The AIDS epidemic is an event that most people understood happened. However, as a child of the 80’s, I’ve recently realized that I have a very limited understanding of what occurred in the decades before effective treatments were developed to combat it. Written by David France, How to Survive a Plague combines his deeply personal experience living through the AIDS crisis in its first 15 years, with the extremely well documented struggle of the community of People With Aids (PWAs) to get the medical, political, and social structures in the U.S. to acknowledge and respond to the epidemic they were facing.

How to Survive a Plague opens in the early 80’s, when a so-called new “gay cancer” was starting to be diagnosed among gay men, who had symptoms such as swollen lymph nodes and the previously extremely rare cancer called Kaposi’s Sarcoma (among a wide variety of other opportunistic infections). This heretofore unknown agent of disease spread quickly through the LGBT communities in cities like New York and San Francisco, and also to intravenous drug users, hemophiliacs, and to people who received blood transfusions from infected blood donors.

David France describes the terror and confusion that followed in an incredible way. By transitioning from the meta-narrative of the activists, medical community, and discoveries about the disease, to the incredibly personal revelations of individuals with AIDS and their loved ones, he evokes the fear, hope, determination and resignation of the community. He also clarifies just how violent bureaucracies and structures can be towards minority groups. The inhumaneness of the political and medical establishments (and the people within them) towards people with AIDS is incredibly chilling, even if it may have been largely unintentional. As well, the sheer uncertainty about what this new disease was, and how it worked to kill people, evokes our deepest human fear of the unknown. Though I can’t actually put myself in the shoes of someone who lived (or died) during that time, the pain, fear and struggle against AIDS (and also homophobia more generally, in fact) has never been more real to me after reading the words from someone who was so deeply enmeshed in it.

I was 10-11 when the first effective drugs were released that were shown to lower viral loads and truly extend the lives of PWAs. Though I have vague memories of the occasional cartoon or TV show referencing a character with HIV, or explaining safe sex or myths about the disease, my generation’s understanding comes from a “post-treatment” time, when people seldom die of AIDS. And yet the reality is that so many of the men and women who survived during the darkest times of the crisis are still alive, due to the incredible efforts detailed in this book. That this happened so recently – in my generation’s lifetime – is an incredible piece of history that needs to be remembered and shared by all of us, not just those who struggled through it. And the fact is, AIDS has not been cured – the struggle persists.

History is indeed little more than the register of the crimes, follies, and misfortunes of mankind -- Edward Gibbon

Don't read it over the holidays. It's too grim -- Former ACT UP member when I said I was going to read the book over the holidays

And yeah, it is grim. In fact, it is more than a whole thesaurus-entry full of words synonymous with grim. Everyone dies, basically. Needlessly, both in hindsight and also in actual at-the-time fact. It's almost like bearing witness, reading this book. I lost track of who some of the people were, but that hardly mattered. This document exists now, but it's hard to say what to do with it. It won't bring anyone back. It isn't to offer absolution. Just witness. Like a writing down of an oral history.

France weaves his own story of a gay man in 1970s/80s/90s New York throughout. It's done deftly, unlike me writing this paragraph, his insertions. Obviously, he didn't die, as all the others around him did.

Then it ends. With protease inhibitors abruptly. It feels like being dragged through trials of Greek-mythic proportions and then stop. The lack of resolution stings, but not as much as all the senseless deaths.

How to Survive a Plague by David France went on sale November 29, 2016.

I received a copy free from Netgalley in exchange for an honest review.