David France  chronicles the AIDS epidemic, from 1981 to 1998.

David France chronicles the AIDS epidemic, from 1981 to 1998. Credit: Ken Schles

HOW TO SURVIVE A PLAGUE: The Inside Story of How Citizens and Science Tamed AIDS, by David France. Alfred A. Knopf, 624 pp., $30.

There are two things you need to know about David France’s book “How to Survive a Plague.”

First: It’s flawless. Masterfully written, impeccably researched, and full of feeling for the living and dead heroes of the AIDS movement. Activists Peter Staley, Mark Harrington and Michael Callen are developed like characters in a novel, and a huge cast of players behind them is memorably brought to life. There can be no clearer picture of the uphill battle against ignorance and bigotry that was the raison d’être of organizations like Gay Men’s Health Crisis and ACT UP in the 1980s and ’90s.

Second: It’s too much. Exhaustive, and also exhausting. You feel you are reading about every meeting, every protest, every drug trial, every news story, every falling-out in every splinter group, every pamphlet and position paper, and every outburst from Larry Kramer, the famously cranky playwright who inspired AIDS activism. When you get to page 440 and it says “the calendar turned to 1991,” all you can think is, Dear God, only 1991?

Fortunately, France has also produced a highly watchable, Oscar-nominated documentary with the same title, available on the web. The film, assembled from archival footage and interviews, hits most of the high points of the story. Should you want more after seeing the movie, the book is perfect.

I imagine many readers have some personal connection to the saga of AIDS in the years from its first appearance in 1981, to 1998, the year The Bay Area Reporter ran a “screaming headline” on the front page: “NO OBITS.” Mine is a close one. I was married to a gay man who was diagnosed in 1985 and died in 1994, very shortly before protease inhibitors started saving lives. The acronyms that pepper every page of this book — HIV, AIDS, PWA, AZT, CD4, HTLV-3, GRID, PCP, KS and GMHC, to name a few — were a big part of my vocabulary for years, and the vision of young men dying horribly is burned onto my retinas.

It’s a rough trip down memory lane, and the aspects of the nightmare that were under human control are particularly painful to revisit. It’s easy to forget how long the government, under presidents Reagan and Bush, refused to pay attention or spend money on the epidemic. Cataloged alongside that are all the useless drugs, from Compound Q to the ballyhooed AZT, which was hard to get, ludicrously expensive and ultimately worthless, yet absorbed the attention of activists and scientists for years.

France was there through almost the whole thing, working as a journalist. He was at the New York Native, a biweekly gay newspaper, in the early days, as the gay community agonized over what caused the disease, and safe sex was first promoted as a way to prevent its spread. He was at the early meetings of the groups that formed to respond to the crisis, including the brave and wild ACT UP.

For a while he worked “undercover” at the New York Post, hoping he might influence their coverage. He cut his hair, retired his earrings and swapped his Chuck Taylors for Thom McAns, but was fired before his trial period was over. “Found out you’re gay,” said his editor. “We don’t need infiltrators here, bloke, not homosexuals in the investigations department.”

But that’s exactly what they did need. Gay men were at the center of every bit of progress made. Because the federal response was so profoundly inadequate and disorganized, citizens’ organizations played a crucial role even in organizing drug trials. By 1994, activists were meeting directly with pharmaceutical executives — quite a change from the days of storming and occupying their offices.

France was there at the beginning, and he was there at the end, at the meeting at NYU Medical Center where protease inhibitors — the drugs that stopped HIV from being a certain death sentence — were announced: “When the room emptied out, I found myself standing in the sun-creased lobby watching the men in the audience exchanging hugs and tears. I noticed how incongruously young everyone looked in the snow-whitened light. Most were like, me, not yet middle aged. . . . I’d lived my entire adult life in the eye of unrelenting death. We all had . . .

“It would never be over. But it was over.”

No better way to say it. No better person to write this book, which had to be written, creating a complete and correct record of this terrible story and its heroes.

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