Survival Guide

By Lawrence Ferber

The resistance began with unaccountedfor appearances of posters on the walls and windows of New York City: the Nazis' pink triangle inverted on a black background over the words "SILENCE = DEATH." It took years to gain traction, but the courage of the resistance turned out to be as persistent as the virus itself. This book shows how none of this was inevitable, how it took specific, flawed individuals of vastly different backgrounds to unite against this plague.

David France's Oscar-nominated 2012 documentary, How To Survive A Plague, brought to light how AIDS activists, through the coalitions ACT-UP and TAG, helped push medical breakthroughs forward by becoming part of the process. Constructed from hundreds of hours of incredible archival video footage, a technique since coined "archival verite," the documentary proved powerful, resonant, and helped reignite interest in that terrible yet profoundly important chapter in LGBT history.
Four years later, France – a journalist who covered the AIDS beat since its early days for publications like the New York Native, NY Magazine, and Newsweek – has authored an even more expansive, intimate, dramatic, and elegantly penned book of the same name.
Released on November 29th, How To Survive A Plague: The Inside Story Of How Citizens and Science Tamed AIDS, traces HIV from its insidious, mysterious emergence in NYC to the game-changing and lifesaving 1990s protease inhibitor breakthrough (plus, in the epilogue, beyond). It's a gripping, engrossing read, the most essential text of its kind to date, and to a degree rights some of the mistakes made in the late Randy Shilts' 1987 account of the early AIDS years, And The Band Played On – for one thing, a holistic view of Gaetan Dugas, aka Patient Zero, who was recently vindicated of his status as "villain" who brought AIDS to North America – while telling the stories of key players in the epidemic and activism, from the scientists to the activists and allies, politicians, celebrities (Rock Hudson for one), and of course, the afflicted.
"My first impulse for going back to this story was Randy had accomplished a sort of historical misdirection," France admits. "He presented AIDS as a San Francisco story, and although S.F. has a story about AIDS, the story of the community's response and literally the epicenter of the global epidemic for 10 or 11 years of those 15 years of plague was New York. Shilts also made mistakes of judgment, he was sex negative, his reporting carried a lot of shame, I think, and then there was the enormous error of Patient Zero. I should also point out Band's last chapter ends in 1985, so he missed many things happening on the ground that were going to produce something, and because HIV took him away in 1994, he missed the historical long view and ability to look back 15 years later and asses what happened, what it meant, and what his legacy will be for the generations."
The NYC-based France says that he actually attempted to get a book going prior to the documentary's production, but found the publishing world disinterested both due to a cautious, recession-era economy, and, more so, a perception that the tale of AIDS had already been told. "I said, it hasn't been told," he recalls. "It's been wrong in certain ways, and nobody has ever told the story about what was accomplished and what the legacy of AIDS activism was."
In researching his book proposal, France revisited archival videos of ACT UP meetings and demonstrations to place himself back in that era (he had been present for many of these), and, since the book was going nowhere, ultimately realized that, "I could do something with that, because nobody can stop ever stop a fool from making a documentary on a credit card." From there, the documentary was spawned.
The enthusiastic 2012 reception to the Plague documentary, and David Weissman's San Francisco-centric We Were Here, proved that audiences did in fact hunger to see and learn about these personal stories and AIDS history, and a dearth of information and personal accounts about those first, critical years in fact existed. Greenlit for a book at last, France commenced a whole new wave of research. He was fortunate to access a trove of material from which he could not only reconstruct the past and lives of key individuals like Dr. Joseph Sonnabend, one of NYC's first physicians to focus on patients stricken by the mysterious onslaught of strange, deadly opportunistic infections, and HIV-positive singer Michael Callen, who co-authored an early safer sex advice pamphlet before a virus was even confirmed as the culprit for AIDS (today, there's an NYC LGBT medical center named after him and Audre Lorde), but even recreate their dialogues word for word.
"Starting in 1981, they were smart enough to tape record everything," he explains. "They knew something remarkable was happening, and that history might attempt to discredit what was really happening on the ground or an artificial narrative would be created. The scene where Sonnabend sits down with one of his patients and says, 'there are people who are going to pervert this for their own means and rewrite this history – we need to keep a record for it ourselves.' That was on tape. Conversations between Callen and his family, on tape. It was incredible for me to discover I could tell these stories with the same kind of archival verite veracity, going back to the first minutes of the plague."
While France regards the documentary and book as separate works of scholarship thanks to their differences in scope and the individuals featured, there is some crossover. Longtime HIV survivor Peter Staley, who France only grew to know during the documentary and its reception – and who has since found renewed life as a robust activist, educator, and PrEP/treatment-as-prevention advocate – is heavily featured, as is legendary firebrand Larry Kramer, who co-founded GMHC and scribed scathing autobiographical play The Normal Heart in the wake of his ouster. France admits that he doesn't let the latter off easy in the book as far as characterization, dubbing Kramer "an essential pain in the ass."
"I don't think he wants to be let off easy," France elaborates. "I think Larry deserves to be treated seriously by history. Not romantically, not angrily, but taken at face value. What he accomplished moves forward the entire AIDS narrative from the first day. If anyone wants to take the experiences and accomplishments of the AIDS movement and write them in another field, they're going to need to know how Larry Kramer did what he did."
Dr. Robert Gallo, whose bitter feud with Dr. Luc Montagnier of France's Pasteur Institute over who discovered HIV led to tragic decisions, chaos, and delays in testing advancements (which also figured into Shilts' And The Band Played On and its 1993 HBO film adaptation), is also a major Plague character. France has been interviewing Gallo since the 80s – and as recently as this year – and credits him as a great science mind despite the ugly skirmishes. "He was the person who first suspected a retrovirus," France says, "and discovered retroviruses. He made every advancement in the discovery process of HIV except for the discovery of HIV itself, and I believe it drove him nuts that somebody could come in and stumble on the virus the way Luc did. He's still upset he didn't get the Nobel Prize."
A few research materials and accounts for Plague's prominent subjects proved more elusive, however, including a series of diaries kept by outspoken "Kaposi's Sarcoma Poster Boy" and Sister of Perpetual Indulgence Bobbi Campbell, whose conservative family had all but one volume incinerated following his death in 1984. "That really broke my heart," France admits. From that one surviving diary, which ended up in the possession of a nurse, France was able to build some scenes. "The brother who had them destroyed is no longer alive, and I spoke with his widow and kept saying, 'do you realize what you took from the historical record?' It did frustrate me remembering back then that our stories were considered so unimportant."
One of the most important and revealing accounts committed to the book, however, was France's own. While he started writing a strict history, "the more I wrote, the more I was realizing I wanted to interpret what was happening and wanted people to know I was making interpretations," he says. It proved a painful process, and even caused France to consider stopping, but the greater mission and responsibility of bringing back that era, and the almost powerless, disenfranchised status of the LGBT community prior to founding of groups like ACT-UP, proved motivation to keep going and finish.
"It's just shocking," France reflects, "and I would think especially for younger LGBT people, who know a modern truth about their connection to civic life in America. We had no connection to civic life then. I did a lot of tracking of polls and opinions on gay people by Americans during that 15-year period, and that change in attitude I credit to AIDS activists, whose first path was to convince people that they deserved to live. There was humanity to gay people, and once they started getting traction on that, they could begin dialogues."
Interestingly, November 29th also sees release of a memoir by longtime HIV survivor and NAMES Project AIDS Quilt founder Cleve Jones, When We Rise, which chronicles the Harvey Milk protege's firsthand experiences before and after the plague era. France, for one, is happy about that coincidence, and hopes there are more such tomes to come.
"We should all be telling stories," he assures. "There has not been a way to teach the history of the AIDS epidemic in college. We need books for people to carry these stories forward, and that's what I'm hoping people will start to produce. So our history can go on the same shelf as all those other dark and triumphal histories that make up the American past."