Nobody Gets Out of Here Alive

Patrick Gourley has seen enough death from AIDS. Now it�s time for rebirth.

Comments (0) By Steve Jackson Thursday, Mar 2 2000

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In a recent interview with Westword, Gourley says the members of HEAL are merely latching onto old paranoias, the same type of thinking that found favor with those gay men in the '80s who spread rumors that their killer was a "bug" planted by the CIA or FBI in the New York subway system. It is they who are trying to argue that the earth is flat, because they cannot understand what they cannot see.

HEAL also claims that gay men's falling death rates due to what they refuse to call AIDS are a reflection of that population simply dying off. Gourley, however, points out that -- as potentially unhealthy as it may be -- the bathhouse scene has been revived, and drug use, including the use of amyl nitrate (which HEAL claims may have been the cause of the immune-system breakdowns) is still prevalent among young gay men. And yet they're not dying from AIDS in the same sort of numbers as before the advent of antiviral drugs.

Fifty-one and counting: Patrick Gourley, head of nursing at the Infectious Diseases Clinic at Denver Health Medical Center.

Queer theory: Patrick Gourley (right) with Harry Hay, from whom he got his "Ph.D. in Queerdom."

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In fact, the number of people with AIDS in the United States has continued to climb -- from an estimated 174,633 in 1993 to 297,136 in 1998. When the antivirals came into use, people with AIDS started living longer. In 1993, according to the CDC, an estimated 44,991 people in the United States died of AIDS. That figure continued to climb, hitting a 1995 peak of 49,895. The next year, however, there were 37,221 estimated deaths, a downward trend that continued in 1997 (21,445) and 1998 (17,171), the last year available. The CDC attributes the fall to "the widespread beneficial effects of new treatment regimens," as well as prevention strategies and education.

In Colorado, the year-by-year statistics mirrored both the growth and demise of the plague, as well as the consequences for those infected in the early years. Colorado Department of Public Health and Environment figures show that there were 79 reported AIDS cases in 1983 through 84; of that number, none are living. Of 95 cases reported in 1985, one is still alive; of 183 cases in 1986, two survive. And of the 3,752 people diagnosed with AIDS between 1987 and 1993 -- the year in which the single most AIDS cases (732) were reported -- there are only 730 still living. But from 1995, the percentage of people with AIDS still living compared to the number of reported cases begins to jump dramatically.

In August, 1998, San Francisco's largest gay newspaper ran a banner headline proclaiming, "No Obits!" For the first time in seventeen years, there were no AIDS-related obituaries in the paper. The headline caused debate, with some people arguing that it would mislead readers into thinking the danger had passed (when it was just moving into poorer communities, where such deaths would not be reported to a gay newspaper) and that it might further erode funding for service organizations (to which contributions had been declining since antiviral drugs had turned AIDS into a "manageable," not-always-fatal disease).

This past December, the Vatican held a conference on AIDS and reaffirmed the church's opposition to condoms as a way to fight the disease. The announcement sparked a tenth-year anniversary protest by ACT UP at St. Patrick's Cathedral, though only thirty protestors showed up.

Unless it's World AIDS Day or there's a juicy scandal (such as the recent revelation that hundreds of Catholic priests have died of the disease), reporters pay little attention. Like many of those in the medical community, the media is turning its focus to Africa, the current epicenter of the disease.

As horrible as the plague was, the United States has a much better medical infrastructure than the African nations, as well as considerably more resources for dealing with an epidemic. Experts like Cohn, who has been to Africa on sabbatical to work for the World Health Organization, are warning that the death toll in the United States will pale compared to the millions who will die in Africa, Asia and Russia.

Only a month ago, Newsweek, which had originally taken nearly four years to recognize the plague in the United States, reported that as much as 30 percent of an entire generation has been infected in Africa. Those numbers are expected to be similar in Asia and Russia -- meaning tens of millions of deaths and, because AIDS in the rest of the world is a heterosexual problem, leaving many more millions of orphans.

The best hope is for a vaccine. However, even Cohn thinks researchers are ten years from an AIDS vaccine. Those who are more pessimistic think a vaccine may be impossible.

Almost twenty years after the first AIDS cases began showing up in Denver, the face of the disease has changed at the clinic. Where once more than 90 percent of the patients were gay males -- almost all of them white, well-educated, middle- and upper middle-class -- now more of the faces are brown and female. Eighty percent of the patients are still gay men, but an ever greater percentage of them are minorities, and those who are white are poorer and less educated. Ten percent are women, almost all of them having contracted the disease through intravenous drug use -- their own or that of their sexual partners.

In January of this year, only two patients at the ID clinic died, and one of them was a suicide. But with 850 patients compared to 550 five years ago, the clinic is actually following more patients now simply because they are living longer.