Dying for the Movement: The Terrible Political Payoff of AIDS - Victory: The Triumphant Gay Revolution - Linda Hirshman

Victory: The Triumphant Gay Revolution - Linda Hirshman (2012)

Chapter 6. Dying for the Movement: The Terrible Political Payoff of AIDS


When Steve Endean arrived in Washington in 1978 to run the Gay Rights National Lobby, the telephone was disconnected for nonpayment. To get the gay PAC, then called the Human Rights Campaign Fund (HRC-F), going in 1980, he had to send a gorgeous young man to entice the semicloseted Tennessee Williams to sign the group’s first fund-raising letter and, even then, the gay politicos had to wait until Williams was mostly in the bag to get his assent. Chicago’s Howard Brown Clinic for gay men shared a room over a grocery store with a coffee bar. The only overtly gay-themed play to have run on Broadway was the historical drama Bent, about the Nazi persecution of homosexuals in Germany.

Roscoe Willett Browne, Robby Browne’s favorite brother, was running Pan Am’s Asian operations out of Sydney and living with his lover, Craig. Closeted lawyer Dan Bradley, head of the US Legal Services Corporation, was praying he would not get caught at the bathhouses he frequented. Randy Shilts had just become the first openly gay reporter at any major American newspaper, the San Francisco Chronicle. Harvey Milk’s right-hand man, activist Cleve Jones, was working for California state assemblyman Art Agnos and making lifelong friends out of the men he casually picked up for sex on the street and in the baths.


In 1996, the gay lobby Human Rights Campaign (HRC) had a full-time staff of sixty, a budget of $10 million, and 175,000 members. The president of the United States spoke at its 1997 fund-raising dinner. The AIDS service organization Gay Men’s Health Crisis (GMHC) was spending $30 million annually. Tony Kushner’s play Angels in America had run on Broadway for two years, winning both the Tony Award and the Pulitzer Prize. Cold sober and with no boys in the picture, legendary actress Elizabeth Taylor had raised hundreds of millions of dollars to cure a disease heavily affecting gay men.

But Roscoe Browne’s mother had to pay the funeral home extra to lay his infected corpse in the family plot in Louisville. Dan Bradley was buried in the blue cap he thought made his eyes look blue. Randy Shilts dictated the end of his last book from his deathbed. Cleve Jones was lying alone on the bathroom floor awaiting the inevitable.

A Civil Rights Movement Unlike Any Other

AIDS was the making of the gay revolution. Before the epidemic struck, the gay movement had settled into a predictable pattern. The charismatic period after Stonewall gave way to newborn bureaucracies. The blandly named National Gay Task Force (NGTF) was taking model civil rights ordinances from one liberal city to the next. The Human Rights Campaign Fund, without even the word “gay” in its name, was raising money from millionaires for its liberal political allies, some of whom would agree to have their picture taken with gay leaders only if the PAC promised not to release it until after their election.

True, the liberation period since Stonewall had thrown up a robust cornucopia of private pleasures. The gay Metropolitan Community Church was growing exponentially and so were the bathhouses. But the robust civic sector was not reflected in a similarly robust political movement. Unlike the other major civil rights movements, the gay movement was still saddled with free riders, people passing as heterosexual while the out activists labored to make the world a better place. Like the racial and feminist movements before it, the gay movement was struggling with a powerful backlash, fueled in this case by the revival of the religious right. By 1980, the racial civil rights movement had stopped well short of achieving anything like the radical economic measures that would have changed the prospects of most black Americans. The black communities of the separatist movement were simply not important enough to white Americans to generate any serious political capital and the availability of integration siphoned off the most economically viable movement beneficiaries. While opening up formal opportunities for women in the workforce, the feminist movement had similarly left the structure of the reproductive family intact, marooning its newly employed female workers in the iron grip of the second shift. While the newer mainstream gay organizations were slowly making progress in their conventional ways, the arc of the movement was by no means clear. Then AIDS struck.

AIDS was just the type of emergency public health institutions exist to address—a fatal, infectious disease. And yet, as the protesters would chant when they finally acted up, many years later, “We die/they do nothing.” For several crucial years the government of the United States did nothing. Most states and cities did nothing. Often their own families did nothing. The existing institutions of the gay movement did next to nothing. The loudest voices in the community urged them to do nothing. Twentieth-century history was full of examples of people who, when threatened, did nothing, and they might have done the same. Instead they created the most successful social movement of the contentious American twentieth century. They came out. Where their families and their state failed them, they created new institutions to replace the family and the state. When their shadow society still wasn’t powerful enough to stop the epidemic, they created yet more institutions, this time, to capture the state itself. What had started when a gay Stonewall patron threw a brick at a policeman in 1969 ended with gay activists leveraging the government to spend billions looking for a cure for a fatal, heavily homosexual, disease.

Getting the government of the United States to help them was a victory that no other movement in modern American history has ever achieved. The racial civil rights movement desegregated the schools and the polling booths. But it never got government resources that would have enabled African Americans to escape the historical legacy of poverty. After the civil rights movement, poor blacks and rich whites alike are free to go to the schools they can afford. The feminist movement decriminalized abortion, the procedure that guarantees women’s control of their reproductive fates. But they never got poor women access to the resources of public health for this essential civil right. After the feminist movement, poor women and rich men alike are free in America to pay for their abortions.

Only the gay-driven AIDS movement captured the resources of the government for their needs. The AIDS movement was an inspiration for every progressive social movement of the next quarter century, including—after the worst of the epidemic was over for the gay community—the revival of the gay movement itself.

They Die/the Government Does Nothing

Dr. Alvin Friedman-Kien’s tasteful waiting room did not look like the boat dock on the river Styx in 1981. And he didn’t think he was in for a trip to the underworld either. The purple spots on his young patient’s nose were weird, but the doctor was not immediately alarmed. When the biopsy came back Kaposi’s sarcoma, he thought that the lab must have mixed up the test reports. Kaposi’s sarcoma was a disease of old Jewish men. The lesions showed up on their legs. In all his years practicing dermatology, Friedman-Kien had never seen them on someone’s face. Then he saw a second case. Both patients were gay men.

“So I began to have a creepy feeling,” Friedman-Kien says. The doctor, a lively, bald and bearded opera-loving guy, had entered dermatology because he didn’t like seeing people die, but he had trained as a virologist and studied epidemiology. He started asking around. Gay doctors in the New York area turned up five KS cases in a week. Friedman-Kien called a friend, gay dermatologist Marcus Conant, in San Francisco. Conant had not seen the cases, but he was going to a dermatology meeting that Friday and would ask. Conant elicited two cases in San Francisco. One of them was dying. When Conant accrued another six cases and the New York docs had twenty, Friedman-Kien called the Centers for Disease Control (CDC).

The CDC doctor told his colleagues that there was a “kooky dermatologist in New York who thinks he’s got an epidemic of guess what—nobody in this room will have heard of it—Kaposi’s sarcoma.” It took them four weeks to send somebody to New York.

At almost exactly the same moment Friedman-Kien saw the purple spots, UCLA immunologist Michael Gottlieb saw his first patient with rampant pneumonia, a kind of lung infection normally seen only in cancer or transplant patients with radically suppressed immune systems. On June 5, 1981, the little-known CDC publication, Weekly Mortality and Morbidity Report, reported five cases of Pneumocystis carinii pneumonia (PCP) among previously healthy “homosexual” young men in Los Angeles, “probably acquired through sexual contact.” Four weeks later, the mortality and morbidity report announced twenty-six cases of Kaposi’s sarcoma among gay males.

The United States CDC is the world’s emergency squad. It has a proud legacy: when an almost entirely fatal, rampant fever broke out near the Ebola River in Zaire in 1976, the CDC detailed its hot young virologist Don Francis to the World Health Organization to deal with it. Three months later, Red Cross volunteers covered from head to toe were digging graves in open violation of local burial customs that had spread the virus, the infected were quarantined, and the potential victims tracked and followed. The Ebola epidemic came to a screeching halt. When the reports of the gay disease started coming in to the CDC, Francis was working on sexually transmitted hepatitis in gay men. He thought the outbreak might be a virus and he knew immediately that a crisis was at hand. “Normally, CDC notices something happening,” he says, “and CDC comes and raises the disease to a level where something has to be done with it.” Condoms were good against hepatitis, he thought; the CDC should start containing the disease by warning people to use them now. Not this time: “The White House [the CDC is run by the cabinet-level Health and Human Services Department] told us to ‘look pretty and do as little as we can.’ ” An illness that at first threatened only gay men was the last issue the conservative Reagan administration wanted to spend government time or money to address.

Even in the gay center of New York, Mayor Ed Koch had little time for AIDS. Certainly the disease was not as important as saving the city from bankruptcy, which he believed he had been elected to do. “I did whatever my medical advisers asked,” Koch contends. His gay health coordinator, Roger Enlow, notoriously pronounced in 1982 that his job did not include telling gay people how to have sex, so no one in the city would consider closing the bathhouses or any program of public education. New York spent no direct money specifically on AIDS services or education, and there was no increase in general New York social or medical services either.

The CDC’s parent agency, the research-oriented National Institutes of Health (NIH), also did as little as it could. When the epidemiologists at the CDC tried to track the disease, using ordinary methods like patient questionnaires, they could get neither the NIH nor the administration to give them money to tabulate the responses. In September 1981, the NIH did convene a small Kaposi’s sarcoma conference. The contemporaneous “summary of the workshop” reflects an eerie passivity typical of the government’s recalcitrant response in those crucial early years. The government recommended measures like “following patients closely” and hoping for “a revival of the immune system.” When the CDC docs presented the cluster of diseases to the researchers at the NIH, the research doctors, including the eminent virologist Robert Gallo, who later claimed credit for discovering the virus, were not interested. “For years,” Friedman-Kien says, “some of the best immunologists at NYU weren’t interested at all because the NIH gave us no money. The NIH will deny it but they were not interested in a disease that affects gay men.”

Seeing that the research scientists weren’t going to start looking for the virus he suspected was causing the disease, Francis tried unsuccessfully to get money to look for the virus himself. Almost two years after the CDC docs started hounding the NIH, the august Dr. Gallo put some serious resources into looking for the virus in the tissues of the now numerous fatally infected patients. (He failed; the Institut Pasteur in France ultimately cultured the virus, though they got the idea of what to look for from Gallo.)

Counsel to the congressional Committee on Health Tim Westmoreland was on a routine visit to the CDC in Atlanta in 1981 when he heard about some cases of an odd disease in committee chair Henry Waxman’s Los Angeles district. One of only two out gay staffers in Congress, Westmoreland, a cheerful and charming guy with a handlebar mustache and a Yale law degree, was an expert on health law. Westmoreland knew from the day the Reagan administration came in and started slashing the budget for public health that there would be a health crisis. He had been betting that cutbacks on child vaccinations would create an emergency, but the emergency he feared turned out to be AIDS.

When Representative Waxman called a hearing on the new disease the following year, he learned that the CDC had had to steal and cadge money from other research to try to do the epidemiology. Waxman did what he could: at the first hearing he sarcastically announced that “the administration would manage to find the money if the disease particularly affected tennis players.” The committee appropriated two million dollars where the NIH had only asked for one. And so it went. At each hearing, the oversight committee asked the witnesses from the executive branch to tell the Congress what they were doing for AIDS, and the witnesses tried to make it look as good as possible for their agency. When the congressmen asked the same witnesses what in their professional and technical expertise needed to be done, sometimes, the witnesses would tell them what they really needed.

The Reagan administration held two meetings on the burgeoning disease in 1983. The first was an informational meeting at Health and Human Services (HHS) between Judi Buckalew, special assistant for public liaison, and two representatives of the Gay Task Force. The second involved public liaison with representatives of the Moral Majority and the Conservative Caucus alone. Two years were to pass before there was a third. Fifteen hundred people died from AIDS in 1983.

They Die/They Do Nothing

Steve Endean, who was, in 1981 and 1982, leading the only full-time gay lobby, was a legend. His colleague at the gay lobby, Vic Basile, recalls that when they traveled around the country raising money together in the eighties, Endean was completely unavailable after ten o’clock at night, because he was in the parks every night in every city pursuing sex partners. Endean was not the only one in denial. For a lot of average, fun-loving gay men, gay liberation and sexual liberation were the same thing. The last thing they wanted was to change their behaviors.

Big mistake, said Dr. Alvin Friedman-Kien. “If I were a gay man,” he told his friend and patient, writer Larry Kramer, “I’d stop having sex.” Kramer was the perfect recipient for this advice. He had just published the novel Faggots, a scathing condemnation of the promiscuous gay male community of the post-Stonewall seventies. One August day in 1981, Friedman-Kien’s phone rang. Would the doctor come to Kramer’s apartment and speak to some gay men? Great, Friedman-Kien thought, these guys have to know what’s going on, most people are just acting as if there’s nothing happening. They’re losing their friends; they’re dying.

Friedman-Kien told Kramer’s group that the culprit was a virus, but it would be a few years until the scientists could prove it. “You’re not going to change your behavior until it’s official,” he speculated despairingly. They had no one to help them but themselves, he told them. Stop having sex. Or use a condom at least.

Many of the men who stayed to help were outraged at what the doctor had said.

Some, like Paul Popham, the closeted businessman whose Fire Island housemates kept dying, were persuaded or frightened enough to stay at Kramer’s apartment and try to figure out what to do. On Labor Day weekend, the group set up a table on the dock where all the boats came to Fire Island and tried to collect money for Friedman-Kien to do his research. People shunned the group. The only thing they were angry about was being told they had to give up the sexual freedom they had fought so long to get.

For a long time, most of the official and visible gay community fought changing their sexual practices. When legendary San Francisco activist Cleve Jones was reported to be advocating closing the bathhouses, people spat on him in the Castro. When Kramer’s group, then called Gay Men’s Health Crisis, had its first fund-raiser in 1982, they had a disco group close its set with a number about having only one sex partner at a time. The men in the audience quickly formed a gay men’s chorus to sing back. “NO WAY,” they caroled merrily. “NO WAY.”

With no authoritative voices from their own community, gay men were left to their own devices. When Roscoe Browne told his brother that he’d just pop over to St. Marks baths after running the New York City Marathon in 1984, Robby tried. “You’re going to go to the bathhouse,” he said. “Don’t you think you might get AIDS in the bathhouse?” And Roscoe said, “Well, I don’t know.” “I think maybe it’s a possibility,” Robby replied. And Roscoe said, “You don’t know how I feel in a bathhouse.” So Robby said, “Okay. I don’t know how you feel there.”

For fifteen years, curtailing sexual behavior was the first, last, and only way to stop the fatal disease. Still, from a movement standpoint, the demand to curtail sexual activity was profoundly offensive. First, as a matter of simple equality, who else would be asked to give up sex as a solution to venereal disease? After all, heterosexuals had been getting syphilis since Columbus discovered America. No one suggested that straight people rein in their sex lives. Given the gay right to gay sex, the only legitimate answer was to get the scientists working and get some drugs.

Second, what would the gay revolution have achieved if gay men had to give up their unrestricted sex practices? In a survey, the San Francisco AIDS Foundation found an astonishing 69 percent of men who’d had three partners in the prior month agreed with the statement that “being gay means doing what I want sexually.” In their piece in Boston’s self-consciously left Gay Community News, activists Michael Lynch and Bill Lewis made the political connection clear. The gay male community, they asserted, is “knit together” by the “promiscuous fabric, that, in its democratic anarchism, defies state regulation of our sexuality.” Even the leading proponents of safe-sex practices, Michael Callen and Richard Berkowitz, conceded in 1982 that “ultimately, it may be more important to let people die in pursuit of their own happiness than to limit personal freedom by regulating risk.” These arguments put a very different frame around the refusal to limit sex. Maybe the guys didn’t, as Kramer accused them, “love their asses and dicks so much” they wanted to die for them. Maybe, like martyrs since biblical times, they were willing to die for the “fabric” of their movement.

The personal-freedom advocates should have been alarmed when they saw who was on their side—and who was not. Time and again, as the preventative role of condoms became scientifically incontrovertible, the religious conservatives in the White House—Gary Bauer, William Bennett, and Carl Anderson—stopped the public-health agencies from informing the homosexual public about the dangers and how to avoid them. In their analysis some years later, sociologists Charles Perrow and Mauro Guillén concluded that substantial numbers of nongay Americans prefer to let people die of AIDS to discourage homosexual sex than teach them how to have limited, but safe homosexual sex.

Doctors, who are professionally unenthusiastic about martyrdom, went crazy over the suggestion that gay liberation required unprotected sex. Gay or not gay, the professional morality of medicine completely obscured all other considerations, even in the lives of people sympathetic with or personally liberated by gay liberation. Powerful head of the National Institute for Allergy and Infectious Diseases Anthony Fauci told people to use condoms. Friedman-Kien said it to Kramer’s guests in 1981. Dr. Marc Conant was damned for saying it. Epidemiologist Dr. Don Francis aborted his career at the Centers for Disease Control in 1985 because the Reagan HHS wouldn’t let him add his voice to the chorus. He did not want to spend his life with blood on his hands.

They Die/Their Own Groups Do Next to Nothing

Congressional staffer Tim Westmoreland rarely found himself in the position of educating interest groups in how to lobby him, but that’s what he found himself doing in the early years of the AIDS epidemic. He had to be on the phone with gay organizers almost from day one. They didn’t even know how the government worked, he remembers.

The ignorance and recalcitrance of the existing gay organizations to recognize the emergency before them must have taxed even Westmoreland’s good nature. The Gay Rights National Lobby’s Steve Endean says in his memoir, “Most of us still didn’t have a clue as to the magnitude of the health crisis to come. A worst case, we thought at the time, was that it might be similar to Legionnaire’s Disease … so initially we resisted dropping the rest of our agenda to focus full attention on AIDS.” “To make matters worse,” he continues, “GRNL was a very young lobby without either the number or quality of staff that would be necessary to meet the challenge.”

When Lambda Legal started a regular conference call among lawyers around the country in 1983 it was dubbed the “sodomy call” by participants, reflecting the high priority that important institution of the gay revolution gave to challenging the criminal sodomy laws. There was no “AIDS call,” although Lambda did find its docket increasingly filled with AIDS-related calls for help.

AIDS was a triple threat: as a disease it required the caring services conventionally found in the biological family; as a sexual disease it threatened the bedrock norm of privacy-based sexual freedom; and as an epidemic it could only be resisted with all the resources of a paternalistic state. Public health was a living manifestation of two principles of the liberal state: people living together needed a government authority to stop them from killing each other, in this case, with their germs, and the institution of collective self-government exists so that citizens can leverage their communities to help them. But there was no place in an epidemic for the third principle—an arena of life where the individual must be left alone. No response could both preserve sexual freedom from the state and also leverage the resources only the state possesses. No wonder the existing institutions were paralyzed.

It was a lesbian, National Gay Task Force executive director Ginny Apuzzo, who, among the organization officials, first recognized the magnitude of the peril. Gay lobbyist Endean remembers Apuzzo castigating him for denial of the disease in light of his “active sex life.” Apuzzo started the first direct-action AIDS group, the short-lived AIDS Action, in 1983, and hired Washington activist Jeff Levi to lobby for action on AIDS.

Apuzzo is but the most visible of the legions of lesbian—and heterosexual—women who stepped up to the crisis, from San Francisco dermatologist Marc Conant’s nurse, leaving her cushy job to run the AIDS clinic, to the garment-business heiress Leslie Fay Pomerantz, the oldest surviving volunteer at Gay Men’s Health Crisis. The NGTF had women leaders early on. But for the decade from the time the women took their dance money out of the Gay Liberation Front (GLF) cash box to the epidemic, most lesbians and gay men followed very different political paths. Women took on the cause of AIDS for many reasons—because the homophobia it triggered threatened them as well, because their friends were dying, and because they really are just good human beings. As Apuzzo’s leadership symbolizes, AIDS was the remaking of the alliance. Despite many rocky moments, it has lasted to this day.

Apuzzo’s lobbyist Jeff Levi recognized that he was asking the gay movement to make a bedrock change. As he told journalist John-Manuel Andriote, “The traditional gay and lesbian agenda is [for government] to stay out of our lives. Now we’re saying we need affirmative programs that will save our lives and that we need a much closer relationship with the government.” As Apuzzo, the rare activist known for her careful utterances, put it, “Getting people to change their perspective was like trying to turn a ship around.”

New York: AIDS Without Politics

If the task is turning a ship around, there’s no tugboat like Larry Kramer. If the existing organizations weren’t going to step up, he’d start his own. The first AIDS-specific group, New York’s Gay Men’s Health Crisis, was born when the men gathered in Kramer’s living room in 1981 to hear from Alvin Friedman-Kien. Gay men and lesbian women have been meeting in one another’s living rooms since people began building apartments in the nineteenth century. From the earliest years of the gay urban migration to the outbreak of the disease, gay men generated shared assumptions, norms, values, and ideas about a good life. That’s what people do when they have no political power. The living-room culture produced everything from enormous, elaborate drag balls in the 1920s to the Gay Activist Alliance (GAA) zappers who ended John Lindsay’s presidential ambitions in 1972. Cleve Jones remembers, “When I was a little kid and came to San Francisco, the old queens took me in, sheltered me, taught me to watch out for the cops, learn the secret language, how to forage for food, how to make fire.”

The men who started GMHC had been shaped by their experience of participating in the gay community. Even the closeted ones, though they didn’t march, had made a community, partially in isolation (Fire “Island”), which inherited the long tradition of gay men and lesbians creating institutions the gay population needed. GMHC turned out to be a throwback to life in Gay New York. They turned in on themselves, and raised money for their own cure. They created an alternative information network outside the normal channels of mass media and medical systems. They re-created the ancestral family from which so many of them had fled or been flung, walking each others’ dogs and visiting the sick. Constituted as they were by their closeted gay life, GMHC must have felt comfortably familiar.

It made Kramer, who had originally called them together, nuts. He wrote furious hortative essays in the New York Native (“1,112 and Counting”) and plays like 1985’s The Normal Heart, exhorting the gay men to make the government do the work of public health and social support. As Kramer continued to pound on them, the founders of GMHC threw him out and handed the reins over to Rodger McFarlane, the large, athletic former hospital administrator, who became its first paid staff member. Born and raised on a chicken farm in Mobile, Alabama, McFarlane joined GMHC within months of its founding, and essentially started all its programs. The original GMHC hotline rang in McFarlane’s apartment. McFarlane set up the volunteer-driven organization with an elaborate bureaucracy, which probably helped it survive when other institutions faltered. McFarlane not only took care of generations of his own friends; he tenderly ministered to his own baby brother who tragically died of AIDS in 2002. Care was Rodger McFarlane’s middle name.

By 1985, GMHC had volunteers answering the hotline, sometimes at the rate of a hundred calls a day. What funeral homes would take AIDS victims? Where could they rent a wheelchair? The ranks of volunteers swelled daily. Real-estate heiress and socialite Joan Tisch stuffed envelopes. The organization bought a building, the Tisch Building. GMHC’s first fund-raiser set a record for gay fund-raising. Although GMHC never became a civil rights movement, the group framed the threat to fit its communal norms and produced social institutions to meet the threat as they had framed it.

In the early years of AIDS, the gay community had none of the psychological or political resources to make a contentious social movement. Gays did not feel aggrieved, because they didn’t know how much the state was at fault. The illness, whatever it was, was seen not as the product of a political decision by an oppressive government, but both as a fact of nature, which it is, and as a sexually transmitted disease, which spread as the result of individuals’ personal behavior. Since the responsible public officials outside of California uniformly resisted addressing the epidemic, gays saw no chink in the establishment armor that might allow them to get some traction. The Reagan administration, the Centers for Disease Control, and the New York City health commissioner were all in agreement: ignore AIDS.

GMHC and the rest of the gay-care revolution were heroic. In the long run, even the most heroic alternative universe of care was not going to solve the problem. Eventually the New York activists were going to have to turn to politics. Meanwhile, however, the gay-care revolution transformed the gay revolution. First, in order to care, the closeted gay population, infected or not, had to come out. GMHC brought wealthy and successful gay men like money manager Jim Pepper out. Pepper had been leading a gay social life for years, but, he says, “Everyone at work just socialized separately. I felt no need to share my sexual orientation.” Pepper was not sick. But with AIDS he saw caring for those who were as his moral obligation. When Pepper decided to go on the GMHC board, he had to ask permission of the partners; board work took time away from business. He told his partners he would resign from the board of his college to make up for his new commitment. And they said, incredulously, you want to join the board of a gay men’s health crisis and drop your board position at your college? And Pepper said, “Yes, I have a moral obligation.” And they said, “Well, maybe you can get them to change the name.” Pepper said he didn’t think Gay Men’s Health Crisis was going to change the name. But there was unanimous approval anyway.

The incident speaks volumes. Before GMHC Pepper’s boutique money-management firm had, unspoken, confined him to a kind of closet at work. In forcing rich, successful gay men out in their powerful circles, AIDS challenged the myriad hidden institutions of society. In 1986, Pepper agreed to sponsor the first New York AIDS walk, a GMHC fund-raiser. Unbeknownst to him, the walk and its sponsors were promoted on posters all over the New York subways. So Pepper came the rest of the way out on the New York subway.

Pepper’s “moral obligation” didn’t arise in a vacuum. For at least a century gays had been constructing elaborate networks of sex, family, and friendship that existed in parallel with their closeted lives at work or in their families of origin. They were embedded in the AIDS community and had to help. In order to help, they had to come out. Outing oneself is powerful and perpetual. Once someone was out to his family and his workplace there was no going back; his fate was then inextricably tied to the fate of the movement.

In addition to coming out, they created institutions that met the deep moral standards of the larger society: love thy neighbor as thyself or, in secular terms, act in a way you’d want everyone to act. For a long time, the larger society had conflated morality with sexual convention and used the weapon of “sexual morality” to beat up on gay people. When the thin morality of sexual convention was posed against the deep morality of the gay IV-changing, shit-wiping, food-delivering, dog-walking care revolution, the moral calculus shifted, silently, to the gay side. The moral revolution was situated in the most contested arena of gay politics: family values. Coming out and caring was a virtuous cycle. As gay activists cared, they grew in their moral self-regard. As sociologist Deborah Gould describes it, pride in their caring community produced a “heroic narrative of early AIDS activism.” Seeing themselves as morally upright caregivers, gay activists were poised to rise up.

San Francisco: AIDS with Politics

New York is always the center ring, but it’s not always the model. From the beginning the San Francisco gay community responded to the epidemic with contentious politics: revolution, not just care revolution. But San Francisco was always different.

Don Francis’s longtime friend and colleague Marc Conant calls Francis “about the most heterosexual person that exists on this earth.” But when Francis fled the CDC in 1985, the very hetero Dr. Francis joined the flood of men who had been migrating to San Francisco, the “gay refugee camp,” as Carl Wittman called it in 1969, from “Amerika.” He got himself deployed to the AIDS public-health empire Marc Conant had built, courtesy of the city of San Francisco and the state of California.

By the late seventies, around one-fifth of the city’s 335,000 registered voters were gay. Many powerful gays in San Francisco were already out. Thanks in part to Harvey Milk, San Francisco gays were concentrated, organized, and allied with powerful nongay political players. San Francisco’s gay men were not left to their own devices to counsel one another about how to avoid the fatal, sexually transmitted disease. When Alvin Friedman-Kien first phoned in 1981, Conant, who had been a volunteer in the Haight-Ashbury VD Clinic for years, had the improbable combination of experience and training that allowed him in his own words “to become hysterical almost immediately.” Every new sexually transmitted disease that could spread, he had observed, spread like wildfire in the gay population.

By 1982, Conant’s San Francisco AIDS Foundation already had a big chunk of a half million dollar AIDS grant from the city of San Francisco. When, a year later, the CDC surveyed AIDS prevention in nine American cities, only San Francisco had the public-private collaboration with any chance of succeeding in educating about prevention.

Conant knew where the money was. When the NIH, which had not even started looking for research proposals, turned down the first round of proposals from the eminent scientists from the California medical centers, Conant went to his man on the city council, Harry Britt, the gay San Francisco supervisor who succeeded Harvey Milk, and a friend, lesbian activist Carole Migden. The gay activists called San Francisco’s representative in the statehouse, California assembly speaker Willie Brown.

The first year, California provided the doctors with $3 million. In ten years, almost $100 million flowed to AIDS research and treatment from the state of California. Don Francis came and did what he could. But Conant and Francis both knew that California could only mount a holding action. Any real solution had to come from the feds. California couldn’t do it alone. What was to be done?