Nobody Gets Out of Here Alive

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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.

It's not all good news. Patients still die from AIDS. The drugs don't always work or they work for a while and then lose their efficacy. There are instances where the drugs themselves have done the killing. But instead of battling to beat back each opportunistic disease, the effort now is to keep patients on their "meds."

Instead of struggling to buy a few more months, weeks or even days of life and then easing the inevitable meeting with death, doctors and nurses can actually tell their patients that they are not necessarily going to die anytime in the next few years or even decades.

Now Gourley's more concerned that some of the lessons learned through thousands of deaths are already being forgotten. He hears young gay men talking about getting HIV as if it's no big deal -- just pop a few pills and they'll be all right, an idea on which the drug industry is capitalizing. "Despite the ads appearing in the gay press, advertising various antivirals accompanied by photos of half-naked hot studs engaging in some vigorous outdoor activity, displaying buns of steel, they are very difficult drugs to take, with significant side effects," Gourley writes. "Hey, buckos, it was/is the glorification of that sort of shallow flesh worship that got many of us in this pickle in the first place."

To avoid a repeat of the '80s, Gourley believes that it is time for the "re-gaying" of AIDS. In another statement guaranteed to cause controversy, Gourley says that the pool of virus in the heterosexual community is so small in Denver that "unless you have sex with people who are using IV drugs, or have sex with men, you are not going to get AIDS here."

He believes that the de-gaying of AIDS -- necessary at one point -- has now become a hindrance. Outside of the gay community, he thinks mainstream society believes that gays have gotten the message so that monies used for prevention and education are being redirected. Inside the community, organizations like CAP have "given us an excuse to quit dealing with it ourselves." CAP and the other AIDS agencies still serve a useful purpose, he adds quickly. But it's time once again for gays to start taking care of their own. And some of what got them into trouble in the '70s -- the bathhouse scene and drug use -- are nearly as prevalent today.

Many of the issues the gay community faced before AIDS are still pressing. Some -- like reaching out to gay men of color and poor whites -- mean the community will once again have to look in the mirror regarding matters of race and class. In the 1970s, the coming-out phenomenon was largely composed of upper- and middle-class white men who moved from their home communities to the "gay ghettos" of major metropolitan areas. Today, men of color, as well as poor whites, tend to remain in their home communities -- among families and friends -- where it is more difficult to be out. It is even more difficult for them to be out and have AIDS, which Gourley believes is causing the "re-closeting" of the disease. The reason AIDS research has gotten as far as it has is because of political activists demanding that something be done. The new victims are not as vocal and have no one to speak for them, Gourley contends.

At the same time, he believes, AIDS should no longer be the health issue. "There are more lesbians and gay men dying of heart disease and alcoholism than AIDS." But it still irritates him that newspapers don't list AIDS as a cause of death in obituaries.

In his tiny office outside the ID clinic, Gourley muses that it's past time for gay men to revive the liberation movement. "It's been the lesbians, bless their hearts, who have carried the torch for the past ten years," he says. "It's about time we started doing our fair share again."

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Steve Jackson