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The Social Impact of Aids in the United States
Institutes of Health, the Food and Drug Administration, and the major pharmaceutical houses to speed the development and release of new drugs (Bryant, 1991; Taylor, 1990).
The tactics of ACT-UP, while often compelling and sometimes effective, have also generated strong criticism, and some gay activists believe them to be counterproductive. Events such as the disruption of U.S. Health and Human Services Secretary Louis Sullivan's speech at the International AIDS conference in 1991 and the zaps at St. Patrick's and Holy Cross cathedrals aroused considerable criticism, leading observers to wonder whether they were, on balance, more harmful than helpful.
Volunteer efforts on AIDS have been critical elements in delivering services and reducing the financial impact of the disease, and they have characterized New York's response from the very first moments of the epidemic. Volunteering in a systematic way, however, has been primarily a characteristic of the gay community (Chambre, 1991). This is not to say all volunteers are AIDS-infected gay men. They include the uninfected, women, persons who are not themselves gay, as well as a large number of professionals from a variety of fields.
Agencies and organizations that serve the gay community have attempted to reach other groups of men who have sex with men, intravenous drug users, and women, with mixed results. Of particular importance has been outreach to men who have sex with men in communities that have limited links to the organized gay community. Many African American, Hispanic, and Asian American men have strong contacts with the largely white gay community that is centered in Manhattan. However, these men find themselves caught between their identities as gay men and their bonds with their own ethnic communities that have negative attitudes toward men who have sex with men in general and toward gay men in particular. In addition, the white gay community also exhibits racism, which limits outreach efforts.
Men Outside Identified Gay Communities
Men who have sex with men are found not only in the predominantly white gay community, but also among men of African and Hispanic descent who are only somewhat identified as gay. At the onset of the epidemic little was known about men who had sex with men in various communities of the city. What has been learned about African American men and Hispanic men has largely emerged from research concerning the rates of HIV infection in these groups and ways of preventing further infection. Of all African American men who have been reported with AIDS in New York State, 33 percent are reported to be men who had sex with men; 49 percent are intravenous drug users; and 5 percent have both risk factors. Of all Hispanic men who have been diagnosed with AIDS, 33 percent are reported