Revisiting the Historical Record on HIV/AIDS, From Reagan to Clinton

Clinton’s gaffe is an opportunity for remembering the real history.

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“We must conquer AIDS before it affects the heterosexual population and the general population,” said President Ronald Reagan’s health and human services secretary, Margaret Heckler, in 1985. By then, ten thousand Americans had been diagnosed, and half of those had died.

That same year, First Lady Nancy Reagan refused a request from Elizabeth Taylor that she attend or at least lend her name to a fundraiser for AIDS.

Two years and fifteen thousand more American deaths later, President Reagan finally gave a speech about the epidemic. He appalled many listeners by proposing mandatory HIV testing for some groups of Americans. Public health experts opposed this and other ideas that Reagan’s religious-conservative advisers flirted with, like quarantining everyone who tested positive or tattooing their arms and buttocks.

So it was deeply enraging for LGBTQ people and their allies when Hillary Clinton told MSNBC’s Andrea Mitchell on Friday, during coverage of Nancy Reagan’s funeral, that the Reagans had “started a national conversation” about HIV/AIDS, “when before nobody would talk about it.” She credited Nancy Reagan with “low-key, effective advocacy.”

Clinton has since apologized for the remarks, rightly acknowledging that “generations of brave lesbian, gay, bisexual, and transgender people, along with straight allies” had started the conversation during the AIDS crisis. While that retraction is not exactly an explanation for how this happened, perhaps it was a matter of ill-deployed decorum: Most of us can accept a former First Lady not wanting to criticize another former First Lady on the day of her funeral. If she’d praised Nancy Reagan’s advocacy for gun control and embryonic stem-cell research without mentioning AIDS—as an initial tweeted apology implied had been her intention—few would have blamed her. But what Clinton said, for whatever reason she said it, felt particularly cruel because, while Reagan got a nationally televised funeral, so many others’ deaths once went unmourned.

The AIDS crisis elicited countless private acts of cruelty, rarely discussed today. Parents, and yes even lovers, turned their backs on the dying. As funerals became a way of life for many, families locked gay partners out of homes and stripped them—and an illness that they considered shameful—from obituaries. The last will and testament of a young man named Roland Pena, which I found while researching his papers in Chicago, specified, “It is imperative that the word AIDS be printed in my obituary. If I die from some other unrelated cause, say that I had AIDS.” *

In An Early Frost, a 1985 made-for-TV movie, paramedics refuse to pick up a man dying from AIDS from his parents’ house because they are afraid to touch him. Fully a decade later, in 1995, the Clinton White House apologized after the Secret Service donned rubber gloves during a visit by a group of gay elected officials. Princess Diana was famously photographed touching people with AIDS. That’s low-key, effective advocacy. Nancy Reagan did no such thing. For those who buried lovers and friends—among whom, perplexingly, Clinton counts herself according to her statement—the pain of those years has not gone away.

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Perhaps in the wake of this particular cycle of gaffe and apology, there’s an opportunity for revisiting the real history—a history that is too often oversimplified. For one thing, while the Reagan administration’s slowness to respond to AIDS was criminal, it was also a major factor in the growth and radicalization of the gay movement in the second half of the 1980s.

In cities like Newark, queer people of color led the effort to connect the related struggles against poverty, sexism, and racism and taught people how to survive through safe sex. More widely known today is the story of the AIDS Coalition to Unleash Power (ACT-UP), founded in 1987 in New York, which grabbed attention from the mainstream media. ACT UP members shut down Grand Central Station at rush hour. They draped an enormous condom over the house of Jesse Helms, the ultra-homophobic North Carolina senator who passed a ban on federal funds for any AIDS prevention materials that discussed gay sex at all. A 1987 ACT UP graphic by the artist Donald Murphy showed Ronald Reagan’s face and a day-glo orange caption, “He kills me.”

After ignoring AIDS in his first term, President Reagan appointed a presidential commission on AIDS in 1987 and stacked it with social conservatives who strongly opposed condom distribution and other lifesaving AIDS prevention tools. Only one member was an out gay man.

Yet, despite this largely shameful narrative, when historians began to dig into the Reagan archive, they found that the administration’s response to some directly AIDS-related policy matters was more complicated than you’d think. The historian Jennifer Brier has argued that the administration was actually characterized by “splits and disagreements” on AIDS policy during the second term, with a moralist faction led by William Bennett and Gary Bauer, both domestic policy advisors working in the Department of Education, and a public-health faction led by Surgeon General C. Everett Koop. By mid-1988, the Koop faction won a key debate, and 100 million copies of a pamphlet, “Understanding AIDS,” went to every American household. It wasn’t perfect, but it was a start.

That said, Reagan’s urban policies also worsened the crisis in many indirect ways. Reagan’s huge tax cuts were paired with massive cutbacks to federal funding for social services and Medicaid, which became the insurer of last resort for many people living with AIDS who lost jobs and housing. He cut funds for inner-city hospitals and clinics. Big cities, already reeling fiscally and crushed by deindustrialization, were forced to take on the burden of paying for AIDS care without meaningful federal assistance until long after Reagan left the White House. With help from Taylor and other entertainers, AIDS activists got Congress to pass, and George H.W. Bush to sign despite misgivings, a law helping cities pay for such care. This landmark Ryan White CARE Act of 1990 was named for an Indiana teenager with hemophilia who contracted the virus through a blood transfusion—a so-called “innocent” victim who did not contract the virus through sex or drugs.

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During the dark days of the ’80s, Clinton was the First Lady of Arkansas, a place where gay and AIDS activists had little or no clout. But once she reached the national stage with Bill’s election in 1992, the issue was squarely in her line-of-sight; indeed, the Clinton administration absolutely marked a more progressive approach to HIV/AIDS. You’d think Hillary would want to brag about that, rather than lending a false good word to a predecessor.

Of course, Bill Clinton’s record was far from perfect. He refused to drop the federal ban on funds for needle exchange programs, which had saved countless lives in the U.K. But his presidency actually contributed to the decline of radical AIDS activism, not by suppressing it, but rather because he seemed so much less hostile and callous than Reagan and Bush. As Deborah Gould wrote in her landmark book on ACT UP, “the revival of hope following Clinton’s election” played an important role in “the demise of the direct-action AIDS movement.”

If nothing else, the response to Hillary’s remarks shows that we’ve come some distance since Ronald Reagan’s death in 2004, when fewer spoke of his AIDS record, toward remembering what actually happened.

The crisis goes on for many Americans, and millions around the world. In the apology she posted on Medium, Clinton rightly attacked Republicans who have blocked Medicaid expansion under Obamacare. This has especially hurt African Americans living with HIV in southern states.

There’s room for her to draw an even sharper contrast, however, while educating Americans about the history of HIV/AIDS. The Clintons faced hecklers from ACT UP, but—except in the eyes of fanatical Republican critics—they weren’t icons of greed, rapacity, and callousness in the 1980s. More to the point, they weren’t pulling down municipal tax abatements for luxury apartments that could have gone to help people living with AIDS afford to stay in their homes. When ACT UP’s New York chapter created a Housing Committee in 1988, as the historian Tamar Carroll recently noted, it was obvious where they should hold their first protest, and others to come: Trump Tower.

*Correction, March 14, 2016: This post originally misidentified Roland Pena as Ronald Pena.