Agents and Structures: Journalists and the Constraints on AIDS Coverage

Ivan Emke

Abstract: Many media scholars have used the news coverage of AIDS as a case study in the operation and effects of the mass media. This research has largely focused on interpretations of textual content, often with an underlying assumption that media workers have either distorted or misrepresented AIDS. However, the stream of media analysis which focuses on the structuring properties of newswork constraints would argue that the media content is in part a reflection of the process of newswork. This paper is organized into three sections: (a) an overview of the effects of newswork practices on content; (b) a survey of early social science research on the media coverage of AIDS; and (c) an application of theories on newswork to the results of open-ended interviews with journalists who covered the "AIDS beat." In sum, the research finds that journalists, who work with newswork constraints daily, are somewhat aware of the effects of these limitations. However, they may also underestimate such effects, preferring to believe that their own media output is able to rise above such structural processes.

Résumé: Beaucoup de chercheurs dans les médias ont recouru à la couverture journalistique du SIDA pour effectuer des études de cas sur l'opération et les effets des médias de masse. Leurs recherches ont porté largement sur des interprétations de contenu textuel, se fondant souvent sur l'hypothèse sous-jacente que les travailleurs médiatiques ont faussé ou mal représenté le SIDA. Cependant, le défilé d'analyses médiatiques portant sur les propriétés structurales des contraintes journalistiques soutiendrait que le contenu des médias reflète en partie le processus suivi dans le travail journalistique. Cet article comporte trois sections: (a) une vue d'ensemble des effets des pratiques journalistiques sur le contenu; (b) le passage en revue des premières recherches en sciences humaines sur la couverture médiatique du SIDA; et (c) l'application de théories sur le travail journalistique aux résultats d'entrevues libres menées auprès de journalistes qui ont écrit sur le SIDA. En bref, cette étude observe que les journalistes qui font face à des contraintes médiatiques à tous les jours ont une certaine conscience de celles-ci. Cependant, ils peuvent aussi sous-estimer ces effets, préférant croire que leur propre rendement médiatique peut échapper à de tels processus structuraux.

In 1985, the death of movie star Rock Hudson broke open the media floodgates and released a tidal wave of stories [about AIDS] that has only recently begun to subside. These stories reflect in part how our society has been thinking about AIDS out loud. They have something to tell us, not just about AIDS, but about journalism itself. - Lister Sinclair, in CBC, 1989, p. 1

In the past 15 years, quite apart from its physical effects, AIDS has also become firmly entrenched within social science as a case study for analyzing the operation of key social institutions such as the media or medical practice. Clearly, it is important to consider the media's role in constructing ways of thinking about AIDS. However, the assumption that society's response to AIDS is a direct reflection of the media coverage of AIDS (and vice versa) may be a misleading overgeneralization. Even in the case of such a widely covered topic, the social construction of AIDS involves more than just media texts.

Despite these reservations about the use of AIDS as a case study, this paper continues in that tradition. And like much of the media research that has gone before, this paper also focuses on the mainstream media as a privileged site for the production of meaning. Nevertheless, the goal here is to reconsider the research on media and AIDS. To date, such research has largely focused on interpretations of textual content, with an underlying assumption that the media either distorted or misrepresented AIDS and People with AIDS (PWAs). Furthermore, there is sometimes an insistence that media content is a transparent reading of broad social panics about sex and death. For example, books like Simon Watney's Policing Desire (1987c) relied upon a handful of stories from one segment of the British press to make larger points about sex and family policy in Britain.1 Or, from the other end of the political spectrum, New Dimensions (a right-wing, U.S.-based magazine) devoted an entire issue to the ways in which the mainstream media had been misled by the "gay lobby" regarding the "real" dangers of HIV and AIDS.

However, the stream of media analysis which has centred on the structuring properties of newswork constraints has largely been ignored within studies of AIDS coverage.2 One journalist, in responding to academic criticism of some of her AIDS coverage, argued that "an academic analysis of a newspaper article cannot be done fairly or accurately without some understanding or knowledge of how a newspaper is put together" (Reich, 1992, p. 236). This paper attempts to be sensitive to both the critical academic work on AIDS coverage and the context of everyday news reproduction, and draws upon evidence gathered from journalists who have covered AIDS for major Canadian news outlets. The interpretations of these actors, who compose and present the news content, have rarely been taken seriously within social science analyses.

To cover these topics, the paper begins with an overview of some of the important effects of newswork practices on content, then moves into a description of some of the social science research on the media coverage of AIDS, and ends by incorporating the perspectives of journalists who have covered the "AIDS beat."

The structuring effects of newswork

As Altheide (1976) wrote, "the organization of news for practical reasons encourages the adaptation of a convoluted way of simplifying events" (p. 9). This seeming contradiction (reconstituting something in order to simplify it) captures the elaborate process of newswork-through the application of everyday work rules, occupational standards, technical possibilities, and professional judgments, complex events and forces become simplified into news stories. And when the original information is both precise and complex, as in the case of news about science, then these newswork practices can result in serious distortions (Panem, 1988; Schwitzer, 1992).

This paper agrees with the position that newswork is a "ritualized" process, and not the random reaction to random events. In order to produce a daily or weekly news product, the practice of journalism requires the application of routines and regulations. Thus, much of the "bias" that some accuse the media of exhibiting may well originate with everyday news practices and constraints, rather than with a journalist's inadequacies or an editor's ideology.

One such simplification is the tendency to construct stories around individuals and personalities, rather than structures and social forces. While this personification might illustrate deep cultural ideals about individualism, it is also an attribute of storytelling whereby readers are drawn into the narrative through "identification" with another person (Galtung & Ruge, 1973; Schudson, 1989). However, the particular individuals who are presented in news accounts tend to come from a limited list of authorized experts who are "over-accessed." Tuchman (1978) referred to news as a dialogue between journalists and their sources, and the latter was necessarily a small circle of authorities who were allowed to participate in the definition and discussion of an issue. Due to repeated exposure, these authorities gain credibility as experts which then heightens their desirability to other media outlets, and the cycle continues.3

But there is another aspect of newswork which may work against this privileging of certain authorities. Sometimes, the search for the "other side" of a debate (which is a crucial exercise in constructing an "objective" account) may lead to an acceptance of questionable theories and spokespeople. In the least, it can provide a forum for those who operate outside of a dominant consensus. This tendency to give "equal time" to people who might undermine the authority of the "experts" is often condemned by scientists, who claim that it might result in audience confusion and inappropriate health information (Cohen, 1982; Schechter, 1993; Wainberg, 1993). Scientific experts, much like their status counterparts in politics, deplore being portrayed by their critics as trying to mislead the public.

Colby & Cook (1991), in a study of the television coverage of AIDS on the three major U.S. networks, agreed that this attempt to get "both sides" of an issue led to confusing stories and the dissemination of inaccurate information: "Reporters, hewing to the strategic ritual of objectivity, never specifically rebutted these misleading statements, apparently considering it sufficient to mix alarm with reassurance from public officials" (p. 234). On the other hand, science has never been a unitary discourse, and its representation as a site of challenge and debate is more accurate than its representation as a sanitized site of consensually legitimated knowledge. The question for the media analyst is not so much which representation is more "accurate," but what particular effects and interpretations each one might produce.

In addition to the overaccessing of certain authorities, there is also an overreliance on particular institutional sources of news. A journalist is fed with news releases and alleged exclusives from a wide variety of organizations, all attempting to receive some media attention. It might be noted, satirically, that "investigative journalism" now largely amounts to attendance at a news conference and then a few telephone calls to official sources in order to check the facts (e.g., Cooper & Soley, 1990; Karp, 1989; Knight, 1982; Miller, 1990). Gandy (1982) referred to this reliance as an "information subsidy":

An information subsidy is an attempt to produce influence over the actions of others by controlling their access to and use of information relevant to those actions. This information is characterized as a subsidy as the source of that information causes it to be available at something less than the cost a user would face in the absence of the subsidy. (p. 61)

And, in the case of medical journalists, who generally lack a science background, this reliance on official sources and definitions is even more pronounced.4

Just as there is a tendency to cover individuals rather than social forces, there is a bias toward the coverage of events (often staged) rather than processes or ongoing programs. Anticipated events, such as the international AIDS conferences, are special times for extended media coverage even if nothing new is being revealed. And studies of media coverage show a positive relationship between the amount of coverage and specific events, often related to individuals. For example, when a famous person is sick, this becomes news, such as in the case of Rock Hudson or Magic Johnson (Rogers, Dearing, & Chang, 1991; Stovall & Cotter, 1992). The event is enough to stimulate an expansion of media interest, and many of the subsequent stories may not even make reference to the initial event. Then the amount of coverage declines until another event comes along to refresh the interest and possibly add some unique news angles to the story of AIDS.

These variations in the amount of coverage are fairly consistent across media sources due to "news envy," or the tendency of editors to define an event as "newsworthy" if another editor has also done so. This ranges from the monitoring of other outlets to the adoption of their news frames to the reproduction of entire news stories from other media sources (Altheide, 1976; Clarke, 1981).5

During a part of mass communication's history, there was a strong interest in the concept of "gatekeepers" who were claimed to be responsible for what became news. As Schudson (1989) pointed out, this necessitated a simplistic view of journalists and editors as information-selectors, rather than as story-constructors. And, with the rise of journalism as a technical and academic discipline and the decentralization of news collection, all journalists perform at least some "gatekeeper" functions in their daily work.

In the least, since journalism education is now widespread, the professional ideologies that media workers adhere to are shared across the occupational spectrum. Critics point to the current fascination with "objectivity" as an attainable attribute or to the conviction that humans can report on events from "nobody's point of view" or to the obsession with technical prowess over intellectual acuity as evidence of the effects of the professionalization of journalists (e.g., Golding & Elliot, 1979; Rachlin, 1988; Richardson, 1989). What this means is that, in everyday practice, even more attention is being paid to how news is done, rather than to the content of that news. But despite these changes in technology, the major production constraints remain the same: limits on available time, space, and money.6

Finally, a part of the work which a journalist (or her/his editor) performs is to determine the news frame for a story. These frames tend to make reference to the appropriate cultural contexts and meanings, in an effort to make the story more immediately understandable. Willis (1971) referred to these as "inferential structures" which journalists use in helping news to "make sense" for audience members. Dominant themes, like deviance and control, become important frames around which to construct particular events.7 Thus, in approaching the issue of AIDS, many journalists chose to fit it into pre-existent frames such as the alleged dangers of deviant sexuality or the perceived advantages of interventionist medical science over public health measures. And on occasion, the anomalies became newsworthy topics themselves (e.g., heterosexuals contracting HIV or the lack of any promise of a cure).

It is only fair to note that media workers may themselves be aware of these constraints on newswork which affect content (and the research reported below bears this out). News organizations periodically do auto-deconstructions of how they have covered certain events, such as political elections, or particular issues, such as AIDS (Cook & Colby, 1992; Treichler, 1992). The point is not to blame journalists for the structuring effects of newswork. Within journalism (as within all occupations) there are exemplary workers who can rise above institutional structures while others cannot see beyond a press release. If we are to understand why AIDS is represented as it is, we must also acknowledge the way in which information becomes "news."

Studies of media AIDS coverage

The most common point of consensus among those who have studied the early media coverage of AIDS in North America is that much of society's understanding of the disease, who it affects, and its future possibilities, comes from the media. The press is claimed not only to mirror the confusion within society, but is often credited for generating it in the first place (e.g., Albert, 1986; Brandt, 1988a; Chen, 1987; King, Beazley, Warren, Hankins, Robertson, & Radford, 1988). AIDS has become a popular case study for the analysis of the media itself, as an industry, as a practice, and as a system devoted to the reproduction of meaning. Treichler (1987) noted that AIDS was not only a physical phenomenon, but also an "epidemic of signification." And since the early 1980s, social scientists of various backgrounds have been attempting to diagnose the entrails of this latter "epidemic." This section summarizes studies of the early media treatment of AIDS. In the process, it presents several of the most prominent themes of this critical literature.

One of the consistent critiques of the media coverage of AIDS is that the stories tended toward sensationalism (Cameron, 1989; Dickinson, 1990; Gallagher, 1991; King, Beazley, Warren, Hankins, Robertson, & Radford, 1988; McCaskell, 1983; Payne & Risch, 1984). This is taken to be true of both texts and visuals, the latter usually focusing on the photos of emaciated PWAs rather than the healthy HIV-positives (Crimp, in CBC, 1989). Media terms for AIDS have ranged from "black death" and "scourge of the twentieth century" to "lethal pandemic unparalleled in human history" and the ever-present "plague."8 And People with AIDS are often referred to as "victims," despite the term being rejected by PWA groups.9

On the other hand, a study of American television coverage of AIDS showed that "the typical AIDS story tended less to sensationalize than to reassure, largely because journalists depended upon government officials and high-ranking doctors to present them with evidence of news" (Colby & Cook, 1991, p. 215). And some critics have argued that the media sensationalize certain aspects of AIDS and understate others. For example, in describing the sensationalized press coverage, Watney (1987a) stated: "the entire [AIDS] epidemic has occurred against the lurid background of the most sordid and sickening press campaign in post-war British history" (p. 62). But elsewhere he also criticized the casual and indifferent approach taken by the British media toward the possibility of the deaths of thousands of gay men (Watney, 1987b). Clearly, the position that the media was involved in some grand hyperbolic burlesque to exaggerate the effects of AIDS, while attractive to some, does not account for the variety of coverage which the media produced. Indeed, some stories did capture the obsessions of newsworkers (e.g., the fears over casual transmission, the active stigmatization of gays, the panic over "carriers"). But others, which could have been capable of similar sensationalism, were ignored or treated blandly (e.g., up until the mid-1990s, the confusion over infected blood).

One characteristic of the media coverage which may relate to the charge of sensationalism is the tendency toward short bursts of coverage and a lack of any significant follow-up on stories. Thus, the coverage of AIDS is shown to skip from one "crisis point" to another, without any evaluation of the progress between those points or how one might have led to the next. It could be said that the naüve media newshound lives in a perpetual state of crisis, the unease of which can only be supplanted by the next (and maybe greater) crisis.

Stories (like the "heterosexual transmission" of HIV) were complex and would have required much time for research. In large measure, news organizations had neither the will nor the resources to assign a full-time journalist to such a long-term task (Brecher, 1988; Streitmatter, 1984).10 Even when a reporter was covering AIDS regularly, it was usually as part of a larger beat-such as medicine or health in general. One possible result of this was the virtual absence of "investigative" journalism on AIDS, at least in the 1980s (Regush, 1986; Shilts, 1987). Caitlin Kelly, a member of the Canadian Centre for Investigative Journalism, was asked whether any Canadian journalists were going beyond the government press releases and taking research initiatives. She replied: "I don't know. I certainly haven't done it....I know that there are some reporters who certainly are more dubious than others of the standard line....But I don't think this [the lack of investigation] is seen as a major problem" (in CBC, 1989, p. 17).

Especially in media reports, the link between AIDS and homosexuality has become a "verbal reflex" (Payne & Risch, 1984). From the use of the term "gay plague" through to the frequent references to the rise of HIV in members of "non-risk" groups, this link has been tended and reinforced to the point where people may see AIDS as something you get for being gay (e.g., McAllister, 1991; Patton, 1986). No doubt this link between disease and a still-stigmatized sexuality further cultivated the latent homophobia and affected the coverage of AIDS (Albert, 1986; Baker, 1986; Watney, 1988).11 And most certainly it coloured the characterization of People with AIDS. Colby & Cook (1991) noted that "gay men were shown individually as victims and collectively as carriers" (p. 228).12

At the same time as the litany of "gay=AIDS" was reasserted, the opinions and preventive activities of gay men were generally ignored. A study of two Canadian newspapers found that gay men were actually underrepresented, despite the epidemiological profile of AIDS (Sussel, 1992). In some cases, straight journalists were uncomfortable interacting with gay men (e.g., Kelly, cited in CBC, 1989). And in other situations, any discussion of homosexuality within the media was circumscribed by the reticence of editors to produce anything which might upset audiences or (more importantly) advertisers.13 As Robert Bazell of NBC noted, "It would be dishonest not to say we couldn't sell the AIDS story early on because it was about gays" (cited in Cook & Colby, 1992, p. 112).

It should be noted that the coverage of AIDS also suffered from the media double standard regarding sexuality. While sitcoms and perfume commercials can be provocative and sexual, public information is often plagued by a fear of the explicit discussion of sexuality. Sex as a joking matter or as an advertising ploy (purified by its contribution to the cash nexus) appears to be acceptable, but the serious consideration of sexuality is usually absent from media content (Cameron, 1989; Patton, 1986). As a result, the link between HIV prevention and modifying sexual practice was often missing in early media coverage.14

Many of the early critics who studied the media coverage of AIDS ignored the effects of newswork on content. Rather, it is more common to find condemnations of the media in general (or certain writers in particular), and suggestions that the coverage is a transparent rendering of public panics and dominant interests.15 This ignores the nature of the production of media content and also blames journalists for any shortcomings, instead of implicating the system of newsgathering (Dickinson, 1990). As Cook & Colby (1992) concluded,

The ebb and flow of AIDS reporting reflects considerable rationality, but by the standards of "media logic." ...Each of these [newswork] strategies represents a journalist's rational adaptation to the uncertainty and vulnerability of trying to figure out what's news. Merely arguing that the media should be more objective or more rational overlooks the possibility that objectivity and rationality led us to the inadequate picture of AIDS that television presented. (p. 111)

Check (1987) agreed with this analysis, noting that "many of the shortcomings in AIDS reporting have resulted from journalistic conventions, rather than being specific to AIDS" (p. 987).16 Aspects such as the emphasis on using AIDS as a way of marking boundaries of "normal" and "deviant" are not specific to the media coverage of AIDS. This use of disease as metaphor is evident within society at large, and within media coverage of other diseases (e.g., Brandt, 1988b; Ericson, Baranek, & Chan, 1987; Sussel, 1992).

Indeed, the fact that most studies of AIDS reporting have focused on media content rather than on institutional (or occupational) relationships and practices indicates the extent to which newswork has been neglected as a contributing factor. And in most cases, the self-reflection of journalists is not used as a form of evidence to help interpret the gathering and production process for news content.

The experience of AIDS journalists

The third major section of this paper is devoted to a consideration of the experience of journalists who work on the AIDS beat. The underlying goal of this section is to evaluate whether the constraints mentioned in the theoretical literature can be seen in the experience of working journalists who covered AIDS. While these are the people who are responsible for developing and presenting the coverage of AIDS, their experience is rarely considered in studies of AIDS and the media, except in the more ethnographic studies of newswork. Generally, the journalists who were consulted in this study were working in the print media, in English, and in Central Canada. The sample is small (six journalists), and thus the results are obviously not meant to be generalizable to all media outlets and media workers. However, their accounts provide an application of the above theory, and the dynamics of their daily experience are included here to provide another perspective on how AIDS is constructed and spoken about in the mainstream media.17

The need to provide "newsworthy" coverage

The ability to determine if something is "newsworthy" is sometimes seen as an attribute of good journalists and editors, and is allegedly a matter of instinct, experience, and feeling. (One journalist in the study explicitly referred to "instinct" in relation to deciding what stories to cover.) However, in case such clairvoyance is absent, there is a set of criteria which is taught in journalism school and which may be used by editors to determine "newsworthiness." According to science and medical reporter Eve Savoury, in the case of science-related stories, the criteria include: nature doing unexpected things; new developments or diseases; humans tampering with or extending nature; and stories which might surprise the audience or fill them with awe or even horror (Savoury, 1989). Such a story accompanied by an enthusiastic, jargon-free talker will be even more likely to be deemed "newsworthy," especially for television or radio.18 All of the stories are subject to the first criterion of news-"who cares?" The information must be of perceived importance to a broad segment of the audience. Thus, stories of famous people contracting HIV are considered to be important simply because the audience is assumed to be interested in what happens to these people. Or stories about "heterosexual AIDS" imply that HIV is a danger to "everyone," whereas stories about gay men contracting HIV are presented as vignettes about "them."19

An additional difficulty which journalists on the AIDS beat experience is the complexity of the science and research around a new disease such as AIDS. Journalists, who come out of a humanities or social science background, might find the reporting of science to be a challenge. One journalist, who took the time to learn the science around AIDS, was rewarded by sources (who appreciated the extra effort). However, the journalists in this study acknowledged that it is very difficult to keep current on AIDS research along with all of their other writing and research duties. Furthermore, their editors might also be from humanities backgrounds, and thus are not able to judge the scientific accuracy and quality of AIDS stories.

Pack journalism

Editors are not always clear about what issues are on the agenda for a particular area. However, if other media outlets are covering a story, they will quickly deem it newsworthy. Savoury (1989) noted that this might not result in the best journalism possible, but at least it was a way in which editors decide what to cover out of the universe of possibilities. It is expected that certain events, such as the annual AIDS conferences, will be covered. Such events also present ready opportunities for in-depth reporting on AIDS, with many experts all within relatively easy access. These events also include numerous news conferences, which are explicitly designed according to the needs of journalists (in terms of their timing, the advance information available, photo opportunities, etc.). In addition, AIDS conferences are also sites where activists and scientists might interact, occasionally in dramatic ways. Such shows of political critique will invariably become deemed "newsworthy."20 The journalists also mentioned other institutional sources for news, such as newswire leads (AP, CP, and UPI especially) and articles in medical journals.

Issues also go through phases of coverage, depending on their perceived salience and the number of related developments which are occurring. For example, The Toronto Star decided not to replace Kelly Toughill after she resigned from the AIDS beat (personal communication, August 31, 1992). It was decided that major policy decisions in the area had been made, educational efforts were well underway, and the story was less crucial than in earlier years. As a result, there was a decline in the amount of AIDS coverage within the newspaper.21

Headlines

One of the most fertile areas for sensationalism in news is the headline (or, in the case of television, the anchor's introduction). These are written by editors, rather than by the journalists themselves (although the latter might have some input). Generally, the excitement of a text never quite catches up to the frenzy of its headline. The headline or introduction is, of course, intended to snag a reader/viewer. But in the process, news content may be misrepresented or exaggerated. Two of the sources in this study argued that it is the headline writers who are responsible for most of the sensationalism of media stories (see Reich, 1992). Journalists might have some input into headlines, but are not the final judges of what will appear. If they feel that a particular headline distorted a story, they might complain to their editor. However, they may not see the offending headline until after the story is printed.22

Use and cultivation of sources

As noted above, Canadian news reports on AIDS during the 1980s rarely went beyond official press releases.23 Major media outlets tended to use sources from the National Advisory Committee on AIDS, the Federal Centre for AIDS, or the Canadian Public Health Association. As a result, some of the characterizations of these organizations found their way into news reports. For example, it was the Federal Centre for AIDS which first reported on the epidemiological breakdown of "AIDS cases" with reference to their "risk group" (rather than "risk activity").24 The lack of precision on the part of institutional sources sometimes leads to ambiguous and imprecise media coverage (see Goodin, 1994).

With the rise of more vocal activist and PWA groups, and the decline in the helpfulness of official sources, the AIDS rolodex of most journalists expanded. However, there is a price to be paid for questioning the position of official sources. Nicholas Regush, arguably the only "investigative reporter" working on AIDS in Canada during this time, experienced hostility from scientists and official sources for having questioned the "litany" regarding AIDS and HIV (Nicholas Regush, The Gazette [Montreal], personal communication, August 31, 1992). In his stories, he argued that much AIDS research does not meet the basic criteria for acceptable science.25 By breaking through this "smokescreen of legitimacy" drawn around mainstream science, he has aggravated many official sources who will no longer talk to him. Thus, this presents an illustration for other journalists that if they wish to continue to have unimpeded access to certain authorities, they need to consider their stories carefully.

As with most beats, there is not enough time or space to relate all of the possible stories about AIDS. As a result, journalists often act as editors themselves, deciding among a variety of news releases and tips on which to follow and which to ignore. In the case of journalists who write on AIDS as a part of a larger beat, such as medicine in general, they must balance the AIDS stories along with the articles on other topics so as not to exaggerate the importance of one particular issue. For example, the charge that AIDS has received too much media coverage has also come from some journalists (e.g., Strauss, 1993).26

Journalists at newspapers with perceived status (such as The Globe and Mail) reported that they often receive far more story ideas than could possibly be covered. The source for these ideas could be an individual, but it is more likely to be an organization, many of which attempt to develop long-term relationships with journalists. When these are successful, the source might be consulted when a journalist is in need of a quick comment or a clarification. Conversely, when an institutional source is not forthcoming, or difficult to contact, they are less likely to be consulted.27 When one organization becomes too difficult to work with, others may become the preferred option of journalists. (For example, three of the journalists I spoke with referred specifically to the Ontario Ministry of Health as an almost-impenetrable bureaucracy, and so were unlikely to use it as a source.) However, one experienced journalist noted that many of the sources used in AIDS stories were actually quite helpful, and less cynical about the media than sources in some other sectors.

In the case of particular stories on AIDS, a journalist might seek out a PWA as a source. This can be a difficult process, as some might not wish to be publicly identified as HIV-positive for fear of reprisals or discrimination. One journalist noted that potential PWA sources look closely at previous coverage of AIDS and if they are displeased with the headlines or the language, they will not agree to co-operate further. The development of PWA Coalitions has been of some assistance, as a journalist can go through such an organization to find a source willing to speak on the record.

Language

Sometimes journalists, who are in the business of choosing their words carefully, might bristle when given particular suggestions for language use. At the International AIDS Conference in Montreal in 1989, several organizations distributed "word alerts" to the journalists. However, as the coverage indicated, the suggestions were not generally incorporated, and the issuing of the word alerts became stories in themselves.

Those who write AIDS stories are by now familiar with the debate over the use of "victim" as a term for PWAs. (Headline writers, on the other hand, seem to be a "hard-to-reach risk group" when it comes to language use.) However, one journalist argued that the term was still appropriate, as AIDS was usually fatal and so to contract it was to be "victimized" by it. Another journalist noted that, even if the term "victim" is not used in a story, an editor might put it in a headline, sometimes arguing that it was more concise than "Person with AIDS."

News angles

As with many other social issues, there are a variety of angles which could be taken to present AIDS. It could be a health story, or a science story, or maybe a lifestyle story. AIDS has been presented in all of those contexts, and often within the same media outlet.

Journalists themselves approach a story with some "angle" intact, possibly based upon a suggestion from their editor. One journalist noted that she was frequently dealing with contradictory demands: to treat AIDS as a horrible disease but also to "normalize" it and work against the prevailing stigma. In an attempt to do the latter, she tries to find PWAs who are willing to speak on the record and be identified, and yet the resultant coverage sometimes dwells on the sickness and tragedy of the PWA's impending death.

Feedback from readers and sources

One method of determining whether one's stories are "fair" or "objective" is by evaluating the reader/viewer feedback. One journalist noted that his coverage must be "fair" and "middle-of-the-road" and "non-controversial" because he gets so little negative feedback.

According to journalists, some complaints from readers (and especially from sources) illustrate a basic misunderstanding of the constraints and the role of the media. A journalist cannot tell everyone's story and they are not there to do the work of AIDS committees or public health authorities. In relation to AIDS prevention, the media makes a clear distinction between being responsible for informing the public and educating the public. The latter is not seen to be a part of the media's role.28 Nevertheless, one journalist noted that the general aims of both media workers and health workers may be largely similar, thus resulting in a relationship that is less adversarial than in some other news beats.

It is also important to note that four of the six journalists interviewed explicitly referred to the emotionally draining nature of AIDS reporting. In addition to the content of many AIDS stories, they noted that it was unusual to cover a continuing story/issue where some of the key sources were dying. One journalist suggested that media workers are a bit like social workers in that they may undergo a process of desensitization in order to avoid "burnout."

Finally, journalists in this study were not particularly familiar with social science research on the media coverage of AIDS, and so did not have any strong feelings about this literature (nor did they express any particular interest in knowing more about the social science research). The only exceptions would be Randy Shilts' And the Band Played On (1987) and James Kinsella's Covering the Plague (1989), which were cited by several respondents. But both books were written by journalists and their accounts of government and media mishandling of AIDS do not seriously challenge the structure of news production.

Conclusions

As the previous discussion suggests, both journalists and social scientists tend to minimize the importance of newswork constraints, but for different reasons. Social scientists sometimes apportion blame to the editors or journalists, whereas the latter see themselves as able to rise above the constraints of their jobs to provide the "best-possible" coverage. One suspects that the actual effects of newswork might be more pronounced than either group admits, as coverage across the media appears to be fairly constant. The ideological positioning of a media outlet is not necessarily directly related to the nature of the coverage.

Indeed, the media needs AIDS as a story, but AIDS workers and researchers need the media as well. This seemingly symbiotic relationship is more often represented as a parasite-host relationship when speaking with either side. As one scientist involved in AIDS research noted, "AIDS research needs media publicity to maintain its impetus and financial support. But having created a monster of over-expectation, scientists must now be responsible for re-educating journalists in the reality of that research" (Weber, 1992, p. 2). While some might characterize AIDS coverage as a dialogue between journalists and a set of official sources, it is clear that neither party is willing or able to terminate the conversation.29

Furthermore, just as journalists pick and choose their sources under their own set of constraints (the need to quickly find authorized experts who are able to simplify the issues), social scientists and cultural critics also pick and choose which media texts to analyze. In the academy, there is also a strategic use of media texts. Certain texts are used as incontrovertible evidence to support a critic's own position, and yet other texts are condemned as being hopelessly distorted and impossibly skewed. One cannot have it both ways. Is it possible to trust certain factual information in the media and ignore the moralizing conclusions and advice? If media texts are not "always and already" misrepresentations, then what makes some worthy of citation and others fodder for condemnation? And how does one tell the difference? In some cases, critics are consciously using media texts to tease out and illustrate the tensions and contradictions within media representation. But in other work, stories are chosen which illustrate only one clearly articulated position, thus simplifying the diverse nature of media texts. In the least, this issue of the strategic use of media texts warrants further study.

In sum, this paper has argued that studies of the media coverage of AIDS have generally underestimated the structuring effects of newswork practices. Journalists, who work in this context daily, are aware of the effects of these practices even if they may underestimate newswork's effects. It is clear that further analyses of the media coverage of AIDS need to take these structuring processes of newswork into account.

Acknowledgments

The author wishes to thank several anonymous reviewers for their useful comments on an earlier draft of this paper, and SSHRC for financial support during the data collection phase of this research.

Notes

1
To be fair, the site that Watney (1987c) takes for his writing is heterosexist society itself, and so he interprets the media coverage of AIDS as fitting in with the homophobia of other segments of social life. Thus, the fit between media constructions and social panics have more to do with "consensus" than "conspiracy."
2
One exception to this trend is Hallett & Cannella (1994), who argue that the "hetero-centric" bias of the news media in the coverage of HIV/AIDS is not simply a result of the homophobia of news outlets and journalists; rather, it is "embedded in the routinized practices of mainstream `news production"' (p. 112).
3
For example, Cooper & Soley (1990) examine this cycle in relation to the privileging of certain sources within American news programs (see also Hallett & Cannella, 1994).
4
A 1989 study by the Robert Wood Johnson Foundation found that the majority of medical reporters had been hired into their positions within the previous two years. This means that they had little time to develop their expertise in the area, and it resulted in a reliance on press releases, especially from pharmaceutical companies (cited in Schwitzer, 1992).
5
Rogers, Dearing, & Chang (1991) found that the correlation between the AIDS coverage of The New York Times and The Washington Post was .96. Ironically, both are considered to be independent "newspapers of record" in the United States. Wallack, Dorfman, Jernigan, & Themba (1993) also noted the agenda-setting function of newspapers such as The New York Times, whereby smaller newspapers would avoid a story if the Times was not carrying it.
6
For example, according to the Managing Editor of The Ottawa Citizen, "the size of the paper is determined by the number and size of the ads" (Burnside, 1992). Thus, since the market for advertising is limited, the space devoted to news coverage is also constrained.
7
Indeed, Ericson, Baranek, & Chan (1987) claim that "deviance and control are the key ingredients of news" and that "most people derive their understanding of deviance and control primarily from the news and other mass media" (p. 3).
8
Social science research on AIDS itself has not escaped such sensationalism. A 1988 special issue of the journal Social Research was titled "In Time of Plague." And even segments of the counter-cultural press have published sensationalist stories, articles blaming Haitians for "spreading AIDS," and blanket generalizations about "heterosexual hysteria" (e.g., Bazell, 1983, p. 17; Cathcart, 1987, p. 52; Nicholson, 1992; Radical America, 1986).
9
In a study of American newswire releases on AIDS, Drushel (1991) argued that the term "victim" might carry a negative connotation for the public, "but its use in newswriting seems almost sympathetic" (p. 57). Given such creative reinterpretations, he argued that AIDS coverage had not been overly sensational.
10
It should be noted that there is no disease which currently enjoys a full-time reporter on its beat. Even illnesses such as cancer or heart disease are covered by someone who also follows a broader range of medical or health developments. Indeed, the fact that a few newspapers identified an "AIDS beat," albeit for a short time, illustrates the significant ability of AIDS to climb to the top of the media agenda.
11
A few media outlets claimed that this link between AIDS and homosexuality had actually been downplayed due to the power of the gay lobby, and this was putting the "general population" at risk (see, for example, Accuracy in Media, 1987; Kupelian, Masters, Harris, & Newton, 1990).
12
Colby & Cook (1991) also noted how gay PWAs were usually depicted in parks or bars, whereas PWAs with hemophilia were shown surrounded by family in a home setting. This reflected the difference in media presentation of PWAs, depending on the presumed mode of HIV transmission.
13
For example, Steele (1992) referred to a decision of one newspaper to pull a picture of two men kissing from a story on AIDS, due to a fear that the readers would respond negatively and this would compromise the newspaper's ability to "accomplish its goals" (p. 30).
14
However, as media workers argued, it was not the job of the press to do public health advocacy work (see Lander, 1988). Also, prevention information may not have been included in every story since that was seen as being too repetitive, and news is supposed to be "new" (see Goodin, 1994).
15
For example, Kinsella's (1989) book, Covering the Plague, does focus on how the perspectives of individual journalists affected their coverage and even considers the inner workings of news organizations. Nevertheless, it largely fails to present an analytical critique of the structuring properties of the media system itself.
16
In a pejorative twist on this recognition of the effects of journalistic practices, Lauritsen (1991) argued that, due to the nature of the crisis, AIDS reporters "should be regarded as war correspondents, in which case their performances, however appalling, are par for the course" (p. 14).
17
On occasion, reference is made to a particular journalist's experience. However, most often the sources remain anonymous.
18
Savoury noted that even if someone is a great expert on a topic, but cannot speak in lay terms, then they should not be handling public events or news conferences. These contexts call for communication skills, not scientific rigour (Eve Savoury, CBC Television, personal communication, August 31, 1992).
19
Caitlin Kelly, who covered AIDS for The Globe and Mail, argued that the mainstream media was (and should be) directed toward a middle-class, educated, urban readership which did not include gay men (referred to as "a bunch of guys down at Church and Wellesley"). She claimed that, since gays had their own publications and shared culture, "I don't think it's realistic to expect...the mainstream media to address some of the more particular concerns of a very small segment of the population" (cited in CBC, 1989, p. 4).
20
For example, opening day coverage of the 1989 International AIDS Conference in Montreal focused on the AIDS activists who "disrupted" the opening ceremonies. The activists provided not only a dramatic angle for the story, but some very compelling visual hooks as well.
21
The news "fatigue" over AIDS occurred early in some media outlets. For example, one editor (after publishing only six stories on AIDS in five months) told his reporter he was "sick and tired of reading about AIDS" (cited in Lander, 1988, p. 69).
22
Linda Barnard, of The Toronto Sun, noted that she made sure to "ride the desk" to make sure that headlines did not misrepresent her stories (personal communication, August 31, 1992). Such active intervention by journalists may be unusual, but may also be necessary given the record of the headline writers of the Sun.
23
In general, news coverage of medical issues tends to use more institutional sources than many other beats. Goodin (1994) found a similar phenomenon in relation to The New York Times, which does have the resources to do its own investigative reporting.
24
In a December 1987 update, the Centre referred to one of the "risk factors" for AIDS as being "homosexual/bisexual male" (Federal Centre for AIDS, 1987, p. 2).
25
Regush also feels that AIDS activists have uncritically accepted mainstream science. He finds it ironic that they might not understand science, but they will still cling to it and claim the medical journals as their holy texts (Nicholas Regush, The Gazette [Montreal], personal communication, August 31, 1992). This shows the power of medical science to operate as a discourse of knowledge for people across the political spectrum.
26
Strauss (1993) noted The Globe and Mail's record during 1991-93 of publishing an average of one story on AIDS every day, and compared that with its coverage of other diseases such as arthritis (which dominated only six stories in the same two years). Strauss believed that this was too much coverage for AIDS. Rod Mickleburgh, who had written many of these stories for the newspaper, disagreed with this argument but recognized that Strauss was not the only journalist who thought that AIDS received too much attention (personal communication, April 14, 1993).
27
Weber (a researcher) argued that, increasingly, scientists are being required to exaggerate their findings in order to maintain access to the media: "the media insist that scientists make bizarre or outrageous claims for their research for it to be deemed newsworthy. Nothing incremental will do; AIDS stories must now concern breakthroughs, and researchers risk contributing to these exaggerations by hyping their own accounts" (Weber, 1992, p. 2). This "rhetoric inflation" may be at least partially a result of the keen competition for news space.
28
However, media outlets have provided free time and space for public health announcements. In the U.S., it is estimated that this contribution accounted for 40% of all AIDS advertising (Cameron, 1989). In May 1987, the President of the Canadian Association of Broadcasters estimated that member stations had broadcast over 150 hours of television programming on AIDS (Bond, 1987). And a study of AIDS coverage in the U.S. mainstream media between 1985 and 1996 argued that "[P]rint and broadcast media devoted the greatest portion of its AIDS coverage to information about transmission and prevention in the mid- to late 1980s, when the public's learning curve showed it was most in need of such information" (Kohut, Hugick, & Brady, 1996, p. 2). Here the authors believe that the media did play a major public health role.
29
The director of the U.S. national AIDS education program argued that continued media coverage of AIDS was necessary in order to maintain education and research programs. He told a group of journalists: "It's so important that you continue to keep this story [AIDS] in front of people's eyes, because if it disappears from the front pages, from the TV programs, then the concern and care for the [AIDS prevention and research] programs will disappear" (cited in Sellers, 1989, p. 16). And the former director of the World Health Organization's Global Programme on AIDS stated: "The media has been essential [in the struggle against AIDS] since the beginning" (Mann, 1988, p. 4). The impact of media coverage on health policy is also discussed by Walsh-Childers (1992) and Wallack, Dorfman, Jernigan, & Themba (1993).

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Interviews

Linda Barnard, The Toronto Sun, August 31, 1992.

Debora Van Brenk, The London Free Press, August 31, 1992.

Rod Mickleburgh, The Globe and Mail, August 26, 1992, April 14, 1993.

Nicholas Regush, The Gazette (Montreal), August 31, 1992.

Eve Savoury, CBC Television, August 21, 1992.

Kelly Toughill, The Toronto Star, August 31, 1992.



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