It’s A Sin—Russel T. Davies’ recent record-breaking miniseries for Channel 4—is the first major British drama to deal explicitly with the AIDS crisis. But there is a wealth of fiction, film and drama that has explored HIV among gay men and queer communities, both at the time and, like It’s A Sin, looking back from a time when HIV is no longer the diagnosis it once was.
The Prettiest Star by Carter Sickels is a revelation: after a diagnosis of AIDS, a young man returns to rural America from New York, where he reconnects with his family and faces up to small-town homophobia. It is difficult and startling, like most of these works, but has a wondrous heart. The Great Believers by Rebecca Makkai and Tim Murphy’s Christadora both explore a network of friends and families in Chicago and New York, respectively, as lives are ravaged and ruined by HIV. They both deal simultaneously with 80s and 21st century storylines, too, examining the legacy of AIDS on their communities.
David France produced a documentary and accompanying book, both called How To Survive A Plague, which does a brilliant and thorough job recounting the history of AIDS and associated activism, primarily in America. The first history of AIDS in America, And The Band Played On by Randy Shilts, is an interesting historical text, but problematic in many ways, not least its reliance on a patient zero narrative, attempting to trace the arrival of HIV in America to a single individual. Richard A. McKay has tackled this issue head-on in Patient Zero and the Making of the AIDS Epidemic, described as “myth-smashing revisionist history at its best.”
In terms of contemporaneous writing from the late-80s and early-90s, I can’t not recommend Close to the Knives by David Wojnarowicz, his “memoir of disintegration,” that beautifully marries mourning, rage, and poetry; it was rereleased by Canongate in 2017 with a new introduction by critic Olivia Laing. Sarah Schulman’s incredible memoir, The Gentrification of the Mind: Witness to a Lost Imagination brings to life the Lower East Side and how it changed during the AIDS crisis, roughly from 1981 to 1996. Later this year, Schulman is releasing a political history of ACT UP—the AIDS Coalition To Unleash Power—one of the most important and impactful international AIDS activist groups, which Schulman was personally involved with.
The best British writing from the AIDS crisis that I’ve come across is by filmmaker and artist Derek Jarman: At Your Own Risk is part memoir, part polemic, which savages Thatcherite policy and institutional homophobia. His diaries from 1989 until his death have also been published in two volumes, Modern Nature and Smiling in Slow Motion, both offering meditations on art, recording the development of his peculiar and exquisite garden in Dungeness, and documenting his deterioration from AIDS. Blue, his final film, a single static shot of a vivid blue with a voiceover documenting his illness, is essential viewing for anyone interested in this period of history. Jarman also directed the Pet Shop Boys’ music video for their single, It’s A Sin, from which the show takes its name, which is well worth a watch and demonstrates Jarman’s exceptionally creative talent.
For anyone who was particularly enchanted by Jill’s story in It’s A Sin—#BeMoreJill trended on Twitter after the show aired—this year saw the publication of Ruth Coker Burks’ memoir, All the Young Men. A young mother in the conservative South of the US, she looked after dozens of men infected with HIV and dying of AIDS, at a time when they were often abandoned by their families and even by the medical community. She kept her story secret for years, out of fear of repercussions to this day within her deeply conservative community—but it’s a powerful and necessary piece of memoir.
There are many important and celebrated plays about HIV/AIDS: Angels in America, for example, or The Inheritance. HBO made a miniseries of Angels in America back in 2003 and the National Theatre’s 2017 production, which won multiple awards in London and on Broadway, is available to stream now via National Theatre At Home. The National has also programmed Larry Kramer’s A Normal Heart for later this year—the first major play that dealt with AIDS—which will hopefully come to fruition.
120 Beats Per Minute is a phenomenal French film about the work of ACT UP in Paris: it’s deeply moving and true to life, having been developed in collaboration with activists involved at the time. It’s also incredibly sexy—one of my criticisms of It’s A Sin was the lack of safe sex depicted, the erasure of eroticism after the characters were diagnosed with HIV. Philadelphia was the first major film to deal with AIDS and is an interesting historical work, but is not without its problems. Dallas Buyers Club, a similarly big-budget, Oscar-winning movie, tells the true story of Ron Woodroof and touches upon some of the specific issues faced by those living with HIV with brutal realism.
We lost a generation of artists and creatives to AIDS: Robert Mapplethorpe, Keith Haring, Felix Gonzalez-Torres, David Wojnarowicz, Peter Hujar, Rotimi Fani-Kayode, Leigh Bowery, David Robilliard, David McDiarmid—the list, sadly, goes on and on. For more information and resources, check out Visual AIDS, an American charity that originated the red ribbon as a symbol of AIDS awareness and runs an annual programme of events for World AIDS Day, entitled Day With(out) Art: “Visual AIDS utilizes art to fight AIDS by provoking dialogue, supporting HIV+ artists, and preserving a legacy, because AIDS is not over.”
The Terrence Higgins Trust do brilliant work providing education and support for HIV and sexual health around the UK. “Don’t let the ‘AIDS’ of It’s A Sin be your view of HIV today,” writes Fraser Wilson from the Terrence Higgins Trust. “Because we’ve come a long way in the fight against HIV since then and worked too hard, with too much still to do, to be taking even one step backwards now.”
There are some wonderful HIV-positive writers and poets working today: I want to mention Danez Smith and Jericho Brown, both incredible and award-winning poets. Brown won the 2020 Pulitzer Prize for Poetry for his collection The Tradition, which includes the stunning little poem ‘Cakewalk’—it starts, “My man swears his HIV is better than mine, that his has in it a little gold, something he can spend if he ever gets old…”
As COVID-19 continues to spike across the globe, the international community mentioned World AIDS Day on 1 December, calling attention to another deadly pandemic that has yet to be curbed. According to UNAIDS, AIDS (HIV) has claimed the lives of an estimated 32.7 million people since the pandemic’s outbreak, and despite there being effective treatments to combat the disease, the virus continues to infect over a million people each year and cause hundreds of thousands of deaths.
As World AIDS Day headlines tumble further down our feeds and the bombastic statements made by politicians pledging to tackle the virus are usurped by other agendas, it is important to take a close look at the current state of the AIDS pandemic, the systemic inequities it highlights, and our governments’ handling of the crisis in order to draw conclusions that will not only help staunch its spread but also assist us in mitigating the scourge of COVID-19 and any future pandemic.
Despite the overall decrease in the spread of HIV and the plummet in mortality rates from the virus (60 per cent since the 2004 peak), the HIV pandemic remains a global health threat to this day. A World AIDS Day statement by the World Health Organisation (WHO) has confirmed that in 2019, 38 million people worldwide still lived with HIV infection, 690,000 people died of HIV-related complications, and 1.7 million were newly infected. WHO further reports that one in five people in 2019 were not aware of their infection and one in three, particularly children and adolescents, experienced some form of disruption in HIV treatment, testing, and prevention services.
Since its outbreak, the HIV pandemic has disproportionately affected the LGBTQ community. According to the Centers for Disease Control and Prevention (CDC), more than 50 per cent of people living with HIV in the US are gay and bisexual men, and a WHO study from 2014 had estimated that trans women are 49 times more likely to be diagnosed with HIV than the rest of the population. Within the community, and across the country as a whole, it is people of colour (specifically black people) who are the most vulnerable to the disease. A 2016 CDC report had found that at the current rate of infection, one in two queer black men and one in four queer Latino men are projected to contract HIV in their lifetime.
The advent of COVID-19 in early 2020 has exacerbated an already difficult situation for people living with or at risk of contracting HIV, as coronavirus has presented increased health threats for people living with the virus and has lead to significant disruptions in provision of HIV-related services, drug stock-outs, and shortages of supplies.
“There is some evidence that people living with HIV may have an increased risk of severe disease and death from COVID-19,” said Tedros Adhanom Ghebreyesus, the head of WHO, in a statement last week. “This increased risk has been compounded by disruptions to treatment for people living with HIV. In a WHO survey of 127 countries earlier this year, more than a quarter reported partial disruption to antiretroviral treatment for people with HIV.”
The widely-anticipated COVID-19 vaccines have filled many with hope that the nightmare of coronavirus will soon be behind as. But as the history of the HIV pandemic demonstrates, when it comes to the populations most vulnerable to the virus, the christening of a new vaccine or drug may not provide significant relief.
“[A] pharmacological intervention alone is not going to get us out of the death and destruction we’re seeing,” said Steven W. Thrasher, professor at the Medill School of Journalism at Northwestern University, in an interview for Democracy Now! on World AIDS Day, referring to both the HIV and COVID-19 pandemics. “There have been various effective medications for HIV for the past quarter of century, and yet tens of millions of people have died since that time,” he further stated, pointing to the fact that in 2015, 20 years after antiretroviral therapy (ART) has been introduced, AIDS rates among black Americans were higher than they had ever been among white Americans before the drugs existed.
“The problem is not just the drugs; it’s the conditions around people’s lives that lead them to become affected by viruses,” Thrasher added, stating that it is the byproducts of capitalism—namely the profit-driven and pharma industry-dominated healthcare infrastructure—and systemic racism that render communities of colour more vulnerable to pandemics and concentrate diseases among certain segments of the population.
Thrasher further cited a November 2020 study that links high eviction rates to increasing deaths from COVID-19, and explained how houselessness (a crisis disproportionately affecting people of colour) makes minority groups more susceptible to contracting viral diseases by siphoning them out of the formal economy, forcing them to live in over-crowded communities, exposing them to sexual abuse, and depriving them of insurance and proper access to healthcare services. Thrasher also iterated that while COVID-19 and HIV are transmitted differently, there is nonetheless great overlap in the conditions that make specific populations vulnerable to them.
While President Trump has repeatedly ignored the havoc wreaked by HIV on the queer community, and has actively inhibited progress in HIV treatment and prevention efforts, president-elect Biden has been vocal about his intention to tackle the virus and help those most affected by it, indicating a potential shift in federal conduct around the pandemic.
In a statement on World AIDS Day, Biden declared that his administration “[w]ill pursue bold solutions and increase our collaboration with affected communities around the globe,” as reported by the Washington Blade. “We will redouble our efforts to tackle health inequities that impact communities of color, LGBTQ+ people, and other marginalized groups, including women and children,” he added.
Biden’s statement last week was in line with a plan he had unveiled in 2019 to advance LGBTQ+ equality, which includes tackling the HIV pandemic globally. In his recent statement, Biden has also pledged to increase funding for several key federal programs designed to battle HIV, including a program that seeks to increase housing opportunities for people living with the disease.
As we grapple with the complex reality of overlapping viral outbreaks, it is important that we remain conscious of the underlying conditions that breed mass health inequities and pressure our leaders to not only deliver crowd-pleasing statements but tackle the core issues that enable such pandemics to spread and ravage society’s most vulnerable communities.