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AIDS in Atlanta: Reliving the plague years

A survivor of the epidemic looks back on old friends — and worries about the future

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Like tens of thousands of other gay men, I live a haunted existence. I can't go anywhere in Atlanta without encountering the ghost of a friend or acquaintance who died during the first 15 years of the AIDS epidemic, which officially began 30 years ago in June.

I sit at a table at Starbucks and gaze out the window at the Ansley Forest Apartments. During the late '80s through the mid-'90s, I was often there spending time with friends who were too sick to get out of bed.

At Ansley Mall, it was common to see skeletal figures walking in slow motion across the parking lot. I often wanted to look the other way as they approached, calling my name in a hoarse voice. Because the disease advanced so rapidly, many men did not seem to realize how their appearance had changed. When their awareness caught up with the reality, many hid in their apartments waiting to die. One day a friend died and I quickly rolled his wheelchair to the apartment of another friend who couldn't afford to buy one. It turned out he had died the day before. Those who couldn't wait often killed themselves. I was asked several times to participate in assisted suicides.

I would not wish my memories on anyone today. But, having lived through the holocaust, I was shocked last month to read the Center for Disease Control and Prevention's new estimates of HIV infections in America. It's worrisome enough that new infections continue at the rate of 50,000 a year, of which 61 percent are among men who have sex with men. But the rate of infection among gay men younger than 30 increased by a third between 2006 and 2009. Infections among young African-American men have increased an astonishing 48 percent.

My intent is not to lecture young gay men about the necessity of using condoms, but to share memories of two people I loved during a time when being gay still meant being marginalized by society.

My first partner's name was Rick. We met in Augusta in the late '70s, not long after I ended a brief, foolish marriage to a woman. After my divorce, I began to experiment with the sexual impulses from which I'd hidden throughout my adolescence and early 20s.

The transition was extremely difficult. By identifying as gay, I knew I was joining a minority whose way of loving was not only illegal in Georgia but still broadly pathologized by psychiatry and demonized by the church. There would be no children in my future. I worried that my parents and longtime friends would reject me. And yet I knew I was incapable of hiding any longer.

I began drinking heavily to medicate my anxiety, going out nearly every night. I met Rick, an artist who had just finished college, at one of Augusta's two gay clubs. I was sitting at the bar ranting about the cruelty of love and the cookbook Alice B. Toklas wrote out of economic necessity after her lover, Gertrude Stein, died. Rick, who was at the other end of the bar, moved beside me and told me in his soft voice, "I have that cookbook." I was amazed that anyone that beautiful was even talking to me.

His apartment was hung with paintings of the biomorphic forms that fascinated him. The dining room table was a work of art he'd built himself from found wood. The kitchen was like a mad scientist's laboratory full of colored liquids and weird tools. A few days later we went to a carnival in North Augusta to see my first freak show. I fell for Rick while Tom the Two-Faced Man turned the burned half of his face toward us and screamed, "There but for the grace of God go you!" Tom became a symbol to Rick and me of the virtue of revealing one's oddity.

During that transitional time, I photographed everything, and I took pictures of Rick the morning after our first night together. Thirty-odd years later, I still have the photos, but can seldom bear to look at them.

Rick and I had a difficult relationship from the outset, principally because I was new to gay life. I was both hungry to explore that world but constantly afraid I would be outed to the owners of the small-town newspaper where I was editor. I had so much anxiety that virtually every time Rick touched me in bed during the first few months, I had an asthma attack.

As terrified and drunk as I often was, I struggled to accept myself. I started seeing a psychiatrist at the Medical College of Georgia soon after my divorce, but he quickly let me know he didn't approve of homosexuality. Next, I saw a female intern who blamed my ex-wife for turning me off to straight sex. She offered to have sex with me to cure me.

ACT UP protesters march up Mitchell Street toward the State Capitol in 1991. During the AIDS epidemic, the volunteer organization lobbied for better access to health care. - COURTESY JEFF GRAHAM
  • Courtesy Jeff Graham
  • ACT UP protesters march up Mitchell Street toward the State Capitol in 1991. During the AIDS epidemic, the volunteer organization lobbied for better access to health care.

This was the way the world was in the years just before AIDS. To assert gay identity still meant taking on an outlaw status. Yes, the nascent gay pride movement was gathering steam in America's largest cities, but it was only a rumor in places like Augusta. I read everything I could about the movement and, because I visited Atlanta frequently, I got a gluttonous taste of hedonistic gay life. It was all about dancing, drinking, cruising for sex and hooking up, night after night. It sounds naïve now, but in those days, many of us regarded having lots of recreational sex as civil disobedience — rebellion against the oppressive and moralistic dominant culture. We were embracing our oddity.

Rick and I moved to Atlanta, then broke up after five stormy years together. Much of our difficulty resulted from my public persona as editor of the Atlanta Gazette and as a frequent contributor to the Atlanta Journal-Constitution's Sunday magazine. He felt overshadowed, unable to make a living as a painter. He returned to Augusta and the safety of his well-known family. Angry and hurt, he wouldn't talk to me for several years.

Meanwhile, the first cases of the mysterious illness that would later be named AIDS had emerged. It would be several years before its cause, HIV, was discovered. Researchers found, too, that full-blown AIDS didn't typically develop until 10 years or longer after the original infection. Then it destroyed the immune system, making its victims vulnerable to opportunistic infections that killed rapidly.

Few took the reports seriously at first. After I quit drinking in 1982, I remember sitting in the lobby of the gay AA clubhouse and hearing one joke after another about what was then commonly referred to as "gay cancer": "Do you know what causes AIDS? Track lighting and ficus trees."

As the disease began to mushroom in New York and on the West Coast, a few cases popped up in Atlanta. Gay friends ruminated constantly about the likely cause of the disease. A favorite theory, repeated in the press, blamed kinky sex. Another blamed poppers, the orgasm-enhancing inhalant. These explanations provided a false sense of control: As long as you avoided poppers, bondage and sadomasochistic play, you might be safe.

I moved to Houston in 1985 with my new partner to become a magazine editor, and it was there I first encountered the true devastation of AIDS. I made a lot of friends quickly because I worked in media and I attended AA meetings. In two years, I watched AIDS sweep through that city's gay population.

Ultimately, all but one of my Houston friends died, as would most of my friends in Atlanta in the coming years. There was no cure, no vaccine and no way to manage the disease. And every gay man I knew felt like it was a matter of time before his own skin erupted in lesions of Kaposi's sarcoma or his lungs filled with suffocating Pneumocystis fungus.

With no effective treatment available, many resorted to magical thinking. Houston had a local chapter of followers of Louise Hay, a New Age guru who claimed AIDS could be cured by reciting positive affirmations. When a friend who was a member developed an opportunistic infection and became gravely ill, his group came to the hospital and in no uncertain terms blamed his critical condition on his thoughts. They said they wouldn't visit again until his thinking improved. He survived that bout of illness and his thinking did indeed improve: He became an outspoken critic of Hay's work.

In 1986, Rick called. He wanted to re-establish communication. I visited him in Augusta, and it was a sweet reunion. We were both in mainly unhappy relationships with other men and our hearts rejoined almost instantly. We cooked our favorite recipe from Alice B. Toklas' cookbook and we drove to the grove of mimosa trees where we picnicked soon after meeting. Rick was living in a cozy old house that he explained was provided by an advance on his inheritance. His family was also paying all his expenses. I wondered why. Then he dropped the bomb. He was HIV-positive.

I was devastated. He tried to calm me, but my heart was broken. He sounded hopeful and said all the right things, but I knew he was terrified and angry. At 33, he would soon be dead.

One afternoon the following March, UPS dropped off a large box. It was from Rick. It contained a set of antique glassware we had fought over when we broke up. There was also memorabilia — our fishing licenses, the diamond earring he wore, notes I'd written him, pictures. When I called, panicked, he explained that he was not long from death and was sending people mementoes.

To this day, his death enrages me as much as it saddens. By 1987, the FDA had approved use of AZT, the first drug effective in slowing the course of AIDS. It apparently was not on the open market but available by special request when Rick was in the last months of his life. Rick's doctor, it turned out, had not completed the paperwork to get him the AZT.

Rick died on Mother's Day, soon after hosting a huge fireworks display he'd originally planned for his funeral.

I remember Rick saying to me, "I'm the least promiscuous person I know. Why did I get infected when so many of you didn't?" Rick was almost certainly infected before we met, so I couldn't understand why I hadn't been infected by him. Later, I learned a fact still not widely publicized: HIV infection is less likely transmitted by someone already infected than by someone who is still testing negative but in the process of seroconverting. The viral load in the sperm is many times higher during seroconversion than later, when it can disappear. One should never forgo protected sex just because someone has tested negative.

In 1987, the same year Rick died, I moved back to Atlanta to become editor of Creative Loafing for the second time. I was glad to be home but horrified to realize that AIDS here was catching up with Houston. I dreaded watching another group of friends die while surviving friends wandered in the blackness of grief.

Accompanying the surge in deaths was a great deal of denial. Early on, Atlanta's gay bars refused to allow anyone to ruin the fun by dispensing free condoms and information about the disease. The same was true of the Hotlanta River Expo, an enormous annual party that attracted men from all over the country. The principal Hotlanta organizer later became infected and wrote an apology to the gay community before dying.

It was also in 1987 that ACT UP was founded. The activist group's motto directly confronted widespread denial: "Silence = Death." ACT UP was founded in New York City but chapters were created all over the country, including Atlanta. Despite controversy — even among gay people — over its in-your-face tactics, ACT UP did more than any other organization to speed access to drug therapy and make it more affordable. Its demonstrations provided a constructive outlet for those of us whose anger at the government, the medical community and Big Pharma had become uncontainable.

One way the government showed indifference to the suffering of gay men was its resistance to grant Social Security disability payments. My close friend Joe, a flight attendant I came to know through AA, had fought for a year to receive benefits before finally being approved. His first check arrived a month after he died.

Of all my friends, Joe's death had the deepest impact on me. During his first hospitalization, some nurses refused to come into his room, even though it had been well established that the disease was not transmitted by casual contact. When Joe no longer responded to treatment and turned into a skeletal figure, his well-known doctor, who was also his friend, simply abandoned him. He stopped visiting and returning phone calls.

A few years later, it became known that the doctor was HIV-positive himself. He continues to thrive, writing checks to this charity and that political candidate — a pillar of the community in another city where his past hasn't followed him.

Joe had a terrific sense of humor, as did most of my friends, even as he lay dying. Gay people learn to use humor to cope with their marginalization. We handily discard the tragic lens for the comedic one.

One evening, Joe lay in bed while Mary Jane Lubinski, a nun who opened her heart to the Atlanta AIDS community, sat on the edge of his bed. Joe said that he wanted to "let go" of life but didn't know how. Mary Jane held his hand and talked quietly about giving himself permission to die. All three of us were crying.

When she got up to get a glass of water from the kitchen, Joe patted my hand and said, "I know I should die. But the Academy Awards are on tonight. Tell Mary Jane I'm sorry." We snapped on the TV and defied death once again.

Joe's religious family wouldn't visit him. His disease had revealed his homosexuality. He cried often for his mother. As the executor of his tiny estate, I talked to her and Joe's brother several times before and after his death. His brother called me one day to ask that I be sure to put Joe's leather coat aside because he wanted to have it after Joe died. I sent that, the TV he wanted and the money left after I paid for Joe's cremation. I was left with the ashes. At one point, I was in possession of the ashes of three friends.

Joe lived a few weeks after the Academy Awards, with one foot in this world and the other somewhere else. He'd tell me about encounters with other beings who talked to him about dying. He wondered if they were hallucinations or creatures at the threshold of an afterlife. They were, in any case, more loving than his family.

Joe's death reshaped my life. I was sick of the pain homophobia had caused my friends. I was sick of Reagan's years-long indifference to the epidemic. I was sick of the medical-pharmaceutical establishment, which enriched itself while its feeble response to AIDS perpetuated the suffering. I discovered, for example, that Joe's home-care provider had received thousands of dollars from his insurance company for services that were never provided. The home-care company had continued to bill the insurance company two months after Joe's death. I called them and they apologized profusely for the "mistake." Rather than refund the full amount to the insurance company, they offered instead to send me $800 that I could donate to the charity of my choice. HIV infection was and is a big business.

In 1990, I enrolled in grad school to get a master's degree in psychology, followed by a doctorate. I wanted to do whatever I could to help people cope with the pain of rejection by society and their families. It offended me that in the first 10 years of AIDS, it was nearly impossible for my friends to find affordable counseling, either as patients, grieving survivors or terrified but sexually active young men. All of us feared that the ongoing trauma would never end.

But things suddenly changed. Fifteen years into the epidemic, scientists discovered a group of drugs that, taken in combination, could radically slow and even reverse the proliferation of HIV in the bloodstream. The terrifying face of AIDS began to fade. Men who'd been wasting away suddenly rejuvenated and returned to work.

My friend Paul threw away his cane and started calling himself Lazarus. Like many others, he'd sold his life insurance policy to a company that paid 85 percent of its value, expecting him to die within a few years. Paul ceased his annoying but hilarious habit of reviewing funerals like Broadway plays. (The nadir was a mutual friend's funeral at which his partner hovered over the open casket and sang, "You Are the Wind Beneath My Wings.")

Having outlived his insurance advance, Paul resumed his career in advertising — apparently, as he says, "doomed to work forever." The same thing happened to thousands of men all over the country, as long as they could afford the expensive new drugs or convince their insurance companies to pay for them. It was a joyous time for many.

But something else happened after the decline of AIDS. Those who lived through the worst of the epidemic stopped talking about their experiences. This is a common response to trauma. Survivors of the Nazi death camps, for example, became famous for falling into silence. Because HIV infection is no longer always visible, even the infected have become comparatively silent, for understandable reasons. There remains a virtual class difference between the infected and the "clean," so there's great reluctance to disclose HIV-positive status. As long as condoms are used, it's not so much an issue.

The media have helped relegate the ongoing epidemic to insignificance by repeating the upbeat, popular myth that HIV infection is a chronic disease as readily controlled as diabetes.

Meanwhile, AIDS still kills 18,000 Americans every year.

Could we see a return to the annihilation of the early years of the epidemic? There is growing concern that new drug therapies are not being developed quickly enough to keep pace with infections. I have little doubt that if AIDS were to experience a surge, right-wing demagogues would do all they can to inhibit federal support, as they are doing now with every aspect of the social safety net. The crippled economy has already greatly increased the number of HIV-infected people reliant on federal and state government for their drugs. But the economy has also impoverished government coffers, so that such programs are being cut back even as they become more needed.

The simple solution to almost eliminate the risk of HIV infection is the use of condoms. For men of my generation, adapting to condoms after years of mindless fucking was difficult. But the association between sex and death remained explicit for many of us. The ghosts of our friends attended our sexual interactions.

To those of us who became involved in helping people with AIDS as friends and care providers, it became obvious early on that getting tested, practicing safe sex and actively seeking treatment were often tied to one's comfort with being gay. Standing up to the disease required standing up to prejudice. That hasn't changed, according to a public health official who requested anonymity. A soon-to-be-published study, he said, confirms that practice of safe sex is strongly dependent on the degree of external and internalized homophobia with which one lives. It's likely that the more homophobic one's surroundings are, the more one internalizes shame and tries to hide. Seeking help, especially if one does test HIV-positive, almost certainly exposes one's sexuality. That's probably why the rate of infection is increasing in the black and Hispanic communities, which remain more homophobic than the rest of society.

We survivors cannot forget the bad years as much as we'd like to, and we don't want to see the horror return. So many beautiful friends were robbed of their destinies. I received a note from Joe after he died, mailed by one of his caretakers. It embarrasses me a bit, but I'm ending this memoir with it:

"Cliff

You were ALWAYS there! Big muscular brute...can't hold back tears, a gentle giant with a mind! I hope that while you're still young, and still able to do it and not be too busy with the newspaper and publishing world, that you will write a book. You have so much inside you that I believe you could make a difference. That's all I ever wanted to do, make a difference. I had to work so hard and yours was just handed to you on a silver tray. Don't drop that tray, Cliff. And if, after I'm gone, you want to write a paragraph or two about a courageous person with AIDS and friend, that would be nice. I love you, Cliff, and thanks for being part of my life. Love, Joe."

This is for you, Joe.

Next: The first two decades of AIDS

AIDS: The first two decades

June 1982 — Reports of illness among gay men in Southern California suggest a newly identified sexually transmitted disease.

July 1982 — AIDS is officially named and recognized as a syndrome of symptoms and diseases by the CDC, which reports 452 cases in 23 states; AID Atlanta forms around this time.

December 1984 — Ryan White, a 13-year-old hemophiliac in Indiana, is diagnosed with AIDS. His subsequent legal battle to attend public school makes him a literal poster boy for the disease in the U.S.

April 1985 — The first-ever International AIDS Conference is held in Atlanta.

July 1985 — Rock Hudson reveals he is dying of AIDS; press coverage makes public his homosexuality and follows the once-robust movie star's physical deterioration.

August 1986 — The federal government makes it illegal for workplaces to discriminate against people with AIDS.

March 1989 — Southwest Atlanta's Childkind becomes one of the first few foster homes in the U.S. specifically for babies and children with AIDS.

August 1990 — Congress approves the Ryan White Care Act, four months after White's death, creating the first significant federal funding to help people living with HIV.

October 1990 — AID Atlanta organizes the first Atlanta AIDS Walk.

November 1991 — Magic Johnson announces he's HIV positive and retires from the NBA; the following day, AID Atlanta is flooded with calls from concerned heterosexuals.

August and July 1992 — Both political parties have women infected with HIV speak at their national conventions, Elizabeth Glaser for the Democrats and Mary Fisher for the Republicans.

February 1993 — A survey of 50 Atlanta business and civic leaders reveals that AIDS is considered the most important health-related topic in the metro area.

August 1993 — Grady Memorial Hospital unveils its state-of-the-art, $7.5 million HIV/AIDS clinic on Ponce de Leon Avenue.

1996 — FDA approves antiretroviral drug cocktail that proves the first effective treatment to delay the onset of AIDS in persons with HIV; within four years, the mortality rate in U.S. drops by 84 percent.

April 1997 — President Clinton puts former AID Atlanta director Sandra Thurman in charge of national AIDS policy.

August 1999 — Two thousand AIDS experts gather in Atlanta for the CDC's National HIV Prevention Conference.

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