Infectious Ideas

U.S. Political Responses to the AIDS Crisis

Jennifer Brier

• Publisher: The University of North Carolina Press
• Year: 2009
• Print ISBN: 9780807872116, 9780807833148
• eBook ISBN: 9780807895474
• Topic: Storia
• Subtopic: Storia sociale

Viewing contemporary history from the perspective of the AIDS crisis, Jennifer Brier provides rich, new understandings of the United States' complex social and political trends in the post-1960s era. Brier describes how AIDS workers — in groups as disparate as the gay and lesbian press, AIDS service organizations, private philanthropies, and the State Department — influenced American politics, especially on issues such as gay and lesbian rights, reproductive health, racial justice, and health care policy, even in the face of the expansion of the New Right. Infectious Ideas places recent social, cultural, and political events in a new light, making an important contribution to our understanding of the United States at the end of the twentieth century.

1

Affection Is Our Best Protection

Early AIDS Activism and the Legacy of Gay Liberation

ON JUNE 18, 1983, almost two years to the day after the Centers for Disease Control (CDC) reported in its Morbidity and Mortality Weekly Report the first cases of the disease that would be called Acquired Immune Deficiency Syndrome (AIDS), Boston’s weekly gay newspaper, Gay Community News (GCN), published a discussion between writer-activists Cindy Patton and Bob Andrews about the personal and political implications of what had become the AIDS epidemic. Patton, who in 1983 served as the managing editor of GCN and would go on to be a prolific social theorist of AIDS, was one of the first women to publish commentary on AIDS.¹ In this early article she made a political argument about how gays and lesbians should respond to AIDS:

What we are experiencing in the gay community right now is “It’s not political until it’s personal.” . . . In dealing with the government agencies and the health industry regarding AIDS, we can channel our anger outside of our community. Turning our anger inward and toward others in our community divides us unnecessarily. Gays are worn down by our oppression. We worry about our jobs, our lovers, about coming out. Straight society has said to us, “You lead this terrible lifestyle and your punishment is to be sick all of the time,” and on some level we’ve accepted that. We have to turn that around now, and say: This society is not going to kill us any more.²

Patton’s analysis illustrated a particular moment in both the early history of AIDS and the epidemic’s place in the larger political history of the 1980s. First, Patton connected AIDS to feminism, albeit in a somewhat altered form. By reversing the feminist proverb “the personal is political,” a phrase that had acquired meaning in the feminist movement of the previous decades, she suggested that lesbians and gay men needed to see their collective health as a political problem, even if only some of them were actually sick or personally affected by illness. Second, Patton’s words echoed the language of the gay and lesbian liberation movement. By rejecting individual solutions and instead calling for the end to “straight” oppression, Patton imagined a response to AIDS that would reinvigorate gays and lesbians in a struggle for more systemic liberation. By combining gay and lesbian liberation with feminism, Patton provided an alternative to her contemporaries who suggested that controlling AIDS required, first and foremost, individual behavior change, in the form of gay men altering the way they had sex. Instead, Patton suggested that mobilizing against homophobic oppression was the only way to address the roots of the AIDS epidemic. A few months after GCN published the Andrews/Patton interview, Patton wrote, “I have developed a personal obsession to understand AIDS in the broad context of gay liberation.”³

Patton’s response to the epidemic does not jibe with much that has been written about the early response to AIDS on three counts. First, we assume that lesbians were largely absent from nascent political conversations about the epidemic, in part because public health officials refused to consider how lesbians might be at risk for AIDS, and in part because they served in caretaking roles for gay men with AIDS rather than as political spokespeople for ways to address the AIDS epidemic. Their support role included organizing blood drives when men were banned from donating blood and serving as buddies in the volunteer programs started by new ASOs.⁴ Second, historical accounts of AIDS have told us that the gay press, except New York’s gay paper the Native, did little to warn gay communities about AIDS.⁵ In his widely republished article about the AIDS epidemic, “1,112 and Counting,” originally published in the Native in March 1983, writer-activist Larry Kramer wrote, “With the exception of the New York Native, and a few, very few, other gay publications, the gay press has been useless.”⁶ Finally, and arguably most significantly, we have come to the conclusion that the earliest gay attacks on AIDS figured the disease as the end to gay liberation. Again, Kramer contributed to this model. In his published essays and plays, Kramer encouraged gay men to stop having sex in the ways they had in the 1970s. Kramer demanded of gay men, “Get your head out of the sand, you turkeys! I am sick of guys who moan that giving up careless sex until this blows over is worse than death. . . . I am sick of guys who think that all being gay means is sex in the first place. I am sick of guys who can only think with their cocks.”⁷ Kramer’s contemporary, reporter Randy Shilts, joined in his effort to effect sexual transformation. A gay man writing for the San Francisco Chronicle, Shilts became one of the most prolific popular writers investigating AIDS in the early 1980s. In his best-selling book, And the Band Played On, published in 1987, Shilts represented Kramer as one of the heroes of the book: “Larry Kramer was growing more militant in this stance . . . [to] tell people that, if they wanted to survive, they should just stop having sex.”⁸ Beyond his defense of Kramer, Shilts coined the term “AIDSpeak” as “a new language forged by public health officials, anxious gay politicians, and the burgeoning ranks of ‘AIDS activists.’ ”⁹ In the process, he characterized attempts to reinvent gay liberation in the age of AIDS as dangerous pipe dreams. “For the past decade, spokespeople of the gay rights movement had held endless press conferences to argue against the stereotype that gay men were sex fiends wholly preoccupied with getting their rocks off. With AIDSpeak, however, many of these same spokespeople were now arguing that bathhouses must stay open because gay men were such sex fiends that they would be screwing behind every bush if they didn’t have their sex clubs.”¹⁰ Together, the two most infamous proponents of the position that the end to AIDS would come from the abandonment of what they defined as the legacy of gay liberation continue to shape our historical understanding of the epidemic.

Patton’s writing suggests the limits of all three historical claims: that lesbians did not play a role in theorizing how to contain AIDS through politics, that the gay press did nothing about AIDS, and that people who embraced the healthy potential of gay liberation just wanted an excuse to have sex in irresponsible ways. Lesbians not only theorized and wrote about how sexuality would change in the age of AIDS, but they also worked with gay men to chart an alternative response to the emerging AIDS epidemic, one based explicitly on gay liberation and implicitly on feminism. In the pages of gay newspapers across the country, but particularly at GCN, the only gay paper that explicitly combined feminism and gay liberation, gays and lesbians who had lived through the liberation movement of the 1970s participated in a vociferous debate about the meanings and practices of health and liberation as well as the role gender politics might play in that discussion.¹¹ In effect, these feminist writers, both male and female, shaped their response to AIDS around both their personal experiences with AIDS and their role as activists in the social movements of the postwar era, particularly feminism, the women’s health movement, and gay and lesbian liberation.

In this chapter I explore the arguments made by these earliest AIDS activists who used the medium of the gay press to communicate a message that AIDS provided a moment in which to return to gay liberation, not run away from it. They struggled with, and argued over, the meaning of key terms, including “gay liberation,” “health,” “behavior,” “fulfillment,” and “promiscuity.” They asked if gay liberation required complete sexual freedom, often described by critics and defenders alike as promiscuity; what role love and affection should play in liberated behavior; and how communities could be empowered by coalition building around sexual health. Taken together, these questions signaled that writer-activists struggled with how to develop complete and long-term sexual health for gay and lesbian citizens. Instead of calling on men to curtail sexually liberated behavior, they sought to reinvigorate gays and lesbians in the fight for political and cultural recognition as well as to push for equality of diverse sexual practices. These women and men argued that sexual expression itself held the potential for containing the spread of AIDS. Numerous gay and lesbian periodicals echoed the theme and struggled to describe a new disease to their readership. In the process, these writers created a conversation about the possibilities for queer community and queer politics among people thinking about and studying AIDS.

Looking at this evolving community-based AIDS work provides an opportunity to see beyond the unfolding of scientific events and toward the kinds of conversations made possible by the scientific unknown. In a period of medical uncertainty, there was room for a far-reaching conversation among a more diverse group of people, in particular laypeople trained not in science but in the intricacies of grassroots political struggle.¹² Community members could talk about AIDS without being trumped by doctors and health professionals. This, when coupled with the legacy of the feminist health movement of the 1970s, which argued that women should participate in their own health care, produced a moment where a community approach to knowledge was possible.¹³

This chapter ultimately argues for a reconsideration of the periodization of both the gay and lesbian liberation movement and the AIDS activist movement. While historians have paid considerable and productive attention to finding the roots of gay liberation earlier in the postwar period, the same kind of inquiry has not been applied to the other end of the period.¹⁴ Few, if any, accounts of gay and lesbian liberation see it continuing into the 1980s. Instead, a multidisciplinary field of scholars has argued that by the 1980s gay and lesbian activism became increasingly concerned with liberal civil rights and abandoned calls for radical, liberationist political change.¹⁵ I do not disagree with accounts that ultimately explain how fights for gay liberation became fights for gay marriage over the course of the 1980s and 1990s, but the material cited in this chapter suggests that AIDS actually allowed liberation politics to define the gay and lesbian social movement well into the 1980s. In a 1983 speech to a Boston community center, delivered a few month after Kramer’s “1,112 and Counting,” activist Diane Feinberg forcefully exclaimed that “AIDS is not just a medical crisis. The intransigence of the U.S. government, . . . the stepped-up violence against lesbians and gay men, violently racist scapegoating of Haitian immigrants . . . all this has made AIDS a profoundly political crisis as well.”¹⁶

Before AIDS

The AIDS epidemic was not the first time gays and lesbians thought about sexually transmitted diseases (STDs) or speculated about the connection between the frequency of sexual acts and sexual health or the link between sexual health and physical health more generally. Before the appearance of AIDS in the early 1980s, gay men experienced the effects of other STDs, including hepatitis B, syphilis, and gonorrhea.¹⁷ At the time, some gay men argued that this was a predictable, even acceptable, consequence of gay liberation. In his memoir about AIDS, Richard Berkowitz writes that “coming of age in the 1970s, many young gay men outside cities had no concept of sex without danger — of being found out, disgraced, arrested, beaten up, etc. STIs [sexually transmitted infections] were just one more thing to be added to a long list.”¹⁸

Without access to competent and sensitive medical care in established institutions, many gay men sought treatment for STDs with the handful of gay doctors whose client roster was almost entirely gay. In New York City, Joseph Sonnabend was one of those doctors. A white South African immigrant trained in infectious disease, Sonnabend embodied this role as a doctor with a large gay practice in the gay neighborhood of Greenwich Village. Known as a “clap doctor,” he regularly prescribed antibiotics and other treatments for STDs to hundreds of clients, many of whom returned to Sonnabend’s clinic often.¹⁹

Sonnabend was not alone in his efforts. Beginning in 1979, Robert K. Bolan, a gay doctor with a private practice in San Francisco, helped form the National Coalition of Gay Sexually Transmitted Disease Services, a network for the just over fifty service groups and individuals addressing STDs in gay men across the country. The organization advocated infusing an understanding of gay life into health services. Writing as a member of the coalition in 1981, Bolan explained that “knowledge of specific Gay sexual activities, and the ability to be supportive of Gay sexual expression while discussing health and avoidance of disease is absolutely essential if individual health education is to be effective.”²⁰ Bolan strongly urged fellow health care providers to reiterate that gay sexuality was, in and of itself, healthy. In an article published in the Bay Area Reporter (BAR), one of San Francisco’s main gay newspapers, Bolan expanded the definition of healthy sexual behavior to “expression of one’s natural sex drives in satisfying, disease-free ways. Guarding your health and respecting the health of your partners means, for one thing, being aware of your body and the messages it may be giving you.”²¹ The reciprocation implied in Bolan’s model came from his commitment to one of the central arguments of gay liberation, that gay sex was healthy.

At the same time that Bolan devised the guidelines for healthful gay sex, other members of the gay community took a number of steps, both formal and informal, to promote gay sexual health. Small groups of gay doctors and health professionals established community health care clinics in several cities, including Boston, Chicago, New York, and Los Angeles, throughout the 1970s.²² In Boston, a city with a long history of women’s health activism embodied by the Boston Women’s Health Book Collective, author of Our Bodies, Ourselves, gay and lesbian health activists took over a community health center called the Fenway Clinic. In 1975 a group of health care providers formed the Gay Health Collective and began to offer a free VD clinic at the Fenway one night a week. Over the course of the next several years, with the hard work of many collective members, gay and lesbian health became an “integral part of the function of the health center.”²³

Ron Vachon, a physician’s assistant in Boston, was a founding member of Boston’s Gay Health Collective and a member of the National Coalition of Gay Sexually Transmitted Disease Services. Vachon worked at the Fenway until 1980, when he moved to New York to work at a health clinic in Chelsea, an increasingly gay and gentrified neighborhood in Manhattan.²⁴ As was the case with Bolan, Vachon expressed a desire to connect sexual health with the forms of intimacy between men that had been at least partly destigmatized by gay liberation. In...

Table of contents

• Table of Contents
• Title Page
• Copyright Page
• Dedication
• Acknowledgements
• Abbreviations and Acronyms
• Prologue
• 1 - Affection Is Our Best Protection
• 2 - Marketing Safe Sex
• 3 - What Should the Federal Government Do to Deal with the Problem of AIDS?
• 4 - AIDS, Reproductive Rights, and Economic Empowerment
• 5 - Drugs into Bodies, Bodies into Health Care
• Epilogue
• Notes
• Bibliography