How AIDS Changed Gay Life in America

By John-Manuel Andriote

Univ. of Chicago. 478 pp. $30

Well before San Francisco and New York doctors saw the first pandemics of pneumocystis pneumonia in 1981, a national gay rights movement was gathering steam. In 1965 the East Coast Homophile Organizations picketed the White House, the Pentagon, the State Department and the Civil Service Commission for firing gay federal employees. The National Gay Task Force and the Lambda Legal Defense and Education Fund were both set up in 1973. The next year Reps. Bella Abzug and Edward Koch introduced the first federal gay rights bill. Five years later, the American Civil Liberties Union started its National Gay Rights Project, and more than 100,000 people showed up at the first gay civil rights march on Washington. Poor but gutsy, these institutions and activist networks shared a national culture.

In "Victory Deferred," his spirited social history of the epidemic, John-Manuel Andriote argues that the gay response to AIDS strengthened this national civil rights movement. He first notes how the epidemic intensified anti-gay discrimination: "Now those already inclined to hate gay people cloaked the daggers of their bigotry in the guise of concern for public health. . . . In view of the access and influence that the born-again right had in the Reagan White House . . . it was with good reason that gay leaders feared a backlash that would irretrievably set back the community's efforts to achieve equal rights." Andriote then shows how, under duress, the growing gay movement had to turn its attention away from basic civil rights to pressing physical wants lower on psychologist Abraham Maslow's hierarchy of needs, i.e. medicine for the sick, prevention for the well, and attempts to get a hostile federal administration to meet its legal and moral duties to its constituents.

Policy-makers and gay activists soon realized that a certain amount of pandering to prejudice was the only way to win over Congress: AIDS had to be made less gay. Andriote explains why: "Quite simply, because all these years and nearly two-thirds of a million [domestic] AIDS cases after the start of the AIDS epidemic, the government remains hobbled by its fear of upsetting Jesse Helms and his anti-sex, anti-gay compatriots at the outer fringe of the right wing." Accordingly, the Ryan White CARE Act of 1990--the Marshall Plan for AIDS--was named after a young hemophiliac. At last, a market was born.

By 1995, as Andriote notes, "AIDS had become a special interest in the truest sense." Thankfully, resources began to flow to black and Latino communities, but black and Latino gay men still got short shrift, especially in prevention. A large proportion of American AIDS cases still occur among gay men, but prevention efforts for them rarely amount to more than 5 percent of the budget of any municipality's AIDS programs. Andriote claims that "the belief obviously persists that gay men can and should take care of themselves, fund their own prevention efforts, and not expect a share of public prevention dollars commensurate with their rates of infection or disease."

Andriote, who lives in Washington, has interviewed every major player during his nearly two decades of reporting on the subject as a journalist, and it shows. The result is a richly textured account of the rise of the AIDS sector that, though detailed and comprehensive, reads quickly. The thematic organization of the book works especially well. The clear chronology of the events reveals how competing models of service delivery, treatment activism and private-public cooperation were subsumed into a national AIDS movement. The book should prove excellent for teaching or recreational reading.

Let's not forget, however, that the activists' biggest victories in getting financing and in accelerating community-based clinical drug trials were nudged along by the invisible hand. Private industry saw a vast untapped market. But legal rights are public goods, typically without a private market, so the AIDS victories will not necessarily translate into a betterment of gays' political positions. Besides, the straight mind can support AIDS services on a cost or humanitarian basis without letting go of its anti-gay bias. Andriote suggests as much when he points to the belated and qualified support of heterosexuals and celebrities for AIDS services: "Where were these people before AIDS? Why weren't they there to assist gay people as they struggled to achieve equality and to lessen the hatred and violence against them?" And where will they be as gay civil rights groups press for change?

Sadly, anti-gay state action has thrived as the AIDS sector has absorbed gay energies. In 1986 the Supreme Court decided that states could criminalize same-sex intimacy. In 1997 our president signed a marriage statute imposing a permanent legal disability on gays. Dishonorable discharges of gay people from the military are at a peak. The real work to end this premodern prejudice is still ahead.

Jose Gabilondo, a Washington lawyer and writer who can be reached at