"Some AIDS Advocates Now Question Need for Special Services"
by SHERYL GAY STOLBERG
NEW YORK -- Behind the swinging glass doors that welcome visitors to the Gay Men's Health Crisis is a world where HIV is not just a deadly virus, but also a ticket to a host of unusual benefits.
At the center, the nation's oldest and largest AIDS social-service agency, almost everything is free: hot lunches, haircuts, art classes and even tickets to Broadway shows. Lawyers dispense advice free. Social workers guide patients through a Byzantine array of government programs for people with HIV, and on Friday nights dinner is served by candlelight.
The philosophy underlying the niceties and necessities is "AIDS exceptionalism." The idea, in the words of GMHC executive director Mark Robinson, is that "AIDS is special and it requires special status." That is a concept that has frequently been challenged by advocates for people with other diseases.
Now some advocates of people with AIDS are quietly questioning it themselves. With death rates from the disease dropping for the first time in the history of the 16-year-old epidemic, the advocates suggest, it is time to re-examine the vast network of highly specialized support services for people with HIV.
Some people are growing increasingly uncomfortable with government's setting aside money for doctors' visits, shelter and drugs for people with AIDS while not operating comparable programs for other diseases.
"Why do people with AIDS get funding for primary medical care?" Martin Delaney, founder of Project Inform, a group in San Francisco, asked in an interview. "There are certainly other life-threatening diseases out there. Some of them kill a lot more people than AIDS does. So in one sense it is almost an advantage to be HIV positive. It makes no sense."
Delaney, a prominent voice in AIDS affairs since the onset of the epidemic, is calling on advocates to band with people working on other diseases in demanding that programs for AIDS be replaced with a national health care system.
He complained that organizations like the Gay Men's Health Crisis had been "bought off" by the special status given to AIDS. "We took our money and our jobs," he wrote in the Project Inform newsletter in the summer, "and we dropped out of the national debate."
That criticism has not won many fans within "AIDS Inc.," as some call the cottage industry of agencies t