Public Seminar (PS) spoke to Katie Batza (KB) about her new book, Before AIDS, which charts the rise and development of a national gay community-based health network in the US, beginning in the 1970s.

PS: What prompted you to write Before Aids?

KB: I initially wanted to write a history of how local gay community health clinics like those in my book factored into the AIDS crisis. I had wrongly assumed that these clinics emerged as part of the initial response to the epidemic only to find in the archive that many of them started a number of years before the first reports of what would become HIV/AIDS. The more I explored, the more I realized that the story of these clinics and the health movement they built around them challenged not only the way we think about the AIDS crisis, but also our understanding of the 1970s, gay liberation, the role of the state in gay institution building, and the relationship between social movements in the pre-Reagan era.

PS: What might readers, both familiar and unfamiliar with the history of the HIV/AIDS crisis, learn while reading your book?

KB: Perhaps, most obviously, readers will learn that gay health activism pre-dated the AIDS crisis by as much as a decade and included a robust set of clinics, community partners, research centers, and professional relationships that spanned the country and medical landscape, from the CDC and NIH to pharmaceutical companies and medical professional organizations. Another key point that readers will find interesting is how the state actually nurtured and enabled the creation, growth, and institutionalization of gay health centers, though often unintentionally. Finally, I think that Before AIDS showcases the diverse political roots of gay institutions to show that gay liberation wasn’t the only force driving gay community building in the 1970s.

PS: What were some of the major challenges you faced in writing it?

KB: There were two major challenges in writing this book: sources and a desire for gender equity. The slapdash and grassroots nature of these clinics, combined with the extreme growth and frenetic pace of necessary medical response demanded by the AIDS crisis of the 1980s, meant that the archival sources for this project were often sparse or non-existent. Uncovering this story took me into people’s closets and garages, basements and attics to sift through old boxes and to slowly build relationships with individuals who were central to this history. The other challenge was that I really wanted to write a history that included lesbian history to an equal degree as gay history, only to find that lesbians were operating in very different physical spaces and political movements, on health issues that were rarely lesbian specific, and never had the force of an epidemic behind them as was the case for gay men. Sadly, I couldn’t fit those two stories together in a coherent narrative.

PS: What are you reading at the moment? Would you recommend these books to PS readers? Why?

KB: I am getting started on my next project that looks at the early response to AIDS in the US heartland and so I am reading a wide array of books that explore AIDS, religion, politics, race, etc. Some of the ones I am spending a lot of time with right now include Emily Hobson’s Lavender and Red, Anthony Petro’s After the Wrath of God, and Robert Self’s All in the Family. Each of these texts looks at the interaction between politics, state, family, and morality in ways that help me make sense of the sources for my next book. I would highly recommend them all. For fun, I am also reading Jennifer Egan’s Manhattan Beach, which I also highly recommend but caution that it might keep you up reading late into the night.

PS: Can you tell us a bit about your writing practice? Do you have personalized rituals that you cannot do without?

KB: I try to touch what I am working on for at least 20-30 minutes a day, every work day, even if I have to get up early or just format footnotes. I NEVER work on the weekends. I also belong to a number of writing groups, one that is mostly focused on accountability, another on sharing writing – where we get and give feedback – and a third that brings folks together to write for scheduled periods of time. If I have a big block of time I can dedicate to writing, I find taking a walk or bike ride at the start is very useful to get my thoughts going. Finally, I would be hopeless if I did not have some sort of internet-blocking app on my laptop.

Gay Liberation

Though various other political movements proved pivotal in the development of gay health services in the 1970s, gay liberation also provided an integral piece in the political puzzle. In Boston, burgeoning gay businesses and social outlets both precipitated the need for gay health services and effectively spread word of them throughout the city and region. Internally, gay liberation played a nominal role in the creation and growth of the Fenway clinic itself as most of its gay activists remained at least partially closeted and only tangentially affiliated with gay liberation activism. In Los Angeles, gay liberation, more specifically the creation of gay spaces and services, proved a strong internal motivation for the Gay Community Services Center and its predecessor, the Gay Helpline. The Los Angeles Gay Community Services Center applied the political framing from numerous other local and national movements to the creation of gay services and community, their ultimate goal.

Chicago’s Howard Brown Memorial Clinic had a more complex relationship to gay liberation. Research and outreach appeared both integral and interrelated in Chicago from the clinic’s start, unlike in other locations. This interest in outreach contributed to the bars and bathhouses of Chicago becoming visible, if somewhat improbable, venues for gay sexual health in the 1970s. In fact, many of the city’s gay bars and bathhouses shared the clinic’s interest in providing outreach services. Their interest in the sexual health of their patrons was twofold. Health services were a business interest for bars and, particularly, bathhouses. Gary Chichester, longtime manager of the largest bathhouse in the Midwest, Man’s Country, explained how venereal diseases were bad for businesses built on gay sex and sexuality: “If people are naked and had a [syphilis sore], they are not going to be parading around.” Providing these services meant that “people were actually on top of it and they actually appreciated the fact that we were doing something to help because the sex was good but we were protecting them also, opening up their minds, and giving them information.” However, business and profits were not the only forces at work behind the creation of gay health outreach programs in Chicago. Rather, the collaboration between bars and bathhouses from the inception of these programs suggests that the historical role of bars and bathhouses as community centers for the larger gay community also were a motivating factor. Man’s Country owner and gay businessman Chuck Renslow explained, “This is family, my community, we’re together . . . you can’t just worry about your bar, you’ve got to worry about the total picture.” In the summer of 1975, as the Howard Brown Memorial Clinic was preparing to move and expand its hours, Chichester and Renslow created what would become the most important outreach program for Chicago gay health in the 1970s —  the VD van program.

The concept was simple: every couple of months, local gay businesses, mainly bars and bathhouses, would financially contribute to renting a Winnebago van that would travel to each business and provide free VD testing. Chichester later recalled in an interview, “My thinking was: it is something that is curable, it is something that is out there, let’s talk about it, and let’s take care of it.” Setting the groundwork for the program, Renslow and Chichester first approached a number of managers and owners of large bars and bathhouses in the Chicago area to gain the necessary support of the business community. Having established an interest in the program, they reached out to the Howard Brown Memorial Clinic, by then already reputable despite having been open only a little more than a year, in search of volunteers capable of conducting the testing. This initiated a relationship between the clinic and the gay bars and bathhouses of the city that would continue for decades, and illuminates the important role gay liberation played in the development of the clinic. Having all the necessary community support and staffing, Renslow rented a large van that volunteers then filled with testing kits, a cooler for blood work and samples, and a handful of knowledgeable medical staff. Participating businesses and local newspapers advertised the program, yet, in July 1975, “when the van first went out . . . we tested four people.”

Gay liberation factored heavily in the collaborative response to the lack-luster turnout. Renslow and Chichester drew on a local gay liberation icon, a drag queen from Man’s Country known as Wanda Lust, who agreed to take on another persona — Nurse Lust — and serve as the poster person for the VD van program. For much of the second half of the 1970s, a poster of the sultry Nurse Lust imploring Chicago gay men with her best Uncle Sam impersonation — “I Want You for a Free VD Test!” — was ubiquitous in gay bars and bathhouses. Nurse Lust was also often on the VD van as it made its stops, bringing with her the campy humor that came to epitomize the program, “She’d walk up to people coming out of the bar and say, ‘Come on sweet- heart, get tested or I won’t let you screw me tonight.’ ” Chichester remembered how businesses further added to the appeal of the program: “We made it kind of fun . . . we offered them cookies and milk, and they would come on and get the blood test and [nurse] Wanda [Lust] would be there being Wanda, it was fabulous!” The VD van became something that many patrons looked forward to as it came to mean not only an act of sexual self-care, but also something fun. The program quickly became so popular that the VD van became a monthly occurrence and stopped at so many bars and bathhouses that it quickly grew from a one-night start-up to a three-night process, and then finally graduated to a weeklong operation. Renslow remembered the program’s success and popularity: “Before it ended, there were lines to get in to be tested.”

The VD van program, with its integration of gay liberation businesses, politics, and entertainment, played a significant role in the development of the Howard Brown Memorial Clinic, as it helped build the clinic’s reputation among the larger Chicago gay community. By integrating testing with entertainment familiar to the gay community, the program strengthened the relationship between the gay and medical communities in the 1970s. Additionally, it helped solidify the clinic’s appeal to city and federal funding sources by allowing the clinic to take much of the credit for staffing the VD van program and other bathhouse outreach programs. As the most effective modes of “prevention” at the time were to educate patrons about disease symptoms and provide access to free testing, the VD van program proved highly effective in containing and treating venereal diseases. Thus, the Howard Brown volunteers teamed with bathhouses and bars to educate the larger gay community and provide services by embracing the politics of sexual freedom and gay liberation.

Gay health activism presents a complex history of the 1970s in which people and institutions previously assumed to be involved in a single identity-based form of activism were in reality drawing on a rich tableau of diverse movements, many of which were grappling with slightly different iterations of the same types of oppression. The direct impact of this cross-pollination of political framing and tactics on the formation and evolution of gay health services challenges the historical narrative that links all gay institutions from this era directly and solely to gay liberation activism. Some gay institutions, like Fenway, did not start out as gay at all, while others, like Howard Brown, became gayer with the help of the local gay community. From this perspective, gay health activism’s origins can be traced back to larger discussions of health access, community survival, and the application of activist ideals to seemingly apolitical issues that occurred on a much broader scale in the 1970s. Yet vague political solidarity, borrowed tactics, and shared individual activists rarely translated into race- and feminist-conscious gay health services. Thus, gay health activism illuminates a different kind of gay institution building during the gay liberation period and captures the complexities of exchanging people and ideas across movement borders in a period characterized by increasingly fragmented identity politics.

The political origins of the clinics in Boston, Los Angeles, and Chicago were wildly divergent from one another. Yet, state regulation, licensure requirements, and funding stipulations replaced each clinic’s politics with narrow definitions of health and a focus on providing services in a highly medicalized environment, making the clinics fairly similar by the end of the decade. The convergence of these three histories at the end of the period reflects the important role of the state in shaping gay health services and organizations during this period. Indeed, by the end of the 1970s, the clinics in Boston, Los Angeles, and Chicago bore much greater resemblance to large social service organizations or medical research institutions than to their meager, more ideologically based origins. The implications of this transformation extend beyond gay health, speaking to the larger role of the state in co-opting or defusing radical social movements, of which the women’s health movement may be the best example. Moreover, this history provides for greater debate and discussion of the evolution of social movements during this period, as the clinics’ struggles with ideology and sustainability through state funding and involvement mirror the choices activists in many movements faced.

Katie Batza is an assistant professor of Women, Gender, and Sexuality at the University of Kansas whose research and teaching examines the intersection of sexuality, politics, and health in the 20th century United States. Before AIDS has been excerpted with permission of the University of Pennsylvania Press, is available in select book stores and can be purchased online here.