To Make the Wounded Whole

The African American Struggle against HIV/AIDS

Dan Royles

• Publisher: The University of North Carolina Press
• Year: 2020
• ISBN:
  9781469659510
• Topic: Social Sciences
• Subtopic: African American Studies
• Index: Social Sciences

In the decades since it was identified in 1981, HIV/AIDS has devastated African American communities. Members of those communities mobilized to fight the epidemic and its consequences from the beginning of the AIDS activist movement. They struggled not only to overcome the stigma and denial surrounding a "white gay disease" in Black America, but also to bring resources to struggling communities that were often dismissed as too "hard to reach." To Make the Wounded Whole offers the first history of African American AIDS activism in all of its depth and breadth. Dan Royles introduces a diverse constellation of activists, including medical professionals, Black gay intellectuals, church pastors, Nation of Islam leaders, recovering drug users, and Black feminists who pursued a wide array of grassroots approaches to slow the epidemic's spread and address its impacts. Through interlinked stories from Philadelphia and Atlanta to South Africa and back again, Royles documents the diverse, creative, and global work of African American activists in the decades-long battle against HIV/AIDS.

CHAPTER 1

A Disease, Not a Lifestyle

Race, Sexuality, and AIDS in the City of Brotherly Love

RASHIDAH HASSAN WAS NERVOUS as she waited to take the stage in Philadelphia’s LOVE Park on a wet September night in 1986. She knew that the short speech she had turned over and over in her mind would anger some of the crowd gathered for the city’s first candlelight AIDS walk. They marched that night to remember the friends, lovers, siblings, and children they had lost to AIDS. Hassan shared their grief. Nevertheless, she was resolute about her message. As board vice president of Philadelphia Community Health Alternatives (PCHA), the parent organization of the Philadelphia AIDS Task Force, Hassan had grown frustrated at her colleagues’ response to the growing AIDS epidemic among African Americans and other people of color in the city. During her speech she would resign her board position and call for a new approach to AIDS in the city’s Black community.¹

Hassan² presents herself as a lifelong skeptic and iconoclast, although her work has also been driven by a deep sense of faith. She recalls being a “fairly concrete thinker” even as a child, when she earned trips to the pastor’s office at her Baptist church for “disrupting Sunday school by asking these very complex questions that the teachers didn’t know how to answer.” Curiosity led her to explore other faiths—Judaism and then Islam, to which she converted. She found the religion attractive because it emphasized “service to humanity, which tied back to my nursing, which was service to humanity, … in ways of care and treatment … which after a bit expands itself into social care and public health. And so there I landed, exactly where I was supposed to be, and in the midst of all that up came the HIV epidemic.”³

That “exactly where” turned out to be a hospital room at Einstein Medical Center in the Germantown neighborhood of Philadelphia, where during the early 1980s she worked as an infectious disease nurse. One of the first African Americans with AIDS she encountered was a young man who had dropped out of high school and was living in poverty. He most likely contracted HIV either from the older men who paid to have sex with him or by sharing needles when injecting the drugs that he bought with their money. Either way, he landed in Hassan’s hospital when his kidneys stopped working; they were clogged with the cornstarch he used to cut his drugs with before shooting up. Hassan recalls that as she entered the young man’s hospital room, she found a horde of doctors, residents, and medical students, all looking at him “as a specimen.” “They literally said to him, ‘Your kidneys are shot. We’re going to put you on dialysis, you have AIDS, and,” gesturing to Hassan on their way out, “she’s going to tell you what you need to do next.” Hassan asked the patient if he understood. He replied, “My kidneys don’t work. I’m not sure about what dialysis is, and I don’t know whatever else it was they said.”⁴

In the young man’s hospital room, Hassan glimpsed the future of AIDS in the United States. Her patient—impoverished, “functionally illiterate,” infected with HIV through drugs or sex work, and disregarded by his doctors—embodied the myriad ways that social, economic, and medical inequities would fuel the AIDS epidemic in Black communities. At that moment, Hassan realized “that this would be more likely the kind of people that would develop AIDS and HIV, and they would die not understanding anything that happened to them.” In fact, the disease had already begun to “settle” in Philadelphia among the city’s Black and Latino residents, and especially among those who were already poor and disenfranchised.⁵

Unlike San Francisco or New York, each of which is the setting for one of the chapters to follow, Philadelphia is neither a gay mecca nor a global capital of finance and culture. However, Philadelphia is a major city, home to over 1.5 million people. Its response to the AIDS crisis in the 1980s illustrates the ways that the postwar fate of many American cities shaped a growing epidemic. Like other urban centers in the Northeast and Midwest, Philadelphia was scarred by segregation, white flight, deindustrialization, and disastrous urban renewal schemes, which left the city with an eroded tax base and dwindling coffers on the eve of the AIDS crisis. Cities like Philadelphia were epicenters of the early epidemic but, thanks to systematic abandonment and disinvestment, lacked the resources to mount an effective response.⁶

At the same time, a vibrant gay and lesbian scene flourished in Philadelphia during the decades following World War II. Downtown Philadelphia emerged in these years as the nexus of local gay life, where gay bars, cafés, and shops near Washington Square and along Spruce Street coalesced into an enclave known as the “Gayborhood.” Here, during the 1960s and 1970s, gay men and lesbians in Philadelphia began to organize for sexual freedom. Some groups, such as the Philadelphia Gay Liberation Front, were quite racially diverse; others less so. In 1974 a group of mostly white gay and lesbian activists tried—and failed—to pass a bill through the city council that would add sexual orientation as a protected category under Philadelphia’s Fair Practices Ordinance. The bill was defeated in no small part due to the united opposition of the city’s Black clergy, who thoroughly rejected the activists’ argument that homophobia was akin to racism. By the early 1980s, leaders of the Philadelphia Lesbian and Gay Task Force came to recognize the importance of racial diversity to their organizing strategy and accordingly built bridges to local Black gay activists. When a second nondiscrimination bill came before the city council in 1982, it passed. Wilson Goode, the city manager of Philadelphia, testified in support of the bill. The following year, with backing from the city’s gay and lesbian community, he became Philadelphia’s first African American mayor.⁷

Nevertheless, the “city of brotherly and sisterly loves” remained divided by race. The downtown gay scene comprised mainly white men, while Black gay men and lesbians instead set up their own social clubs in West Philadelphia. When Black gay men went out drinking and dancing downtown, they faced discrimination at bars that catered to white gay men. A bouncer might ask them for multiple forms of identification while letting white gays who appeared to be underage enter freely. Black gay men who did get inside reported being served last by bartenders and ignored by white patrons. The problem was not limited to Philadelphia; Black gay men in other cities described similar experiences with racial discrimination.⁸

As a result, a handful of bars catering mostly to Black gay men had cropped up in Center City by the early 1980s, including Smart Place near Tenth and Arch, Pentony’s near Thirteenth and Arch, and Allegro II at Twenty-First and Sansom. However, as Black gay activist Arnold Jackson noted, “If blacks think they are escaping oppression by going to these bars, they are truly mistaken.” Black gay men decried the bars’ white owners for their “apparent refusal to spend money on upkeep.” Philadelphia’s gay bars, it seems, were both separate and unequal.⁹

Moreover, the treatment that Black men received at the city’s gay bars was emblematic of a racial tension that suffused the community as a whole. Black gay men in Philadelphia reported that their white counterparts viewed “blacks as being inferior or less intelligent or sex objects.” Others reported being made simply to feel invisible. Joseph Beam, a Black gay writer who lived in Center City, described being ignored by his “mostly young, white, upwardly mobile” neighbors, except when they wanted to see “if I had any reefer.”¹⁰

Black gay men and lesbians felt similarly marginalized in local gay politics. In a 1986 letter to the gay newspaper Au Courant, Don Ransom, a Black gay man, criticized the “plantation mentality” in Philadelphia’s gay and lesbian community. He pointed to the lack of local Black gay speakers at a protest organized by the Philadelphia Lesbian and Gay Task Force in response to the Supreme Court’s decision to uphold state anti-sodomy laws in Bowers v. Hardwick. The group had invited Gil Gerald of the Washington, D.C.-based National Coalition of Black Lesbians and Gays to speak at the event, but Ransom saw this as evidence that the Philadelphia Lesbian and Gay Task Force “had to go out of town and find someone who wouldn’t know about their behavior or their exclusionary policies.”¹¹

Racial divisions in gay Philadelphia were exacerbated by the role that gay men played in gentrifying Center City and the surrounding neighborhoods beginning in the 1960s. As they moved into the area around Washington Square and along the South Street corridor, they drove out residents who were disproportionately Black and working-class. Gay men were not the sole participants in the “back-to-the cities” movement that brought young, upwardly mobile professionals to the urban core. However, newspaper coverage framed the new urban residents as bourgeois sissies, describing the “quiche-and-fern bars” that they brought to neighborhoods like Queen Village, which bordered Center City along the Delaware River.¹²

Through both discrimination and gentrification, white gay men marked their downtown enclave as a space for affluent and middle-class whites. For Black gay and bisexual men in particular, the whiteness of the Gayborhood’s bars and clubs also extended to its political institutions. This would have significant consequences for the way those same men, along with other Black Philadelphians, understood their risk for AIDS. With a cash-strapped city and with state and federal officials largely unwilling to address an epidemic associated with gay men and drug users, groups rooted in the Gayborhood took on the work of responding to a growing public health crisis. The whiteness of early AIDS groups in Philadelphia also reinforced the idea within the city’s Black community that AIDS was primarily a white gay disease. As the disproportionate impact of the new disease on African Americans became clear, activists challenged local AIDS groups to improve their minority outreach.¹³

In the ensuing debates over Philadelphia’s AIDS response, issues of race, sexuality, and the division of urban space took center stage. The predominantly white gay AIDS groups that grew out of the Gayborhood argued that prevention efforts should be focused on the bars, bathhouses, and bookstores that anchored gay life downtown. After all, gay and bisexual men made up the overwhelming majority of people with AIDS in Philadelphia. But critics, including Rashidah Hassan, argued that these groups failed to reach Black gay and bisexual men, who appeared to be at greater risk. For Hassan it was race, not sexuality, that structured Black gay men’s daily lives. She argued that Black gay men would best be reached by canvassing the Black neighborhoods that lay to the north, west, and south of Center City, and in 1985 she founded Blacks Educating Blacks about Sexual Health Issues (BEBASHI) to do just that.

Hassan’s approach represented a view of Black gay identity that emphasized racial solidarity over sexual difference, one that was shared by at least some Black gay activists in Philadelphia. Yet this represents just one of the ways that African American AIDS activists made room for queerness within prevailing ideas about Black community and identity. As we will see in later chapters, other groups took diverging approaches.

One New Case per Week

As in other cities, Philadelphia’s first response to the AIDS epidemic came from within the predominantly white gay community. In 1979, gay health activist and regional health commissioner Walter Lear founded Lavender Health, a gay and lesbian community health group, which was renamed Philadelphia Community Health Alternatives in 1981. The following year, as reports of a new and deadly “gay cancer” began to spread, PCHA members formed the Philadelphia AIDS Task Force, a volunteer group dedicated to fighting the disease. Task force members distributed educational materials outside gay bars, operated an informational hotline, and provided “buddy” services to those who had become sick and had trouble caring for themselves.¹⁴

The downtown gay enclave in which the PCHA and the AIDS Task Force were found was in many ways a segregated neighborhood and was perceived as a specifically white space, especially by the Black gay men who felt excluded from it. As a result, gay men in Philadelphia developed overlapping but distinct racial and sexual geographies. Black and white gay men tended to live, work, and play in different parts of the city, or at least in different clubs downtown.¹⁵

Even as public health reports began to show that a disproportionate number of African Americans in Philadelphia were succumbing to AIDS, the Gayborhood’s reputation as a specifically white space shaped the way that Black gay and bisexual men understood their own risk for the disease. In July 1983, Don Ransom and Len Bost, both members of the local Black and White Men Together (BWMT) chapter, told the Philadelphia Gay News that even as statistics showed that half of the city’s cases were among African Americans, other Black gay men regarded AIDS as “a white man’s disease.” Both men urged the AIDS Task Force to reach out to the city’s Black and Latino communities.¹⁶

The following year, the AIDS Task Force launched its “One New Case per Week” campaign to inform the public that AIDS affected all racial groups. It produced posters with three different faces—one white, one Black, and one Latino—along with a tagline about the rate of new AIDS diagnoses in the city. Perhaps in a deliberate attempt to push its message beyond Center City a...