They took on bigoted politicians and ineffective scientists to triumph over a terrifying epidemic. The author of How to Survive a Plague remembers the spirit – and the stunts – that turned despair into hope

David France burst into tears when he heard he had won this year’s Baillie Gifford prize for non-fiction. His eyes fill up again as he tells me it is the 25th anniversary of his partner Doug Gould’s death. The winning book – How to Survive a Plague, a personal history of Aids activism in the US in the 1980s and 90s – is a remarkable survivor’s story: a lament but also a story of hope. In the end, the activists won.

The book is long and filled with remarkable characters who pushed scientists and uncomprehending politicians to find a treatment. One critic likened it to a Russian novel in its scope. France says the timescale was so long – from recognition of the epidemic in 1981 to the introduction of effective medication in 1996 – that he had to give the book a “driving rhythm” to carry the reader through all the scientific, political and media battles.



France, who is 58, grew up in Michigan but moved to New York in June 1981, just as stories of the epidemic were breaking. He was soon writing about the search for a treatment, first in the gay press, then for mainstream publications. He was part activist, part commentator and the book weaves together his own story, that of his friends in what he calls the “gay ghetto” in downtown New York, and the broader canvas of a society trying to come to terms with what seemed like an apocalypse.

Facebook Twitter Pinterest ‘We assumed that if we didn’t have it today, we would have it tomorrow’ … David France, centre, on a march in 1983.

Did he always know he would have to write this book? “I did not,” he says. “The breakthrough in 1996 was disorientating. None of us believed it was a lasting breakthrough, so there was nothing to celebrate. As the years went by and it appeared that it was going to be possible to survive an HIV infection, we were mostly overtaken by grief – a grief we hadn’t processed in that 15-year period because it was just too enormous. If you knew one person who died, you knew dozens.”

It was over 10 years before grief was replaced by another emotion. “It took me a while to realise it was a great story of triumph,” says France, “and how central activism was.” It was activists who forced politicians to take the epidemic seriously. They also taught themselves about the science of HIV/Aids and starting guiding researchers, asking them to look for suppressants rather than a magic-bullet cure and demanding they speed up testing.

Gould died from Aids-related pneumonia. France never became HIV positive but he recounts moments of terror when he was convinced he had. “We assumed that if we didn’t have it today, we would have it tomorrow, and that none of us would get out alive. In the small tenement I lived in, there were people with Aids on every floor. The building itself was gripped. You could look out of the window and see Aids on the sidewalk. It was everywhere, and yet if you didn’t live in that neighbourhood and you weren’t in the gay ghetto, it was possible you knew nothing about the epidemic. That dual reality was shocking.”

I was told the Aids canon was complete and no one wanted to read more about it

Act Up (Aids Coalition to Unleash Power) and other gay groups saw their job as challenging the ignorance of the public, the indifference of the government, and the hostility of religious groups and ultra-conservative politicians. In a famous stunt, Act Up covered the home of anti-gay Republican senator Jesse Helms in a giant condom. “I didn’t understand it at the time,” says France, “but ridicule as a political strategy is actually quite effective.”

HIV-positive activists who survived into the “treatment era” found it difficult to adapt. Like soldiers returning from combat, they no longer had a mission. “They had been living moment to moment,” says France. “When this thing we’d all been fighting for – this ordinary life – made itself available, we had no idea what to do with it.”

France’s story was first told in 2012, in the Oscar-nominated film of the same name, his first foray into movie-making. He chose cinema because publishers had shown no interest in a book: “They said the Aids canon was complete and no one wanted to read more about it.” The film’s success showed they were wrong. “It convinced them the story had a new audience, and that this was a seminal moment not just in terms of gay rights but in the way science and medicine are organised and conceptualised. All of that was revolutionised by Aids activism.”

Facebook Twitter Pinterest ‘Ridicule is effective’ … the giant condom on the house of Jesse Helms.

The book pays homage to those revolutionaries. “The gay community doesn’t really have heroes,” says France. “For some reason, gay history is not typically recorded or published or taught. It means we don’t know what our predecessors accomplished and nor does anybody else. This really was transformative, heroic work that had not been acknowledged. Aids gave us gay marriage.”

He believes that, despite the incursions of Donald Trump, Aids activists’ achievements will not be reversed. “It’s harder to take away liberties than to grant them. Even having declared war against transgender soldiers – the department of defence is refusing to follow up on that. The generals are in lockstep defence of transgender service people. That’s remarkable and a symbol of how hard it would be to bring us back to a time when gay people have no role in civic life.”

Some critics have suggested that telling the story of predominantly white American activists taking on the political and scientific establishment distorts the history of Aids, reinforcing the notion that it was essentially an epidemic affecting the western world. But France insists he does not mean to downplay the effects in sub-Saharan Africa and elsewhere, or the fact that millions are still dying in developing countries. “There are a million narratives, all of which would make remarkable stories,” he says. “What a battle they fought in South Africa for access to drugs. The battle for access is what comes after 1996.”

But that’s another story, in need of another chronicler. France describes the world he knew, the friends he lost and the fight to survive – a first-hand account of a war that is now gradually receding into history.