Claiming the Epidemic
How did members of the affected communities respond to these formulations? Gay communities in the United States were both contributors to the "gay disease" frame and important critics of it. Initially, rumors of various lifestyle risks—a microbe in the water supply or the ventilation system at the most popular bathhouses, for example—spread rapidly through gay communities. Writers in the gay press showed little tendency, early on, to dispute the homosexual connection, as evidenced by the frequent use of the locution "gay cancer" (though often in quotation marks) to characterize the epidemic in 1981. This phrasing, however imprecise, effectively served as a rallying cry to alert gay men to the presence of a new danger.
Since many of the early reports in medical journals were written by
clinicians well connected to gay communities, who were treating the patients in question, many gay people—and particularly health writers such as Lawrence Mass, himself a physician—were inclined toward sympathetic views of the medical and public health authorities. Increasingly, however, many gay writers, especially in the more left-leaning publications, were openly critical of medical researchers' tendency to blame the epidemic on gay promiscuity. Much as an earlier generation of feminists had conceived of medicine as a sexist institution, these writers and activists argued that medical science was a heterosexist and sex-phobic institution that reinforced norms of sexual conformity.
Gay physicians, such as those who were members of Physicians for Human Rights, an organization of gay doctors, found themselves at the felcrum. On one hand, they were called on to introduce their professional colleagues and epidemiological investigators to many specific aspects of the "gay lifestyle," often running up against a judgmental reception within the biomedical establishment. On the other hand, they felt a sense of responsibility to warn their communities about suspected risk behaviors—but knew they would lose credibility if they were perceived to be "sex-negative" or puritanical, given that gay liberation as a political movement was so closely tied to sexual liberation as a personal ethic.
By early 1982, gay and lesbian activists had created two grassroots organizations that would prove to be pivotal in confronting the epidemic: the Gay Men's Health Crisis in New York City and, across the country, the Kaposi's Sarcoma Research and Education Foundation, later renamed the San Francisco AIDS Foundation. A testament to the high degree of political mobilization and access to resources in gay communitiess at the time, the appearance of these organizations marked simultaneous attempts to provide services to people suffering from the syndrome, relay relevant information rapidly to gay men at risk, and serve as an organized voice regarding questions of public policy.
In the early period, these organizations took no position on the question of etiology. As the Gay Men's Health Crisis advised gay New Yorkers in an open letter in mid-1982: "Unsettling though it is, no evidence exists to incriminate any activity, drug, place of residence or any other factor, conclusively, in the outbreak facing us." At the same time, simply by organizing gay communities to confront—and, in effect, claim—the epidemic, these organizations helped to solidify the popular connection between the syndrome and homosexuality (as
even the name "Gay Men's Health Crisis" implied). AIDS became a "gay disease" primarily because clinicians, epidemiologists, and reporters perceived it through that filter, but secondarily because gay communities were obliged to make it their own.