Okay, Gays, Now Let’s Get in Formation
ACT UP emerged in the late 1980s as a fiery and unapologetic response to the AIDS epidemic, a crisis that was devastating communities while being met with indifference from the government and broader society. Formed in 1987 in New York City, this grassroots activist group harnessed the power of direct action, civil disobedience, and media-savvy campaigns to demand life-saving policy changes, greater funding for research, and equitable access to treatment.
With its iconic pink triangle and bold slogan, "Silence = Death," ACT UP galvanized marginalized voices, challenging the status quo and redefining what activism could achieve. Even with advances in HIV prevention and improvements in antiretroviral medications, ACT UP remains active today, continuing to fight for health equity and raise awareness about ongoing challenges in the global fight against HIV/AIDS.
The AIDS Crisis: A History Lesson
To understand the impact and legacy of ACT UP, it’s crucial to touch upon the origins of the AIDS crisis and the societal and governmental failures that fueled its devastation. The crisis began to surface in July 1981, when news outlets reported on a rare cancer disproportionately affecting gay men. This marked the early days of what would become one of the most significant public health emergencies of the 20th century.
The response from the U.S. government, particularly under the Reagan and George H. W. Bush administrations, was widely criticized for its lack of urgency. It wasn’t until September 1985—four years after the initial reports—that President Ronald Reagan even mentioned AIDS publicly.
By then, the disease had claimed tens of thousands of lives. Pressured by growing public concern and media attention, Reagan’s administration began to allocate increased funding for AIDS research. In October 1985, Congress approved nearly $190 million for research, signaling a reluctant shift toward addressing the epidemic.
Throughout the late 1980s, federal initiatives like AIDS Awareness Month and the “America Responds to AIDS” campaign sought to educate the public and reduce stigma, but these efforts came too late for many. By 1987, approximately 47,000 people in the United States had been infected with HIV, and countless others had lost their lives due to inaction and neglect.
The Birth of ACT UP
The AIDS Coalition to Unleash Power (ACT UP) was born out of a collective rage against the widespread neglect and discrimination surrounding the AIDS crisis. On March 10, 1987, activist and playwright Larry Kramer delivered an impassioned speech at Manhattan's Lesbian and Gay Community Center, calling for the formation of a direct-action group to confront the epidemic and its systemic mishandling. Just two days later, approximately 300 individuals gathered to establish ACT UP as a non-partisan coalition committed to non-violent direct action and advocacy.
ACT UP was more than a protest movement; it was a lifeline for many in the LGBTQ+ community and those affected by AIDS. The group adopted the powerful motto "Silence = Death," a slogan derived from a poster created by the Silence=Death Project. This symbol, featuring a pink triangle, not only drew attention to the urgency of the crisis but also reclaimed a painful emblem of oppression from the Holocaust.
ACT UP quickly became a space for community and strategy, with members meeting regularly at the Lesbian and Gay Community Center to organize protests, discuss tactics, and find solidarity. Its approach was as much about fostering community as it was about demanding change. As noted in The New Yorker, the group provided a safe haven for those abandoned by their families, medical institutions, and the government, offering hope in the face of a terminal illness that society largely ignored.
Through its innovative campaigns and art-driven activism, ACT UP would go on to challenge the political and medical establishments, forcing the world to confront the human toll of AIDS and to take action.
ACT UP Takes to the Streets
On March 24, 1987, ACT UP staged its first major protest on Wall Street, targeting pharmaceutical companies profiting from the AIDS crisis, particularly Burroughs Wellcome, the manufacturer of AZT. At the time, AZT was one of the first drugs approved to treat AIDS, but its prohibitive cost—estimated at up to $12,000 annually for patients—made it inaccessible to many who desperately needed it. The demonstration, involving 250 members, strategically disrupted the morning rush hour at Wall Street and Broadway, amplifying the group’s call for equitable access to life-saving drugs and a coordinated national strategy to combat the epidemic.
ACT UP's demands were clear and urgent: faster FDA approval of experimental drugs, affordable pricing for treatments, public education to prevent the spread of AIDS, and policies to end discrimination against people with HIV/AIDS in housing, workplaces, insurance, and medical care. The protest ended with 17 arrests but achieved a significant breakthrough—shortly afterward, the FDA announced it would reduce the time required for drug approvals by two years, a critical win for those living with HIV.
The momentum didn’t stop there. On October 11, 1987, ACT UP joined the March for Lesbian and Gay Rights in Washington, D.C., amplifying their demands for government action. A year after their inaugural protest, on March 24, 1988, the group returned to Wall Street with over 1,000 demonstrators. They protested pharmaceutical profiteering and government inaction, chanting slogans like “No more business as usual” and scattering symbolic dollar bills imprinted with protest messages. The event resulted in 111 arrests but cemented ACT UP's reputation as a fearless force in the fight against AIDS.
Over the years, ACT UP expanded its reach, organizing high-profile protests at venues like the Centers for Disease Control in Atlanta, the New York Stock Exchange, and even the State of the Union Address in Albany. These actions, fueled by a blend of creative disruption and strategic demands, not only brought global attention to the AIDS epidemic but also forced meaningful changes in drug policy, public health education, and societal attitudes.
The Stop the Church Protest
One of ACT UP’s most controversial and high-profile demonstrations occurred on December 10, 1989, at St. Patrick’s Cathedral in New York City. Known as the “Stop the Church” protest, it targeted the Roman Catholic Archdiocese’s opposition to AIDS education, condom distribution, and reproductive rights. The protest drew an estimated 5,000 participants, highlighting the intersection of public health and religious influence on policies affecting marginalized communities.
The action began as a silent die-in during mass, with protesters lying on the cathedral floor to symbolize lives lost to the AIDS crisis. Despite the dramatic imagery, Cardinal John O’Connor continued the service uninterrupted, prompting a shift in tactics. AIDS and LGBTQ+ activist Michael Petrelis broke the silence, condemning the cardinal’s stance as deadly and discriminatory. What followed was a chaotic scene as demonstrators chanted slogans, blew whistles, chained themselves to pews, and scattered condoms throughout the church.
This protest was polarizing, garnering both outrage and praise. Critics decried the disruption of a religious service, while supporters applauded ACT UP’s willingness to challenge an institution they viewed as complicit in policies that exacerbated the AIDS epidemic. The demonstration underscored ACT UP’s commitment to direct action and its readiness to confront powerful institutions, even at the risk of alienating public opinion.
Expanding ACT UP’s Reach and Influence
By the late 1980s, ACT UP’s impact had spread beyond its New York roots, with chapters forming in cities like Los Angeles, Boston, and across New England. These regional groups expanded the movement’s reach, mobilizing local communities in the fight against the AIDS epidemic and the systemic failures that allowed it to flourish.
Central to ACT UP’s efforts was its creative and confrontational approach to activism, often brought to life through the work of Grand Fury, an anonymous art collective. Grand Fury produced striking visual media for ACT UP, from posters and billboards to public installations. By remaining anonymous, the group functioned as a unified voice, avoiding individual recognition to keep the focus on the issues at hand. Their mission was to expose systemic homophobia and the lack of investment in the AIDS crisis by bringing bold, provocative artwork into public spaces to reach the widest possible audience.
Despite its powerful messaging, Grand Fury often encountered censorship. Their works were rejected for public billboard space, and attempts were made to exclude their pieces from art exhibitions. Undeterred, the group took to the streets, illegally pasting their art on walls to ensure their message was seen.
Another vital contributor to ACT UP’s activism was Diva-TV (Damned Interfering Video Activist Television), formed around 1989 or 1990 as an affinity group. Diva-TV documented ACT UP’s protests and broader community responses to HIV/AIDS, amassing over 700 hours of footage. Through their weekly public access television series, such as AIDS Community Television and ACT UP Live, the group brought visibility to the epidemic and the activism surrounding it. This video documentation not only captured the urgency of the moment but also preserved ACT UP’s legacy for future generations.
Day of Desperation and ACT UP in the 1990s
By the early 1990s, ACT UP had firmly established itself as a force for change, using direct action to highlight inequities in government spending and public health policy. On January 23, 1991, the group staged the "Day of Desperation" protest, condemning the U.S. government’s allocation of funds. While President George H.W. Bush committed billions of dollars daily to the Gulf War, funding for AIDS programs remained grossly inadequate.
The protests were bold and disruptive. On the eve of the Day of Desperation, activists interrupted the live broadcast of CBS Evening News to demand action, while chants like “Fight AIDS, not Arabs!” underscored the disparity in government priorities. The following day, ACT UP organized protests across New York City’s five boroughs, culminating in a powerful demonstration at Grand Central Station. There, activists raised a banner reading “MONEY FOR AIDS NOT FOR WAR” to the ceiling with helium balloons, drawing attention to the stark imbalance in national spending priorities.
As the decade progressed, medical advancements began to transform the landscape of the AIDS crisis. In 1996, the introduction of antiretroviral treatments significantly improved the prognosis for people living with HIV, enabling many to manage the virus and live longer lives. However, this breakthrough did not mean the end of ACT UP’s mission. The group recognized that systemic inequities—such as the high cost of medication and cuts to healthcare programs—still needed to be addressed.
On March 24, 1997, ACT UP marked the 10th anniversary of its first Wall Street protest with another major demonstration, dubbed “Crash the Market.” This action targeted the pharmaceutical industry’s profiteering and cuts to Medicaid funding. More than 500 activists from ACT UP chapters nationwide gathered at City Hall Park before marching to Wall Street. Protesters demanded Congressional hearings on the soaring cost of AIDS drugs, chanting slogans like “We die — they make money.” The demonstration ended with 73 arrests, showcasing ACT UP’s unwavering commitment to civil disobedience in pursuit of justice.
As the movement entered the 2000s, ACT UP continued its advocacy, focusing on expanding healthcare access, combating stigma, and addressing the needs of those living with HIV/AIDS. Its enduring activism highlighted that even as treatments improved, the fight for equitable healthcare and LGBTQ+ rights was far from over.
ACT UP Today
HIV/AIDS is not just a chapter in history—it remains a pressing global issue. ACT UP’s mission endures, focused on addressing the ongoing challenges of the epidemic and the systemic barriers that exacerbate its impact. Today, the group advocates for sustained investment in the development of new medicines and treatments for HIV/AIDS and related co-infections, ensuring equitable access to prevention, care, and healthcare at large. It also confronts structural drivers of the epidemic, such as stigma, discrimination, and poverty, which perpetuate inequities in treatment and support.
In 2017, ACT UP marked its 30th anniversary with a strong message of resistance. During New York City’s annual LGBT Pride March on June 25, members carried black coffins inscribed with the names of crucial services under threat during the Trump administration. These included the Ryan White Care Act, the nation’s largest federal HIV program; the President’s Emergency Plan for AIDS Relief (PEPFAR), a global initiative providing lifesaving HIV/AIDS services; and the Affordable Care Act (ACA), which faced the risk of repeal. This powerful demonstration highlighted the vulnerability of essential programs that millions rely on for healthcare and support.
ACT UP’s activism today reflects the same urgency and determination that defined its early days. While advances in HIV prevention and treatment have transformed the landscape of the epidemic, ACT UP continues to fight for a world where healthcare is a right, not a privilege, and where no one is left behind in the battle against HIV/AIDS.
Continuing the Fight
ACT UP’s legacy is a testament to the power of resilience and community. In the 1980s, LGBTQ+ people faced overwhelming challenges: a lack of basic rights, widespread stigma, and the devastating emergence of the AIDS crisis. At a time when government and societal support was nearly nonexistent, they had no choice but to rise up and fight for their lives and the lives of others in their community. It wasn’t easy, but they refused to be silenced.
Today, ACT UP continues its critical work advocating for LGBTQ+ rights and for people living with HIV/AIDS. And the fight isn’t over. With every shift in political landscapes, there are renewed threats to LGBTQ+ rights and to equitable healthcare access. But ACT UP’s history shows us that change happens when we refuse to accept oppression and choose action instead.
This isn’t just their story—it’s a reminder for all of us. Speaking up, standing together, and refusing to be complicit remain vital. The work of fighting for justice, dignity, and equality for all LGBTQ+ people is far from finished, but the courage and determination of those who came before us prove that progress is possible.
Let’s continue to act up, break the chains of oppression, and create a world where everyone is free to live authentically and without fear. Together, we can honor their legacy and push the movement forward.
And remember. Every day is all we have, so you've got to make your own happiness.
For more information on this topic, listen to Episode 51. ACT UP: Silence = Death.
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