Fighting Aids: getting pills into bodies
by Elizabeth Pisani, Prospect Magazine:
A new account of the early days of Aids shows how cleverly activists influenced the powerful.
“It’s time gay guys just grew up!”
This jarring comment came recently from a youngish gay friend, a former Aids activist and sex worker. We were talking about whether the NHS should pay for pre-exposure prophylaxis (PrEP), which involves people who don’t have HIV taking small doses of treatment to avoid infection. Several large trials have shown that PrEP works very well when it is used consistently, just as condoms and abstinence work very well when they are used consistently. My friend (who works for the NHS) has no clinical or moral issues with PrEP; he just doesn’t think the NHS should buy it for people who could pay for it themselves. If men could buy recreational drugs before having unprotected sex, he reasoned, they could also buy the HIV treatment pill Truvada that works as a preventative.
My friend’s opinion was jarring not because it was wrong, necessarily, but because it sounded nannyish about sex, and that’s desperately unfashionable, especially within the gay community. According to David France, whose new book How to Survive a Plague chronicles the early years of the Aids epidemic in New York, that’s been true for at least three decades.
When the New York Times first reported in July 1981 on what was to become known as Aids, the paper noted that most cases “had involved homosexual men who have had multiple and frequent sexual encounters with different partners.” France, at the time young, gay and enjoying everything the city had to offer, reports that: “I was more annoyed than alarmed by the news, which seemed like a new slander on the gay community…” Later, when it seemed the deaths may indeed have been triggered by a sexually-transmitted pathogen, a handful of prominent gay men, including playwright Larry Kramer, began to warn of the dangers. “We’ve been too accustomed to fear, particularly the fear that our sexual freedom, so hard fought for, will be taken away from us,” Kramer wrote in 1982. “But we must realise sex is not the fabric holding our community together.” At the time his comments were greeted with outrage by those who believed that any suggestion of sexual constraint was an attack on gay identity.
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