Introduction

HIV/AIDS and disability are often discussed in relation to one another. There have been numerous studies examining disability and HIV by focusing on employment issues people living with HIV/AIDS face (Glenn et al., 2003), the intersection of migration, HIV/AIDS, disability, and neoliberalism (Serrano, 2018), labour force participation for people living with HIV/AIDS in light of HIV/AIDS as disability (Worthington et al., 2012), the vulnerability of people with disability to HIV (Hanass-Hancock & Nixon, 2009), and discrimination and human rights law for people with disability and/or people living with HIV/AIDS (Elliott et al., 2009) among others. HIV/AIDS is not only regarded as a disability by society. It is understood as such in legal documents and policies. For example, the Americans with Disabilities Act, which was amended in 2008, states that disability is “[…] a physical or mental impairment that substantially limits one or more major life activities” (ADA, 42 US Code 12,102). Ostiguy-Finneran and Peters (2018, p. 467) further explain that this definition “[…] covers both physical and mental impairments, […], emotional disabilities, learning disabilities, intellectual disabilities, […], and chronic illnesses (such as diabetes, HIV/AIDS, cancer, chemical sensitivities, and epilepsy).”

In relation to HIV/AIDS and/as disability, Hanass-Hancock and Nixon (2009) state that disability refers to “[…] the disabling effects of HIV, its secondary conditions and the side effects of medication.” As a result of the medical advancements that followed 1996, Hanass-Hancock and Nixon revisit definitions of disability and argue that these no longer reflect the realities of living with HIV/AIDS. They propose a new concept, episodic disability, to describe the conditions that people living with HIV/AIDS experience. These are conditions that, although not permanent in nature, temporarily prohibit people living with HIV/AIDS from enjoying a healthy life. The term further reflects how people living with HIV/AIDS experience the effect of living with the virus. O’Brien et al. (2009) conducted a study where people living with HIV/AIDS did not identify disability as a well-suited term - except when doing so provided them access to state benefits and relevant social services. It appears that episodic disability better highlights the temporal nature of the side-effects of HIV/AIDS-related medication. This article does not aim to put forth an argument for or against considering HIV/AIDS as episodic disability. Rather, it aims to challenge and expand the definitions of disability, particularly how HIV/AIDS is categorised within medical and social models. By exploring different perspectives, such as impairment and functional limitations versus ecological and human rights views, the article encourages a deeper understanding of disability that transcends conventional medical classifications. Another aim is to critique how societies and legal systems respond to individuals living with HIV/AIDS. The article discusses the benefits and limitations of classifying HIV/AIDS as a disability, considering the legal protections and social benefits this classification can confer, alongside the stigmas and challenges it might perpetuate.

To do this, the article examines masculinity vis-á-vis HIV/AIDS and disability primarily because HIV/AIDS has often been presented as a disability on masculinity. After discussing models of defining disability, the article examines masculinity and disability and its portrayals in relation to HIV/AIDS, particularly how societal expectations and dominant cultural narratives shape and are shaped by perceptions of masculinity. This involves a critical examination of how these narratives either reinforce or challenge traditional roles and identities. It further focuses on how health-related behaviours, particularly within the context of HIV/AIDS and practices like bugchasing, intersect with cultural and moral judgments. It examines how these intersections challenge traditional notions of wellbeing and morality, particularly within the framework of modern medical advancements. By highlighting the practices of bugchasing and the barebacking subculture, the article aims to provide insight into how these groups subvert conventional understandings of risk, health, and disability. This exploration serves to question and potentially redefine what constitutes normative health behaviours and how these definitions influence societal and individual identities. Ultimately, the article seeks to promote a reconsideration of stable, taken-for-granted views on health, disability, and disease and their relationship to normative definitions and understandings of what constitutes masculinity. It aims to open up dialogue on how these concepts are culturally and socially constructed and how they might be reconsidered in light of evolving understandings of agency, identity, and community within the context of disability.

Defining Disability

Elliott et al. (2009) summarise perspectives on the definitions of disability in light of medical and social models. The medical model is one that focuses on issues related to the physical and/or mental health and wellbeing of an individual, while the social model focuses more on the ways in which disability is perceived by others and the effects this has on societal responses to disability and disabled people. The social model of defining disability views the experiences of disabled people at the physical and/or mental level as objective and takes them for granted. Even though it does not challenge or question them, this perspective is more focused on the way society responds to disability, rather than the ways in which disability manifests itself physically. The medical model of defining disability has generated two perspectives: the impairment and the functional limitations perspective. Definitions that follow the impairment perspective focus on the body and/or the mind. That is, they take physical and/or mental anomalies which affect one’s health in a limiting manner as indicators of a disability. It follows from this model that disability is understood as a personal condition and, as such, policies that follow such definitions are of an intervention type aiming to bring the individual back to a ‘normal’, healthy state. The functional limitations perspective also stems from the medical model in that it focuses on the body and/or mind of the individual person but considers as disability any physical and/or mental ‘abnormality’ insofar as it affects the individual’s ability to function healthily within their physical and social environment. By contrast, definitions that focus not on the limitations of an individual but rather on the limitations imposed to an individual as a result of their having a physical and/or mental condition are part of the social perspective. This perspective acknowledges the fact that societies are “[…] ability-oriented and ability-dominated environments […]” (ibid.), and they focus more on the restrictive and limiting societal responses to people with physical and/or mental needs that are not a priori addressed by the sociocultural systems in place. Within the social model, there are also definitions which focus more on the dignity, rather than the medical conditions, of people with disabilities and such definitions fall under the human rights perspective (Office of Disability Issues, 2003).

Definitions of disability do not only reflect medical or social perspectives; they also reflect the historical time in which they are used. Covey (1998) explains that disability was initially presented in religious terms. It was thought that it was the result of sinful behaviours, thoughts or actions. It was understood as a physical manifestation of the wrath of god prohibiting people from committing sins, but it was also described in religious terms in lieu of any other convincing explanation. Ostiguy-Finneran and Peters (2018) discuss the varying societal responses to people who were considered to be disabled, which ranged from throwing children out of balconies and leaving them to die, to turning disabled people into spectacles for entertainment in the infamous freak shows, to turning them into objects for scrutiny and examination. “The medicalization of disability fostered the belief that people with disabilities needed to be monitored and controlled by licensed physicians and medical specialists with authoritarian powers” (p. 469). The history of societal responses to disability and the history of sexuality do not differ significantly. In the 19th century, disability and sexuality were adopted by medicine and psychiatry as their domains for enquiry and control (Foucault, 1978). This resulted in people been labelled as abnormal due to a physical and/or mental disability or a non-heteronormative sexuality. These are two reasons to study how these two, disability and sexuality, intersect.

Definitions matter. For one thing, definitions lead to policies, but perhaps most importantly, definitions allow a more thorough understanding of the complexity of the concept of disability at the personal, collective, and institutional level. The fact that there is no one definition of disability suggests the multi-dimensional level of complexity inherent in the concept - and the lived experiences - of disability. Given the variety of definitions, the adoption of specific ones by states, organisations, and institutions when designing policies suggests that definitions matter and highlights the importance of developing complex understandings of the implications of considering a particular health condition, such as HIV/AIDS, as disability.

Confirming Masculinity: on Not Being that Man

HIV/AIDS has been examined from a number of perspectives over the past four decades. Of relevance to this article is the relationship between HIV/AIDS, disability, and masculinity. In particular, this section demonstrates that HIV/AIDS has often been represented in popular cultural products as a disability of masculinity. This section focuses on the relationship between HIV/AIDS and masculinity, particularly how it’s been represented in popular culture from the late 1990s to the mid-2010s. Kagan (2018) analyses these representations and their societal and cultural implications. Through this analysis, Kagan offers insight into the construction of viral masculinities, that is a discursively constructed type of masculinity whereby masculine gender identity and performance is inexorably connected to a person’s HIV positive status. For example, in The Living End (1992), both main characters, Jon and Luke, are HIV positive. Jon is a film critic who embodies a more introspective and contemplative demeanour. He is grappling with the reality of his HIV diagnosis, which adds a layer of existential dread to his already pessimistic outlook on life. Jon’s character is marked by a certain timidity and hesitancy to fully embrace the kind of reckless abandon that Luke represents. Luke, on the other hand, is almost the polar opposite of Jon. He is a more reckless and defiant drifter. His reaction to his HIV status is charged with a nihilistic energy; he adopts a more anarchistic and confrontational approach to life. Luke is characterised by his impulsiveness and a desire to live on the edge, reflecting a deep-seated anger towards the societal structures that marginalise and stigmatise individuals like him. The HIV status of both characters is a defining characteristic of how they behave as men which also functions as a frame through which audiences are invited to engage with them and their trajectories.

In contrast with The Living End (1992), many early portrayals of people living with HIV/AIDS often included the presence of HIV-negative men. These HIV-negative characters served as a comparison, embodying traditionally dominant masculine traits. In this dynamic, the person living with HIV/AIDS is consistently presented as the Other, reinforcing the dominance of the HIV-negative character’s masculinity. This juxtaposition often takes different forms ranging from actual physical differences to socio-economic differences. In a similar manner to disability which was once understood as divine punishment for sinful behaviours, HIV/AIDS was - and to a more limited extent still is - presented in popular cultural narratives as a deserving punishment for amoral sexual behaviours (Bollas, 2022, 2023). Living with HIV, or dying with AIDS, was viewed as the expected consequence of being gay (Williamson, 1989; Butler, 1990). People’s understanding of HIV/AIDS was often portrayed - or framed - as if it were “[…] the disease of gayness itself” (Miller, 1993, p. 212). Consequently, HIVI/AIDS and its effects on one’s health, body, and ability to be an integrated member of society came to be viewed as the equivalent of being gay and, by extension, as fundamentally opposed to traditional understandings of masculinity.

Halkitis (2000) confirms that forms of masculinities are understood and expressed in comparative terms with one another. For example, heterosexuality was presented in a manner that confirmed “[…] maleness, muscularity, sexual aggressiveness, and virility” (p. 130), while viral masculinities - at least in the initial years of the AIDS pandemic - were associated with weakness, disease, and death (Patton, 1990). The emergence of HIV/AIDS altered the heteronormative discourse of masculinities. Prior to HIV/AIDS, masculinity (in the singular and with regard to the male body only) was defined as non-femininity. When gay men were presented in popular culture, they were presented as effeminate, confirming the masculinity of their heterosexual counterparts. With the emergence of HIV/AIDS and its representation within popular culture, masculinity was not only understood as non-femininity; it was also understood in opposing terms to contagion and disease.

However, it was not only heterosexual men whose masculinity came to be defined in relational terms to people living with HIV/AIDS. When certain gay liberation social movements adopted assimilationist agendas, non-HIV positive men also affirmed their masculinity by disassociating themselves from people living with HIV/AIDS. In Reality Bites (1994), for example, an American romantic comedy-drama directed by Ben Stiller, one of the characters, Sammy, is gay and celibate. However, if the film aired 10 years earlier, Sammy may have very likely been presented as promiscuous, engaging in anonymous and careless sex. The image of the promiscuous gay man whose lifestyle will inevitably lead him to contracting HIV was now replaced by the image of the desexualised gay character. However, the association between HIV and promiscuity is not absent from this drama. Even though we are not presented with an HIV-infected character, Sammy’s best friend and housemate, Vickie expresses her fear about the possibility of contracting HIV as a result of being sexually promiscuous. In other words, in the 1990s, HIV/AIDS was represented in order to be disavowed (Miller, 1993). The disavowal of HIV/AIDS includes the desexualisation of the gay character as well as “[…] rituals of symbolic purification, including domestic labour, the obsessive eradication of dirt, the symbolic burial of the AIDS body and the renunciation of the PLWHA” (Kagan, 2018, p. 52).

In the first two decades of the HIV/AIDS pandemic, viral masculinities were presented within a binary system. In the 1980s, the heterosexual was placed in binary opposition to the AIDS-infected or soon-to-be-infected. In the 1990s, the opposition tended to be between the de-sexualised gay man on the one end and the promiscuous, disease-bearing gay man on the other end. Further to that, the way each binary was positioned constructed power formations between the two ends, with the non-infected end of each binary being presented as the norm. According to Kristeva’s concept of abjection (1982), the Other - in this case, the infected or potentially infected individual - becomes a symbol of everything society rejects and finds repulsive.Footnote 1 This concept helps better understand the function of the Other in representations of HIV/AIDS. In Powers of Horror (1982), she writes that

A wound with blood and pus, or the sickly, acrid smell of sweat, of decay, does not signify death. In the presence of signified death - a flat encephalograph, for instance - I would understand, react, or accept. […] refuse and corpses show me what I permanently thrust aside in order to live. These body fluids, this defilement, this shit are what life withstands, hardly and with difficulty, on the part of death. There, I am at the border of my condition as a living being (p. 3, emphasis in original).

Following Kristeva’s thought, the subject-position offered by the representation of viral masculinities is one of the abject.Footnote 2 It is through the repudiation of viral masculinities that heterosexuals, in the 1980s, and non-infected gay men, in the 1990s, can maintain a dominant position in society. Situating this trend in the representation of viral masculinities within the sociocultural context of the time highlights a parallel with what was happening in activism. On the one hand, there was AIDS activism, and on the other hand, the 1990s marked the emergence of gay activism. AIDS activism is centred around the organisation ACT UP and its ongoing efforts to improve the lives of PLWHA (Douglas & Rolston, 1990), while gay activism is following a more assimilationist direction by highlighting the similarities between homosexual and heterosexual people in order to allow the former to assimilate into normalcy (Huebenthal, 2017). As it is further observed by Duggan (2003),

[…] AIDS activism deepened and expanded the scope of gay politics, crucially supplementing a newly well-established gay rights movement focused on antidiscrimination and decriminalisation. New activist energies organised in the face of the AIDS pandemic also helped to spawn a vigorous, emergent queer political front with visions of social and cultural transformation beyond the limits of identity politics. [But] alongside radical and progressive AIDS activism, a new strain of gay moralism appeared - attacks on “promiscuity” and the “gay lifestyle” accompanied advocacy of monogamous marriage as a responsible disease prevention strategy. […] In this fertile ground, new gay politics [emerged] - a politics that offers a dramatically shrunken public sphere and a narrow zone of “responsible” domestic privacy” (p. 53, emphasis in original).

This assimilationist tendency manifests itself in representations of viral masculinities relating to the third decade of the pandemic. In depictions of viral masculinities of the 2000s, we are presented with the buff body which signifies an anxiety to associate viral masculinities with an ideal physical existence. Not only can the buff body be someone living with HIV/AIDS; rather, it is almost imperative that someone living with HIV/AIDS strives to create a buff body for themselves. Here, we should not forget that this follows the introduction of antiretroviral drugs (ARVs) in 1996, which rendered life with HIV possible (Race, 2001). “It is in this milieu that gay men, both HIV positive and negative, have perpetuated this subculture that so clearly associates masculinity with physicality […]” (Halkitis, 2000, p. 132). Early appearances of HIV-positive characters in American television were focused on portrayals of disease. However, in Queer as Folk (2000–2005), we are presented with an HIV positive character, Ben, who is shown to be healthy with a strong, muscular body. Further, Ben also functions as a vehicle for the series to discuss serodiscordant relationshipsFootnote 3 which further illustrates its ground-breaking approach in portraying contemporary issues of concern for HIV-positive people.

Unlike earlier portrayals, in this series the HIV positive person is not represented within a binary involving heterosexual or HIV negative gay men. Rather, we follow HIV-positive characters’ journey without being led to compare their trajectory to HIV-negative characters. Additionally, the series focuses on issues of social stigmatisation and exclusion of HIV positive people caused by both the heterosexual and the homosexual community. There is a highlighted emphasis on the struggles that Ben goes through in order for him to be socially accepted, namely adopting a healthy lifestyle which includes numerous hours at the gym and a fixation with his body image, being educated to the highest level, maintaining financial independence, and seeking a monogamous romantic life, all of which are ideals that have culturally been associated with heterosexual masculinity.

Kagan (2018) criticises the series for highlighting the differences between HIV positive and negative men and argues that “[…] this narrative demands both the privatisation of the individual’s everyday management of HIV and the couple’s quiet, domestic administration of the problem of serodiscord” (p. 124). I want to return to the discussion of subject positions concerning viral masculinities by focusing on a new binary created by their representation in this series. One of Ben’s activities includes volunteering and offering psychological support to newly diagnosed HIV positive men. In the third season, Ben offers shelter to a teenage man, Hunter, who is HIV positive. It is through the relationship between Ben and Hunter that the series creates a new binary. Ben is portrayed as a fully realised individual for whom another character of the series says that he is “[…] perfect except for one thing,” that one thing being a reference to his HIV positive status. Hunter, on the other hand, is a teenage prostitute who lives on the streets. In a similar fashion to the binaries created in the 1980s and the 1990s, we are now presented with a new opposition: on the one hand, there is the subject-position of the HIV positive man who works hard to redeem himself for whatever led him to contract HIV and enjoys, to a certain extent, the privileges of a normative life; on the other hand, we are presented with a reckless and promiscuous HIV positive man who exhibits no signs of remorse and is socially excluded and isolated. In other words, during the third decade of the virus, we were presented with representations of viral masculinities which, through their repudiation as abject enabled the confirmation of non-viral masculinities as dominant, accepted, and desirable. The difference here is that this time the HIV positive individual is marginalised in relational terms to another group of people - HIV negative non-heterosexual ones.

The representation in popular culture of two subject positions as oppositional binaries enables the construction of power formations between the dominant one and the Other. Through such representations, viral masculinities are consistently situated in the position of the Other resulting in the stigmatisation of the HIV positive individual on three accounts: against heterosexual masculinities, against non-heterosexual HIV negative masculinities, and against HIV positive but conforming masculinities. In the fourth decade of the virus, these representations persisted through the emergence of the AIDS heritage and AIDS retrovision genres, both of which were criticised by Kagan (2018) for contributing to situating HIV and AIDS in the distant past, suggesting that it is no longer a matter of concern. Kagan argues that this is an effect of neoliberal homonormative politics whereby the attention has shifted to securing legal and social recognitions that benefit norm-conforming non-heterosexual individuals but further stigmatise those who do not fit nor follow the norms.

Subverting Masculinity: Taking it Like a Man

The earlier discussion shows that the HIV positive body can be understood as a contested site where masculinities - heterosexual, homosexual, or otherwise - are legitimised. However, it also has a subverting potential whereby expectations around masculinities are challenged and non-normative forms of masculine expression are reclaimed. This becomes more obvious in the examination of barebacking subcultural practices. Within such practices, the HIV-positive body itself becomes a manifestation and confirmation of a masculinity that is otherwise treated as abject. Further, contrary to understanding practices, such as bugchasing, as leading to a disability, they enable membership in a subcultural group and offer a critique of what Dean (2009, p. 21) calls “identification politics […], politics grounded in recognition, namely, the politics of the ideal image.” Dean further identifies a reluctance within the academic community to acknowledge and account for such practices in fear of jeopardising the public image of gay men. He explains that since the emergence of civil rights movements and their effect in scholarly work, academics sought to correct “[…] erroneous images of minorities” (p. 18). In doing so, the focus of scholarly work became the ‘accurate’ representation of women, gay men, non-whites, and people with disabilities, among others. However, what is defined as an accurate representation and who defines it as such is a critical question the answer to which is beyond the scope of this article. What concerns the discussion of this article, though, is that such efforts led to the sanitisation of queer and disabled people, among others; this, in turn, further alienated and marginalised them.

Warner (1999) concurs with this approach and highlights the dangers that sweeping the effects and possibilities of disability - and the deviation from the ideal image in general - under the rug, might have for “[…] queers, slits, prostitutes, trannies, club crawlers, and other lowlifes […]” (p. ix). With regard to the intersection of gender, disability, and sexuality - the locus of which is arguable the HIV positive male body, Dean (2009) observes that “[…] you can now proudly market your body as a biological weapon, embracing the fears that many HIV-negative people harbor about those who are HIV positive, while advertising your dangerous availability to fellow barebackers” (p. 21). In the previous section, I discussed the repudiation of HIV positive men by HIV negative ones, and I also made a case for the repudiation of HIV positive men by other HIV positive men. Dean (2009) and Tewksbury (2003), among others, report on the emergence of barebacking culture as a means of reclaiming the ability part of disability. This is in line with various critiques offered by the disability community with regard to norms about the body. Baynton (1996) and Padden and Humphries (2005), for example, discuss treatment of an impairment as a contributing factor to disenfranchisement and argue against it. Similarly, Dean (2009) invites us to rethink positivity and the sexual practices of the barebacking culture as a means of subverting common understandings of health.

To further understand how the barebacking subculture appropriates bugchasing as a practice that challenges normative understandings of health and ableness, one needs to consider the ‘pig’. Pig is a term that refers to a man who engages in sexual practices with as many different men as possible at a time. Sexual practices of pigs often involve group sex, barebacking, and fisting among others (Florêncio, 2020). What is of significance to this article is the ways in which the sexual behaviour of pigs “[…] defies normative constructions […]. Being a pig entails committing oneself to sexual excess, to pushing beyond boundaries of propriety and corporeal integrity; being a pig thus positions a man for membership in a sexual avant-garde […]” (Dean, 2009, p. 49). In other words, those identified as pigs engage in sexual practices that both literally and metaphorically push their bodies to their limits, extend our understandings of what is possible and normal, and challenge the normative positioning of health as the antipode to sexual pleasure. In engaging in activities that are considered to be unhealthy - be it physically, mentally, emotionally, or socially unhealthy that is - pigs report maximised sexual pleasure while challenging commonly held notions around wellbeing. What makes this relevant to a book on disability is the categories of pigs, already discussed in this article, and bug chasers. These are men who want to become HIV positive by engaging in condom-less sex with HIV positive men who ejaculate inside one’s anus. The contributions they offer to the renegotiation of masculinities is of particular importance here. Dean (2009) explains that,

[I]f being regarded as a pig in the world of gay masculinity is equivalent to being considered a stud in the world of straight masculinity, then the principal difference between the two lies in the fact that a gay-sex pig usually acquires his status through voracious bottoming - by taking as many penises and as much semen inside him as he can (p. 50).

Not only is the pig to be understood as more able than other men in their ability to endure physical pain - and transform it into pleasure, but they are also understood as more male than non-gay men by engaging in activities that are associated with the feminine such as the ejaculation of semen inside their bodies. Dean further explains that “[h]ypermasculinity accrues to the man who assumes what used to be thought of as the female role in homosexual relations. The more men by whom one is penetrated, the more of a man he becomes” (ibid.). What should be noted here is that there is no conflation between HIV positive men and the sexual practices described above. It is not suggested that all HIV positive men engage in such practices, nor is it suggested that common expectations of sexual practices in which HIV positive men engage involve group sex and pig sex - although, the (mis)association between promiscuity and HIV/AIDS has been a long held one. However, the prospect of becoming HIV positive as a result of engaging in sexually pleasurable activities without ascribing to normative views around health and sexuality contributes to the (re/de)construction of norms around masculinity.

What has been established through gay pig men’s sexual practices is that anal penetration is not a sign of femininity; rather, it functions as confirmation of one’s (hyper)masculinity in that it confirms their ability to endure “[…] without complaint any discomfort or temporary loss of status, in order to prove one’s masculinity” (Dean, 2009, p. 51). As the expression goes, by ‘taking it like a man’ one proves their being a man. Arguably then, a bug chaser does not simply want more semen or HIV; rather, through semen and HIV, bug chasing becomes a rite of passage into reclaiming one’s masculinity, into manhood. The bug chaser appears to acquire what is perceived as disability as a way to prove their manliness. HIV, in this instance, becomes a means through which one not only becomes a man but also joins the group of men. With reference to Cohen’s (1980) understanding of the function of subcultural groups to subvert taken-for-granted truths maintained by mainstream culture, Dean (2009) further clarifies that bug chasing and the barebacking subculture are subversive by “[…] embracing risk as a test of masculinity, counterphobically reinterpreting the pathogen as desirable, diminishing fear of HIV/AIDS, increasing doubts about HIV as the cause of AIDS, eliminating anxiety by purposefully arranging seroconversion, and resisting mainstream health norms” (p. 51). It is at the very act of seroconversion through bug chasing that the intersection between sexuality and disability has the potential to become subversive.

Conclusion and Implications

At the onset of this article, definitions of disability were examined. In doing so, disability was presented in either medical or social terms. The former gave rise to the impairment and functional limitations perspectives and the latter gave rise to the ecological and human rights perspectives. Since 1996, people in the wealthier parts of the world who have been living with HIV have had the medical means to maintain good health and live a long life through ARVs. As such, the extent to which HIV/AIDS should still be framed as disability is questionable. Arguments for the inclusion of HIV/AIDS as disability based on the medical model are based on the fact that people living with HIV/AIDS are dependent on continuous medication which can have adverse side effects interfering with the wellbeing of the individual and the quality of their life. Additionally, including HIV/AIDS as disability provides people living with HIV/AIDS with additional legal protections against discrimination as well as with material means, such as state benefits, which provide them with some sense of stability during periods where their medication affects their ability to work. However, the very notion of maintaining one’s wellbeing is challenged within the barebacking culture and bugchasers. The identification of the maintenance of good health with the upholding of good morals, rooted in the medical advancements of the 19th century (Rose, 2007; Crawford, 1980) is now challenged by a renewed identification of the maintenance of good health with the perpetual anxiety of being at risk (Leichter, 1997). Through bugchasing, understandings of risk and wellbeing are subverted in that the latter, wellbeing, is understood as achievable only through a perpetual anxiety over the possibility of risk. Dean (2009, p. 55) observes that “[…] it seems unhealthier to live in a state of permanent terror than to live a life that treats HIV as a sort of occupational hazard […]” and continues by identifying bugchasing as healthier in that it “[…] transforms seroconversion into a matter over which one exercises choice and thereby demonstrates one’s sexual freedom.” It should be made clear that although the suggestion is not to encourage people to engage in the practice of bug chasing as a practice for maintaining one’s health, what is to be considered here is that notions of health and disease are challenged providing opportunities for reconsiderations of understandings that are often taken for granted as stable and given. With particular attention to the impairment and functional limitations perspectives, HIV/AIDS invites a reconsideration of what we perceive as impairment or functional limitation insofar as the role of agency, exemplified by the bug chaser here, is concerned.

With regard to the social model of defining disabilities, the ecological and human rights perspectives encourage us to consider societal (and institutional) responses to disability as well as the ways in which disability has been operationalised to maintain the dominant position of those who are not considered to be disabled. In the first part of this article, attention was given to popular culture representations of people living with HIV and their function as confirming dominant masculinities. As it was discussed, viral masculinities were ascribed characteristics that were to be repudiated. In doing so, they became a trope for what dominant, thus accepted, masculinities ought not to be like. As such, in representations of masculinity in popular culture, some of which were discussed earlier in the article, it was common for male characters, irrespective of their sexuality, to be presented in contrasting terms to HIV positive male characters to confirm their dominant masculine characteristics. This was also the case among HIV positive male characters where those who wished to assimilate within mainstream dominant society were hostile toward those who refused to conform, further stigmatising them as not only immoral, but also weak, disabled, and non-contributing members to society. In addition, bug chasers also subvert understandings of HIV/AIDS as disability under the social model in that their practices provide a novel way for negotiating kinship among the barebacking subculture. Also, through the appropriation of intentional seroconversion into an ultimate or ideal form of masculinity, the practice of bug chasing provides an alternative imagining of the notion of dominance within the field of masculinities, encouraging a redefinition of what it means to be a man. Once again, it is important to note there is no intention to reverse a binary where masculinity is quantified and ascribed to one or another man. The question is not who is more of a man, nor is the aim of this article to suggest that for one to be more of a man, they ought to become bug chasers. However, what is of importance are the opportunities for subverting normative views around health and ability that are offered through critical considerations generated by the intersection between sexuality and disability.

The article suggests a redefinition of what constitutes a disability, especially in light of the agency shown by individuals like bug chasers. This redefinition could influence how disabilities are conceptualised in academic and medical discourses, potentially leading to a more nuanced understanding that includes personal agency and the socio-cultural contexts of health. Further, the discussion on viral masculinities and the subversion of dominant masculinity through practices like bug chasing opens new avenues in gender studies. This could lead to deeper insights into how masculinities are constructed and the role that health status plays in these constructions. Such theoretical explorations can influence how society understands and interacts with concepts of masculinity and health. Additionally, the implications for the social model of disability are profound. As it has been suggested above, this model encourages a re-evaluation of societal and institutional responses to disability. This can lead to a more critical understanding of how disabilities are operationalised to maintain power structures and how they might be reimagined to foster more equitable social environments.

From a practical perspective, the narrative surrounding HIV/AIDS and its association with disability requires public health policies to adapt continually. This involves not only supporting the medical needs through ARVs but also considering the psychological and social impacts of living with HIV/AIDS. Policies could be developed to better address the complex needs of individuals within this context, including mental health services and social support systems that acknowledge the diverse experiences of those living with HIV/AIDS. Also, as the conclusion suggests, including HIV/AIDS under the umbrella of disability offers legal protections and access to benefits that can greatly assist those affected, especially during times when they are unable to work due to medication side effects. It is crucial for legal frameworks to continuously evolve to ensure they are inclusive and protective of all individuals, particularly those who rely on such frameworks for their wellbeing and stability. Finally, there is a need for educational initiatives that address the stigmas associated with HIV/AIDS, particularly within the contexts of masculinity and sexuality. Education can also play a crucial role in challenging outdated notions of health and masculinity, promoting a more inclusive understanding that respects diverse experiences and identities.