The AIDS Epidemic in San Francisco: The Response of Community Physicians, 1981-1984, Vol. I

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Handling a Health Crisis in the Gay Community

Hughes

Which BAPHR committees dealt with AIDS?

Andrews

We had several standing committees, including Scientific Affairs and Social Concerns. Scientific Affairs took on the safe sex guidelines. They quickly became the committee that tried to put together the information that we were going to distribute. I don't think we ever called it the AIDS Task Force.

There was an AIDS Task Force at the San Francisco Medical Society, and we participated in that.

Hughes

What did BAPHR set out to do?

Andrews

First it was information collection and trying to get the best information about what was going on to try to understand it. And then there was this challenge of how to respond as a gay medical organization. Suddenly there was a health crisis that seemed to be affecting mostly gay men. We wanted to respond to the community about what to do.

And the gay community was, as I said, suspicious. It is important to understand what had been happening in the gay male community leading up to the AIDS epidemic. I don't think it's an understatement to say that there has been little or no acceptance of homosexuality throughout history, or at least in Western civilization. Certainly in America, there has never been a period when homosexuality was acceptable; quite the contrary. Some of the most severe punishments have always been reserved for those who were found guilty of this "crime." With that in mind, imagine what it was like in San Francisco, and a few other cities that had large urban gay populations, for gay men, for the first time, to feel free to be who they were: to seek out other men without significant fear of being physically harmed. Finally there was a freedom to explore and express yourself, socially and sexually.

So what happened? Male sexuality, not gay sexuality, began to flourish with few inhibitions. I think it is important to realize that lesbians generally have fewer sexual partners than straight women. Why? Because female sexuality, in most species of the animal kingdom, is expressed differently than male sexuality. Take the bathhouses: they should not really be called gay bathhouses, but male bathhouses. It is a rare female,

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straight or gay, who seeks out multiple anonymous sexual partners. If straight women were interested in this kind of activity, there would be plenty of straight men prostituting on city corners, and straight bathhouses would be very busy indeed. So what we've got are two men, both highly sexual, as most men are, left to "go at it" with abandon.

Okay, so this man-man thing starts getting into high gear. Bathhouses and sex clubs flourish. The rate of STDs skyrockets as "bugs" get passed around between more and more men. So everyone just goes to the city clinic and gets a shot of penicillin and is back in action in a week or less. Even hepatitis, a much more serious illness, is looked at as only a minor inconvenience that can put someone "out of action" for a few weeks or months. And then something changes: people start getting much sicker and dropping like flies from some mysterious cause that no one knows about.

So very early in the epidemic, when little is known, and nothing is proven, we still have a good hunch this is a new sexually transmitted disease of some kind. But when I, as president of BAPHR, meet with members of the community and bathhouse owners, and tell them that it does look like a sexually transmitted disease, it is not really surprising that people are upset and angry to hear this possibility. People suggested this was a plot by the CIA to eradicate homosexuals and they were putting something poisonous in air vents at the bathhouses. The local gay papers would also repost this as a possibility. It was wild!

Hughes

Can you say something about your general approach when you were confronted with a person who was close to hysterical? Or was it that far along?

Andrews

It was that far along pretty early. The hardest thing initially was to try to keep my composure, because it was upsetting to hear some people that I even knew and had considered friends addressing their anger as if I were responsible for the problem. I mean, I'm the messenger and the messenger has a bad message, like, "We need to think about the fact that it might be something sexually transmitted, you guys." The response would be, "Boo! Go away! You're a liar, you're a turncoat, you're an Uncle Tom, you're working for the government."

All that kind of stuff leaves you a little baffled. You feel like you've been working for several years, to be an advocate for gay health, coming out, et cetera, and then to be looked at as a traitor and as an enemy was very disconcerting. It was very--well, it was very difficult, is what it was. Frankly, a lot of our [BAPHR] members didn't want to go to these

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meetings. They knew what was going to happen when you went into this roomful of people. You're not getting friendly people in there; you're getting very angry, upset, fearful people. They didn't want to hear what we had to tell them.

Hughes

Did denial play a role? "This can't happen to me, and it particularly can't happen to me if it means that I'm going to have to change my sexual practices."

Andrews

Absolutely, absolutely.

Hughes

Also, the epidemic came on the heels of the gay liberation movement, and here were these people trying to regulate or even close the bathhouses.

Andrews

Yes, that's right.

Hughes

Which were symbolic of--

Andrews

Freedom, absolutely. I think that is the main thing. We had come from a time in the late seventies where sexual expression and freedom were tested to the limit, and there were people who would boast of their casual sexual experiences anywhere--in a department store, in the park--just about anywhere.

As I said, I was never in that group, partly because I just felt uncomfortable going to bathhouses. I always wanted to know who I was having sex with, and I wanted to have sex with someone that I was attracted to. I didn't like anonymous sex, so the bathhouses just didn't appeal to me, or I would have been there myself.

To hear, "Wait a minute, things may be worse than hepatitis. They may be worse than gonorrhea. They may be going to kill us," was the worst thing you could say to someone. It was like saying, "You're bad." It was like the Bible saying, "You shall reap the vengeance of the Lord." There was just enormous anger and anxiety and fear when there began to be the awareness that there was some deadly disease that was affecting large numbers of gay men in our town and L.A. and New York and causing quick deterioration.

Hughes

How was the BAPHR membership reacting? Was there a consensus of, We're physicians, we should take such-and-such a stand, or was there a lot of division within BAPHR itself?

Andrews

I must say that there were very few physicians that I heard from who would come to the conclusion that this was a plot by the CIA. Most medical folks were saying, "Damn it, there's got to be something transmissible." There were a few people who would say,

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"I think it's a plot; someone's introduced something," but that was very rare.

But as for what to do about it, there was enormous controversy. Should we take a stance on limiting sexual activity? There was a major, major resistance to imposing restrictions on civil rights that had been fought for for so long. So that was divisive in the organization.

About this text
Courtesy of Regional Oral History Office, University of California, Berkeley
http://content.cdlib.org/view?docId=kt6580067h&brand=oac4
Title: The AIDS Epidemic in San Francisco: The Response of Community Physicians, 1981-1984, Vol. I
By:  Sally Smith Hughes
Date: 1996
Contributing Institution: Regional Oral History Office, University of California, Berkeley
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