Illustration by Richard Down
When youre gay, 57 years old, HIV-negative, and three-quarters of the friends and loved ones whove meant the most to you in life are dead, its odd the way little things can set you off. Thats what happened to me, watching the new film adaptation of A Home at the End of the World, in a scene toward the end when the two leading characters discuss the spots on the body of one of them.
See, its faded.
And I (who rarely ever cry at the movies) just lost it. How many times had I, and countless others, played this scene in real life? Denial is sometimes the only way to get through the day. And where are we in 2004? Surprisingly enough, not in all that different a place.
Denial is huge right now, says Michael Mayer, the films director. I keep reading all sorts of very scary statistics about the rise of HIV infection. And with the political climate the way it is, it seems to me to be a good time for A Home at the End of the World to come out. We should really be talking about AIDS and remembering where it came from and how it started. Were not through; its not over. Far from it. In fact, in the world community its just beginning.
Mayer isnt an AIDS expert, as the mainstream media would have it, or an activist. Hes simply a gay man who, like so many of his generation, has lost many loved ones to the epidemic. Hes a successful stage director (everything from Thoroughly Modern Millie to Youre a Good Man, Charlie Brown, from The Triumph of Love to After the Fall) whose screen adaptation of novelist Michael Cunninghams saga of love and friendship arrives at a time when a well-received revival of Larry Kramers seminal AIDS play The Normal Heart was unable to find a public, while the television adaptation of Angels in America, Tony Kushners fantasia about AIDS, has received an unprecedented 21 Emmy nominations. And thats because these days, when the protease-inhibitor drug cocktails are extending HIV-positive lives, even as infection rates climb, AIDS seems more marginalized than ever part of life and yet oddly taken for granted to the degree that its off the radar, save as 80s nostalgia.
It was very important to me that A Home at the End of the World not become one of those AIDS stories, says Mayer. In 1982-83, AIDS was a death sentence. And it was as simple as that. A lot of people I knew wouldnt even know enough to call the lesions by their name Kaposis sarcoma. It was always the way it is in the film, One of those purple things one of those spots. I wanted it to be about that one specific moment in our lives when our friends started dying and we didnt know what the hell it was. We were looking into a maw of absolute terror and doom.
And despite all thats happened since the 1980s in the way of activism, awareness and treatments, were still staring into that maw, whether we want to believe it or not. And for the most part we dont. The disease has killed off the better part of a generation of activists. Those who have followed have yet to rise to the new challenges the disease has created. While the world is alert to the way AIDS has ruined Africa and now threatens China and Russia, complacency has hit stateside.
At the just-concluded International AIDS Conference in Bangkok, Thailand, it has been noted that 40 million people worldwide now suffer from full-blown AIDS 30 million of them in underdeveloped countries. Only 400,000 of those suffering from HIV infection in those poorer countries are receiving any sort of drug treatment. Since the last International AIDS Conference, which was held in Barcelona, Spain, in 2002, 6 million people have died from the disease. Since 2003, 5 million have become HIV-infected. Estimates are that by 2010, 100 million people will be infected worldwide, leaving 25 million AIDS orphans in their wake.
While the United States has earmarked $15 billion in a five-year emergency plan for AIDS relief, it has been widely criticized by participants in the Bangkok conference for undertaking it unilaterally and not in conjunction with the global fund that reaches 128 countries as part of a collaborative effort. Worse than this unilateralism is an emphasis on sexual abstinence over condom use in U.S.-sponsored prevention programs and the Bush administrations refusal to pay for generic AIDS medicines endorsed by the World Health Organization and used successfully in many countries. U.S. policies were denounced at the Barcelona conference in 2002, where Health and Human Services Secretary Tommy Thompson was booed. And this led to the administration sharply cutting back on U.S. participation in the Bangkok conference, going so far as not to allow Marc Bulterys of the Centers for Disease Control to deliver an important Journal of the American Medical Association report on AIDS childish pettiness typical of all things Bush.
Meanwhile, in a world where people are trying to swim against a rising tide of death, one goal of the conference, to provide drugs to 3 million AIDS sufferers by 2005, clearly wont be met. AIDSVAX, the only vaccine to complete two large-scale clinical trials, has proved a flop. While a new drug to inhibit HIV enzymes shows promise, a cure for this plague is in many ways as remote now as it was in the 1980s, according to longtime AIDS researcher Dr. Anthony Fauci. All this comes at a time when the gay community, headed by a new generation untouched by the struggles of the past, is to a large degree uninterested in the pandemic.
Now its back to the early days with AIDS, Village Voice gossip scribe Michael Musto declares. The population that was around back then doesnt want to remember it. The new crowd doesnt want to know about it at all. So its an uphill struggle. Thats the most likely reason why The Normal Heart didnt do well. But Angels in America did okay. And thats probably because Oscar winners were attached. And it wasnt really harrowing. It was more poetic.
Another 80s throwback, though far from a poetic one, is the way AIDS-related deaths are being fudged in obituaries, with AIDS not mentioned as a contributing cause of death even those of acknowledged HIV-positives like photographer Herb Ritts and makeup artist Kevin Aucoin. As a result, Musto has begun to use his La Dolce Musto column as a means of correcting the record, most recently on 70s-era fashion plate Egon von Furstenberg. Someone like Egon who may have been bisexual or, worst-case scenario, was leading a double life, you expect them to fudge the obit, says Musto. But with an out gay male like Herb Ritts? Thats really shocking. That shows its still unspeakable.
One of those who has always been more than willing to speak is Gabriel Rotello, whose 1997 study, Sexual Ecology: AIDS and the Destiny of Gay Men, inspired a whirlwind of controversy when it was first published. Going further in its criticism of gay-male promiscuity than Larry Kramer did in his controversial novel Faggots (which was published just prior to the epidemics emergence), Rotellos book met with opposition so strong that a group called Sex Panic was created to proselytize against it.
A number of key members of Sex Panic have died, Rotello notes, though in far from an I told you so manner. They predicted that the result of my book would be legislation that would be bursting down peoples bedroom doors, arresting people for unsafe sex and all that kind of thing. Obviously, nothing like that happened.
So after the wake-up call of the 80s, did we just go back to sleep? In many ways, Rotello thinks, we have.
The AIDS epidemic, Rotello continues, challenged in a really, really profound way that underlying tenet of the gay sexual revolution, which was not only that you can have, but you ought to have, as many partners as you can handle, and thats an integral part of being gay and being liberated as a gay man. We were all willing to attack the government, the news media, the drug companies, but not talk about ourselves. The introduction of the drug-combination therapies potentially drove infectivity way down, but they dont completely eliminate HIV from the body. So the likelihood is that it will prompt the mutation of multiple drug-resistant strains. And as that happens, if people increase their number of partners and increase their amount of unsafe sex, those strains will be the ones that get passed along. But we refuse to address that.
We just kept wringing our hands and saying, Why cant we get everybody to use a condom all the time? You have to address the number of partners that people have. A 50 percent condom-use level is pretty good. If you can get 25 to 30 percent of the population to do something all the time, thats considered really good. To get 100 percent is inconceivable, impossible, and its never happened.
And while the baths are not the sexual center for gay men that they were in the 70s, Internet-created hookups have come to replace them as a vector of HIV transmission. Its not as simple as it was in 1979, Rotello notes, when a different breed of drug than exists today fueled the sexual atmosphere. Now, with the combination of Viagra and crystal meth, the worst situation arises, because you have somebody whos psychologically out of control and sexually voracious, yet quasi-impotent because of crystal, subject to a host of diseases and, thanks to Viagra, immediately turning around and fucking 20 people in a row. This has created an epidemiological hot zone that weve never had before.
As for the hot zone in the rest of the world, thats quite a different matter, far beyond the ken of gay sybarites. In places like Africa, women who come from a small village get married when theyre 15, get pregnant, their husband immediately goes off to the capital city for like eight years to work there, only rarely sending any money home. So she resorts to casual prostitution. She has sex with two or three men a week, generally truck drivers, and thats a way to earn money. Meanwhile, the husband goes to prostitutes in the big city. Truck drivers are giant conduits of spreading disease from one end of the continent to the other; prostitutes in big cities have no access to health care. And thats considered normal. In a situation like that, HIV gets a foothold, and it spreads just as it did with gay men here.
For gay men here, everything pivots on the problem of health care a burning issue for gay and straight, HIV-positive and -negative alike. Its the number-one concern for that most controversial of AIDS activists, Michael Petrelis, the San Franciscobased firebrand whose vocal displeasure with complacent public officials led to his incarceration for some of his more harassing campaigns.
Id say its the most important thing, says Petrelis, who has been HIV-positive since 1985. I discovered last fall, when I was sick with some infection, on top of the AIDS cocktail I take daily I had to take new drugs. I didnt know that Californias Medi-Cal had a limit on the number of drugs anyone can get on Medi-Cal. I had to make appeals to Sacramento to get these additional drugs on top of the cocktail that I take some of which is paid for by the state, some of which is paid for by federal programs. But it was quite a shock when I was in Safeway, at the pharmacy, and they said, Michael, we cant fill these prescriptions, because youve reached your monthly limit. You have to file an appeal. I filed the appeal, and eventually they did give me the drugs.
One of the drugs I take is Kaletra, which has to be refrigerated, Petrelis continues. What if youre living on the streets of the Tenderloin because you cant get a rental subsidy to keep an apartment, and the doctor gives you Kaletra how do you keep it? I mean that kind of basic question is being asked in, what is it, year 23 of this epidemic? In San Francisco?
And that in turn leads to the other factor that upsets Petrelis that the history of the AIDS epidemic is slipping away from public memory. The passing of Ronald Reagan, whose inaction on AIDS spurred activists fury, briefly brought the topic to light on the public stage in ways that frustrate Petrelis.
I could care less about all this talk about when he finally said AIDS. He didnt take any action. So he is going to be remembered for saying Mr. Gorbachev, tear down this wall. How come he didnt say America, pay attention to AIDS? At least some good came out of all that canonization of Reagan in the mainstream media. You saw things about AIDS. But, my God, the push we had to make Sean Strub, Larry Kramer and others to say to the press, What about criticism of Reagan? It was like a monumental task. For me it was good to remember the horribleness of the 80s. But it is not over, theres still not enough action.
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And as far as Michael Mayer is concerned, we cant count on art to inspire action as we once did. I think The Normal Heart is truly one of the great plays of our time, he says simply. Its a fantastic piece of writing, and I think Larry is a real hero.
So do we need a Normal Heart for the new century? A new Larry? Surely the latter, but Mayers not so sure about the former.
Theres something about what the theater is trying to do now thats . . . confusing to people. I dont think that audiences are feeling the same way about it. I dont think people are turning to the theater to get any of their political or social function as a society. People are going much more than they used to for spectacle and movie stars. Not politics. Not AIDS.
And on we snooze . . .