Free HIV testing for everyone is crucial to GMHC’s HIV/AIDS prevention and treatment work, but when Louis Bradbury became GMHC’s board president in 1993, the official policy was: Do not get tested.
“When I told the staff that recently, they couldn’t believe it,” Bradbury said, adding that his proudest act as board president was launching GMHC’s Testing Center in 1997.
“Now, it’s accepted that testing for HIV is the way we get people on PrEP [pre-exposure prophylaxis] as soon as possible, or into effective medical treatment,” he said. “That’s the closest thing we have to a vaccine to prevent the spread of the disease.”
In the absence of a cure, Bradbury remains a staunch proponent of HIV testing, but now as a donor. He’s the board president for the Calamus Foundation, which funds HIV/STI testing and prevention for both GMHC and Planned Parenthood of NYC.
But in the early 1990s, Bradbury said, GMHC and other AIDS services organizations opposed testing, because there were no effective treatments and an HIV/AIDS diagnosis exposed people to severe discrimination.
Instead, GMHC promoted safe sex to prevent the spread of HIV with uniquely frank and sex-positive education campaigns.
An AIDS diagnosis was still considered a death sentence in 1993. That year, a major clinical trial of AZT, approved by the FDA in 1987, found it didn’t prevent HIV from progressing to AIDS. And AZT, despite the toxic side-effects, was the only treatment there was.
“It was a very dark time, without much hope,” Bradbury said. “I was going to funerals almost every week for a GMHC staff member, volunteer, or client I might have known.”
By then, three-quarters of the 161,000 Americans diagnosed with AIDS since the epidemic’s onset had died. In New York City, AIDS had become the leading cause of death for both men and women.
“I thought we needed to do testing and help people deal with the outcome either way. I argued all the time with Larry Kramer about it.” said Bradbury, a lawyer.
When he met Kramer in 1989, Bradbury, now 74, had just turned his considerable energies to philanthropy and nonprofit work, after a career in law and business.
The GMHC co-founder was “vehemently” against HIV testing and just as adamant about safe sex, Bradbury said–to the point of suggesting gay men should have no sex at all. Kramer had moved on to co-found ACT UP by then, but the anti-testing viewpoint was common among people fighting the AIDS epidemic.
People known to have AIDS risked losing their jobs, apartments, and healthcare—and being shunned by their families and community, Bradbury said. The discrimination was also about being gay, he added, since all gay men were assumed to be HIV positive.
In that climate, people at risk for HIV—-gay men, but also IV-drug users and women potentially infected by a male partner—feared a positive diagnosis would not stay confidential, Bradbury said.
The NYC Health Department had opened the city’s first anonymous HIV testing center in Chelsea in 1986, but the results weren’t always accurate, Bradbury said. “People didn’t trust it.”
And people worried that if they got an HIV test at a doctor’s office, their health insurer would find out and inform their employer, he said. What’s more, he added, “Doctors often didn’t know what to say to people who were HIV positive, and they didn’t know what safe sex was.”
Getting that information to GMHC’s clients was crucial to their health, Bradbury thought, no matter their HIV status. He wanted GMHC to offer a confidential test, where people could pay cash, find out their HIV/AIDS status, and get counseling.
“But it was not my persuasive arguments that got the testing center,” he said ruefully.
Instead, GMHC finally abandoned its anti-HIV testing stance in the mid-1990s, he said, because new cocktails of protease inhibitors had emerged that made HIV/AIDS a treatable disease. Even Kramer came around later, Bradbury added, stating publicly in 2016 that testing was the way to beat the epidemic.
The David Geffen Foundation agreed to donate $2.5 million to start a testing center in 1996, but only over 10 years. Bradbury said he asked Geffen for “more up front, and sooner,” and the film mogul agreed to accelerate the payments over three years.
Moving With the Disease
By the time the Testing Center opened the following year, Bradbury said, gay white men made up less than half of GMHC’s clients.
“By then, many white gay men were on the cocktail,” he said, but in the more marginalized communities GMHC served, most Black and Latino people, including women, were not—and they urgently needed confidential HIV testing and counseling.
“The wonderful thing about GMHC is we followed the disease,” he said. “Yes, it was founded by gay white men, but the disease also affected the Black community, IV drug users, and their wives or girlfriends.”
Bradbury said he was often asked why GMHC didn’t open satellite centers outside of Manhattan for greater accessibility to HIV-related social services. It was to preserve clients’ anonymity. “People wanted to come to GMHC, not somewhere in their neighborhood where everyone would know,” he explained, adding that GMHC provided free subway passes.
Bradbury supports making PrEP available to all, he said, because it’s still marginalized communities, such as transgender and gender non-conforming people of color, who are often hardest-hit by HIV.
GMHC is backing three bills currently before the New York Legislature to expand PrEP access. Respectively, they would require insurers to cover the cost of the HIV-prevention medications, bar insurers from requiring prior authorization for PrEP, and allow pharmacists to dispense limited quantities of PrEP without a prescription.
“Testing is as important today as it ever was, because it’s inextricably connected to prevention through PrEP,” Bradbury said. “We still need to reach people who are not aware of the risk, so they can get testing, treatment, and live a longer life.”