by Randy Shilts
Certainly, the surfacing of Dr. Brandt’s twenty-two-page memo proved the watershed event in the AIDS budget battle of 1984. Its delivery could not have come at a more fortuitous moment. Congress was about to begin deliberations on the next fiscal year’s budget, and the administration still maintained that AIDS funding was entirely adequate.
Even after the HTLV-III announcement, Reagan officials had not requested any additional AIDS funds for the next year’s budget. The official administration request for the fiscal year due to start on October 1 stood at $51 million, a mere 6 percent increase over the previous year’s AIDS spending. Although mounting AIDS caseloads indicated the need for drastically increased funding, liberals had no persuasive documentation. Brandt’s memo lifted the camouflage off administration claims that doctors had all the resources they needed. Here was the Reagan-appointed health secretary himself making the case for more money.
Within days, Westmoreland had distributed additional copies of the memo to sympathetic legislators on Capitol Hill. Various members of Congress privately relayed their dismay to Secretary Heckler and hoped that the administration would boost its AIDS request. Their entreaties, however, found no response. Westmoreland leaked a copy of the story to the Washington Blade, a gay paper distinguished by its investigatory articles on AIDS funding. He hoped some major East Coast paper would pick it up and run with it. The Blade ran the story on page one, but the eastern newspapers weren’t printing stories on AIDS, so it was ignored.
July 13
UNION SQUARE, SAN FRANCISCO
Six men, dressed as nuns, gathered ritualistically around a table where a woman was being held down.
“We are here to exorcise lies and prejudice,” shouted Sister Boom Boom to the crowd of 2,000.
The pinioned woman was playing the part of Phyllis Schlafly, the anti-feminist leader who had spearheaded opposition to the Equal Rights Amendment. Schlafly was appearing a few blocks away at an anti-gay “Family Forum” hosted by the leader of the Moral Majority, Rev. Jerry Falwell.
“Phyllis Schlafly’s heart is corrupted with fear and greed,” shouted Boom Boom. “We shall remove her heart of lies and fear, and replace it with a heart of purity and love.”
From the folds of the woman’s dress, Boom Boom pulled a rubber snake and tossed it in the air.
Moments later, a man walked out dressed as Falwell, and the assembled Sisters of Perpetual Indulgence ripped off his pants, exposing fishnet stockings and a black corset.
“Cast off the demons of shame and repentance,” Boom Boom intoned.
The Democratic National Convention had arrived in San Francisco.
More than 2,000 reporters had gathered for the meeting, due to start in a few days, and they were being treated to much local color in an unusual array of demonstrations and political protests. Delegates from the Second International Hookers’ Convention marched for Prostitutes Rights; advocates of marijuana legalization held a “smoke-in.” At the site of the Family Forum, earnest members of the Revolutionary Communist Party and other radical groups were fighting with police officers. At City Hall, an environmentalist named Ponderosa Pine, who frequently dressed up as a tree, was leading an “All Species Rally” of fellow ecologists who had donned plant, bird, and fish costumes to call attention to the “fate of other species.”
Unable to resist, Jerry Falwell also came to the city and took out newspaper advertisements, asking Democrats to “return to moral sanity” and not provide homosexuals with “special recognition and privileges under the law.” The fact that both the Catholic archdiocese and the San Francisco Council of Churches had officially asked Falwell to avoid San Francisco did not deter him and thus came the predictable protests from gay men dressed up as nuns.
Republican leaders were privately ecstatic that Democrats had chosen the gay mecca as their convention site. This allowed the Sisters of Perpetual Indulgence to stroll into America’s living rooms on the evening news as an unofficial welcoming committee for the loyal opposition. Fundamentalist ministers across the nation asserted that the Democrats had become the party of the “three A’s”—acid, abortion, and AIDS. Mainstream Republicans were more circumspect, although campaign rhetoric routinely included references to the “San Francisco Democratic Party.”
The fear of just such a label had created some reluctance among Democratic leaders to include overt references to gay rights and AIDS in the party platform, setting the stage for Bill Kraus’s last political battle. Once again, Kraus served as a member of the party’s platform committee. The committee chair, Representative Geraldine Ferraro, was eager for the platform to contain only generic language opposing discrimination against all minorities. With sixty-five lesbian and gay delegates from a score of states, Kraus threatened a floor fight over gay rights. You don’t beat the redneck Republicans by becoming one of them, he maintained. Privately, he also alluded to the fact that he wouldn’t predict what those unruly street radicals might do if the platform didn’t include explicit support for gay rights. In the end, Kraus finagled the most sweeping endorsement that any major party had adopted for gays, including a pledge to end the exclusion of gays from the military and as immigrants. The platform put the party on record as promising to end violence against gays and to bolster spending to “learn the cause and cure of AIDS.”
The priority that Bill Kraus and San Francisco gay leaders put on AIDS irked gay activists from other parts of the country. As they gathered in San Francisco for the convention, they gossiped that California leaders were obsessed with the disease. The National Gay Task Force had not even wanted, to address AIDS as a separate issue, arguing that it should be included as a subcategory in an overall statement about “health concerns.” For their part, gay Republican groups heartily endorsed President Reagan’s reelection, determined to show that they were not “single-issue” political activists. Meanwhile, the American Association of Physicians for Human Rights largely avoided any stand on the federal role in the AIDS epidemic, channeling its energies into such issues as criticizing medical journals for using such “judgmental” terms as “promiscuous” in articles about AIDS risk factors.
Two days before the convention opened, bathhouse owners quickly let their priorities be known in a meeting of the National Coalition of Gay and Lesbian Democratic Clubs. For the preceding two years, Gwenn Craig, former Milk Club president, had served as co-chair of the group. However, bathhouse owners controlled gay Democratic clubs in Miami and Chicago. Even before arriving in San Francisco, they were campaigning against Craig, frequently referring to her support for bathhouse closure. As a first order of business at the coalition’s San Francisco meeting, Craig was ousted from her post, although she continued to serve as chair of the convention’s gay caucus.
The next day, 100,000 lesbians and gay men gathered on Castro Street to march to the convention site. Their numbers filled the neighborhood. Demonstration leaders were busily reassuring the press that the march was not a protest but a show of support for Democrats, and, as he had on the sunny June day four years before, Bill Kraus walked at the front of the throng with other delegates and party officials. As the group strode toward downtown, Kraus thought back to the Gay Freedom Day Parade on that sunny afternoon in 1980.
How different the goals and the future of the gay movement seemed now, Kraus thought, and the nagging question returned to him: How many of these people will be alive for the next presidential election?
July 25
NEW YORK CITY HEALTH DEPARTMENT
The city-sponsored conference on the implications of the HTLV-III antibody test marked a novel development for AIDS policy in the United States. For the first time, officials were planning for a problem before it happened. The unprecedented foray into intelligent AIDS policy planning was indeed timely. No issue would prove as complicated and potentially volatile as AIDS testing, and the battle lines drawn at the New York City conference would mark debates that accompanied use of the AIDS test for years to come.
Within days of the Heckler HTLV-III press conference in April, scientists and AIDS organizers knew that the advent of the blood test would create a public policy problem. Federal health officials saw the test as a rare opportunity to define the extent to which the AIDS virus had penetrated the United States. At last, they would be able to see the part of the iceberg of AIDS infection that lay below the visible tip of full-blown, CDC-defined AIDS cases. Traditionally, efforts to control any disease began with authorities determining who was infected and who wasn’t, and then keeping the infected people from giving it to the uninfected. Obviously, the antibody test, once licensed for widespread use, would be an essential tool in making such a determination.
Don Francis, for one, was itching to implement widespread voluntary testing for gay men. Jim Curran also viewed testing as essential to any long-term strategy in fighting AIDS. That’s what Curran told the 200 health officials and AIDS workers who had assembled for the New York conference.
Paul Popham, president of Gay Men’s Health Crisis, moved uncomfortably in his chair when he heard the enthusiastic support for antibody testing. The antibody assay, he knew, could be used in effect as a blood test for sexual orientation. He thought about the new estimates that the typical AIDS patient needed $100,000 in medical care, and wondered what insurers might do once they got this test. “If the insurance industry can find relief from these enormous expenditures, it will,” Popham said, voicing concern that no gay man would be able to get an insurance policy once the test became available.
Other gay leaders cited concerns with employment and confidentiality. If test results were easily accessible, people with antibodies could be subject to a wide array of discriminatory moves. Already, the New York Native had written a story predicting that people with positive antibody tests might at some point be ordered to report to quarantine camps.
Either the Food and Drug Administration or the National Institutes of Health could have allayed such fears had they simply announced that test results were subject to federal confidentiality guidelines, such as those used routinely in other federal health projects that involve such sensitive personal matters as alcoholism and drug abuse. The mechanism for granting confidentiality was already in place; it could be enacted with the stroke of a pen.
Federal health officials were reluctant to take this act, fearing it would be viewed as coddling homosexuals at a time when the election-minded administration was taking a more forthright anti-gay stance. For public consumption at the New York meeting, however, the agencies maintained that such a federal move would be “too restrictive,” and that gays should lobby each institution administering the test to issue such assurances. The suggestion brought loud guffaws from the audience.
“Why burden the community with that?” asked Rodger McFarlane, GMHC executive director. “The feds should require uniform statements of confidentiality.” Without such guidelines, McFarlane added, he would suggest that gay men not participate in AIDS research involving the antibody test.
Cooperation remained the trump card that gay community leaders held in negotiations with the federal government. For the past three years, the gay community had provided some of the most helpful study subjects in the history of medical science. Virtually everything the federal researchers understood about AIDS epidemiology stemmed from this unprecedented cooperation. The gay community’s good faith, however, was running short, given the lack of reciprocation on the part of the federal health establishment.
Already there was difficulty enlisting volunteers for a NIAID study of San Francisco gay men by University of California researchers because it involved antibody testing. The threat of noncooperation was the only leverage gays had in the debate. Federal officials were sufficiently uneasy at the end of the New York City meeting that they pledged to listen to more “community input” on the issue before making any final policy determination.
Although the meeting was short on definitive policy recommendations, it left Paul Popham troubled. The growing rift between AIDS groups and the federal government troubled the Republican streak in Popham’s personality. At one point, he would have considered rhetoric about quarantine camps to be so much paranoia from fringe radicals, but his old-fashioned trust in the government had been profoundly shaken by the AIDS epidemic.
By now, it was clear to him that the government would do as little as possible to research AIDS as long as only homosexuals were dying. This thought bothered him. Before AIDS, Paul had never believed that gays really were all that oppressed; now he was worrying about wholesale employment discrimination and quarantine camps. Paul had spent a lifetime believing in his nation, and he had fought in Vietnam to protect it. One of his greatest disappointments in the AIDS epidemic was that he felt robbed of his faith in the United States.
Paul had another reason for concern with the antibody test. In 1982, he had enrolled in one of the first prospective studies of gay men. Blood drawn for the past three years had been ferreted away in the freezers of St. Luke’s-Roosevelt Hospital in Manhattan. A few weeks before, Dr. Michael Lange had sat down with Paul to tell him that he had been infected with this new virus since the study began, probably longer. In fact, 50 percent of the sixty men participating in the study were antibody positive, and they were now the first gay men in the United States to be given the disquieting news that they were carrying the AIDS virus.
The news didn’t surprise Paul. After all, his old boyfriend, Jack Nau, was one of the first dozen AIDS cases diagnosed in New York City. It also explained why his lymph nodes had been swollen for so long.
The confidentiality issue dominated AIDS concerns in the summer of 1984. The particulars often demonstrated the complexity of the question, even as it denned the shape of things to come in the AIDS epidemic.
In late July, Jim Curran caused an uproar when he sent a memo to all state and territorial epidemiologists asking whether authorities should start keeping a registry of everyone whose blood donations proved to be infected with HTLV-III once the blood test was available. Already, authorities throughout the nation kept a similar registry of people infected with hepatitis B and syphilis. Adding HTLV-III to the list would help avoid situations like that of the California man who had donated blood to eleven different centers even though he suffered from immune problems stemming from his AIDS infection. Gays worried that such a list would amount to little more than a registry of homosexual men and pointed out that the list could be put to nefarious use in the twenty-five states where gay sexual acts remained illegal.
In San Francisco, where health officials anxiously kept track of gay concerns, confidentiality-obsessed health department staffers saw a unique opportunity to advance their privacy agenda with the departure of Selma Dritz. Like a good soldier, Driti had left the department her plump notebooks jammed with observations on the first years of the AIDS epidemic. The information was amassed on health department time, Dritz figured, so it belonged to the department. And in the summer of 1984, the San Francisco Department of Public Health took the politically correct action of feeding the notebooks into a paper shredder.
The same day that the antibody test conference convened in New York City, the San Francisco Chronicle published the contents of the May 25 Brandt memo that had asked $50 million more for the war on AIDS. When questioned, a spokesman for the Office of Management and Budget said the budget agency had never heard of the request. Brandt’s plea, it turned out, had never moved off Secretary Heckler’s desk in two months.
The next day, Representative Ed Roybal of Los Angeles walked into an executive session of the subcommittee in charge of appropriations to the U.S. Department of Health and Human Services and threw the Brandt memo on the table. The committee immediately approved $8.3 million in additional AIDS research money to be spent in the remaining two months of fiscal year 1984. Senator Alan Cranston put together a Senate bill seeking the full amount of Brandt’s request. And the wide circulation of Brandt’s memo on Capitol Hill ensured that Republicans would not toe the adm
inistration line that government doctors had all the funds they needed to fight AIDS.
On August 8, Secretary Heckler responded to Dr. Brandt’s memo and rebuffed his request for new funds for AIDS research. Instead, she gave him authorization to redirect the funds from other projects within the NIH and CDC.
Between the time that Brandt wrote his memo and the date that Heckler answered it, 600 Americans died of Acquired Immune Deficiency Syndrome and another 1,200 were diagnosed with the disease.
It was during these difficult weeks that Brandt decided he would retire from government service at the end of the year. He had been offered the post of chancellor at the University of Maryland in Baltimore, a respected medical school. Gay leaders, sympathetic to Brandt’s position as a sincere public servant, spread the word that the doctor was quitting in frustration over his inability to secure a commitment to AIDS research from the administration. But Brandt later said that the problems with AIDS funding had the opposite effect. “I couldn’t help but worry about what would happen if I weren’t there to fight for the money,” he said.
August 1984 was a month of death in San Francisco, as the mounting number of AIDS casualties included increasingly well-known people. Jon Sims, the former Kansas music teacher who organized the San Francisco Gay Freedom Day Marching Band, died of brain infections, having spent the last weeks of his life blind and suffering from dementia. The city’s most prominent AIDS sufferer, Bobbi Campbell, died on August 15 of cryptosporidiosis. He was the “AIDS Poster Boy” who went public with his plight in 1981 and ended up on the cover of Newsweek two years later. By an eerie coincidence, in the last months of his life, Bobbi Campbell had made his home at 1040 Ashbury Street, in the same apartment that was left vacant nearly three years before by the death of the city’s first diagnosed AIDS patient, Ken Home.