCSE anthologies nationwide, is about a missing girl who has flown the nest, leaving behind an unworn pair of shoes which seem to speak of unspent potential. Waiting For Godot – a play where no one goes anywhere – opens with a lonely visual of a worn-out pair of boots that no longer fit. Nancy Sinatra’s had enough; her boots are gonna walk all over you.

The red-shoed woman, too, is a woman who dares, who takes the bull by the horns, from Hans Christian Anderson’s thoroughly judgey tale of woe to Dorothy’s ruby slippers. So for me the visual of all our shoes on show is a good way to put the question: where from here? whilst also adding god damn it, somewhere, though. Somewhere good. Somewhere better.)

But I want this post to be more than just flag-waving – after all, since we are not in the US and cannot fully participate in the project at large, it surely doesn’t change much about HIV stigma for us to simply photograph our feet. The arresting visual of the shoes – and the Red Pump Project are running a full fashion show at the end of the month – is a starting point or conduit, like wearing the World AIDS Day red ribbon, to having a conversation. So I’m gonna put a lot of UK links in here too.

Across the Pond

In that post I made I talked about the importance of awareness/prevention campaigns not using a kind of shock tactic to alienate and stigmatise people living with HIV. Without going too deeply into UK/USA healthcare provision comparisons, initiatives like the RPP (excepting the NAT-spearheaded fundraising drives pre-World AIDS Day) don’t feel so common over here. Perhaps because we assume the NHS will carry our HIV testing and awareness needs, but also because services who do take a non-discriminatory approach, like Positive East and the Terrence Higgins Trust are very much up against Tory cuts just now. Unfortunately, this dovetails with the fact that the NHS is facing “reforms” that threaten to stitch it up like a free market kipper, so in drumming up awareness for the RPP I guess I’d also like to talk briefly about the importance of trying, in the UK, to both appreciate the gravity of our own situation, and the commonalities between the areas the RPP is concentrating on – urban districts where people just aren’t talking or thinking openly or inclusively about HIV – and UK equivalents. HIV affects so many people that a lot of UK feminists simply don’t see it as a specific enough issue, but the thing is, it often interacts with more commonly accepted feminist issues such as contraception, sexual assault, and so on in complex and – as far as the feminist blogosphere is concerned – markedly under-analysed ways.

HIV transmission rates, access to support services, and the level of stigma faced by people living with it, all intersect with, and are influenced by, cuts to advocacy, disability benefits, education and healthcare services. And when the latter are in play to the level they currently are in Britain, they mean that existing social inequalities get very heavily underscored. Stigma around living with HIV then gets worse, and this underscores inequalities even further, and you get a snake-chew-tail plughole situation. Stigma is very often doled out in inherently gendered terms, with a load of harmful assumptions about what kind of woman or man would be likely to contract or transmit the virus, so not engaging with it feeds more general problems of racism, homophobia and gendered prejudice. As far as I’m concerned this makes it very much a feminist issue in the same way that issues of poverty, class and race are, and indeed these areas are all affected by HIV in complex ways which keep people in disadvantaged groups one step removed from the care they need, and have a right to access.

In the UK at least, I don’t think enough women, feminists or otherwise, are receiving the information and discussion they need and deserve on this issue, so I’ll always come out loudly shouting for a project like the RPP which encourages a discussion which takes into account the intersections of gender, race and class and their impact on HIV issues.

‘Girlhood in the time of AIDS’

For an illustration of how a lot of ‘western’ mainstream “girl culture” – like teen magazines – has historically displayed an unfortunately privilege-waving “us and them” attitude to the prevalence of HIV, along with some harmfully obtuse ideas about who contracts it, where, why and how, I would recommend the essay Girlhood in the time of AIDS by Nancy Lesko and Elisabeth Johnson, from the book Girl Culture. Reading it – it’s pretty US-focussed – just makes me that much more relieved there are initiatives like the RPP going strong.

As founder Karyn put it in her comment on that earlier post:

One of the main goals of our nonprofit and the campaign is to promote open dialogue, to fight the stigma around the disease, and to share knowledge around the issues so that women are EMPOWERED to advocate for their health and the health of the women in their lives.

I couldn’t agree more.

Back on the UK Front…

It’s important to recognise the power of grassroots projects like this whilst also refuting David Cameron’s position that community-based initiatives are a “Big Society alternative” or in any way an oppositional model to a free national health service. Some NHS Trusts in the UK work in partnership with community-specific schemes such as, for example, the Terrence Higgins Lighthouse projects – a fact this article, for example, which contains a great example of a grassroots HIV activism project, fails in my view to take account of. There are lighthouses and there are ports. Having both is generally not a bad idea. I would not be optimistic about the storm of social inequalities facing either in the event this bill passes uncontested.

Tonight the TUC are declaring a rally at Westminster to make this point again. In the week a doctor was caught on film openly challenging Lansley’s bloody-minded assault on our services in the hospital in which he works, in the week June Hautot cried “Codswallop!”, and as an NHS employee myself, I would invite anyone who is in the area to swing by and raise your voice.

Boots, after all, were made for walking.

Have some bonus daleks on us.