The Gay Community's Response
The gay community in fact had little choice from the start but to accept one side of the dilemma: it had to identify itself with AIDS in
order to provide the necessary care and support to those of its members who had contracted the syndrome. In embracing AIDS as a peculiarly gay problem and reality, however, it would not draw the same connections and conclusions from that identification that the non-gay world had drawn. Gay people could hardly accept common metaphors of AIDS that were based on fear and loathing of homosexuality itself. Unlike much of the heterosexual world, the gay community, if it was to survive as such, was incapable of constructing AIDS as a disease of "the other"—the outsider—but was forced to attempt to "normalize" it; that is, to deal directly with the pain, suffering, and social problems it caused without allowing it to abolish gay people and their sexuality in the process.
Paradoxically, in order to deal with AIDS on these terms, the community was forced to strengthen rather than weaken its identification with AIDS: the stronger the identification, the greater the possibility that the community could control the social meaning of the disease, act effectively in dealing with it, and persuade or pressure the heterosexual majority to move in positive ways. It was forced, in other words, to "own" the disease.[28]
This is a phrase borrowed from Harlan Dalton, "AIDS in Blackface," Daedalus 118 (Summer 1989): 205-28, at p. 213.
By owning it, the community could reconstruct both the disease and its relationship to it on its own terms.The process of identifying the community with AIDS was, of course, never a simple one, nor was it the product of internal community unanimity. Some in the community saw that identification as a trap for gay people, in which the most important achievements of the past would be rolled back in the interest of the heterosexual majority. Many others were quite bewildered by the new epidemic and reacted in panic or disbelief, reactions that inevitably led to an inability to deal with it at all.[29]
Bayer, Private Acts, Social Consequences, pp. 20-29.
Eventually, a small group of gay men, mainly in New York and San Francisco, succeeded in convincing the great majority of the gay community of the need to identify with AIDS in order to combat it. These men alerted other gays to the problem, created new institutions to deal with it, and attacked what they saw as the sluggishness of the community in coming to terms with the new reality.[30]
I thank Gerald Myers for this example. See also Conner and Kingman, The Search for the Virus, pp. 212ff, and Peter Piot et al., "AIDS: An International Perspective," Science 239 (1988): 573-79.
We may take as symbolic of this group the efforts of Larry Kramer, who—in a series of strident but effective articles in the gay press—castigated the community for not acting rapidly enough, and who was instrumental in the founding of New York's Gay Men's Health Crisis.[31]Qui-Lim Choo et al., "Isolation of a cDNA Clone Derived from a Blood-Borne Non-A, Non-B Viral Hepatitis Genome," Science 244 (1989): 359-62.
Even after the community had basically accepted the identification with AIDS and the need to contend with the disease (during 1981 and
1982), there was never perfect agreement regarding the management of the AIDS crisis. The response to AIDS by the gay community was the product of innumerable and only minimally coordinated day-to-day actions, choices, and struggles by particular individuals and groups. That response appears, especially in hindsight, more coherent and rational than it actually was, because it was created within and through gay institutions that already had purpose and meaning and by a community with a relatively firm identity and history of struggle against oppression. By themselves, however, the most determined gay efforts would probably have failed in these and many other areas of the AIDS struggle. What enabled them to succeed as fully as they eventually did was a combination of factors: an American tradition of self-help and voluntarism,[32]
See Altman, AIDS in the Mind of America, chap. 8.
the existence of natural allies and sympathizers in the wider non-gay world, and significant resources in community political and social institutions as well as funds, talent, and labor that could be brought to bear on the crisis. In addition, and at least as significant, a peculiar set of historical circumstances existed for the gay community in the first few years of the epidemic. The combination of the relative strength of gay identity and institutions inherited from the 1970s and the widespread avoidance of the crisis by other elements of society provided the gay community with what may be termed a "window of opportunity" through which to claim the major role in the epidemic that it came to play.Putting this another way, one might say that it was the lack of other claimants to the ownership of AIDS—especially the scientists, physicians, and government officials who normally take control of disease, its meanings, and its treatment in our society—that allowed the gay community in large measure to make good its claim to own the disease and the manner in which it was dealt with. The gay community thus was able to use the power of medicine, medical science, the healing and social professions, and government without granting them nearly as much power over itself as would otherwise doubtless have been the case. In addition, the relative weakness of other so-called groups within the crisis meant that, when they did enter the struggle, they were in large measure forced to negotiate with the gay community over many aspects of the crisis and to rely on it for much of the resources (especially nonmonetary resources) and skills that were necessary to deal with it.
Thus, in embracing AIDS, and in seeing that its own needs and structures were congruent, at least in this arena, with the realities of the wider American health and social spheres, the gay community was able
to become the single most powerful force in the struggle against AIDS. But at the same time, in so acting, the community consciously and unconsciously was shifting the site of major elements of its own identity, especially for gay men. As sexuality became a sphere of uncertainty and danger, requiring significant alterations, it was displaced, to a large degree at least, from the center of gay male identity, to be replaced by a new sense of identity built up around the political, cultural, and health care aspects of the AIDS struggle itself.
Like sexuality, however, AIDS has both strengths and weaknesses as a source of gay identity. AIDS provided a powerful and renewed source of strength to gay identity and gay institutions because, at least temporarily, it made any divisions in the community relatively less important, since the common life-and-death struggle took precedence over almost all differences; it formed a set of issues around which all parts of the community, including those excluded by male sexual practice, could work together; and it created a sense of crisis that moved even the most nonpolitical homosexuals and those whose participation in the community had hitherto been marginal to provide their money, labor, and talent for the struggle.
At the same time, the gay community could never embrace AIDS as a source of identity without a profound sense of ambivalence. AIDS could never be truly gay in the same sense that sexuality had been. The disease had become gay in the circumstances of a specific historical conjunction, not because it was gay in any innate sense. AIDS would, thus, always remain tendenciously related to other aspects of gay identity. In addition, not only did non-gays also suffer from AIDS—and they would become increasingly important in the epidemic as time went on—but non-gay institutions also had an interest in the meaning and management of the epidemic, and would have to be dealt with by negotiation and compromise. Finally, a more or less single-minded focus on AIDS could lead to the neglect of other issues important to the community. As a central focus of gay identity, AIDS therefore had serious weaknesses, weaknesses that would emerge more fully in the more recent stages of the epidemic.
Nevertheless, AIDS did become central to gay identity, at least during most of the 1980s, and determined the nature of the gay community and its activities in that period. A number of common, closely intertwined threads run through all the gay responses to the crisis in the period from 1981 to the present. It will be convenient to summarize them at this point, since they form the (sometimes unspoken) context
in which gay people confronted AIDS as a disease and as a social reality. In essence, these common threads involve the alteration of the perceived nature of the disease, the reconstitution of the community's institutions and self-identity around the struggle against the disease, and the restructuring of the community's relationship to the non-gay world.
Redefinition Of Aids And Persons With Aids
From the beginning the gay community insisted that AIDS must be viewed as a disease and not as a divine judgment or a revenge of nature. That is, it had to be understood and dealt with in the spheres of medical science, social welfare, and politics rather than those of morality or theology. In short, persons with AIDS must be seen as human beings with a disease rather than as moral outcasts. As such, and as participants in the American "social contract," they deserve to have the full force of society's scientific, healing and caring, and material resources available in their struggle against a deadly pattern of disease.[33]
See Richard Goldstein, "AIDS and the Social Contract," in Taking Liberties: AIDS and Cultural Politics, ed. Erica Carter and Simon Watney (London: Serpent's Tail, 1989), pp. 81-94.
In addition, and crucially, persons with AIDS must be treated not as passive "victims" of a disease but as active participants in the struggle against it, participants who have their own voice and whose viewpoints, knowledge, and skills must be taken into account and respected at all times.From a gay perspective, therefore, the AIDS crisis must be viewed as a full political and social struggle, in the broadest sense of those terms, and not merely as a medical event. In this perspective gays were, if only implicitly, insisting on the social construction of AIDS as a disease, a social construction whose nature could be contested at every moment.
The Gay Community As Subject
The gay approach sought to empower not only persons with AIDS but the entire community as well.[34]
See Brian Wallis, "Aids and Democracy: A Case Study," in Democracy: A Project by Group Material (Seattle: Bay Press, 1990), pp. 241ff.
Here, too, the point has been to avoid the objectification of the community, something it had, as we have seen, struggled against for many years. As a subject, or group of subjects, the community has insisted that there be a gay voice—a public presence—in all aspects of the epidemic and its management. Specifically, gay people have insisted on their need, and right, as those most affected by AIDS, to share power over the crisis: the power to define it, the power to deal with it, the power to negotiate with outsiders over it. This insistence has its roots in prior gay history, but it has been reinforced by the perceived tendency of the non-gay world to ignore gayinterests, gay welfare, and gay knowledge and capabilities in defining and confronting the epidemic.
Through its insistence on its right to subjectivity and a voice in the epidemic, the community demanded that it be treated as a community with its own interests, and not merely as a set of individuals who are only loosely connected together by the fact of potential or actual disease. Only the community as a whole could assert the interests of its individual members and combat the tendency of the wider society to exclude gay people as well as people with AIDS. Thus, for example, the community's resources, its legal defense and AIDS advocacy groups, were used in the struggle against HIV antibody testing, quarantine, exclusion from insurance, and the like. Although there was considerable disagreement within the community about the correct approaches to take on each of these issues, there was no debate over the need for gay leadership to defend gay community interests.[35]
Bayer, Private Acts, Social Consequences; Shilts, Band Played On.
Transformation Of Community Institutions
Throughout the crisis the gay community was aware that to meet the challenge of AIDS and survive, it would not only have to confront the outside world, but would, just as significantly, have to restructure its own institutions. This has been a twofold process, involving the creation of new institutions as well as the elimination or alteration of older ones.
With respect to new institutions, the provision of necessary services for those affected by the epidemic has naturally been at the center of the gay response from the earliest days. It is no accident that the first gay institutions that sprang up to deal with AIDS (notably New York's Gay Men's Health Crisis and San Francisco's Shanti Project) were devoted to the care of persons with AIDS and the provision of necessary social welfare services for them, and that the majority of the many hundreds of gay AIDS-oriented institutions that were eventually founded continue to be of this type.[36]
See Suzanne C. Ouellette Kobasa, "AIDS and Volunteer Associations: Perspectives on Social and Individual Change," Milbank Quarterly 68, Suppl. 2 (1990): 280-94, which provides further references.
The severity of the epidemic, the large numbers of members of the community who have contracted the disease or who are HIV positive, and the unwillingness or inability of major elements of the wider society to provide these services required the gay community to do so.In addition to such organizations, the community has created a number of more or less formal ways to deal with the grief, pain, and tragedy that AIDS has caused.[37]
On the absorption of "death" and the immense meanings AIDS has given it within the gay community, cf. Michael Bronski, "Death and the Erotic Imagination," in Personal Dispatches: Writers Confront AIDS, ed. John Preston (New York: St. Martin's Press, 1989), pp. 133-44.
For example, periodic candlelight vigils andprayer services have been held; and a San Francisco group, whose work has now become national and has been shown in many cities, created a giant quilt containing hundreds of panels in memory of those who have died of AIDS, thus both "individualizing" persons with AIDS and allowing members of the community (and even those not directly connected to it) to share and express their grief and anguish.[38]
Cindy Ruskin, The Quilt: Stories from the NAMES Project (New York: Pocket Books, 1988); Robert Dawidoff, "The NAMES Project," in Personal Dispatches, ed. Preston, pp. 145-51.
The community's attempts to meet the immediate and most urgent needs of people with AIDS through its own efforts have resulted in a partial break with past traditions of gay politics, whose major aims were those of civil liberties and rights rather than health care or the elements of material welfare.[39]
Dennis Altman, "Legitimation through Disaster: AIDS and the Gay Movement," in AIDS: The Burdens of History, ed. Fee and Fox, pp. 301-15, esp. 302.
Moreover—although the community has continually insisted that society as a whole must deal with the crisis—the community's own efforts, by filling the caregiving void, not only stretched its resources to the limit but may well have allowed the wider society to avoid its responsibilities for a longer period than might otherwise have been the case.[40]See Peter S. Arno, "The Contributions and Limitations of Voluntarism," in United Hospital Fund, AIDS: Public Policy Dimensions (New York: United Hospital Fund, 1987), pp. 188-92; and Peter S. Arno and Karyn Feiden, "Ignoring the Epidemic: How the Reagan Administration Failed on AIDS," Health-PAC Bulletin 17, no. 2 (December 1986): 7-11.
At the same time, some of the most central institutions of the community, those organized around sexual expression, have had to be changed dramatically or, in some cases, simply jettisoned if gay people were to survive at all—HIV is, after all, transmitted, at least in part, through sexual intercourse. What was being abandoned, it is important to stress, were particular forms of sexual expression—in particular, those that took place in back-room bars, bathhouses, and other places where sexuality was freely available—rather than gay sexuality itself. In this respect the community acted on the belief that it had to preserve itself during the health crisis without giving up its sexual existence and its control of its own sexuality.
Here again, the major changes that emerged were accompanied by substantial, at times acrimonious, debate within the community over the role of multiple sexual partners and other aspects of gay sexuality as practiced in the 1970s. Some directly implicated "promiscuity" in the spread of AIDS even before HIV had been identified, and many in the community turned to a renewed emphasis on the importance of "monogamy."[41]
See Shilts, Band Played On; Bayer, Private Acts, Social Consequences, pp. 21ff.; Michael Callen and Richard Berkowitz, "We Know Who We Are," New York Native, November 8-21, 1982, pp. 29ff.
Others were much more cautious, suspecting that AIDS would be used to attack what they considered the positive features of gay sexuality and gay autonomy, less because of the threat to gay health than because of illegitimate moral and political considerations.[42]See, e.g., J. Lynch, cited in Bayer, Private Acts, Social Consequences, p. 26.
At times the controversies generated were unsolvable within the community, as in the bathhouse controversy in San Francisco and other cities, where certain members of the gay community deliberately used
the forces of local and state government to eliminate sexual meeting places that, in their view, were focal points for the spread of HIV infection.[43]
Shilts, Band Played On; Bayer, Private Acts, Social Consequences, chap. 2.
Ultimately, as the etiology of AIDS became better known, most activity respecting gay sexuality became focused not on number of partners or site of sexual encounter but on the type of sexuality practiced. Most of the significant changes in sexual behavior that have affected gay men have derived from the safe-sex efforts of the community itself. Safe-sex education was, at least in the early years, considered at least as much a political act as a medical one. Cindy Patton has put the matter well:Safe sex organizing efforts before 1985 grew out of the gay community's understanding of the social organization of our own sexuality and from extrapolations of information hidden in epidemiologic studies. Informed by a self-help model taken from the women's health movement and by the gay liberation discussion of sexuality, safe sex was viewed by early AIDS activists, not merely as a practice to be imposed on the reluctant, but as a form of political resistance and community building that achieved both sexual liberation and sexual health.[44]
Cindy Patton, "The AIDS Industry: Construction of 'Victims,' 'Volunteers,' and 'Expert,'" in Taking Liberties, ed. Carter and Watney, pp. 113-26, at p. 118.
Ultimately, the effect of AIDS on the gay community and of the community's own efforts has been to render gay sexuality more like that favored by the wider society. That is, there has been an increased emphasis on monogamy and closer relationships and a decreased emphasis on mulitiple sexual partners and wide sexual experience. Concomitantly, those community institutions where sexuality was freely available have declined in importance. That is, a smaller proportion of the community now frequents them, and they have become less significant to gay identity and the process of "coming out" into the gay world. At the same time, the newer caregiving, social support, welfare, legal, and political action groups organized around AIDS have become far more significant to the community—not only because of their overt purposes but because they serve as places to socialize and meet other gay people—and have become central to the identity of a large proportion of gay men and lesbians.
Changes of this sort in gay institutions have had major effects on various subgroups within the community—particularly older gay persons, for whom the muting of the sexual aspects of gay life has meant an opportunity to reenter the mainstream of the community as providers of care, money, and labor.
AIDS has also played an important role in restructuring gender relationships within the community. Hostility between gay men and lesbians
has become considerably less visible, giving way to a variety of cooperative efforts to meet the challenge of AIDS. Many lesbians threw themselves into the struggle against AIDS at its beginning and have continued to play a major role in all gay AIDS-related institutions, even though, from an epidemiological point of view at least, AIDS mainly affects them indirectly. Their response to the suffering and death of their male friends and to a potential political disaster for the wider gay community has been little short of heroic.[45]
Cf. Ines Rieder and Patricia Ruppelt, eds., AIDS: The Women (San Francisco and Pittsburgh: Cleis Press, 1988); and Kris Balloun, "Lesbians and the Epidemic," San Francisco Sentinel, August 24, 1990, p. 11.
The renewed ability of lesbians and gay men to work together fruitfully, if not always without significant tensions (largely, it appears, because of the persistence of sexism among many gay men), is attributable to the decline of sexuality as a major component of gay identity. Whether this working relationship will continue in the future, as AIDS ceases to be the predominant issue of importance to the community, is uncertain. In large measure the outcome depends on the success of efforts currently being made by AIDS organizations—particularly the newer and more radical ones (which we will deal with in the section headed "The Present and Future")—to eliminate sexism in their operations, to be more attentive to issues of concern to lesbians and other women, and to integrate women more fully into positions of leadership.
Relationship To The Outside World
AIDS has had a paradoxical effect on the relationship of the gay community to the wider society. On the one hand, because of the close identity of gay people and a deadly disease, it has distanced the community from the heterosexual majority. On the other hand, it has brought the two closer through the need of the wider society to deal directly and explicitly with AIDS and its etiology, which naturally involves more open discussion of homosexuality and an end to gay invisibility; through the need of the wider society to work directly with the gay community to combat the crisis; and through those changes, already noted, that have made the community more like the straight world than ever before.
Two aspects of the community's relationship to the wider society, one that illustrates the distancing effect of AIDS and one that illustrates the opposite effect, will make these points clearer.
AIDS has created a situation in which antipathy toward persons with AIDS as well as gay people in general has become a serious problem. The community has, through its political and legal structures (such as
the National Gay and Lesbian Task Force and Lambda Legal Defense Fund), struggled against public hostility toward gay people—hostility created or intensified by AIDS—as well as the many forms of discrimination and prejudice directed against people with AIDS and HIV-positive persons. These organizations have opposed particular instances of discrimination (for example, in housing, employment, or insurance); advocated the passage of protective legislation and the use of public agencies to protect the civil rights and other interests of gay people and persons with AIDS; and insisted that the gay community has the right to determine whether specific public health and related measures proposed as weapons in the fight against AIDS (most notably the HIV antibody–testing controversy) will have adverse or positive effects on its civil rights or liberties.[46]
Cf. Bayer, Private Acts, Social Consequences, pp. 101-36.
The links between the gay community and the scientific and professional communities also define the relationship of gay people to the outside world. As a group, scientists, physicians, and other professionals have tended to monopolize control over the definition of, and response to, illness and other problems of social welfare in our society. This monopoly is precisely what the gay community has attempted to rupture in its desire to empower itself and act as a fully active subject in the case of AIDS. The problem for the community from the start of the epidemic was how to use the power and resources of medical and other professionals as well as government and private philanthropic bodies—resources that the community could scarcely muster by itself—without allowing those groups to attain, or regain, significant power over the community, its sexuality, and its institutions. This problem placed the community in a difficult position, one that Ronald Bayer, in a felicitous phrase, has described as "between the specter and the promise of medicine," a description that could be expanded to all areas of science, healing and caring, and social welfare.[47]
Ronald Bayer, "AIDS and the Gay Community: Between the Specter and the Promise of Medicine," Social Research 53 (Autumn 1985): 581-606.
The necessity to use the promise and resources of the scientific and professional worlds forced the community to eschew total distrust and distancing and attempt to work closely with them without granting them total trust or authority over AIDS.This attempt was made in two closely interrelated manners. First, the community has insisted, both explicitly and implicitly, that professionals must provide their expertise to persons with AIDS and to gay people in general but that they must act in partnership with the persons they serve. Second, the community has in general attempted to learn as much as possible about medical care, epidemiology, and clinical research regarding
AIDS. It has clearly believed—as did the women's movement before it—that only through knowledge can it deal with professionals on a basis of relative equality and prevent them from simply imposing their interests, aims, and methodologies on the community and on individuals with AIDS.[48]
Cf. Mark Harrington, "Let My People In: The Results of Direct Action Have Been Fruitful, Further Validating the Activist Approach to Medical Bureaucracy," OutWeek, August 8, 1990, pp. 34-37.
Such an approach probably has a better chance of working in the applied spheres of the provision of care and social welfare than in those of "purer" scientific research, but even in the latter areas (for example, in pharmaceutical research and trials) the community has made unusual and often successful efforts not to allow professionals to monopolize knowledge and its applications.[49]See Harold Edgar and David J. Rothman, "New Rules for New Drugs: The Challenge of AIDS to the Regulatory Process," Milbank Quarterly 68, Suppl. 1 (1990): 111-42.
These approaches to the scientific and professional communities were handled through a complex process of negotiations over the terms of research into the nature of AIDS. The community could, in fact, enforce it role in this process precisely because its members were needed by scientists as research subjects, just as the community itself required the expertise of scientists and medical researchers. One important illustration of this point involves negotiations over confidentiality of patient data within the research process, something that was naturally of great interest to a community concerned with the possibility of AIDS-related discrimination.
During the first years of the epidemic, the insensitivity of public health researchers forced the gay community into a defensive posture. For example, gay activists learned that the CDC maintained computerized files, with full identifiers, of all reported AIDS cases and had released names of such cases to local health departments and agencies not affiliated with the federal government—agencies such as the New York Blood Center.[50]
Personal communication to G. Oppenheimer from Carole Levine, Executive Director, Citizens Commission on AIDS for New York City and Northern New Jersey, June 1989.
Gay leaders demanded greater safeguards to protect the privacy of all AIDS patients and research subjects through strict confidentiality strictures. These included the reduction of identifiers, the control of AIDS data from the CDC and the health departments of origin to other agencies, and the creation of a consent form that clearly explained the degree to which the information provided could be protected against release.[51]Ibid.
To do less, according to gay leaders and their allies, would be to jeopardize the validity of epidemiological research, since many research subjects would, out of distrust or fear, provide inaccurate or incomplete information.Because each needed the other, the gay community and the CDC negotiated. Having empowered itself by "owning" AIDS, the gay community was given de facto recognition as a partner by the U.S. government; the community's authority was therefore heightened. As a result,
an almost unprecedented event occurred: the objects of scientific investigations helped define the conditions under which they would agree to participate in studies.
Given the realities of the actual social and historical environment in which it had to operate, the gay community was only partially successful in the efforts we have been discussing. In spite of the gay political movements of the 1970s, it had not yet achieved anything like full legitimacy in American society when AIDS struck. In addition, its search for legitimacy was hindered not only by AIDS itself but by the continued need to struggle on more than one front, most notably against the New Right.
The gay community had internal weaknesses as well. Not all cities or regions heavily affected by AIDS had equally visible or strong gay presences. Those in San Francisco, New York, and a few other large cities had the greatest success in creating caring institutions and in dealing with their local governments and societies. Others were often late in entering the struggle and sometimes failed to develop the full range of gay institutions needed to face the crisis. In this respect, the situation closely echoed the pattern of development of local gay communities and their strengths and weaknesses that had emerged in the 1960s and 1970s.
In addition, the community was never completely united. The community, is, as we have seen, a diffuse and diverse one without a single political voice, and much of its natural constituency is prevented from identifying with it publicly because of the persistence of homophobia and oppression. While the great majority of gays doubtless accepted the broad principles of dealing with AIDS that we have delineated here, many internal struggles arose over particular aspects of the crisis, the community's relationship to the non-gay world, and the community's own institutions. These differences were most notable, as we have seen, in the sphere of sexuality, where conflicts arose over the desirability of closing bathhouses and other sexual establishments. As a result, essential decisions were taken out of the hands of the community and were made instead by governmental and medical personnel.
Given these conditions and difficulties, the achievements of the gay community in the struggles surrounding AIDS have been substantial. Most notably, the community has provided services to persons with AIDS, has helped them to empower themselves, and has fought against discrimination. There have, in addition, been substantial successes even in the more difficult areas of scientific research and the procurement of
funding from the federal and local governments. A gay voice has been established in most major aspects of the struggle against AIDS, and large numbers of the scientists, professionals, and government agencies most intimately involved in that struggle have learned to listen to it, at least to some degree. The community has successfully restructured many of its most important institutions and made them into relatively effective forces in the struggle against AIDS. Finally, although the community has not fully succeeded in changing the larger society's perception about AIDS (and about homosexuality itself), especially the perceptions among right-wing groups, it has done so to some degree; and it has certainly in large measure ensured that the crisis has not been ignored even among the most vociferous and powerful opponents of gay people and persons with AIDS.
The paradox seen here is that, just at the time when the wider society was distancing itself from AIDS and persons with AIDS and manifesting the greatest hostility toward gay people, gay people were able to exercise the greatest control over the crisis and to use what by any standard must count as a disaster to empower themselves within American society.