Mortal Secrets

It is an aim that succeeds to an extraordinary degree... So well thought-out is this study, and so well presented are the accounts of the participants, that I put the book down with a real—and rare—sense that my understanding had grown and my thinking about the ethics of HIV—in particular the responsibilities of those infected—had shifted... The examples given here put such bald statements into a new context, and make the social and cultural factors that shape the pandemic seem vivid and emotionally real. Such vividness serves powerfully to enhance understanding.

In this pioneering work, Bayer and Klitzman shed light not only on the complex and poorly understood world of communicating about HIV but also on the realities of morality as it is lived in the real world of frail and fallible human beings trying to talk about the most intimate matters imaginable. It is easy to advise our children and one another to always tell the truth. As Mortal Secrets reveals, that injunction can be and is applied in a variety of ways and with great nuance when the subjects at hand are sex, infection, and the transmission of disease. This study shows in ways poignant and telling that being ethical, while desirable, is neither simple nor easy.

The ethical dilemmas of modern life are all too often discussed in general terms via presumptive rules and imagined examples. In Mortal Secrets, Klitzman and Bayer describe HIV-positive individuals struggling to decide when and when not to inform lovers, relatives, or friends of their condition through the troubled, eloquent, and above all concrete testimonies of those individuals themselves. The result is a powerful and moving portrait of moral deciding as it actually happens—practically, specifically, in the midst of fear, suffering, and the incertitudes of love.

The women and men who people the pages of this book are not philosophers or humanistic scholars. But out of their lived experiences as individuals infected by HIV, or as partners of those who are, they speak with wrenched insight and authority about the deep and complex moral issues with which their situations have confronted them. Through the medium of their startlingly frank interview-testimonies, we hear them grapple with questions about truth and lies, candor and deception, secrecy and disclosure, silence and communication, physical and psychic intimacy, risk and safety, the reciprocity of trust, and responsibility for the protection of self and of known and unknown others. These questions are not confined to the realm of HIV/AIDS. They are fundamental to the viability and meaning of human relationships, and to life in society.