The early years of the HIV/AIDS epidemic were marked by uncertainty, false information, and fear about the cause and transmission of the disease. Though it is likely that IV drug users were dying of AIDS in New York City in the 1970s from what was then known as “junkie pneumonia, (Pneumocystis), AIDS came to medical attention in the United States in 1981 when otherwise healthy gay men in New York and San Francisco contracted Kaposi’s sarcoma, an unusual form of skin cancer that caused purple skin lesions. Although evidence showed that others exhibited the same symptoms as gay men, scientists termed the syndrome Gay-Related Immune Deficiency (GRID), leading to the linkage of the disease with homosexuality and dramatically increasing the stigma surrounding it.

Homophobia, along with rising economic inequality, shaped public responses to the unfolding epidemic. Frightened parents tried to keep kids with AIDS out of public schools, while city officials closed bathhouses and other meeting places for gay men. People with AIDS suffered from social isolation, including the loss of homes, jobs, and relationships with partners or family members. Despite having roughly half of the country’s reported cases, New York City did not mount a systematic response to the emerging epidemic. Patients experienced stigma and neglect in the city’s health care system. Some private hospitals, overwhelmed by the rapidly increasing numbers of patients, and sensitive to the general public’s fears of the spread of the disease, began refusing to admit AIDS patients; hospitals that did admit them, especially public institutions, had too few resources to care for them properly. AIDS activist Keith Cylar recalled, “New York City literally had hospital gridlock and that was when they were keeping people out on hospital gurneys in the hallways. That was when people were not being fed, bathed or touched. It was horrendous.” Volunteer groups such as the Gay Men’s Health Crisis (formed in 1982) took on caring for and housing AIDS patients.

The AIDS Coalition to Unleash Power (ACT UP), a direct-action group founded in 1987 after a fiery speech by playwright Larry Kramer, used stunning visual art, spectacular street theater, and civil disobedience to draw attention to government inaction and the need for effective treatment and prevention to end the AIDS epidemic. The organization targeted both medical and public health authorities, the pharmaceutical sector, and the financial industry, demanding faster drug development and testing, and more affordable drug pricing. ACT UP also targeted the media for their inaccurate portrayal of the epidemic and who was at risk, luxury real estate developers like Donald Trump for exacerbating homelessness, and city hall for its failed response to the epidemic.

ACT UP’s membership included artists and designers, some of whom had extensive experience in marketing, and they created iconographic images including the Silence = Death Project, which urged viewers to “turn anger, fear, grief into action” on AIDS. Other members were veterans of prior social movements including the civil rights and feminist peace movements, and orchestrated elaborate civil disobedience actions, such as disrupting trading on Wall Street and occupying the Food and Drug Administration headquarters. Photographer Thomas McGovern recalled covering ACT UP protests, and the ways in which they were strategically planned to ensure they would be documented and disseminated to a much broader audience via the media. Like ACT UP itself, McGovern hoped to change the public’s perception of people with AIDS through his portraiture, “showing the horrors of what people with AIDS suffered through politically and medically,” but also, “celebrating people’s strengths and the indomitable human spirit.”