|AIDS:The Burdens of History|
source ref: ebook.html
This chapter is about a paradox and its political impact. Although the AIDS epidemic has occurred in a period when social conservatives have been politically dominant in most Western societiesincreasing the stigma against homosexuals and homosexualityit has also translated into much greater recognition of the homosexual community and a homosexual movement, in most Western democracies. (Most of the examples discussed in this chapter will be drawn from the United States and Australia, although similar tendencies can be seen in other Western countries.)
Central to understanding the paradox described above is the fact that when AIDS was first recognized as a new disease, it was conceptualized as a disease of urban male homosexuals. We now know enough of the natural history of the syndrome, however, to realize that it almost certainly existed in central Africa, and maybe in Haiti as well, before it was first reported by the Centers for Disease Control (CDC) in 1981. But the fact that AIDS was linked in its original conceptualization to gay menand that in most Western countries male homosexual sex remains to date the largest single source of transmissionis crucial to understanding the paradox.
It is not, of course, homosexuals who are at risk for AIDS but rather those who practice certain forms of "unsafe" sex. This distinction between behavior and identity, which often seems academic, is in fact vital to a rational understanding of AIDS. Because the media and the public generally do not make these distinctions, "gay" and "AIDS" have be-
come conflated, so that the public perception of homosexuality becomes largely indistinguishable from its perception of AIDS. This, in turn, has two consequences: (1) It causes unnecessary discrimination against all those who are identified as gay (including, in some cases, lesbians), and (2) it also means that people who are not perceived (and do not perceive themselves) as engaging in high-risk behaviors can deny that they are at risk of HIV infection.
In the early stages of the contemporary homosexual movementwhich developed out of the whole social, political, and cultural ferment of the late 1960smany of its demands could be summarized with the slogan "Get the State Off Our Back!" As the gay movement matured in the 1970s, however, it made more concrete demands of governments, pressing for antidiscrimination ordinances and for financial support for gay organizations and activities. But, in large part, the gay movement retained an adversarial relationship with government, a relationship made possible because of the movement's emphasis on self-assertion ("coming out") and challenging social stigma.
All this changed with the appearance of AIDS. Demands for government-funded research were first made by New York's Gay Men's Health Crisis, the first community-based AIDS organization. And the demands have not stopped there: Governments are asked to support research, patient care, services, and education programs. Inevitably such demands involve gay participation in the processes of governmentpolicy-making, membership on liaison committees, day-to-day contact with bureaucrats, and so forth.
But the process has been two-way. Governments have understood that to research the disease, to provide the necessary services, and to bring about the behavioral changes (primary prevention) believed to be the most effective strategies against the spread of the disease, contact with the most affected groups is required. AIDS has thus forced governments to recognize organizations they had previously ignored, and this has resulted in strengthened gay organizations, often with the help of state resources. Ironically, the conservative Reagan administration has had more contacts with organized gay groups than any of its predecessors, largely because of AIDS. In a number of other countries gays have been accorded some official recognition in formulating official AIDS strategies, and their organizations subsidized; in the Australian state of Victoria, for example, the government fostered the development of a Gay Men's Community Health Centre. Even Great Britain, where the Thatcher government has hardly been sympathetic to gay demands,
belatedly helped to fund the Terence Higgins Trust, which was established in 1982 to provide care for and information on AIDS.
Faced with a new epidemic disease, public health authorities have had to find ways to control its spread, minimize its consequences, and care for those who are sick. In the absence of either a cure or a vaccine for AIDS, there is clearly considerable room for divergence on how best to respond, epitomized by the difference between the measures taken by the city of San Francisco and the Australian state of Queensland.
I want to stress at the outset one crucial difference between these two casesnamely, that San Francisco was prepared from early on in the course of the epidemic to devote considerable resources to AIDS, and to develop a partnership between government and community-based organizations in the use of these resources . As two researchers note, the city developed "a relatively coordinated set of services for AIDS patients and citizens in major risk groups, from outpatient care to housing and counseling to prevention through community education."
Through large-scale city support for the largely gay-based AIDS Foundation and the Shanti Project, a number of programs were developed to provide care and support for AIDS patients; large-scale educational and counseling programs were also established for groups perceived as at-risk. As a consequence, hospitalization costs for AIDS patients in San Francisco were lower than in other cities, where home-care facilities were less freely available; moreover, the level of public knowledge about the medical facts of the disease was considerably higher.
Where San Francisco has been a pacesetter for the rest of the United States, the state of Queensland has lagged behind the Australian federal government, even refusing to cooperate with the National Advisory Committee on AIDS (NACAIDS) because of the presence on the committee of openly gay members. The Australian system of universal health insurance and the Queensland tradition of free hospitals have meant that basic medical services are available to all. In dealing with communities affected by AIDS, however, the state has shown itself to be punitive and uncooperative. A conservative state, Queensland has draconian drug laws and (like two other Australian states) has retained the criminal status of homosexuality; these attitudes are reflected in the government's response to the epidemic.
In 1984 the Queensland government legislated to make the transmission of AIDS a criminal offense unless the person was in a marital relationship and voluntarily ran the risk of being infected. National at-
tempts to implement anti-AIDS educational programs have been resisted by Queensland, whose premier has publicly opposed any attempt to make condoms more widely available. The crucial point here is that the Queensland government to this day refuses officially to cooperate with either gay community groups or with the (not exclusively gay) Queensland AIDS Council (QAC). The federal government has therefore made special arrangements to bypass the state and provide financial assistance to the QAC.
Both the San Francisco and Queensland governments exercise limited jurisdiction; in both cases, ultimate responsibility for crucial aspects of health policy rests with the federal government. In the United States, where there is no equivalent to the universal national health insurance system found in almost every other Western country, the Reagan administration's determination to cut back on health-care spending has placed particular strains on local governments and community organizations; many individuals with AIDS in the United States (and almost certainly many more with AIDS-related complex [ARC]) do not have access to even minimum medical care. Partly because of its unwillingness to accept federal responsibility for health, and partly because of the pressures of right-wing moralists, the United States has failed to develop any coordinated national response to the epidemicdespite calls for action from a number of organizations, and the reality that the epidemic has hit the United States far harder than any other Western country.
The most serious problem in the United States has been the reluctance to mount a national program of AIDS-prevention education similar to that in a number of European countries. Even though a report by the U.S. Surgeon General C. Everett Koopa conservativestressed the need for large-scale education, virtually nothing has been done in large areas of the United States; in most states, what education programs exist are run mostly by gay community organizations, using their own resources. Squeamishness regarding open discussions about sex and drug use, and politicians' fear of the right have been major factors in limiting these campaigns.
Australia shares some of the United States' moralism (though there are also significant differences; fundamentalist Protestantism is less important, but Australia's Catholic church is even more conservative than the United States'). Nonetheless, the greater direct role of the federal government, in addition to the part played by a national advisory struc-
ture with community representation, have meant that Australia, like most of northern Europe, has embarked on a national education campaign, employing the image of "the Grim Reaper" in television advertisements to create widespread awareness of the threat of AIDS transmission. The campaign led to criticism from all quarters: Some gay groups felt it was not nearly specific enough, while the right condemned what they called "a condom culture."
As a generalization, the response of gay groups and those working in local AIDS education and advocacy programs has been to stress large-scale education about primary prevention, while conservative medical, political, and religious figures have emphasized widespread testing for the HIV antibody and restrictive legislation. The issue of testing for HIV antibodies among high-risk populations (i.e., is it a useful tool in AIDS prevention?) has been a major debate in most Western countries. AIDS organizations have generally argued that large-scale testing is undesirable and that mandatory testing of high-risk groups will, in the words of Surgeon General C. Everett Koop, compel "those infected with the AIDS virus [to] go underground out of the mainstream of health care and education." As the National Gay and Lesbian Task Force (NGLTF) argued:
The experience of the gay communitythe only group where significant prevention and risk-reduction programs have taken placedemonstrates that education and counseling, not testing, are critical to changing behavior. Not everyone needs or desires to know his/her antibody status. No one should be forced into that position, particularly given the potentially severe social, legal and economic ramifications of testing.
The NGLTF's antitesting position is further strengthened by the fact that test results often obtain false positives for the presence of HIV antibodies.
It is easy to portray this dispute over testing as one that pits public health advocates against proponents of gay rights. In reality, the dispute centers on different conceptions of public health: Those who oppose mandatory testing are concerned that the fear of discrimination resulting from seropositive results will force those most at risk to avoid needed testing, counseling, and contact with support services. This argument has been used against Reagan administration proposals on test-
ing, and against state legislation that requires the reporting of names of those who test positive. It is vital to understand the extent to which discrimination (real and perceived) against "AIDS carriers" is a factor, and how it is strengthened every time a politician or religious figure talks of quarantine or isolation.
Even enlightened governments have aroused fears of discrimination against homosexuals in the name of AIDS prevention. In Sweden major disagreements have emerged over the provisions for confidentiality in HIV-antibody testing, with the national gay organization expressing apprehensions about the consequences. At this writing a similar dispute has erupted in Australia between Victoria's AIDS Council and the (Labour) state government, which, in marked contrast to the Reagan administration, has enabled and even encouraged gay participation in resolving the dispute.
Of course, certain sorts of discrimination are justified in the interests of public health, and reasonable people can disagree about the balanceas was true in the protracted debate in San Francisco concerning the gay bathhouses. But few diseases in recent history have led to as many stringent proposals to restrict the rights of those affected, and even fewer have led to claims for discrimination against all members of "high-risk" groups, whether or not they were actually ill or contagious. Fear of AIDS has elicited a welter of irrational reactions based on the stereotyping of homosexuals. The U.S. Justice Department has ruled that persons with AIDS may be dismissed from their jobs because of fear of transmission, even where such fears are not medically supported; some state courts and legislatures, however, have taken an opposite position. Fear of AIDS was invoked by the state of Georgia in its successful defense of its antisodomy law before the Supreme Court in 1986. A number of governments (including the United States) have sought to make evidence of HIV-antibody-free (noncarrier) status a requirement for immigration or even entry; in West Germany this provision has led to a bitter dispute between the Interior and Health ministries.
Fear of and hostility toward those with AIDS most clearly overlap with more generalized homophobia in the attempts by some politicians and a number of fundamentalists to use the epidemic to argue against
homosexual rights. In the eyes of the religious right, AIDS is literally viewed as a God-given opportunity to reverse social attitudes toward homosexuality, which have grown more tolerant over the past decade; in English-speaking countries particularly, fundamentalists have invoked fire-and-brimstone rhetoric to argue that AIDS is evidence of God's wrath. It seems likely that some of President Reagan's reluctance to commit his administration to the battle against the epidemic has had much to do with his unwillingness to antagonize the fundamentalists in the Republican constituency; latest victim of right-wing attacks is Surgeon General C. Everett Koop, who has been bitterly assailed for his espousal of widespread AIDS-prevention education.
The greatest danger of discrimination can occur where the religious and political right combine to organize antihomosexual campaigns invoking the fear of AIDS. For example, in California's November 1986 elections a group associated with Lyndon LaRouche proposed a measure to quarantine those who test antibody positive; it was defeated after gay and medical groups mounted a major campaign against itsupported by almost all mainstream politicians. Even though there is no good medical argument for a large-scale quarantinelet alone the extraordinary practical difficulties it would involvethis will undoubtedly not be the last time quarantine measures are proposed. (Introducing a bill for notification of all HIV-positives, one New Zealand member of parliament (M.P.) said: "As far as I'm concerned, they should be monitored and bloody well isolated."
These extreme examples, however, need to be balanced against the ways in which the increased visibility of gays owing to AIDS has also increased recognition that they constitute a legitimate community; one study in California suggests increased support for gay civil rights over the past decade, despite fear of AIDS. Nevertheless, the political balance still seems unclear. New York City finally adopted an antidiscrimination ordinance in 1986 protecting homosexuals, despite concern about AIDS, and decriminalization was achieved by a free parliamentary vote in New Zealand in 1986; on the other hand, Western Australia rejected decriminalization largely because of AIDS-related hysteria. Several U.S. cities, including Los Angeles and San Francisco, have adopted specific ordinances against AIDS-related discrimination. That these are necessary is suggested by the rise in AIDS-related cases before various state and city human rights commissions over the past year.
Gay groups have quickly learned which aspects of the political system are most amenable to pressure; in the United States, at a national level, this has involved working through the courts (a vast number of AIDS-related cases are already working their way through the judicial system) and, especially, sympathetic members of Congress. The first hearings on AIDS were those organized by Rep. Henry A. Waxman (D.-Calif.) in 1983 and Rep. Ted Weiss (D.-N.Y.) in 1984; not surprisingly both men have large and well-organized gay constituencies. They were subsequently supported by other congressional members, almost all of whom also have strong gay organizations in their districts. Openly gay politicians, in addition, have run successful, or nearly so, campaigns for national office: San Francisco City Council member Harry Britt was almost elected to Congress in 1987. Congressman Gerry E. Studds "came out" as a result of the scandal following his initial election, and has since been reelected; he has more recently been joined by Congressman Barney Frank, also from Massachusetts; there are, or have been, openly gay state legislators in Minnesota and Massachusetts.
In the executive branch of governmentexcept for some local jurisdictions, especially in Californiagay participation in policy-making has been informal and, to that extent, dependent on personal networks. In other political systems, where legislatures are far more dependent on executives, the possibilities for political intervention (available in the United States through congressional initiatives) are far less viable. Thus, in Australia, direct lobbying of the federal Health Department has been much more important than contact with parliamentarians; as early as 1984 the government allowed gay participation in policy-making when it established a ministerial advisory committee on AIDS and included representatives of gay-community groups; it followed this action with government support (and funding) for a national association of AIDS organizations designed to allow direct contact between the federal government and the AIDS-prevention movement. There is, in Australia, a parliamentary committee on AIDS, but its role vis-Ã -vis making policy is minor compared to the roles played by the National Advisory Committee or the more medically oriented Federal AIDS Task Force.
Two points need be made: First, the recognition of homosexual rights is fragile, and can easily change. (It is unlikely, for instance, that it would survive a change of federal government in the Australian case.) Second, recognition and incorporation into the system itself have presented new problems for the gay movement.
Among the groups most affected by AIDS, only the homosexuals have been able to mobilize and articulate political demands. The public's perception of the disease therefore continues to be more closely linked with homosexuals than its epidemiology suggests. In the United States this is further complicated by racial divisions and intravenous drug use, as a far higher proportion of AIDS cases that are not sexually transmitted are found among blacks and Hispanics than among whites. Even now one feature of AIDS organizations is the underrepresentation of people of color, including homosexuals. Even in countries where this is not a problem, the dominance of AIDS as an issue makes the gap between gay women and men increasingly more difficult to bridge; although many lesbians are heavily involved in AIDS work, most gay women cannot identify with AIDS as a central issue in the way true for many gay men.
No AIDS organization is exclusively gay, and few are as restrictive in their nomenclature as the Gay Men's Health Crisis (GMHC, which ironically has a considerable heterosexual clientele and corps of volunteers). Even so, AIDS has mobilized more gay men into political and community organizations, although not into specific demonstrations and marches, than any other event in the short history of the gay movement. In every major city of the United States, Canada, Australasia, and most of northern Europe, the appearance of AIDS has led thousands of gay men (and others) to volunteer in programs of care, support, counseling, and education. But this in turn creates several problems: It reinforces the public's misperception of the causal link between AIDS and homosexuality; it forces other issues off the gay movement's agenda and monopolizes its attention; and it creates new tensions as dependence on government and the emergence of a new class of AIDS experts leads to growing strains within the movement.
One could in fact posit that AIDS has created a shift in the leadership of the gay movement, accentuating the trend toward leaders who can claim professional expertise instead of activist credentialsa move already under way during the late 1970s. This has been most obvious in the rise to prominence of openly gay medical doctors, who have been able to use their professional skills and sexual identity to claim a certain legitimacy in the eyes of government; groups like the American
Physicians for Human Rights have become prominent within the gay movement largely because of the epidemic. But the new leadership also includes those skilled in legislative and bureaucratic lobbying, and one consequence of this shift has been to reduce the representativeness of leadership in terms of class, race, and age.
Observing the gay movement as a participant, I have found that AIDS has changed the movement in ways none of us could have anticipated in the much headier days of the 1970s. Obviously the stakes are higher: However important law reform was, it does not compare with the urgent need to respond to an epidemic that in some cities (New York, San Francisco, Houston, Copenhagen, Sydney) was striking nearly every gay man. In response, new people have come into the movement; many gay men who had hitherto regarded gay politics as irrelevant, have become the front-line activists because of AIDS.
But many experienced activists have found that AIDS has turned them into professionals; the people who run the large organizations, such as GMHC, the Terence Higgins Trust, the San Francisco AIDS Foundation, the AIDS Council of New South Wales, and so forth, spend much of their time now dealing with government bureaucrats, health-system managers, and various authorities whom they had once denounced as "the enemy." Unconsciously, certain forms of co-optation inevitably take place; governments fund jobs, trips, and conferences, and those who take part begin to see things differently. Thus, a new tension develops within the rank-and-file, many of whom came into AIDS work as volunteers concerned to look directly after the sick and dying, who feel estranged from the new bureaucrats their own movement seems to have spawned.
Despite very different political, medical, and cultural contexts, both New York and Melbourne have undergone similar developments. In 1987 a bitter exchange erupted between GMHC and its critics, who accused the former of timidity, political cowardice, and an inability to cope. Although the tone in Melbourne is different, almost all of the issues present in the New York clash emerged at a May 1987 public meeting organized by the Victorian AIDS Council to canvass the community regarding some proposed legislation. Similarly, one observer of the Terence Higgins Trust claimed that the criticisms of GMHC were equally applicable in Britain. This is hardly surprising: The social and political ramifications of AIDS are enormously complex, requiring unprepared community groups to create institutions that can keep pace with the rapidly escalating caseload, political complexity, and adminis-
trative problems in an atmosphere of considerable emotional and political tension.
There is evidence that gays in the United States are becoming increasingly militant about AIDS, and that the tendency of the past few years for co-optation into the system is being superseded by a recognition of the limits of such an approach. The attacks on GMHC presaged a new anger at conferences held in 1987for instance, Duke Comegys's widely reported call for nonviolent civil disobedience to put pressure on governments (Comegys is cochairman of the Human Rights Campaign Fund, a gay political action committee).
One of the fascinating social aspects of the AIDS epidemic is the different responses of various societies and governments. As a gross generalization, the most effective responses have been observed in those areas where the gay movement already existed as a legitimate and recognized pressure group; this would be true of San Francisco, the Netherlands, and Scandinavia, and to a lesser extent, Switzerland and several Australian states, where governments have been willing to work alongside gay community groups to deal with the epidemic. (The earliest official response came from the already existing San Francisco City Office of Lesbian and Gay Health.) With the partial exception of hemophiliacs, other affected groups were too unorganized and socially stigmatized to be able to exert any meaningful pressure for government action, although more recently drug-treatment professionals have played a role in AIDS politics. (At a conference in Stockholm in October 1986, I observed obvious tensions between gay activists and social workers with a drug-user clientele.)
Canada (although not each province), Great Britain, New Zealand, West Germany, and some other areas of the United States (the rest of California, New York, Massachusetts, Washington, D.C., etc.) were slower to respond but have basically moved toward the San Francisco model of large-scale education and service programs in cooperation with community groups. Even so, as Daniel M. Fox has pointed out, "Without a national program, community-based organizations are unlikely to emerge or to be influential in cities with small, politically weak gay populations." Other parts of the United States and most of Mediterranean Europe still typify what my editors at the Village Voice called "malign neglect." The oddest case is France, where despite a consider-
able caseload and a leading role in medical research, virtually no government action has been forthcoming from either Socialist or conservative ministers, and where even the gay movement, in decline throughout the 1980s, has failed to mobilize around AIDS. (In an overview of the French gay world written in 1985, Alain Sanzio spoke of "the persistent refusal of the gay community to recognize the reality of AIDS.") Reports of a similar form of denial are made about Italy, where, so far, the majority of cases are found among intravenous drug users.
Of course, other factors besides the existing strength of the gay movement have affected the extent to which AIDS organizations have been included in policy-making; Australia's apparent lead has a lot to do with the concern of the Labour Health Minister, Dr. Neal Blewett, who was greatly influenced by his fact-finding visit to San Francisco in early 1985 (his New Zealand counterpart has been less willing to endorse official gay participation in decision making). Although hardly a surprising assertion, nominally left-wing governments have generally been responsive to gay demands on AIDS-related issues (although there are some exceptions such as Greece, whose Socialist government has a very bad record on gay issues, and Switzerland, whose conservative government took the lead in national AIDS-education campaigns). Differences in political culture, too, are significant; Denmark's response appears more in alignment with its gay groups than does Sweden's, and the explanation seems to have more to do with cultural differences than with differences in the strength of the gay movement in the two countries. Where governments are themselves influenced by traditional morality this will, of course, be reflected in their policies; Italy's Christian Democrat health minister, Carlo Cattin, assailed any suggestion that he should support "publicity for anal intercourse and condoms."
Nor should we forget Alexis de Tocqueville's comments on volunteerism: "Wherever, at the head of some new undertaking, you see the government in France or a man of rank in England, in the United States you will be sure to find an association." Tocqueville would hardly be surprised that the largest community response to AIDS has come in Anglo-Saxon societies. The differences in the extent to which gay communities themselves have mobilized around AIDS reflect deeper variations in national political cultures and their attitudes to volunteerism and interest-group organization. (The American irony is that groups such as the GMHC or AIDS Project-Los Angeles are almost perfect examples of Reaganite volunteerism, but right-wing moralists have prevented the White House from acknowledging their roles.)
It is difficult to speak of the impact of AIDS without speaking of the changing perceptions of homosexuals, so intertwined are the two in the public imagination. AIDS seems to have heightened both the stigma and the respectability of homosexuals; in unraveling this apparent contradiction, we can come to terms with certain crucial social changes.
The common assumption is that AIDS has been responsible for reversing, or at least halting, a gradual social acceptance of homosexuality as an "alternate life-style," an acceptance that had grown out of changes in sexual mores and the commercialization of sexuality during the 1970s. It is not hard to point to the hostile rhetoric, increased antigay violence, and the quite considerable discrimination directly linked to AIDS. Evidence of increased violence directed against homosexuals, much of it linked to AIDS, was recognized by a special congressional hearing in late 1986.
The reality may well be that the response to AIDS thus far has largely been a reflection of the extent to which preceding gay-rights struggles had achieved a place in the political process for gay organizations; AIDS has thus highlighted a process already under way. The point has often been made that the epidemiology of AIDS would have been very different in most Western countries had it not been for the expansion of gay sexual networks in the 1970s. Equally, the response of governments would have been very differentand almost certainly slower and more repressiveif this expansion had not also been accompanied by the growth of gay political organizations that provided a basis for the development of community-based groups in response to the epidemic. Thus, the paradox I set out at the beginning of this chapter is no such thing; shorn of its emotional and voyeuristic content, the politics of AIDS follows closely the assumptions of interest-group politics in most Western societies. At the level of conventional liberal political analysis, the case of AIDS bears out the adage that the squeaky wheel gets the oil.
AIDS has brought issues of central concern to the gay movement onto the mainstream political agenda: at an enormous price the gay movement has become a recognized actor in the politics of health policymaking. Thus, while I agree with Allan M. Brandt that "the AIDS epidemic threatens to undo a generation of progress toward gay rights," such a development is not inevitable. Political will and mobilization can have a large effect on the social impact of the disease.
1. Dennis Altman, The Homosexualization of America (Boston: Beacon, 1983), ch. 2.
2. Dennis Altman, Homosexual : Oppression and Liberation (New York: Avon, 1972); for the relationship between gay liberation and earlier gay organizations, see John d' Emilio, Sexual Politics , Sexual Communities (Chicago: University of Chicago Press, 1983).
3. Dennis Altman, "The Impact of AIDS," British Medical Bulletin 44 (1987).
4. Peter Arno and R. Hughes, "Local Responses to the AIDS Epidemic: New York and San Francisco" (Paper presented at the Annual Meeting of the APHA, Washington, D.C., November 1985).
5. For an overview of the city's response, see K. Leishman, "A Crisis in Public Health," Atlantic , 1985, 18-41.
6. See A. Scitovsky, M. Cline, and P. Lee, "Medical Care Costs of AIDS Patients in San Francisco," in AIDS : Public Policy Dimensions , ed. J. Griggs (New York: United Hospital Fund, 1987), and L. Tempshok, D. Sweet, and J. Zich, "A Three-City Comparison of the Public's Knowledge and Awareness About AIDS," Psychology and Health (forthcoming).
7. See S. Waldman, "The Other AIDS Crisis," Washington Monthly , 1986, 25-31.
8. See Institute of Medicine and National Academy of Science, Confronting AIDS (Washington, D.C.: National Academy Press, 1986); P. Lee and P. Arno, "AIDS and Health Policy," AIDS : Public Policy Dimensions , ed. J. Griggs.
9. "Bishops Condemn 'Condom Culture' in AIDS Campaign," Melbourne Herald , 20 May 1987.
10. Surgeon General ' s Report on AIDS (Washington, D.C.: U.S. Public Health Service, 1986), 30.
11. National Gay and Lesbian Task Force, news release, Washington, D.C., 5 February 1987.
12. See S. McCombie, "The Cultural Impact of the AIDS Test," Social Science and Medicine 23 (1986): 455-459.
13. See e.g., G. Bell, "AIDS in Australia," Sydney Bulletin , 17 March 1987; Gawenda, "AIDS: Reaping Responsibility," The Age (Melbourne), 2 May 1987.
14. See Mark Vandervelden, "Colorado Legislature Approves Mandatory AIDS Reporting Law," The Advocate , 26 May 1987.
15. See Dennis Altman, AIDS in the Mind of America (Garden City, N.Y.: Anchor/Doubleday, 1986), 146-155.
16. See P. Tatchell, AIDS : A Guide to Survival (London: Gay Men's Press, 1986), 97-101; M. Somerville, "Structuring the Legal and Ethical Issues Raised by AIDS," in AIDS : Social Policy , Ethics and the Law (Monash: Monash University Centre for Human Bioethics, 1986).
17. "Frighten and be Fired," The Economist , 28 June 1986.
18. See "Facing the AIDS Crisis," Newsweek , 9 June 1987.
19. "LaRouche Initiative Stopped Dead," New York Native , 17 November 1986, 6.
20. "Jones Plans Introduction of AIDS Law," Wellington Dominion , 30 May 1987.
21. A. Sniderman, B. Wolfinger, D. Mutz, and J. Wiley, "Values under Pressure" (Paper delivered at the Annual Meeting of the American Political Science Association, August 1986).
22. "AIDS Bogy Foils Labor Bill," Weekend Australian , 20 June 1987.
23. See "The AIDS Epidemic and Business," Business Week , 23 March 1987, 62.
24. See Margaret Duckett, Australia ' s Response to AIDS (Canberra: Department of Health, 1986).
25. See R. Goldstein, "The Hidden Epidemic: AIDS and Race," Village Voice , 10 March 1987.
26. "See the Open Letter" by Larry Kramer, New York Native , 26 January 1987, and responses in the 9 and 16 February issues.
27. Simon Watney, "The Politics of AIDS," City Limits (March 1987).
28. "Gay Health Conference; The Advocate , 28 April 1987.
29. Daniel M. Fox, "AIDS and the American Health Polity," Milbank Quarterly 64 (1986): 7-33.
30. A. Sanzio, "Splendeurs et misÃ¨res des gais 80 . . . " Masques 25-26 (1985): 59.
31. W. Franklin, "Italian Fast-Tracking," The Advocate , 17 March 1987,32.
32. Lionel Poverb, "La mitre on la copote?" Gai Pied Hebdo 258 (Paris), 21 February 1987.
33. Alexis de Tocqueville, Democracy in America , abr. ver., ed. Andrew Hacker (New York: Washington Square Press, 1964), 181.
34. See Altman, AIDS in the Mind of America , 178.
35. See R. Meislin, "AIDS Said to Increase Bias against Homosexuals," New York Times , 20 January 1986.
36. "Gays Testify on Homophobic Violence," The Advocate , 11 November 1986.
37. Allan M. Brandt, No Magic Bullet , rev. ed. (New York: Oxford University Press, 1987), 194.