The Mechanisms of Change

9 FEBRUARY 2025

As a young person eager to positively impact the world, the mechanisms of change fascinate me. How does meaningful progress happen? What role can I play in catalyzing it–particularly in combating chronic diseases through lifestyle changes? These questions guided my final history essay last semester, in which I explored AIDS activism. 

AIDS, caused by the human immunodeficiency virus (HIV), was an overwhelming threat to public health and especially affected the gay community (for more on the science of AIDS, watch this short video). Despite the disease's rapid spread, governmental indifference and social stigma persisted, exacerbating the crisis. Two major activist organizations emerged in this period, adopting different strategies to fight for change. The Human Rights Campaign Fund (HRCF), worked within normative channels–lobbying Capitol hill, raising funds, and forming relationships with policymakers. In contrast, The AIDS Coalition to Unleash Power (ACT UP) emerged as a radical grassroots force, staging bold, confrontational protests that demanded attention. 

I began my research with a binary question: which of these groups successfully lead to meaningful change? Which strategy–working within established systems or challenging them outright–contributed more to fighting AIDS? Yet as I experienced crucial sources, including the 2012 documentary United in Anger: A History of Act up and Vic Basile’s book Bending Toward Justice, I realized that my questions were overly simplistic. 

Rather than competing forces, I learned that ACT UP and the HRCF complemented each other. The HRCF’s deliberate lobbying efforts built essential relationships and secured financial resources, paving the way for key legislative victories. Meanwhile, ACT UP’s fierce public demonstrations created awareness and galvanized public support, which in turn pressured policy makers to act. Without ACT UP’s visible outrage, many of the HRCF’s quieter successes may have remained elusive. And without the HRCF’s steady, behind-the-scenes work, ACT UP’s protests may have gone unanswered. 

This deeper understanding prompted me to reshape my original research question. Instead, I asked: How Did the Contrasting Approaches of ACT UP and the Human Rights Campaign Fund Contribute to the Success of AIDS Activism in the 1980s and 1990s? Exploring this synergy provided a richer, more nuanced view of the mechanisms behind activist success. 

Below, you can read my full essay, which provides detailed arguments and insights beyond this introduction. After reading, I invite you to share your thoughts in the comment section. What do you think of this post? Which strategies do you think are most effective for creating change? Where do you see nuance and collaboration where others might see rigid boundaries? And finally, what change are you eager to make in the world? 

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In the 1980s, the AIDS crisis tore through the LGBTQ+ community, claiming lives and exposing the devastating consequences of government inaction and societal indifference. Faced with this urgent crisis, activists responded in drastically different ways. The Human Rights Campaign Fund (HRCF) sought to work within the system, leveraging wealth and political connections to fund lobbying efforts and secure life-saving policies. In contrast, ACT UP disrupted the system through grassroots direct action, public protests, and provocative challenges to institutions perpetuating harm and inequality. While the Human Rights Campaign Fund (HRCF) and ACT UP employed contrasting approaches to AIDS activism in the 1980s and 1990s, both played essential roles in achieving significant progress in the fight against AIDS, together contributing to the transformative shift in AIDS advocacy and the visibility of the LGBTQ+ community.

The Human Rights Campaign Fund exemplified the power of working within the system, using wealth and political connections to amplify LGBTQ+ voices during the AIDS Crisis. Founded in 1980, the HRCF began as a small political action committee in Washington, D.C.  The organization aimed to raise money and elect candidates who supported LGBTQ+ rights, leveraging financial resources to build strong relationships with lawmakers. Like earlier LGBTQ+ groups such as the Mattachine Society, the HRCF cultivated a respectable image, often wearing suits to present a credible, law-abiding face to the political establishment. Their early efforts, including advocating for an amendment to the Equal Rights Amendment and lobbying for federal protections, proved that working within the system could yield tangible progress for LGBTQ+ rights, even in a hostile political climate.  By doing so, the HRCF laid the foundation for legislative victories that grassroots activism alone could not have achieved.

The emergence of the AIDS crisis in the early 1980s dramatically reshaped the trajectory of the Human Rights Campaign Fund (HRCF). In July 1981, The New York Times reported on a rare cancer affecting 41 gay men, marking the beginning of a public health crisis that would devastate the LGBTQ+ community.  By 1985, this condition, identified as Acquired Immunodeficiency Syndrome (AIDS), had claimed the lives of more than 40,000 Americans. In response to this growing crisis and the federal government's inaction—exemplified by President Ronald Reagan’s silence—the HRCF adapted its advocacy strategies. One of its most effective methods was hosting black tie dinners. These elegant events not only raised significant funds but also expanded the visibility of the LGBTQ+ community, and fostered a sense of unity and pride. Held in upscale venues, the dinners attracted wealthy donors and high-profile allies, such as then-President Bill Clinton, who helped elevate the events' visibility and mission.  In contrast to more hidden queer social spaces, like house parties or bars, the black tie dinners presented a new, respectable image of queerness. They challenged stereotypes and reframed public perceptions of LGBT individuals as sophisticated and worthy of acceptance.

These dinners marked a pivotal moment in LGBTQ+ advocacy, mobilizing a previously disengaged yet influential demographic: wealthy, white gay men. For many in this group, the AIDS crisis destroyed the insulation their privilege provided, confronting them with systemic discrimination and existential threats for the first time. This newfound fear and urgency drove them to take action, with the HRCF strategically harnessing their resources and influence to support pro-LGBTQ+ candidates and lobby for AIDS-related policies. The millions of dollars raised through these dinners allowed the HRCF to expand its financial and political reach, securing critical victories in the fight against AIDS. The events also helped create a narrative of respectability, presenting a refined image of queerness that resonated with mainstream audiences. However, the exclusivity of these dinners—fueled by expensive tickets and an emphasis on attracting affluent donors—risked alienating lower-income and marginalized LGBTQ+ individuals. In prioritizing the wealthy, these dinners sometimes sidelined the diversity within the broader LGBTQ+ community, underscoring the tension between leveraging privilege and maintaining inclusivity in the fight for equality. Despite these limitations, the dinners succeeded in their primary goals: raising substantial funds, building community, and enhancing LGBTQ+ visibility in mainstream society. Ultimately, they embodied the HRCF’s strategy of working within existing social and political systems to drive change.

While the black tie dinners were a key part of the HRCF’s fundraising efforts, the organization also took steps to engage a broader, more inclusive group through initiatives like the Speak Out campaign. Steve Endean and a small team of HRCF volunteers sought “every LGBTQ+ individual they could find” to sign people on to the program. For just $10, individuals authorized the HRCF to send three letters in their name to their congressional representative. In a time when long-distance phone calls were costly, only businesses could afford fax machines, and email did not exist, Speak Out uniquely enabled the HRCF to flood a congressional office with constituent fervor overnight.  In contrast to the black tie dinners, Speak Out was accessible to anyone the HRCF could reach. The mailing service provided the anonymity that some individuals genuinely required, as many were not 'out of the closet' due to pervasive homophobia in their professional and personal lives. While the black tie dinners catered to those who could afford both the cost of participation and the public visibility, the Speak Out campaign provided a platform for those who lacked the financial means or desire for public exposure to engaging in activism. Thus, Speak Out complemented the black tie dinners as an inclusive, anonymous platform for advocacy. 

Both initiatives, however, reveal the HRCF’s understanding of how to work within the system. The black tie dinners enabled the HRCF to build rapport with lawmakers in Washington by giving them substantial financial contributions and fostering relationships with politicians inclined to support causes backed by their donors. Speak Out drew lawmakers’ attention to pressing issues and reinforced the visibility of gay people. The HRCF recognized that politicians would not defend the rights and interests of constituent communities unless they knew those communities existed and were influential. The HRCF united queer constituents into a powerful political movement, one significant enough that politicians had to pay attention and cater to it, or risk facing personal repercussions in their campaigns.

After building its influence, the HRCF played a pivotal role in securing $47 million for the distribution of AZT, the first drug treatment for HIV. With the National Institutes of Health unable to fund the distribution, the HRCF worked with Senator Lowell Weicker to introduce an amendment in the Senate. Due to Weicker’s sly strategies, the amendment passed without debate, marking the first federal allocation of funds to address AIDS. This victory demonstrated the HRCF’s skill in leveraging political connections to secure vital resources when the government largely ignored the crisis. By strategically using financial power and political lobbying, the HRCF not only pushed for immediate medical support but also proved the effectiveness of working within the system to address urgent health needs. This success underlined the critical role of well-placed advocacy in overcoming systemic neglect.

The HRCF’s next significant contribution came with its involvement in the passage of the Federal AIDS Research, Information, and Care Act, which would dedicate unprecedented resources to combating AIDS. As the vote approached, the HRCF invested $66,000 in nationwide newspaper advertisements and used its Speak Out campaign to send approximately 2,500 letters to lawmakers daily. However, the bill faced a major setback when the homophobic Senator Jesse Helms proposed an amendment to prohibit the use of federal AIDS education funds for activities promoting homosexuality. Helms’s amendment passed, nullifying the funds that would have gone to AIDS education. In response, Senators Edward Kennedy and Orrin Hatch, in a rare bipartisan effort, introduced a counter-amendment, which required AIDS education programs to "stress the public health benefits of abstinence and a single monogamous relationship and the avoidance of illegal intravenous drug use." The Senate overwhelmingly approved this amendment, and on November 4, 1988, President Reagan signed the Federal AIDS Research, Information, and Care Act into law. This legislation led to the establishment of an office of AIDS research within the NIH and the hiring of 750 new employees by the CDC, NIH, and FDA to administer the latest programs. For the first time, state and local communities received funding for AIDS education, counseling, and testing.

Despite these advances, the bill was not without its drawbacks. The emphasis on abstinence and monogamy in the counter-amendment reflected conservative, heteronormative values that marginalized more inclusive and effective harm-reduction strategies. By framing AIDS education in such restrictive terms, the legislation limited its potential impact, failing to fully address the needs of high-risk groups such as LGBTQ+ individuals, intravenous drug users, and sex workers. Nonetheless, the bill marked a significant turning point. As Vic Basile noted, “With the allocation of $47 million for the distribution of AZT... and the passage of S. 1220, I felt as if we in the lesbian and gay community and HRCF had finally turned a corner.” The passage of the Federal AIDS Research, Information, and Care Act was a crucial step forward in the fight against AIDS, setting the stage for future victories in public health advocacy and support for affected communities.

The HRCF’s focus on civil rights and legal equality for LGBTQ+ people, while narrowing its agenda to specific, achievable goals, was both its strength and its limitation. As Jane Meek critiques, the HRCF’s strategy often served a narrow demographic of wealthy and white, reinforcing the boundaries of socially accepted identities without challenging the broader systems of power that sustain them. This approach, aimed at securing legislative victories through lobbying, was effective in making tangible progress, especially in securing rights for those who could benefit from a more formalized legal framework. However, critiques that the HRCF’s methods left out more radical cultural, social, and economic reasons are valid—particularly when considering how the organization’s strategy often sidelined marginalized voices within the queer community. Despite these criticisms, the HRCF’s targeted focus on lobbying and political engagement allowed it to succeed where broader, more inclusive approaches may have struggled. The reliance on politicians, as Meek notes, did compromise the strength of some policies in exchange for bipartisan support, but it also made those policies possible in the first place. In many ways, the HRCF’s approach was a necessary response to the rising political influence of the religious right, demonstrating the utility of working within established systems when direct action alone may not be enough. While the critique of the HRCF’s exclusivity is important, its focus on specific, measurable progress was crucial in the battle for LGBTQ+ rights during a time of political hostility.

Just as the HRCF was combating the AIDS crisis by working with the political system and adhering to societal norms, a more radical activist group was forming in New York City. On March 10, 1987, Larry Kramer, an artist and gay activist, gave a speech calling attention to the number of people who would die from AIDS and demanding that people “get angry and fight back.” Charged with anger and a desire for change, some audience members reconvened in the days after Kramer’s speech and started the AIDS Coalition to Unleash Power (ACT UP) to end the AIDS crisis through direct action rather than social service. 

ACT UP held one of its most significant protests on September 14th, 1989. Hundreds of ACT UP members protested at the New York Stock Exchange, insisting that traders sell their shares of Burroughs Wellcome, the manufacturer of AZT. Protestors brandished signs and chanted ACT UP’s trademark slogan: “Act up, fight back, fight AIDS!” Since the federal government had contributed money to AZT’s production in 1965, protesters found the cost unreasonable. As one protestor asserted, “These drug companies are profiteering on our lives and we cannot accept that anymore.” Just four days later, Burroughs Wellcome lowered the price of AZT by 20%. This protest and its immediate results demonstrate the power of direct action and grassroots organizing for tangible change. By targeting the New York Stock Exchange, ACT UP effectively leveraged economic concerns to influence corporate decision-making, showing how activists can impact business practices. This event underscores how street activism, when strategically planned and executed, is a powerful tool for marginalized groups to challenge institutional power and create meaningful change. It demonstrates how direct action can succeed where traditional advocacy channels may fail, particularly in urgent situations like the AIDS crisis. 

In one of its most audacious protests, ACT UP targeted Saint Patrick’s Cathedral on December 10th, 1989, challenging Cardinal John O'Connor's opposition to abortion and condom use for HIV prevention. Organized with WHAM!, a women's rights group, the protest exemplified ACT UP’s intersectional approach, blending feminist and LGBTQ+ activism, in contrast to the HRCF’s focus solely on gay and lesbian issues. Inside the cathedral, protesters distributed programs about AIDS and ACT UP’s mission, then staged a "die-in" during the homily to dramatize the consequences of inaction. ACT UP member Michael Petrelis shouted, “Stop killing us!” while Tom Keane declared, “Opposing safe-sex education is murder” while crumpling a eucharist wafer. The police intervened, removing over 100 protesters from the church. The protest’s chaotic and disruptive nature led to condemnation from political figures and even some AIDS organizations, who criticized ACT UP for being overly radical. Despite this, the protest drew significant international media attention, thrusting ACT UP and the AIDS crisis into the global spotlight.

Dubbed "Stop the Church," the protest highlighted ACT UP’s radical approach, sharply contrasting with the more institutional methods of organizations like the HRCF, which focused on behind-the-scenes lobbying with politicians and often avoided direct public confrontation. While the HRCF worked within political circles to secure legal victories, ACT UP took to the streets, using direct action to force immediate, visible conversations about the AIDS crisis. By targeting a major religious institution, ACT UP brought the intersection of religious influence and public health policy into the public eye, demonstrating the power of grassroots activism to generate media attention and shape public discourse. This protest led to tangible policy changes, including the distribution of condoms in public schools, and shifted the media’s portrayal of AIDS activism. Donna Binder, a photojournalist, reflected on the shift, noting, "Prior to 'Stop the Church,' media outlets showed only images of AIDS patients on their deathbeds. After the protest, they sought pictures of people with AIDS actively fighting for their lives." This shift in perception underscored the protest’s success in drawing urgent attention to the AIDS crisis and showcasing the strength and determination of the LGBTQ+ community in ways the HRCF’s more politically focused approach could not.

Beyond the immediate outcomes, the protest also served as a crucial emotional outlet for ACT UP members, channeling their collective anger and frustration into a forceful display of defiance. The protest was not only a strategic political act but also a way for activists to express their rage at governmental inaction and societal indifference. The anger displayed at Saint Patrick’s Cathedral was visceral and undeniable—it was both a release for the activists and a message to the world. ACT UP’s anger became an essential part of its identity, signaling to the public that the community would no longer silently endure the suffering imposed by systemic neglect. As one activist’s mother, previously seeing gay men as "weak and wimpy," remarked after the protest, she now saw them as "strong and angry." This emotional transformation mirrored the broader shift in public perception, showing that ACT UP’s anger was not just a personal catharsis but a necessary and powerful force in the fight for visibility, action, and justice.

In conclusion, both ACT UP and the HRCF played crucial yet contrasting roles in combating the AIDS crisis, each addressing the other's shortcomings. The HRCF’s institutional approach, centered on political lobbying and financial resources, secured important legislative victories, such as funding for AZT, but also alienated marginalized members of the LGBTQ+ community due to its appeal to wealthy donors. In contrast, ACT UP’s radical tactics, like the "Stop the Church" protest, provided an emotional outlet for anger and frustration, directly confronting societal and religious institutions while amplifying the urgency of the crisis. While the HRCF worked within the system, ACT UP’s confrontational approach created visibility and forced a public reckoning on the intersection of religion and public health. As Sarah Schulman notes, “Movements who try to force everyone into one analysis or one strategy have all failed,” underscoring that the strength of these movements lies in their ability to embrace diverse, complementary tactics. Though controversial, the HRCF’s quiet lobbying and ACT UP’s bold, angry actions ultimately proved vital in reshaping the public perception of AIDS, driving structural and social change, and compelling the world to confront the epidemic. This discussion illustrates not only the evolution of LGBTQ+ activism but also the broader lessons about the importance of both strategic alliance-building and unapologetic disruption in achieving meaningful change. 

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