When the Gay Mens Health Crisis announced last week that, after years of opposing the initiative, it would now support the creation of a confidential statewide registry of people with HIV, conservative politicians and right-leaning pundits were delighted. At last, the Post sighed, honesty about AIDS. Many activists were not so impressed, and a coordinator of an upcoming GMHC benefit has reportedly threatened to withdraw his support.
The fact that the countrys oldest and most established AIDS-advocacy group was being praised by its longtime enemies -- and scorned by its comrades -- struck many as the end of an era. Once upon a time the battle lines were clear: activists united in struggle on one side, government and pharmaceutical companies on the other. But the politics of AIDS hasnt been that simple in a long time.
For the past several years, activist groups like Treatment Action Group (TAG) and Project Inform have forsaken ACT UP-era shock tactics for a place at the table with legislators and executives. Though significant victories can be attributed to this new model of collaboration, it has effectively removed the political debate from the public domain and restaged it behind the closed doors of boardrooms and state chambers. And that shift troubles a lot of advocates.
GMHC says the case is simple. The Department of Health has been keeping a confidential registry of people with full-blown AIDS since 1981, and no one has much objected; adding HIV cases to that list will make it easier to direct funding and treatment (especially with new drugs, like protease inhibitors, that can be used to treat the disease earlier in its course) to those who need it most. But critics fear that the list wont be all that confidential -- and then whats to stop someone from publicizing the names (as happened with Nushawn Williams, suspected of infecting several girls in upstate New York)? Or to jail people who have spread the virus? Protease inhibitors change how we can take better care of ourselves, says Tim Horn, a TAG member. But you cant have the state practicing medicine from the bench.
When GMHCs policy department announced the shift to the rest of the staff, however, there was no ruckus, says one senior employee. Drug companies already maintain and sell patient lists, it was argued, so allowing the government to compile that information just isnt that big a deal. And by shifting its support, GMHC gained political leverage. Instead of being cornered, the staffer explained, we want to have some negotiating ability.
Trading outsider power for insider access has made for some strange bedfellows within the AIDS community. For example, authors Michelangelo Signorile and Gabriel Rotello -- loose-cannon agitators turned best-selling authorities -- now advocate that gay men stop sleeping around and settle down. Which, in the estimation of many former allies, puts them nearly in league with the Christian Coalition.
The problem is, says Nan D. Hunter, former director of the ACLUs AIDS project, the space for outsider advocacy is shrinking. There needs to be somebody who performs the function that GMHC performed at the beginning, which is really to bring up the clearest, most uncompromised version of what the outsider perspective is.
The people at GMHC steadfastly deny that theyve sacrificed any ground or sold out any constituents. I dont know what coalition we busted, says Ron Johnson, the groups managing director. A number of AIDS organizations across the country have come out for an HIV-reporting system. We are in line with that consensus.
GMHCs announcement did at least succeed in making headlines -- calling attention to aspects of the disease too often eclipsed by scandals and tabloid-driven panics. Doing nothing would have been worse, says the senior GMHC staff member. The reality is, its good publicity.