#the cannibalism and child labour were pretty fucked up

[jaegerbroshoe]

I just watched the original Snowpiercer movie and man, that was dark.

[scriptmedic]

I have an alternate history where, during the AIDS crisis, mandatory quarantines where put in place for all HIV+ people. I know HIV can be passed from mother to child, but can a baby born the virus pass it to their child and so on? It's in a future setting, so medicine has advanced (they might even be more medicaly/sciencey than the non-quarantined because they came up with all of the life saving/extending stuff). How might "genetic HIV" affect their health and everyday lives?

Hey nonny! This is really interesting, and I’d be interested in reading your story when it’s done…. but you have some research to do before you get started.

I hope you’re aware that a lot of the context around HIV is actually homophobia. In fact, HIV wasn’t called HIV at first – it was called Gay Related Immune Deficiency (GRID) in a time when gay was a dirty word. So understand that what you’re calling “quarantining HIV” would amount to a sequestering of, in large part (though far from exclusively), gay men. (And intravenous drug users.)

….You see where this is going, right? A majority “quarantines” a vulnerable population because they’re a “threat to the society at large”, complete with “scientific justification”. This is also in a time when the disease was soundly ignored and research was underfunded because the victims were gay men.

You’re basically looking at some really strong comparisons to Nazism and concentration camps in America in the 1980s. And unless you’re writing something horrifyingly dystopian – in which case go ahead!! – you need to be prepared for that perception from your readers.

What I am saying is this: spend a lot of time researching the disease and its history. And the social history of gay men in the 70s and 80s through today. And the history of antiretroviral medications. In fact, further down, I’m going to give you a read/watch list. It will be far from complete. But it will be a start.

I have a good news / bad news moment for you as well. The good news is that HIV isn’t genetic. It’s not carried down from mother to child via DNA transmission or even viral load entering the bloodstream of the fetus in utero.

So how do babies get HIV? Well, birth is a messy, bloody, poopy business. Neonates become infected when they’re delivered through a bloody  bloody birth canal and the blood enters their mucus membranes (eyes, mouth, etc). Also, babies drink bodily fluids for the first 6 months of life, which is definitely a transmission vector for the disease.

From a WHO page on mother-to-child transmission:

The transmission of HIV from a HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called mother-to-child transmission. In the absence of any intervention, transmission rates range from 15% to 45%. This rate can be reduced to below 5% with effective interventions during the periods of pregnancy, labour, delivery and breastfeeding. These interventions primarily involve antiretroviral treatment for the mother and a short course of antiretroviral drugs for the baby. They also include measures to prevent HIV acquisition in the pregnant woman and appropriate breastfeeding practices. 

So first off, the chance of any child of an HIV-positive mother getting HIV are less than one in two. Second, again, the virus isn’t “genetic” in its transmission. So if a child of an HIV+ mother was infected, the odds of them transmitting the disease to their child is the same as it was for them. It’s not a guarantee.

Also understand that if medicine is “more advanced” than it is today, and we already have cases of HIV being completely eliminated from people’s bloodstreams with modern medications, your society would likely get to a place where HIV can be, if not eliminated, made far less of a global crisis.

In fact, you mentioned medicine being “more advanced” inside of the “quarantine” than outside of it. But this isn’t likely, because you have to understand that the “quarantined” area is wholly dependent on the outside. They only get what they’re given (or can monkey-wrench from what they have). And separate but equal is inherently unequal. They’re social pariahs, they’re the underheels of society – they won’t be given the tools to advance beyond the society around them. If anything they’ll be the subjects of unwilling experimentation and get gaslighted into horrendous conditions with the vague and distant promise of a cure.

Here’s the thing about HIV (that, admittedly, wasn’t well understood at the beginnings of the disease): Without blood to blood or sexual contact it’s almost impossible to contract. You can’t get it from saliva without (drinking a liter of it). You can’t get it from sweat.

So I’m going to give you some homework to help you understand the background of the story you want to write.

First, films, because they’re easy and fast and will get you up to date as quickly as possible. There’s a list from Verywell (which, admittedly, I don’t love completely) with a list of films portraying HIV in culture.

I would start with #9, a movie called And The Band Played On. (It’s even on YouTube if you don’t mind a little piracy). It’s the story of how HIV came to be understood, told from the scientific side, and dealing with all of the prejudices of the Reagan administration. Philadelphia is also amazing and a must-watch. Angels in America was supposed to be phenomenal (I haven’t had the chance to see it yet).

Also do some searches on HIV and then-president Reagan, and how he dealt with –  or, more accurately, did sweet fuck-all about – HIV. It’s the story of one of the biggest failings in American history (and there have been some whoppers of failures!).

I also reached out to lovely blogger poztatt, who has commented on this blog in multiple instances about the relationship between medicine as a whole and HIV, and here’s what Pozzy had to say:

One : Transmission.  Here in BC vertical transmission has been pretty much eliminated due to good regimens.  We can, if we know about it, prevent it by using pre-existing regimens with mothers so they don't transmit it.  Clinical guidelines are that mothers have to be on the medication (there are actual legal cases of women being charged for reckless endangerment and/or negligence for not informing doctors of their status.  Also all women in Canada that are pregnant are automatically tested.  It's less thrilling, human rights wise, than I personally like but that's Canada.

Second : Well, you're sort of right about quarantine.  Fun fact : it actually is legally entirely possible to quarantine someone with a public health threat - aka communicable diseases.  Second fun fact in 1987 there was a bill proposed here in BC called Bill C34 that would have sent all people with HIV / AIDS to a leper colony island in the Georgia Straits. 

It got defeated but it had components cannibalized and put into the health care acts that allows quarantining of people with communicable diseases.

Though it's not been enacted as there are no precidents for it outside Ebola.

So while it's not presently a thing, it was proposed in multiple jurisdictions across N. America.

Also location is important. Sidenote: In N. America it landed in the gay male community and hit white gay men hard.  They had influence and power, as well as money, so they made noise.  It ALSO hit injection drug users and other sections of the gay community but they had less social cache to fight for care.Outside of N. America it's predominantly location dependant. Huge swathes of African countries it's heterosexual.  When writing about it (for the question) it's important to note the different history depending on WHERE it's being written about.

Poz also recommends the films When We Rise and How to Survive a Plague, as well as reaching out to your local LGBT centers and seeing if your city has an LGBT archive.

If anyone has additional resources for the Nonny here, leave a comment. I’ll screenshot them in a day or two, or copypaste, and reblog this with additional resources.

Best of luck,

xoxo, Aunt Scripty

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