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Curated by:
Brenda Lein

 
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In the early 1980s, frightening reports began to surface in San Francisco, Los Angeles and New York City of gay men and injection-drug users dying of a mysterious illness with no known cause or treatment. Fears mounted quickly as the evidence grew that this new disease was transmissible and moving at a fast pace through gay neighborhoods in urban centers.

The history of AIDS treatment activism in the Bay Area is inextricably woven into the history of the LGBTQ community and the global history of AIDS. Here germinated the earliest AIDS treatment activism in the world. From the founding of the AIDS underground to a patient-empowerment movement that swept across the country, redefining the role of “patient” and “community” in medical care and research, AIDS treatment activism changed the course of history.

ACT UP business cards; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
 
 
This online exhibition explores the following central themes of the AIDS treatment movement through the unique lens of Bay Area activism:

 
Determined to seek treatment for themselves and loved ones, activists founded the underground buyers’ clubs and alternative-treatment movement.
As research into the disease progressed, treatment activists insisted in being involved at every level of HIV clinical, basic and drug-development research.
Treatment activists channeled and focused their anger in a laser-like, strategic fashion to demand changes in research and access systems.
 
Continue scrolling for the rest of the exhibition.
Click on the individual images to expand documents, enlarge photos and read captions and credits.
 
 
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In April of 1980, a San Franciscan, Ken Horne, was reported to the Centers for Disease Control (CDC) with a rare cancer called Kaposi’s Sarcoma (KS). By June of 1981, a report of five gay men from Los Angeles with unusual pneumonia appeared in the CDC’s Weekly and by July, 41 gay men had presented in San Francisco and New York with KS.

Even as the death tolls from the newly recognized disease—which was christened the acquired immune deficiency syndrome or AIDS in 1982—began to rise, the medical community’s response to the epidemic was sluggish at best. The LGBTQ  community in Northern California was already comparatively well organized in the early 1980s, thanks to the precocious development of the gay-rights movement in San Francisco in the 1970s. The community organized to respond to the unmet needs of the crisis and develop much-needed services.

Though initially AIDS was identified in gay men, in the 1970s sex workers, injection-drug users and children were also living with HIV, but tests would not confirm this until long after most had died.

Morbidity and Mortality Weekly Report, June 5, 1981, reprinted in HIV-AIDS History in Wisconsin. MMWK, a publication of the U.S. Centers for Disease Control and Prevention (CDC) described a rare lung infection, Pneumocystis carinii pneumonia (PCP), in five gay men in Los Angeles. This was the first official report of what became known as AIDS. Morbidity and Mortality Weekly Report, Centers for Disease Control, all rights reserved. Click here for the full article.

 
The new AIDS pandemic sparked chaos, fear and desperation.
How this deadly new disease spread was a mystery and whether it was possible to protect oneself was a question mark. Doctors feared treating patients because of these unknowns. Roommates feared catching the disease from each other when one fell ill. Was it airborne? Was it transmitted by touch or proximity? There was no way to predict who was at risk of becoming sick. In 1981, 337 people were diagnosed with AIDS in the U.S., of whom 130 had died by the year’s end.

Silence=Death button; Art and Artifacts Collection, GLBT Historical Society.

"Silencio = Muerte" ACT UP/SF flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

The iconic “Silence=Death” image was created in New York, 1987 by a small collective of East Coast queer political artists, led by Avram Finkelstein, who was a driver in many radical queer political groups including Gran Fury and ACT UP.
 
 

AIDS quarantine flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

Try to imagine this through the lens of your COVID-19 experience.

Rumors are spreading that a new illness is infecting people like you. Perhaps it’s no more serious than a seasonal flu? First a patient in San Francisco, then a few more in Los Angeles, followed by a larger handful from New York and San Francisco. The disease is increasingly revealing itself to be deadly….

Unlike COVID-19, which is splashed across the 24-hour news cycle of the early 21st century, in the 1980s the silence from the media was deafening. In fact, the first article about this disease would not be published until nearly a year after the first reports—an article in a gay newspaper in New York, which proclaimed that the rumors of a new disease were an unfounded hoax.
 
 
 
HIV spread unabated, as did fear and misinformation.
Faced with a vacuum of leadership on nearly every level, the Bay Area LGBTQ community rose to meet this moment. Despair turned into self-determination and the community moved to take care of its members.
A test for HIV was not available until 1985—five years after the first reported case, by which time approximately 10,000 people had died of AIDS in the U.S., including about 1,000 San Franciscans, mostly gay and bisexual men in their 20s and 30s. And it was not until the fall of that year that President Reagan uttered the word “AIDS” in public for the first time. Even then, the Presidential Commission on the HIV Epidemic was not convened until 1987.
In the early 1990s, Rebecca Denison tested positive for HIV. After searching for an organization that would support women living with HIV, in April of 1991 she founded Women Organized to Respond to Life- Threatening Diseases (WORLD) with a group of her peers. WORLD provides peer support, information, training, advocacy and a speaker’s bureau for HIV-positive women.

ACT UP flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
 
Tim Kingston, interviewed by Joey Plaster 2017; ACT UP Oral History Project, GLBT Historical Society. Video transcription coming soon.

Tim Kingston talks about the reciprocal relationship between ACT UP and Project Inform and ATN following a discussion of Compound Q and the desperate situation of People Living with AIDS when there were so few treatments available. Kingston was a journalist at The Bay Times during the ACT UP protests.
 
 
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Organizations and individuals were stepping up throughout the Bay Area to serve the diverse spectrum of needs emerging from the communities impacted by HIV/AIDS.
A new kind of movement was born that would revolutionize the way biomedical science is conducted in the U.S. AIDS treatment activists provided input to community-education materials and programs. This grounded and connected advocates with a national constituency, which set Bay Area treatment activists apart from others across the country.
 
 
 
Project Inform was founded in 1985 by Martin Delaney and Joe Brewer. They wrote a foundational workbook, Strategies for Survival: A Gay Men’s Health Manual for the Age of AIDS. Delaney initially sought to educate the community on potential therapies, but promptly broadened his focus to include policy and advocacy work.

Delaney’s earliest advocacy work is chronicled in Jonathon Kwitney’s book Acceptable Risks. He pushed for policy reforms to allow for the importation of experimental drugs for personal use. He advocated for research into untested options by both urging the National Institutes of Health (NIH) to act and by funding and running a small community-based study of a controversial therapy, Compound Q.

Cover of book Strategies for Survival, courtesy of Brenda Lein

 
 
 
Image detail from the article “Daring To Stay Alive,” Bay Area Reporter, December 3, 1987; Ephemera Collection (PFLAG-PURP), GLBT Historical Society. Click image for full article.

Image detail from the article “Daring To Stay Alive,” Bay Area Reporter, December 3, 1987; Ephemera Collection (PFLAG-PURP), GLBT Historical Society. Click image for full article.

 
 

"Project Inform: A History," 1990; Ephemera Collection (PFLAG-PURP), GLBT Historical Society.

Project Inform Ribavirin fact sheet, 1988; Ephemera Collection (PFLAG-PURP), GLBT Historical Society. Click image for full samples.

Project Inform Ribavirin fact sheet, 1988; Ephemera Collection (PFLAG-PURP), GLBT Historical Society. Click image for full samples.

 
 
 
John James began production of AIDS Treatment News (ATN) in 1986. Dedicated to educating people with HIV/AIDS about cutting-edge research, John attended medical conferences, pharmaceutical meetings and frequented ACT UP meetings.

AIDS Treatment News pin-back button; AIDS Treatment News Records Collection, UC San Francisco, Library, Special Collections, all rights reserved.

Project Inform’s PI Perspective and John James’ AIDS Treatment News were considered the gold standard for HIV-treatment information publications.
 
 
 
ACT UP flyer with artwork by Keith Haring; Ephemera Collection (ACT UP/SF), GLBT Historical Society.
 
 
 
 
 
 
 
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Buyers’ Clubs were used in the early days of AIDS to smuggle large amounts of non-FDA approved drugs into the United States and they were redistributed among club members. Some were "membership" driven clubs, where people paid monthly fees to have access to the club.

In San Francisco, the earliest underground access was through the "Guerilla Clinic" (1982) and later the Healing Alternative Foundation (HAF) was formed in 1987.

The buyers’ clubs served to galvanize a movement to consider and evaluate holistic and non-Western medical approaches. Buyers’ clubs also provided access to alternative therapies and holistic remedies, including micronutrients (e.g. vitamins) and other herbal or alternative therapies.

AZT/alternative therapies meeting flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
Matt Sharp, interviewed by Joey Plaster, 2017; ACT UP Oral History Project, GLBT Historical Society. Video transcription coming soon.

Matt Sharp talks about Healing Alternatives Foundation, smuggling treatments across the border, Dennis Peron, "bathtub DDC," and a cease and desist order from the FDA. Sharp is a long-term HIV survivor and a founding member of ACT UP Golden Gate. He has a 30-year history monitoring treatment and research for HIV, advocating for ethical, speedy and comprehensive drug development and has participated in over a dozen clinical trials.
 
 
Cover of The Buyer's Club Newsletter, Volume 1, Number 1, Healing Alternatives Foundation Records, 1989; UC San Francisco Library, Special Collections, all rights reserved. Click on image for full document.

Cover of The Buyer's Club Newsletter, Volume 1, Number 1, Healing Alternatives Foundation Records, 1989; UC San Francisco Library, Special Collections, all rights reserved. Click on image for full document.

The Healing Alternative Foundation (HAF) opened in 1987.

It was as one of the first HIV buyers’ clubs in the nation. Although most therapies sold in the clubs failed to halt the course of the disease or provide effective relief, the clubs served to galvanize the resolve of the community not merely to nurture and support people as they died, but also to nurture and support people to fight for their lives.

"Legalize Marijuana" on the Corner of Castro and Market Streets, 1984; photograph by Max Kirkeberg, Max Kirkeberg Collections, DIVA, San Francisco State University, all rights reserved.

Buyers’ clubs paved the way for “medical marijuana” clubs.
Marijuana advocates first framed legalization and access as an AIDS issue. Mary Jane Rathbun, popularly known as “Brownie Mary,” was a volunteer at San Francisco General Hospital’s AIDS Ward. She baked and distributed marijuana brownies to patients.

Brownie Mary worked closely with Denis Peron, a leading medical-marijuana advocate, to legalize medical marijuana in California. She helped to establish the San Francisco Cannabis Buyers’ Club—the first in the country. Donald Abrams, a prominent oncologist and AIDS researcher in San Francisco, compiled some of the earliest studies of marijuana as a treatment for HIV-related conditions.
 
 

The AIDS Health Project button; Art and Artifacts Collection, GLBT Historical Society.

 

Universal Healthcare for the AIDS crisis button; Art and Artifacts Collection, GLBT Historical Society.

 
 
Compound Q is likely the most infamous underground therapy.

An extract from the root of a Chinese cucumber plant, it was administered intravenously and had serious side effects; at least one death is attributed to the drug.

The government research establishment was failing the community, so the community took matters into its own hands. Research on HIV/AIDS proved more difficult than expected—slower, cumbersome and complicated.

Project Inform conducted a study of the first Compound Q trials in the late 1980s, drawing national media interest. While studies failed to show benefit, the process of setting up a study, dealing with the intricacies of drug acquisition, study design, statistical evaluation and review gave activists an important lesson in the drug-research and development process. They developed tools to critique and analyze scientific work, and began to identify shortcomings that doctors and scientists closely involved in the process were missing.
 
 

Cover page of “Compound Q Clinical Protocol”, 1990; Project Inform (2000-59), GLBT Historical Society.

Compound Q community trial interviews, a cautionary tale, what we learned about community-based research and questions about legality and ethics, “Q Trials ‘89/Project Inform Interview ‘97”; Emily Mariko-Sanders Collection (2019-31), GLBT Historical Society. Video transcription coming soon.
 
 
AL-721, a smelly egg-based therapy, was among the experimental options tried in the early days of AIDS.
Jim Corti, known to some as the “Dex Kid,” smuggled dextran sulfate into the country for sale at buyers’ clubs.
Perhaps the only drug the buyers’ clubs sold that proved itself in studies was a veterinary-grade version of the anti-HIV drug ddC (HIVID, Zalcitibine). While the drug eventually received FDA approval, it is considered among the least effective anti-HIV drugs and is rarely used.
 
 
 
 
 
DNCB, a sensitizing agent, created a reaction similar to poison oak when applied topically; some reactions were severe. Billi Goldberg, a DNCB advocate, contended that it would help the body fight HIV.

Project Inform sponsored a study of DNCB that did not yield impressive results. This remedy and its proponents became a point of divisive community contention, as DNCB proponents aggressively marketed the drug, in spite of the lukewarm data and troubling side effects. The situation resembles the ongoing controversy regarding the use of hydroxychloroquine as a treatment for COVID-19.

Cover page of DNCB Clinical Protocol booklet, Project Inform; National Task Force on AIDS Prevention Records (2000-59), GLBT Historical Society.

DNCB Clinical Protocol booklet, Project Inform; National Task Force on AIDS Prevention Records (2000-59), GLBT Historical Society. Click on image for complete text (2 pages).

DNCB Clinical Protocol booklet, Project Inform; National Task Force on AIDS Prevention Records (2000-59), GLBT Historical Society. Click on image for complete text (2 pages).

 
 
 
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What began with a few individuals taking risks to bring experimental and untested treatments to their loved ones and community would ultimately blossom into a movement that democratized the scientific process and forever changed biomedical research.

This shift occurred gradually, as activists began to advocate for both government- and industry-sponsored research into AIDS. It began with knocking on doors with questions and a sense of urgency. Over time, activists would succeed in bringing the voice and experiences of the community to the design of research and the setting of research priorities.

 
 

AIDS buttons; Art and Artifacts Collection, GLBT Historical Society.

 
We can observe a stark contrast in how the U.S. government, researchers and the world at large responded to AIDS in the 1980s compared to COVID-19 in 2020.
Although AIDS and COVID-19 spread in different ways and responses vary, it’s hard to escape the conclusion that less value was placed on the communities perceived to be at risk for AIDS. Since January 2020, when the first cases of COVID-19 were reported out of China, hundreds of research projects have been launched and several drugs have already completed Phase I testing. In a few short months, one of them has proven useful in shortening the clinical course of the disease, hundreds of journal articles have been written and science is moving at a breakneck pace. In contrast, the first drug to treat AIDS was not approved until 1986, six years after the first identified case. As one top AIDS researcher has remarked, “it’s like ten years of AIDS research shoved into four months.”
 
 
Terry Beswick, interviewed by Joey Plaster 2017; ACT UP Oral History Project, GLBT Historical Society. Video transcription coming soon.

Terry Beswick talks about gaining a seat at the table through activism, the legacy of TAG and Martin Delaney, and changing the minds of "antagonists" such as Anthony Fauci. Beswick says of AIDS activism: "a grand experiment that saved a lot of lives."

At the height of the HIV/AIDS epidemic in San Francisco, he was a founding member of the local ACT UP and was the first national coordinator of ACT NOW, the national AIDS activist network. He advocated for HIV/AIDS research and treatment with Project Inform, the Human Rights Campaign and the White House Office of HIV/AIDS Policy.
 
 
 
Finding a seat at the table, and sometimes creating the table, the treatment-activist community became involved with every level of basic, clinical and drug-development HIV research.
In addition to grassroots efforts that successfully lobbied for massive increases in research funding, AIDS treatment activists participated in strategic planning; helped set research priorities; reviewed grants and initiatives; engaged as team members for developing both government and industry-sponsored programs and studies; reviewed data and participated in FDA advisory panels regarding the development and approval of new HIV drugs and diagnostic tools; and created forums for innovative and out-of-the-box thinking on AIDS research.

Because of their unique position with access to bleeding-edge information, activists launched national educational programs to disseminate information to patients and providers. In the days before the internet, this was accomplished predominantly through Project Inform’s National HIV/AIDS Treatment Information Hotline and a national community town meeting program.
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Cover page of “Parallel Track: What it is, why we need it, where it is and why we should be pissed that we don't have it already” handout; Ephemera Collection (ACT UP/SF), GLBT Historical Society. Click on the image for full document.

 
 
 

Community Forum flyer (with AAP and AIDS/ARC Vigil, 1988; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

After a time, it was clear that real progress was going to require partnerships with researchers, government agencies, industry and public and private funders. 
Pharmacies had nothing to offer, so the community created its own sources for therapies. The media remained silent, so the community created its own information networks. The research establishment failed, so the community began its own research projects.

When one person learned something new about research or the drug development process, they taught others.
Groups like the AIDS Coalition to Unleash Power (ACT UP) held weekly meetings to share what they learned and get input on ideas to move research along toward a cure. These were not scientists and doctors. These were businessmen and women, waiters, hotel workers, retail sales clerks, bartenders, artists, dancers and writers.
 
 
 
While physicians, researchers and activists were familiar with the needs of their local communities, the Bay Area activists were interacting with people in incredibly diverse communities, across the country, on a daily basis.

When the government lagged in providing guidance for the use of approved anti-HIV therapies, Project Inform stepped in and developed the first set of guidelines to assist patients and providers in navigating the complexities of treatment decision-making and in understanding HIV drug resistance and interactions.

Northern California treatment activists had access to a national constituent base, both largely through the programs of Project Inform and ACT UP’s agenda, and translated their concerns into advocacy and education priorities. As a result, broad-based constituent concerns drove nearly every aspect of all their activist efforts.
Cover of Project Inform's "Advocacy Positions for 1990 and Beyond," 1990; Ephemera Collection (PFLAG-PURP), GLBT Historical Society.

Cover of Project Inform's "Advocacy Positions for 1990 and Beyond," 1990; Ephemera Collection (PFLAG-PURP), GLBT Historical Society.

 
 
 
Policy groups sprang up to lobby for increased funding for AIDS prevention, care, treatment and research. These included Mobilization Against AIDS, the San Francisco AIDS Foundation, Life Lobby (a coalition of California state lobbyists working on LGBTQ and AIDS issues), the National Task Force and Project Inform, including its grassroots-lobbying effort, the Treatment Action Network.

While some of these policy efforts were not treatment-research specific, Project Inform and ACT UP were the champions of that unique component. Both of these groups issued calls for a coordinated effort for a cure, a “Manhattan Project” on AIDS. ACT UP’s was largely directed from New York and was called the “AIDS Cure Act.” Project Inform’s initiative was coordinated by its policy director, Anne Donnelly, and called “The Madison Project.”

Project Inform group marching in the 1988 San Francisco Lesbian and Gay Freedom Day Parade; AIDS Treatment News Records Collection, UC San Francisco Library, Special Collections, all rights reserved.

 

"Mobilization Against AIDS" sign, 1994; photograph by Max Kirkeberg, Max Kirkeberg Collections, DIVA, San Francisco State University, all rights reserved.

Cover of Mobilization Against AIDS History, 1991; Mobilization Against AIDS Records Collection, UC San Francisco Library, Special Collections, all rights reserved. Click on image for full document.

Cover of Mobilization Against AIDS History, 1991; Mobilization Against AIDS Records Collection, UC San Francisco Library, Special Collections, all rights reserved. Click on image for full document.

Mobilization Against Aids buttons; Art and Artifacts Collection, GLBT Historical Society.

 
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ACT UP Golden Gate newcomer's information packet, selected page; Ephemera Collection (ACT UP/SF) GLBT Historical Society. Click on the image for full packet.

ACT UP Golden Gate newcomer's information packet, selected page; Ephemera Collection (ACT UP/SF) GLBT Historical Society. Click on the image for full packet.

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Knowledge became power and that power became the force behind a quiet revolution. Some attribute the noisy and colorful street theatre of street-activist protestors with helping to open doors, and certainly it played a role, but there were people making change “at the table” before, during and after the rise of AIDS street activism.

The major local players included the staff and volunteers at Project Inform and the treatment activists, most of whom went on to form ACT UP/Golden Gate (later known as “Survive AIDS.”)
 
 
 
Across the country, Bay Area treatment activists spearheaded the charge on advocacy on immune-based therapies, advanced stage disease and “cure” research.

The ACT UP/NY Treatment and Data Committee launched the “Countdown 18 Months Plan” in December 1990 to focus research attention on AIDS-related conditions, and activists everywhere participated in anti-HIV drug activism. The plan consisted of a set of scientific procedures and demands designed to implement treatment and research for controlling the five currently most devastating opportunistic infections (cytomegalovirus, histoplasmosis, pneumocystis carnii, toxoplasmosis and mycobacterium avium complex).

ACT UP/Golden Gate members Jesse Dobson and Brenda Lein crafted a proposal for “Project Immune Restoration” for Martin Delaney, who embraced the idea wholly under the auspices of Project Inform. Dobson directed the program as a volunteer, leading a world renowned think tank called the Immune Restoration Think Tank: The Dobson Project. Lein went on to direct Project Inform’s Information and Advocacy departments, taking over leadership of Project Immune Restoration after Dobson’s death in 1993.

Immune Restoration Think Tank conference, 1999; photograph courtesy of Brenda Lein.

 

Jesse C. Dobson (1957–1993), AIDS treatment advocate; photograph courtesy of Brenda Lein.

 
 
 
A number of studies emerged as a result of Project Inform’s Immune Restoration Think Tank, including the infamous baboon-to-human bone-marrow transplant.

The study attempted to test the safety and feasibility of transplanting baboon cells, which naturally resisted HIV infection, into a human with AIDS, with the hopes of repopulating a human with functioning, HIV-resistant cells.

ACT UP/Golden Gate member Jeff Getty made major media headlines as the bone-marrow recipient. His physician researcher, Steve Deeks, went on to become a leader in clinical AIDS research, and continues to chart new territories in research for an AIDS cure.

Project Inform's "Immune Restoration Think Tank: The Dobson Project" conference binder, 1999; courtesy of Brenda Lein.

Growing out of both the Project Inform Immune Restoration Think Tank and several other cure-research think tanks, and incorporating components of the Madison Project recommendations, a funding initiative for a multimillion-dollar, bench-to-bedside AIDS cure research effort was launched in 2009 by the U.S. government.

The initiative, the Martin Delaney Collaboratories for HIV-1 Cure Research, is named after Project Inform’s founder. There are several funded collaboratories, now augmented by privately funded projects through the Foundation for AIDS Research.
 
 
 

ACT UP benefit flyer, 1993; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
Treatment activists began emerging in both likely and unlikely places.

It was not unusual for a physician working in a specific research or treatment field to become an activist for that field and their patients, but it was unusual for them to start attending ACT UP meetings and partner with the LGBTQ community in more direct ways.
ACT UP/Golden Gate broke ground on solid-organ transplants for people living with HIV. As people with HIV lived longer, they began dying of comorbidities, including liver failure due to HIV or hepatitis. An HIV diagnosis excluded a patient from qualifying as a candidate for organ transplant.

A former ACT UP treatment activist turned physician researcher, Michelle Roland, worked with the University of California San Francisco (UCSF) transplant team to write the first protocol for solid-organ transplantation. Activist Jeff Getty and his ACT UP/Golden Gate colleagues led the way to secure funding from the state for a pilot project for solid-organ transplantation in HIV+ people, and advocated for removing procedural barriers.
 
 
 
Treatment activists were dedicated to ensuring that research met community needs and that new therapies came to market to better control the disease.

They were also deeply committed to treatment access. In the earliest days, access was largely restricted to setting up the AIDS underground buyers’ clubs. Later, activists participated in clinical trials in community-based research venues. Still later, activists worked to make sure that health insurance and government drug formularies included a wide spectrum of therapies that patients and providers needed to manage the disease.

ACT UP flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
 

T-Cells on Drugs poster, used for the advocacy efforts leading to AIDS Drug Assistance Program expansion; courtesy of Brenda Lein.

The ACT UP/Golden Gate activists were among the first to engage in AIDS Drug Assistance Program reforms, a program established initially as the “AZT Availability Program.” This program served the uninsured and underinsured by providing access to therapies to manage HIV disease.

Jesse Dobson, Todd Kooyers and Brenda Lein, along with their ACT UP/Golden Gate colleagues, worked together to design and implement reforms that led to an expansion of the program from two drugs to over 100 therapies, an increase in funding for the program and the creation of a Medical Advisory Board. The Board, which included patient representatives, reviewed the formulary and suggested many other reforms to remove barriers to accessing therapies through the Drug Assistance Program.

Initially they were met with pessimism from local San Francisco health officials, who claimed that it was impossible to change the system and add even two drugs. Yet within a year even the city‘s mayor and members of the board of supervisors were celebrating their success.
 
 
 
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While treatment activists worked on the “inside” and “at the table,” they also used the power of street activism and demonstrations as a critical leverage tool.

The ability of activists to work seamlessly together, at the table and in the streets, was one of the AIDS treatment-activist movement’s strengths. Protests and demonstrations brought public awareness to critical issues and frequently created the pressure needed to open a door.
 

ACT UP flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
Through powerful graphics, demonstrations, street theater and “affinity actions,” AIDS activists put on attention-grabbing spectacles to garner media attention. An “Affinity Action” is an action by a small group of individuals who come together to undertake an action in solidarity with, but not formally associated with or coordiated by, a larger parent group, often to limit potential legal consequences.

They quickly learned that the greater numbers arrested at a demonstration, the more likely and the better the press coverage. Activists used demonstrations to maintain media interest in AIDS issues, spotlight breaking news and shed light on emergent issues. They also deployed them as leverage in stymied negotiations between the community and industry and/or government representatives.

Rarely, perhaps never, did street actions take place without a coordinated plan, strategies, demands and a clear goal. Entire committees dedicated themselves to cultivating media contacts, planning demonstrations, designing creative artwork and catchy slogans, and developing street theater repertoires. These demonstrations created a space for people with varying interests and talents to come together and express their rage, grief and solidarity.
 
 
 

ACT UP/Golden Gate stickers, ca. 1990s; Ephemera Collection (ACT UP/Golden Gate), GLBT Historical Society.

Next to grief, anger was a powerful motivating force spurring the growth of AIDS demonstrations. Those affected by the disease felt that they had been deemed expendable; they were seemingly abandoned by the government, the research establishment, the media and society at large. This anger found a vessel, a direction and an outlet in the already vibrant, creative and youthful movement of ACT UP.

ACT UP/Golden Gate sticker, ca. 1990s; Ephemera Collection (ACT UP/Golden Gate), GLBT Historical Society.

 
By the 1990s, AIDS was decimating the gay and trans communities in San Francisco—and disproportionately impacting gay men of color. In the United States, more than 100,000 people had died of AIDS. While AIDS rose to one of the leading causes of deaths among all men aged 25 to 44, those dying were predominantly young gay men in urban centers.
 
 
 
Leather-clad kids in Doc Martins poured into the streets and demanded to be heard. They stopped traffic, held “die-ins” and refused to be silent. Their brazen acts of defiance against a complacent system were backed by articulate and well-researched messages and demands for change. Powerful images of young LGBTQ people with their fists raised—militant, irreverent and strong—reinvented the county’s idea of what queer people “looked” like and underlined the resilience and strength of the community.

Of course, these actions were controversial. Stopping traffic is inconvenient, shouting down speakers at conferences isn’t polite, and time and again, the media quoted bystanders who made remarks such as, “I understand what they’re saying, but I think they are working against themselves with these tactics.”

Postcard of the Golden Gate Bridge Blockade, 1989; photograph by Rick Gerharter, Ephemera Collection (State-Stop), GLBT Historical Society.

 

AIDS button; Art and Artifacts Collection, GLBT Historical Society.

History has revealed, time and again, that asking for things nicely does not always lead to the same results as direct action.
ACT UP and Survive AIDS became a galvanizing force of strength in the Bay Area’s LGBTQ community. Increasingly, those being arrested weren’t just punk-mohawked kids; businesspeople, doctors and lawyers in suits appeared, standing in solidarity.

A doctor might show up to a meeting, planning to share knowledge with the group, only to be awed by a brain trust of scrappy kids from all walks of life who proceeded to school him on the drug-development process and the barriers to accelerating the pace of biomedical research. To the outside world, the activists may have appeared intimidating, but they were kids trying to stay alive and doing whatever they could to keep their friends alive too. The streets were a blank canvas for direct action and change.
 

Stop AIDS Now or Else button; Art and Artifacts Collection, GLBT Historical Society.

 
 
The Split
The AIDS Coalition to Unleash Power, known as ACT UP, formed in 1987 at the Lesbian and Gay Community Services Center in New York. In San Francisco, ACT UP grew out of already established organizations, most notably AIDS Action Pledge. In 1990, after a growth spurt in the wake of the Sixth International AIDS Conference held in San Francisco that year, tensions rose within ACT UP/San Francisco. It split into two chapters, ACT UP/San Francisco and ACT UP/Golden Gate.

Even those involved characterized the reasons for the split differently, but the major disagreement centered on the decision-making process: one group insisted on consensus, while the other preferred a large majority vote. ACT UP/San Francisco could not abandon its decision-making process without consensus, and could not reach consensus to change the decision-making process, so those advocating for majority-vote decision-making formed a new group, ACT UP/Golden Gate.

The two groups continued to work together for several years on overlapping issues, but by 1994, ACT UP/San Francisco had largely been taken over by fringe AIDS denialists and profiteers. ACT UP/Golden Gate maintained a focus on treatment-research and access activism. In 2000, ACT UP/Golden Gate changed its name to “Survive AIDS” to further distance itself from ACT UP/San Francisco.

ACT UP/Golden Gate statement of purpose; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

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A Capsule History of ACT UP/San Francisco; Ephemera Collection (ACT UP/SF), GLBT Historical Society. Click image for full document.

 
 
 
 

ACT UP flyer on access to Clarithromycin for MAI, Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 

ACT UP flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

Target Abbott Labs at the San Francisco Stock Exchange
Most of the AIDS therapies being developed focused on antiviral strategies to suppress the virus, not rebuilding the immune system ravaged by the disease. But this latter strategy—immune therapies—was a major focus of Bay Area treatment activism. Abbott Laboratories had a license to develop this approach, called HIVIG (HIV immune globulin), which involved transferring potentially potent antibodies from healthy, HIV-positive people to people in more advanced stages of the disease.

San Francisco activists advocated testing this procedure in both adult AIDS patients as well as in HIV-positive pregnant woman, in the hope of preventing HIV transmission from mother to child. Abbott wasn’t interested in researching this treatment, which meant it would languish “on the shelf.” To pressure Abbott to release the product for research—or sell it to another company willing to develop it—activists held a demonstration at the San Francisco Stock Exchange on July 16, 1992, encouraging stockholders to sell Abbott stock.

An “affinity group” of activists dressed up and had scheduled stock exchange tours for that day, while the street protestors organized outside. In a moment of well-orchestrated chaos, three activists made their way to the stock exchange floor. One, Michael Lauro, released helium balloons attached to a drop-down banner reading “Sell Abbott Stock.” The banner rose to the ceiling while activist tour attendees chanted slogans and rained colorful flyers onto the unsuspecting stock traders. Two other activists had made their way to the middle of the stock-trading floor, where they tossed flyers through the crowd of brokers, all while the street demonstration continued outside.

This was the first, and perhaps only time that activists disrupted trading on the floor of the Pacific Stock Exchange. It proved to be a tipping point for Abbott, which initiated negotiations in late 1992 to sell the product to NABI, a pharmaceutical company committed to further developing the therapy.
 
 
 
Brenda Lein, interviewed by Joey Plaster, 2017; ACT UP Oral History Project, GLBT Historical Society. Video transcription coming soon.

Brenda Lein talks about direct action, as exemplified by the Abbott Labs action at the Pacific Stock Exchange (with mentions of Michael Lauro and G'Dali Braverman), including the use of arrests to get the attention of the media and the need to be honest when treatments don't work out. Lein served as a member of ACT UP San Francisco and was a founding member of ACT UP Golden Gate.
 
 

ACT UP/Golden Gate postcard from campaign to expand definition of AIDS to be more inclusive of conditions impacting women, ca. 1990s; Ephemera Collection (ACT UP/Golden Gate), GLBT Historical Society.

Women Get AIDS!
ACT UP supported and encouraged Rebecca Dennison in the founding of the organization WORLD. ACT UP’s advocacy on behalf of women and on pediatric issues, led by Virg Parks, was often quieter work, influencing study designs to be more inclusive of women or pushing for studies of therapies in children. Together as part of a national campaign, the group held several demonstrations on women and AIDS visibility to raise awareness of the need for the CDC to change the definition of AIDS to include the specific manifestation of the disease in women.
Backgrounder on expanding the definition of AIDS to include women-specific conditions; Ephemera Collection (ACT UP/SF), GLBT Historical Society. Click on image for full document (2 pages).

Backgrounder on expanding the definition of AIDS to include women-specific conditions; Ephemera Collection (ACT UP/SF), GLBT Historical Society. Click on image for full document (2 pages).

 

Andrew Zysman obituary, 1993; Bay Area Reporter obituary database, GLBT Historical Society.

The “C” in ACT UP stands for “Coalition.”
Eleanor Pred, the founder of Breast Cancer Action, forged groundbreaking relationships with San Francisco AIDS treatment activists that had a positive impact on the course of breast-cancer research. Andrew Zysman, a physician turned activist, fought hard for drugs with promise for both KS and breast cancer, in hopes of accelerating discoveries that might benefit LGBTQ people affected by breast cancer. Zysman was invited to speak at the annual Mother’s Day rally on breast cancer, held in Sacramento. Breast Cancer Action hosted special educational forums, inviting ACT UP and Project Inform activists to speak on treatment-activism and drug-development topics.

In turn, ACT UP invited breast-cancer activists to weekly meetings where they were given support, mentorship and partnership for their treatment advocacy. Eventually this led to the setting-up of a breast-cancer subcommittee at ACT UP, whose members included Virg Parks and which was led by Gracia and George Buffleben from Breast Cancer Action, who found a home in both organizations. This partnership led to the earliest negotiations in 1992 with Genentech over its promising breast-cancer drug, Her2Neu, later called Herceptin.

Flyer for joint demonstration between AIDS and breast-cancer activists, “Demonstrate for Compassionate Access to Drugs for AIDS and Breast Cancer;" GLBT Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 

DDI and DDC or DOA action flyer; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
DDI, DDC or DOA. AZT is Not Enough.
ACT UP/Golden Gate’s first demonstration was at the Federal Building in San Francisco demanding early FDA approval of the AIDS drugs DDI (Videx) and DDC (HIVID). At the time, only AZT (zidovudine) was approved for treating HIV infection. The group claimed that more information was available about the two drugs than had been about AZT at the time it was approved. ACT UP/Golden Gate organized coordinated actions with groups across the country. ACT UP was also involved in lobbying for and demanding access to combination therapies that involved taking three or four drugs simultaneously, sometimes in a single pill. This approach was proven more effective than existing sequential therapies that may have inadvertently contributed to the spread of drug-resistant strains of the virus.
DDI Early Release program flyer (with chronology); Ephemera Collection (ACT UP/SF), GLBT Historical Society.

DDI Early Release program flyer (with chronology); Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
 
Astra Pharmaceuticals – My Sight or My Life
In 1989, Activist Terry Sutton was living with HIV and cytomegalovirus or CMV-disease, a common virus that only causes severe problems in people with compromised immune systems. In such cases, it can impact the retina and is the leading cause of blindness among people with AIDS.

Sutton was desperate for a new drug, Foscarnet, being developed by Astra Pharmaceuticals to treat CMV. To qualify for studies of the drug, Sutton had to forgo other treatments. In essence he was being asked to chose between his sight and his life. After this caught the attention of the media, Astra offered to provide Sutton with the drug, but he declined on the principle that everyone should have access to it.

This value of advocating for the larger community and not just for oneself was a hallmark of the early days of AIDS treatment activism, one that some feel became diluted over time. Many of the earliest treatment activists hold Terry Sutton up with reverence as a symbol of what we should strive for—fighting for change that benefits everyone, not just those with privileged access.
 

Zap Astra flyer, 1989; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

Terry Sutton foscarnet trials article, San Francisco Chronicle newspaper clipping, 1989; courtesy of Brenda Lein.

ACT UP flyer, 1989; Ephemera Collection (ACT UP/SF), GLBT Historical Society.

 
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Brenda Lein was a Shanti volunteer in the late 1980s and early 1990s, providing practical support for people with AIDS. She also served as a member of ACT UP San Francisco and was a founding member of ACT UP Golden Gate.

Lein helped to form Women Organized to Respond to Life-Threatening Diseases (WORLD), an organization for, by and about HIV-positive women. She also held the dual positions of director of information and advocacy and director of Project Immune Restoration at Project Inform.

Most recently, Lein served as the program director for the Delaney AIDS Research Enterprise to Cure AIDS, a large, government-funded, international, multicenter, bench-to-bedside research effort. She is currently the president of the Linda Grinberg Foundation for AIDS and Immune Research, which funds cutting edge immune and HIV/AIDS cure research.
 
 
 
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AIDS Treatment Activism: A Bay Area Story includes research, references and sources from collections of the GLBT Historical Society, the San Francisco Public Library, University of California San Francisco, and private collections.
This online exhibition was made possible with support from California Humanities, a non-profit partner of the National Endowment for the Humanities. Visit www.calhum.org.
 
Nalini Elias, Director of Exhibitions and Museum Experience, Website Design
Leigh Pfeffer, Manager of Museum Experience, Public Programs
Mark Sawchuk, Ph.D., Communications Manager, Editor 
Ramón Silvestre, Ph.D., Museum Registrar and Curatorial Specialist 
Eric Sneathen, ACT UP Oral History Project Director
Contact, GLBT Historical Society
 
Copyright © 2020 The GLBT Historical Society; all rights reserved.
The contents of this exhibition may not be reproduced in whole or part without written permission.
 
 
 
 

 
 
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