UNIVERSITY OF CALIFORNIA, SAN DIEGO Risky Subjectivity: The Effects of Cultural Discourses of Addiction on Methamphetamine Using HIV+ Men Who Have Sex with Men in San Diego A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Anthropology by Theodore Karwoski Gideonse Committee in charge: Professor Janis H. Jenkins, Chair Professor Suzanne Brenner Professor Norman Bryson Professor Steven Parish Professor Thomas Patterson Professor Nancy G. Postero 2013 Signature Page The Dissertation of Theodore Karwoski Gideonse is approved, and it is acceptable in quality and form for publication on microfilm and electronically: Chair University of California, San Diego 2013 iii Dedication This dissertation is dedicated to the man who in the text I call Sam. iv Table of Contents Signature Page .......................................................................................................................... iii Dedication .................................................................................................................................. iv Table of Contents ....................................................................................................................... v List of Figures .......................................................................................................................... vii Acknowledgements .............................................................................................................. viii Vita ............................................................................................................................................... xi Abstract of the Dissertation .............................................................................................. xiii Introduction: Problems, Questions, Claims, Theories, Methods ............................. 1 The problem ............................................................................................................ 5 The argument and key findings............................................................................. 10 Theoretical context................................................................................................ 12 Questions............................................................................................................... 42 Methods................................................................................................................. 44 Plan of this dissertation ......................................................................................... 52 Chapter 1: The “Double Epidemic” As A Moral Panic ................................................ 57 Moral panics, representation, and meaning .......................................................... 59 Meth, HIV, and the superstrain: “A wake-up call” ............................................... 68 Ripped from the headlines .................................................................................... 86 Losing me to meth ................................................................................................ 95 “Naked Man Scuffles With Police And Later Dies At Hospital” ....................... 103 Conclusion .......................................................................................................... 106 Chapter 2: The Moral Ethos of San Diego’s Anti-Meth Apparatus ...................... 107 The moral exchange ............................................................................................ 107 Creating a moral subject ..................................................................................... 112 Enforcing the law, exercising governmentality .................................................. 118 Treating the tweakers .......................................................................................... 129 Research and development ................................................................................. 137 Preventing and reducing harm ............................................................................ 139 Leading the way .................................................................................................. 144 Conclusion .......................................................................................................... 149 Chapter 3: Using Meth for Pleasure and to Escape Pain ........................................ 151 v Theories for meth use among MSM ................................................................... 153 Glenn ................................................................................................................... 159 Adam ................................................................................................................... 163 Jonathan .............................................................................................................. 169 Glenn, again ........................................................................................................ 173 Conclusion .......................................................................................................... 175 Chapter 4: The Trouble With Trying To Be Normal: Pride, Shame, Frustration, and Risky Subjectivity ....................................................................................................... 176 Normal, abnormal, and subjectivity .................................................................... 179 Narrativizing addiction and psychopathology .................................................... 182 Hoping for a homo/normative future .................................................................. 188 Pride, shame, and emotional subjectivity ........................................................... 192 Hovering in-between: Risky subjectivity............................................................ 196 Conclusion .......................................................................................................... 197 Chapter 5: Productive Members of Society: Tactics and Strategies of HIV+ MSM Who Use Meth in San Diego ............................................................................................. 199 Max ..................................................................................................................... 202 William ............................................................................................................... 207 Sam ..................................................................................................................... 213 Conclusion .......................................................................................................... 221 Conclusion: Empathy, Ethics, and Applied Activism ............................................... 223 Theoretical implications...................................................................................... 229 Witnessing........................................................................................................... 231 Policy implications.............................................................................................. 237 Works Cited ........................................................................................................................... 240 vi List of Figures Figure 1. Demographic breakdown of central sample. ..................................................... 47 Figure 2. Billboards warning against meth and encouraging disclosure of HIV status. ... 57 Figure 3. The first victim. ................................................................................................. 88 Figure 4. The detectives watch the protest on their surveillance monitors. ...................... 89 Figure 5. At Gabriel's arraignment. .................................................................................. 91 Figure 6. "Don’t punish him too harshly." ........................................................................ 92 Figure 7. A "Me, Not Meth" poster in a Hillcrest gay bar. ............................................... 95 Figure 8. Lost. ................................................................................................................... 98 Figure 9. Skinny. ............................................................................................................... 99 Figure 10. Adam's wrists after he had been bound and tortured. .................................... 231 vii Acknowledgements The research and writing of this dissertation has been the most rewarding intellectual experience of my life, and it would not have been possible without the intellectual, moral, and practical support of a community of scholars, friends, and family. The members of my committee provided me with the tools I needed to develop a theoretical position, formulate an ethnographic project, and perform the research, and then go about the strange process of turning all that into something resembling a book. My chair, Prof. Janis Jenkins provides me with the theories, approaches, and concerns that inspired this project. She gave me the light bulb that appeared over my head and blinked on in 2008 when I figured out what I wanted, and needed, to write about. That light bulb is still shining. Prof. Nancy Postero guided me back into the field of anthropology after 10 years away, giving me a political and moral understanding of the discipline that I had not appreciated or understood. Prof. Suzanne Brenner, over many hours in the homes of many of San Diego’s gay couples,