reflecting in 2008 on aids in south africa during the final phase of the anti - apartheid 
 struggle and the transition to democracy , edwin cameron , aids activist and justice of the 
 constitutional court , observed that the transition period brought to the fore the intricate 
 relationships that existed between illnesses , ideologies and ( intimate ) identities , 
 resulting , in  the unavoidable politicisation of homosexuality. 
  indeed , as the oral testimonies in this article reveal , this politicisation of 
 homosexuality often affected both public and private spheres , and , for two health care 
 professionals on whose narratives this article focuses , their own sexual identity and 
 personal and professional relationships with ( gay ) men dying of aids mediated the urgency of 
 responding to aids . 
  in july 1983 an article by five medical professionals reporting on the first officially 
 documented aids cases in south africa appeared in the south african medical 
 journal . 
  while the  two cases were not named in the journal article the initial responses by the  general public 
 to the first documented cases were primarily characterised by fear and stigma and reflected 
 prejudice , homophobia and  moral panic that were deeply rooted in the dominant conservative 
 morality that pervaded south africa in the 1980s . white , flight stewards , not 
 as two people who had died and would be mourned . ralph kretzen died on 26 august 1982 and pieter danil ( charles ) steyn died on 1 
 january 1983 , and we know very little about their personal histories . we do however know that the association of the new syndrome with an undefined idea of homosexuality replicated the initial link between  homosexuality and aids that had been 
 made by the centers for disease control in atlanta , usa ( cdc ) in june 1981 . white 
 homosexual men by elites  both medical professionals guiding and directing early aids 
 research and advising government departments and ministers ; and people or organisations in 
 positions of political power including government health departments and ministers , mps and 
 political parties  shaped and influenced responses , research , and narratives about aids in 
 these and other spheres . the resultant moral outrage expressed in parliament , from pulpits and in 
 conservative media provoked by this initial association did not allow for reflective 
 discussion about sex and sexuality , but rather positioned  homosexuality and homosexuals 
 negatively in broader public spheres and , in so doing , politicised homosexuality . moreover , authors of the hegemonic scientific narratives whether in medical journals , 
 health care organisations or parliament often used the term homosexuality only to refer to 
 undefined sexual contact between  white men in a narrative which was preoccupied with an 
 imagined middle - class , white , male , sexuality that was the primary referent against which 
 normative and non - normative behaviours were judged . 
  drawing on narratives about aids primarily from the uk and the usa , influential 
 medical practitioners and scientists , and politicians responsible for addressing aids in 
 south africa focused attention on this understanding of homosexuality and in doing so 
 rendered invisible heterosexuals , lesbians , bisexuals , transgendered and intersexed people , 
 and linked male homosexuality only to whiteness . in the 1980s , being gay in south africa was a process mediated by apartheid legislation and 
 questions of morality , race , sex , gender and class amplified by the socio - political and 
 economic turmoil of the time . the oppressive , conservative , moral climate of south africa did not allow sexuality 
 organisations or lgbti communities to flourish , especially not in a context where ( male ) 
 homosexuality  or more specifically , sodomy  was illegal . 
  while gay organisations and communities in the usa and uk had fought for , and built 
 on , social changes in the 1960s and 1970s , in south africa apartheid s effect on sexuality 
 politics meant that corresponding socio - political gains had not been made . despite this , 
 some gay activists maintained international contacts with gay organisations and aids 
 education organisations , resulting in a flow of information and exchange of ideas between 
 south africa and countries with more established and politically active gay communities . gay groups in south africa were not necessarily concerned with addressing sexism , racism , 
 homophobia or sexuality politics . agendas ranged from providing safe social spaces to gather 
 and talk , directing legal challenges to homophobic legislation and laws that discriminated 
 against people because of their hiv status , to aligning the struggle for sexuality rights 
 within broader anti - apartheid and international human rights campaigns . as mark gevisser and edwin cameron noted in one of the earliest and most influential works on the histories of 
 sexualities in south africa the two factors that exemplify  homosexual experiences in south 
 africa are  the history of division and resistance and  the demographic divergence our 
 country reflects. 
  they note that  from the  developed world  , we inherit notions of sexual freedom and 
 gay subculture ; from the  developing world  we gain the imperatives of struggle , resistance , 
 and social transformation. 
  importantly , they add ,  there is no single , essential what 
 has passed for  the gay experience  has often been that of white , middle - class urban 
 men. 
  at the outset it was predominantly communities of urban , middle - class , white men  
 with multiple gay identities  who came together to organise around aids and it is this this article is drawn from a larger thesis project which explored how narratives about aids 
 were constructed by elites in medico - scientific and political communities , and examined 
 practical responses to aids by governments , the african national congress ( anc ) liberation 
 movement in exile and progressive health movements . the thesis revealed the complex relationships between these communities , tracked the 
 changing hegemonic aids narratives , and revealed the constructions of morality , it also showed how the relationships and narratives 
 shaped and influenced practical responses to aids . most of the sources used for this project 
 were written sources which occasionally provided glimpses of the effects of narratives and 
 practice on personal experiences , but none provided insights into the specific experiences 
 of gay health care professionals . the relationships ( nationally and internationally ) between 
 medico - scientific and political elites could be drawn out by combining written and oral 
 sources , but the personal accounts of people at the nexus of the polemic and politics that 
 combined to influence practical responses were hidden . while accessible published work and archived sources provide insights into the experiences 
 of progressive figures and sexuality activists , the stories of gay health care professionals 
 living and working in a predominantly homophobic society and medical community at the start 
 of an epidemic linked explicitly to  white gay men while important , were not readily 
 available . of the twenty oral interviews undertaken with medical professionals , political 
 figures , activists and academics for the thesis , only two were with health care 
 professionals who had openly declared their sexual orientation during the time period under 
 discussion . their stories offered unique perspectives and a way to record the effects of 
 politics and polemics on people s lived experiences . the article uses oral interviews to examine the experiences of two gay health care 
 professionals addressing aids during the early years of the epidemic . it follows the example 
 set by gerald oppenheimer and ronald bayer of recording the experiences of physicians and 
 nurses in their book in shattered dreams : an oral history of the south african aids 
 epidemic . their book incorporates interviews with gay doctors , including dennis 
 sifris and steve miller , and , in recording their oral histories , begins to address how some 
 gay health care professionals experienced the epidemic . this article expands on the oral testimony of sifris that appears in 
 shattered dreams and contributes the oral testimony of pierre 
 brouard . the face - to - face interviews with sifris and brouard were carried out in single sessions 
 lasting from one and a half to two hours . they were recorded in 2008 using a digital voice 
 recorder and verbal permission was sought and obtained from interviewees to record the 
 interviews . while specific questions relevant to the professional experiences of each 
 interviewee were devised , all interviews were predominantly open - ended and unstructured . 
 during the interview notes were taken by the author , and the interviews were later 
 transcribed . the purpose of the interviews and the nature of the research were also 
 explained to each interviewee and they confirmed the accuracy and representation of their 
 statements in the original chapter from which this article is drawn . sifris is a medical doctor who worked with one of the first south african medical 
 researchers investigating aids , ruben sher , and helped to establish the aids clinic at the 
 large public and academic johannesburg general hospital ( also widely known as joburg gen ) 
 and has been involved in aids education campaigns since the early 1980s . 
  a  clinical psychologist , brouard was involved in some of the earliest counselling 
 and support initiatives for people who were hiv - positive at a variety of venues , including 
 the clinic at joburg gen , at atic ( the first aids training and information centre ) that 
 opened at the south african institute for medical research ( saimr ) in 1987 , and at the city 
 of johannesburg s esselen street sexually transmitted infection ( sti ) clinic in 
 hillbrow . both sifris and brouard moved between and through the spheres of medical science , 
 activism and sexual identity while attempting to address aids . while sifris and brouard are 
 both professional , white , middle - class , urban , gay men , whose paths overlapped and who 
 shared some similarities in their experiences of the early days of the aids epidemic , their 
 professions , personalities and individual contexts resulted in different experiences . these early experiences laid the foundations for two men who , now both in their 
 fifties , have spent almost three decades of their professional lives involved in aids health 
 care and education . their personal reflections provide vignettes that contribute to understanding how 
 narratives about , and responses to aids ( and sexual orientation ) , affected individuals . their stories provide insight into personal experiences of addressing aids in the early 
 years of the epidemic when researchers and decision - makers were constructing a hegemonic 
 aids narrative that was fundamentally conservative and homophobic . their stories are 
 micro - narratives that act as a counterpoint to the meta - narratives about aids featured 
 elsewhere and act as a reminder of the emotional and psychological realities of an epidemic 
 that continues to take lives , thus contrasting the  unemotional writing about aids in 
 medical journals , the politically charged language in parliament or the official 
 correspondence of political organisations . the article presents first sifris and then brouard s recollections of the early years of 
 the epidemic and some of their reflections on sexuality , health care provision and aids 
 after almost three decades as health care practitioners . sifris and sher began working together in the late 1970s after sher had heard that sifris 
 had  a large gay practice and asked if he would collect serum samples for a hepatitis b 
 study . after the first official aids death in south africa in 1982 they met to discuss 
 further collaboration . sher was based at the saimr and sifris had his own practice in the 
 city centre . while these collaborations would result in a long - term professional 
 relationship , sifris s experience as a physician involved in aids research was mediated by 
 how colleagues and government officials responded to his sexual orientation as a gay man . soon after the first recognised aids deaths sifris sought to address aids among  the gay 
 community and contacted other gay doctors ( an anaesthetist , a psychiatrist , and a 
 neurosurgeon ) to discuss what could be done . he recalled that , as a starting point in 1983 , they  put the word out in the gay 
 community that there was this disease which nobody really knew about , while calling for 
 volunteers to give blood samples to be sent to sher at the saimr . sher and sifris compiled a questionnaire that followed research in the usa and uk 
 and included questions about the number of sexual partners volunteers had , their medical 
 history and current state of health , and their use of recreational drugs . 
  to facilitate the work sifris extended his practice hours to include saturday 
 mornings : word got out and we actually got about 700800 people coming to my office over a period of 
 about four or five months and we pulled the bloods and we did nt quite know what we were 
 looking for . we did a full blood count , we did an std [ sexually transmitted disease ] profile 
 and we stored bloods to see if there was anything we could find  . sifris kept a list of names that linked volunteers  the majority of whom came from south 
 africa but also from countries such as lesotho , swaziland , malawi , zambia and zaire  to 
 their samples , but there was little that could be done medically to assist the increasing 
 number of people who in the mid-1980s started to become sick and die . the lack of an 
 effective medical response did not necessarily make the medical community in johannesburg 
 more interested in learning about other , non - medical , engagements and responses , however , as 
 is evident from sifris s account of a visit to johannesburg by glen margo in 1985 . margo , who was originally from south africa , was involved in aids education in san 
 francisco . he contacted the gay association of south africa ( gasa ) as he wanted to deliver 
 talks about aids in johannesburg . sifris , a gasa member , agreed to arrange the lectures for 
 margo and organised one at the department of medicine at joburg gen . sifris recalls : there 
 were all these cardiologists and respiratory physicians and this hippy san francisco guy 
 came along with handmade sandals and ringlets in his hair and told them about this funny 
 [ sic ] disease that was affecting gay men that they should all be aware of 
  and he was almost laughed off as a joke . it was a wee bit embarrassing but that was the 
 context of the medical community . it is unsurprising that medical elites in johannesburg did not pay serious attention to a 
  hippy social worker talking about something that apparently only affected gays. however , 
 as sifris was to discover , even being a medical doctor defined as white and 
 male , did not guarantee an attentive audience if one did not also despite the apparent lack of interest , sifris and sher persuaded hospital authorities to 
 allow them to establish an aids clinic at joburg gen in 1983 . by 1985 sifris was managing 
 the daily running of the clinic and sher moved between the clinic and the saimr . they 
 decided to bring specialists from various fields , including respiratory illnesses and 
 dermatology , into the clinic . despite the dominant medical and popular association of aids 
 with gay men , sifris recalls that the first person they saw as an outpatient was an 
 hiv - positive ( then htlv - iii positive ) womyn : she came in and we  sat there , eight of us 
 doctors  this poor woman came in , i still remember her sitting there and i think she was 
 intimidated by all these doctors sitting there in their white coats . 
  during the mid-1980s there was an increase in the number of patients attending the clinic 
 and being admitted to the hospital with aids - related complex . the 
 guys we had seen two or three years ago , who were friends of mine . a lot of them were saa 
 ( south african airways ) people who were now getting sick and dying with this disease , and 
 this was the time in the hospital where they were doing barrier nursing. 
  in 1985 the advisory group on aids ( aga ) was established by the department of health to 
 advise the conservative and ostensibly christian government led by the nationalist party on 
 aids policy and sher was invited to become a member . however , a medical background , an 
 interest in aids , and experience researching and monitoring the epidemic did not guarantee 
 membership of the group , as sifris discovered . high - risk group and   if we have a gay man on the ( aga ) we 
 have to have a prostitute , we have to have a haitian , and we have to have a black  . this decision made sifris determined to  just go ahead and do my own thing so he called on 
 medical professionals such as steve miller , des martin and clive evian ( all of whom would 
 become key aids researchers ) to work with him at joburg gen ; and , in conjunction with gasa , 
 established an alternative aids group . sifris and other   concerned professionals and 
 volunteers formed the aids action group in 1985 , with the intention of providing 
  psychological , social and concrete support services for people with aids and the 
 aids - related complex. 
  the group shared information about aids with interested parties and undertook 
 education campaigns amongst sections of johannesburg s gay community . on trips to the usa and uk , sifris gathered literature  and came home with bundles of 
 it. 
  the aids action group decided to distribute information leaflets and safe - sex cards 
 in gay clubs in johannesburg and approached club owners for support . in one club the group 
 set up  a little ( information ) thing outside and people walked past and we said ,  hey , we 
 are giving out safe sex cards  , and everyone kept away from us!. 
  on one occasion sifris asked if the music in the club could be stopped at midnight 
 so that he could make an announcement :  so they stopped the music and i came out onto the 
 dance floor with a microphone and i said , listen this is not a police raid or anything , 
 just relax , nothing is happening here , i just want to make everybody aware that there is a 
 problem called htlv - iii which is affecting gays in america and all over the world  and 
 everyone just moved away from me . i stood there in the middle of the dance floor trying to 
 say ,  now listen people it is up to you to volunteer , to create awareness , to get the people 
 aware , to give out pamphlets and please we have a desk in front , please come and sign  . there was no interest , just apathy  like we were ruining the 
 party . the pre - emptive declaration in sifris s statement that his announcement was not part of a 
 police raid speaks to the constant stress , suspicion and fear of arrest that was associated 
 with being gay in south africa . the majority of people in south africa faced the constant 
 threat of police and military violence by virtue of being declared black in the apartheid 
 state , and whiteness usually afforded privilege and protection to people declared white gay men maintained significant privilege in most socio - economic and 
 political spheres , they did not maintain sufficient privilege to remain exempt from raids 
 because of their sexual orientation . black gay men maintained some privileges 
 by virtue of being male in a patriarchal system , but faced persecution for being both 
  black and gay . the unwillingness of people to listen or respond to a potential health concern mirrors 
 responses in most communities when faced with frightening news . it is not possible to determine how effective these interventions ultimately were , 
 nor how much impact the distributed literature may have had on awareness raising . nonetheless , it is significant that at a time when official responses to aids failed to 
 cater for a group of people identified and constructed as high - risk , alternative , 
 non - official efforts were made to raise awareness and provide support . the group decided to focus their energy on talks , engaging with the press and fundraising 
 for aids - related work . sifris and sher were already giving talks for audiences ranging from 
 medical professionals to staff and students at schools , and to  a group of jewish single 
 people over the age of 40. sifris gave talks to gay groups around the country and spoke at 
 the official opening of anti - apartheid activist simon nkoli s township aids project ( tap ) in 
 soweto in 1990 . sifris both received calls from journalists seeking his expert medical opinion , and 
 challenged journalists and editors about homophobic or inaccurate content in articles . he 
 felt frustrated that many journalists were more concerned with writing sensationalist 
 articles than with conveying educational information . these challenges extended to his 
 engagements with the editor of exit the longest running gay magazine in 
 south africa . exit ( originally known as link / skakel ) 
 started in the early 1980s as gasa s newsletter . it was renamed exit in 
 1985 and published its 200th edition in 2006 when it cast a reflective eye on some aspects 
 of its reporting on aids . sifris criticised moolman for running a sensationalist article about a person 
 apparently getting aids from their dentist , rather than featuring comprehensive aids 
 education information . botha reflected on the early years of exit : during the 1980s a new 
  gay disease was discovered in america and eventually found its way here . although we 
 started publishing safe sex guides and lists of symptoms , very little was known about this 
 mysterious killer affecting  at that stage  mostly gay men . i am still haunted by the front - page headline that said something to 
 the effect  aids [ sic ] scare overrated  . an exclusive  black - tie event and art auction launched the aids action group s fundraising 
 initiative . the event 
 raised close to r10,000 for what was referred to as the  aids action fund. another shaft 8 included information and education stalls and provided an 
 opportunity to remember those who had died . i 
 bought those  jewish yahrzeit candles , and i laid out a table with one 
 candle for each person who had died of aids . the shaft 8 event raised a significant amount of money and brought  all the gay communities 
 together  a gay christian community , a support group called outreach , a gay motorcycle 
 group , and  gay lesbians. while aids may have connected these communities , it hardly united 
 them . sifris noted that there was  all sorts of internal politics  and stress in the 
 organisation . black gays or lesbians and often a lack of 
 gender sensitivity or awareness of racial prejudice . aids may have created spaces for 
 collaboration and co - operation , but these spaces were not necessarily all - inclusive or 
 self - reflexive ; and addressing aids amongst a certain group of gay men who experienced 
 discrimination did not amount to challenging the economic , social or racial position of that 
 group of men , nor other forms of discrimination . in order to increase fundraising opportunities and more effectively manage funds , the group 
 needed an official fundraising number . it prepared a proposal outlining its plans to print pamphlets and undertake a 
 countrywide outreach programme and had it endorsed by medical professionals , a professional 
 in the finance sector , and people in the marketing and advertising sectors . the group 
 presented the proposal to a representative from the department of health and asked for a 
 grant of r20,000 . however , because the organisations associated with the project were 
 sexuality organisations , the fundraising number and the grant request were denied . lombard apparently listened carefully to the 
 presentation and then said ,  you know , aids is not a problem in this country , tb is a 
 problem in the country . besides which homosexuality is illegal , and we do nt have 
 homosexuals , so we do nt have aids. the department of health s rejection of the funding request meant the group was unable to 
 initiate extensive aids education programmes based on those of the san francisco aids 
 foundation , the gay men s health crisis , london lighthouse , and the terence higgins trust , 
 whose pamphlets and programmes were the template for their own local campaigns . 
  thus , the content , politics and practice of aids education programmes developed by , 
 and for , male gay communities in the usa and uk , shaped and influenced responses amongst 
 some sectors of the male gay community in south africa . for sifris the frustration at not 
 being able to implement  ready - made education programmes that could save lives was 
 compounded by the denial of the very existence of homosexual men . invisible in official apartheid discourse . had the grant had been successful , there is no guarantee that imported education campaigns 
 would have been appropriate or effective in the south african context . however , in the 
 absence of official responses or help for gay communities , they would at least have 
 bolstered existing education efforts by gay organisations to prevent new infections . access to medical scientists and research organisations in the uk and usa shaped 
 both sifris s and sher s professional engagement with aids , and contact with gay activists 
 in these countries deeply influenced sifris s personal and political outlook . sifris remembered going with sher to a research laboratory in bethesda , maryland , and being 
  drag[ged ] into the halls of the walter reed hospital in washington or to some top - level 
 research conference. 
  in 1985 sifris went on ward rounds at the san francisco general hospital and at the 
 aids unit in london , experiences that  really opened ( his ) eyes to the realities of the 
 epidemic , the strategies being employed to address aids , and the remarkable solidarity and 
 politicisation occurring around aids . sifris had his most profound experiences at the points of intersection between personal , 
 professional and political spheres . in the mid-1980s he attended an aids conference in 
 washington where members of the aids coalition to unleash power ( act - up ) protested over the 
 lack of action in addressing aids . the conference changed sifris s understanding of how 
 people could organise politically to challenge medical and discursive responses to aids : 
  larry kramer was there from act - up and he was wearing a concentration camp uniform . at the 
 time , and i thought this was very strange , he would shout and scream and carry on . they had 
 a scientific session , and they had one or two sessions of people with aids and it was very 
 funny because people stood up and said , i am so and so , and i have got hiv  and everybody 
 applauded , and everybody clapped for support i remember 
 that to this day and i really learnt a hell of a lot [ particularly ] that there was a lot of 
 mobilisation . 
  during trips to london , new york and san francisco , sifris took part in aids memorials that 
 made a lasting impression on him : i was in castro street and they had it at castro s station 
 there , a candlelight memorial for rock hudson [ it was ] very moving . they unfurled the quilt and there was nt a 
 dry eye in the house , everybody was crying  . contacts with gay organisations and ( gay ) doctors working on aids in the usa and uk were 
 important in providing models of engagement , education , commemoration and grieving . for 
 sifris and others like miller , who participated in conferences and marches overseas , these 
 were spaces that demonstrated the potential for public protest , and subsequently influenced 
 education and mobilisation efforts among sectors of the gay community in south africa . 
  on a trip to san francisco a group called inspired by the experience of seeing doctors organise around 
 political issues relating to the realisation of rights , sifris decided to start a gay 
 doctors group in johannesburg that numbered about twenty clinicians and met monthly at the 
 hiv clinic . brought together by an interest in hiv , the primary aim was  just to keep 
 everybody up to date with hiv news , but  eventually it just sort of fell to pieces because 
 nobody was interested in coming anymore because there was not much more we could do. 
  it was only in the late 1990s that sifris , des martin and others decided to 
 establish a new association , the southern african hiv clinicians association . this was open 
 to all clinicians involved in hiv work and included a number of gay doctors . martin was 
 appointed the first chair of the organisation and the first meetings were held at the 
 national institute of virology . from small beginnings the organisation continued to grow and 
 recently claimed to be  the largest professional hiv interest group in the world , with over 
 12,500 members. 
  the mid-1980s were particularly turbulent times in south africa , both for anti - apartheid 
 and sexuality activists . in 1986 gasa collapsed , but its demise , gevisser notes , resulted in 
  two new forms of gay political activity. one  found the notion of single - issue gay 
 politics to be untenable in south africa and sought to align sexuality struggles with 
 broader human rights and anti - apartheid struggles ; the second  insisted on fighting 
 specifically for the reform of laws that discriminated against homosexuals. 
  in 1985 president p.w . interracial ( hetero)sex which had been made 
 illegal by the immorality act , 1927 ( amended in 1950 ) . the immorality act also covered other 
  sexual offences such as prostitution and sodomy between men and botha tasked an ad hoc 
 committee with investigating these sexual offences , including homosexuality . this committee 
 proposed : a strengthening of legal prohibitions against homosexuals ; that greater effort 
 should be made to determine how to appropriately  rehabilitate or punish homosexuals ; and 
 that a strategy should be formulated to express society s the collapse of gasa and the suggested law reforms had a direct impact on the aids action 
 group and on organisations that had come together to raise money for aids programmes . key 
 gay activists established a national law reform fund ( nlrf ) to fund challenges to the 
 proposed legislation . the organisers of shaft 8 were asked to consider reallocating the 
 money they had raised to support the nlrf . numerous meetings ensued and sifris recalls that 
  it was decided among the committee that the law reform fund was now more of an emergency 
 than aids , so all the money was given over to the law reform committee . we thought we could 
 always just raise more money for aids. 
  determining which threat  aids or the further criminalisation of homosexuality was the more pressing could not have been an easy task , but the historical coincidence of 
 the two issues coming into the spotlight at the same time detracted from plans to address 
 aids . as it turned out , the investigations into homosexuality and law reform never got 
 underway and the nlrf was transformed into a charitable trust . the late 1980s were also difficult times for sifris and others working at the hiv clinic at 
 joburg gen , primarily because of the inherent homophobia and stigma associated with aids . although sifris and sher had convinced hospital authorities to provide space for the hiv 
 clinic it was not easily accessible to clients or visible , and both the name of the clinic , 
 and who attended it , became contentious points . immune disorders clinic but sifris was adamant 
 that after the identification and naming of the hi virus it was important for the clinic to 
 be known as  the hiv clinic to reduce the secrecy and fear associated with hiv . after 
 several years of running the clinic on an honorary basis , sifris was formally employed as 
 its director in 1985 . 
  despite vocal opposition , one of the first things sifris did as director was to 
 rename the clinic  the hiv clinic. it retained that name until sifris s resignation in 
 1990 , when it was renamed  the immunity clinic. 
  the hegemonic aids narrative of the time constructed gay men with aids as guilty 
 offenders who got aids because of their sexual orientation and  deviant lifestyles. 
  conversely , haemophiliacs infected through contaminated blood products were 
 constructed as innocent victims. so strong was the stigma and homophobia that a separate 
 clinic was established for haemophiliacs and others . sifris recalled  the haemophiliacs had 
 their own clinic because they did nt want to come to the gay clinic they did nt want to 
 come to the hiv clinic , so they had their own clinic  . we never had anything to do with 
 them  they did nt want anything to do with us because we were gays . things came to a head for sifris and miller because of a devastating interplay between 
 discrimination , drug pricing and public health care provision . in 1986 one of the first 
 antiretroviral ( arv ) drugs , azido - thymidine ( azt ) also known as zidovudine , came onto the 
 market in the usa . as the first significant medical intervention for aids it was a 
 breakthrough , but it was staggeringly expensive , costing approximately $ 10,000 a year in the 
 us at the time . 
  the number of south africans who could afford it when it was first distributed to 
 the country in 1987 was minimal . while paying for the drug was completely impossible for 
 most patients attending the hiv clinic , it did at least provide hope because it prolonged 
 the life of aids patients . the hospital eventually purchased azt but only wanted to 
 prescribe it to people with haemophilia . the hospital said we will give azt 
 to the haemophiliacs but we wo nt give it to the gay people because it is their own fault 
 and haemophiliacs are innocent victims. 
  livid at this blatant discrimination , sifris contacted reporters and informed them of the 
 hospital s policy , resulting in the story being featured in newspapers . shortly afterwards the superintendent of the hospital informed sifris that they had 
 been called to a meeting with the secretary of health in pretoria . at this meeting sifris was reminded that as a member of staff of a public hospital he was not allowed to make 
 statements to the media about hospital policy , and was duly admonished by the health 
 secretary . i do nt 
 want anything more to do with the hospital. 
  after sifris s resignation miller took over as head of the clinic , but was not in 
 that position for long as he was told to leave by hospital authorities after supporting a 
 patient s legal claim against the hospital . a final example of the ongoing frustrations experienced by miller and sifris related again 
 to the aga . miller , like sifris , had been excluded from joining the group because of his 
 sexual orientation and his designation as a member of a high - risk group. nonetheless 
 sifris made a second attempt to join the group when it decided to expand its membership . frustrated that the government had  sewed together a bunch of old fogies who did nt do 
 anything , sifris thought that membership of the group might afford him the chance to 
 facilitate change or action . in his application sifris argued that as head of the largest 
 hiv clinic in the country he had considerable experience in addressing aids , which was 
 augmented by the lectures he had given , the travelling he had done both regionally and 
 internationally in connection with aids work , and the conferences he had attended . own coffee cup in case you are worried that a gay man is 
 going to infect you. 
  sifris s application was rejected , and the group appointed someone who  had never 
 seen an hiv patient in his life. 
  while sifris has never explicitly commented in interviews on the racial dynamics within 
 gasa or any of the aids - related organisations that he was involved in , he did discuss the 
 problems he and sher faced at the clinic in the late 1980s  getting black doctors 
 involved. 
  they organised a world aids day event and wanted to invite black doctors to attend 
 but were unsuccessful :  we searched and searched and searched and searched and could nt find 
 any black doctors to come out. they approached a prominent  black doctor in soweto with known links to the anc but were 
 turned down . black doctors  were nt interested because it was not a 
  black problem , it was a gay disease . it was a gay disease and nobody worried about the 
 gays. 
  because aids was not being identified among black patients , and places like the 
 hiv clinic were either not legally integrated or welcoming of  black patients , it was not 
 seen as important amongst black doctors may not have wanted to participate in the events , not 
 least of which were the other health concerns exacerbated by apartheid which at the time 
 were regarded as being more pressing . in the early days of the epidemic , sifris recounts , it was difficult coping with the 
 deaths , government and community inaction , and general homophobia . burnout. added to the stresses and strains of battling 
 government and hospital officials , he experienced a personal loss that caused him to 
 withdraw from professional and public spheres . sifris met an hiv - positive man at an aids 
 conference in stockholm and the two fell in love and lived together for five years . as his 
 partner s health began deteriorating , the couple travelled to sweden for treatment twice a 
 year . after his partner suffered a mini - stroke that left him paralysed , the couple decided 
 that he needed to return to sweden to see his doctors and be with his family . as he recalled 
 some twenty years later , while they were in transit at brussels airport , sifris s partner 
 suffered a major stroke and a massive brain haemorrhage :   as we were getting onto the plane 
 he collapsed and died so , i sort of withdrew at that time a little bit , but ( since then ) 
 i ve slowly gotten back. 
  in 2013 , sifris has semi - retired but continues to deliver lectures on aids , acts as a 
 medical consultant to a disease management company , and contributes health information to 
 exit and other media fora . having seen so many people die of aids over the course of three decades , sifris 
 expressed disappointment in the interview that successive post-1994 democratically - elected 
 south african governments have put up so many barriers to procuring and distributing 
 life - saving drugs . his recollections reveal the inherent and blatant homophobia that gay men experienced , 
 regardless of their  race or class . frustration at official inaction around aids and the 
 reality of friends , colleagues and lovers dying , provided the impetus for sifris and others 
 to mobilise in the early 1980s , soon after the seriousness of the epidemic was becoming 
 apparent to them . the importance of international connections and experiences is evident in 
 sifris s personal politicisation around aids . as a doctor involved in the first hiv clinic 
 in south africa , his professional status and resources allowed him to travel to 
 international conferences and connect with other doctors and with gay organisations 
 addressing aids , and to bring important information and ideas back to sectors of the gay 
 community in south africa . while sifris and brouard were both involved in addressing aids as health care 
 practitioners , they occupied different positions in the health care facilities they worked 
 in , and their experiences correspond and contrast each other , as will be shown below . pierre brouard is a clinical psychologist and currently the deputy director of the centre 
 for the study of aids at the university of pretoria . brouard s recollections on the early 
 days of the aids epidemic are noticeable for their reflexive and contemplative nature . his 
 discussions about the epidemic , and his involvement in various counselling and support 
 positions , are imbued with a critical awareness of the broader socio - political landscape of 
 south africa during the 1980s and early 1990s . brouard came out in the late 1970s and believes that coming out before aids was  on the 
 scene shaped his sexual identity in a different way to people who were coming out during 
 the epidemic and helped form his perspective on the fears and considerations that framed 
 peoples sexual lives . reflecting on the late 1970s , brouard view was that one of the key issues that concerned 
 many (  white ) gay men at the time was that homosexuality was illegal . under the immorality 
 act and subsequent amendments , there was the continued threat of being arrested , harassed , 
 hounded , shamed or imprisoned . legal concerns aside , from a personal physical health 
 perspective the most immediate health concerns were stis such as herpes , syphilis or 
 gonorrhoea , all of which were treatable . while fear of the law remained , in the early 1980s 
 physical health priorities were to be radically altered as the first murmurings  that 
 something was amiss started to surface with news often coming from  middle class , white , 
 gay men who travelled internationally , and from people working in the airline 
 industry . new disease that was framed entirely as a 
 gay disease , complete with the acronym grid ( gay - related immune deficiency ) . central to both brouard s and sifris s narratives , is the importance of international 
 travel and networks for transmitting information about aids . brouard remembers that people 
 who travelled internationally  brought back newspapers , pamphlets and magazines  or knew or 
 corresponded with people overseas. 
  in the early 1980s brouard and his partner at the time noticed that one of their 
 friends , who had moved to the uk but who regularly visited south africa , was getting 
 increasingly ill . they speculated as to whether their friend had aids , but he never told 
 them and they never asked . the friend subsequently died , ensuring that from early on in the 
 epidemic , brouard was acquainted with the reality of aids - related deaths . brouard saw that aids - related illness and death mobilised people both as individuals and as 
 members of organisations :  those early responses were really located in the gay community . people  mobilised around friends , tried to get support groups going  tried to understand the 
 treatment options available , and set up informal networks . the latter was 
 the director of gasa-6010 , was hiv - positive and died of aids - related illnesses . brouard commented on different political outlooks between organisations :  gasa was 
  the main organisation for more middle - class , mainstream , men and women and was 
 apolitical. 
  he recalls that gay organisations that were more  left - orientated appeared to be 
 more active in cape town , than in johannesburg . regardless of geographic location however , brouard s retrospective sense of the situation 
 was that middle of the road , white , gay men were really just trying to hold it all together 
 in the absence of really much available [ sic]. 
  reflecting on the arrival of a serious new health concern brouard suggested that 
 aside from the emotional impact of the deaths of friends , family members , lovers and 
 partners , the association of aids with homosexuality required people to address their 
 sexuality without internalising aids as something that was inherently related to being gay . 
 at the same time as challenging ideas that being gay was  wrong , evil or sick , gay men were 
 faced with a health crisis that was portrayed as being intrinsically linked to what was 
 apparently gay sexuality. gay men thus had to address both internalised homophobia and 
 societal perceptions of homosexuality being evil or sick , in the context of a new fatal 
 disease that many medical professionals , politicians , media and religious groups directly 
 linked to sexuality . the ramifications of aids affected both individual and community identity formation , 
 as brouard recalls :  just to try and retain a sense of healthy sexuality and healthy 
 identities when aids spoils your identity and spoils your sexuality  that was a real 
 challenge of those times . i remember having feelings like  the community is 
 self - destructing , there s just so much stuff going on , and people just are nt caring for 
 themselves or each other . it was an incredibly distressing and painful time to live through and people were just 
 getting sick and  aids  struck the old and the young , and the beautiful and the ugly , the 
 fat and the thin  it was a great equaliser  . my sense of the time , perhaps it was a 
 psychological sense , was that some people who were the beautiful glittering stars of the gay 
 firmament , were deeply shamed and humiliated and distressed about being hiv positive because 
 it  reduced them to their physicality and was ultimately a reminder that we are physical 
 creatures and we get ill and we die and nobody is immune from that no matter how beautiful 
 or glamorous you or your lifestyle are . it was really an incredibly fraught time to be gay and i do nt know that , historically , if 
 we look back , how that whole time affected the psyche of the gay community . to what extent 
 it damaged it , or created a particular response or a feeling of what it means to be gay in 
 the twentieth century . research into how aids , the illegality of homosexuality , socially - sanctioned homophobia , 
 apartheid ideologies and  race shaped gay male identity in south africa historically is 
 another area of research that requires further exploration . the hegemonic narratives around men and aids created by medico - scientific and 
 political elites in south africa and elsewhere in the early 1980s and not challenged 
 significantly until the mid-1990s strongly suggested that it was not types of sexual 
 practices such as unprotected anal or oral sex , or higher - risk behaviours that needed to be 
 examined , but rather something the focus in 
 medical journals and parliamentary discussions , throughout the 1980s and mid - way into the 
 1990s , was thus not on sexual acts and practices that could be performed by sexually active 
 people regardless of their sexual orientation , but rather on constructed aids avatars of deviant gays ,  dirty prostitutes ,  infected foreigners , and  sexually rapacious this prevented serious attention from political and medico - scientific elites falling 
 on male sexuality more broadly and assumed a normative , healthy , while these avatars were used to construct a hegemonic aids narrative , this does not 
 mean that the narratives were not contested , challenged and reconfigured or rejected by some 
 health care professionals such as brouard . conflated identity with risk 
 and assumed that something about   the gay condition  ( or )  the gay being presupposed 
 vulnerability to aids to hiv. 
  this  fitted in with broader public health paradigms of the time that were modelled 
 on popular understandings of sexuality , that did not sufficiently interrogate the 
 relationships between sexual practice , sexual identity and basic biology . in this paradigm it was  not the fluid that was the problem , it was who you were that posed the risk. 
  this understanding of sexuality and confusion over sexual practice and sexual identity 
 resulted in  a lot of mythologizing even in the medical sphere. 
  brouard recalled counselling a heterosexual couple in the esselen street clinic 
 where the man was concerned about their risk of hiv infection because they practised anal 
 sex . further questioning revealed that they were both hiv - negative and in a committed 
 monogamous relationship . brouard explained that , in light of this , they were not likely to 
 be at risk of hiv as it was not the practice of anal sex per se , that was 
 the primary risk , but rather bodily fluids containing the hi virus . these and other 
 experiences left brouard with a sense that , for many people , understandings of aids and hiv 
 transmission , and sexuality more broadly ,  were very mystifying and mystified. 
  brouard started counselling people in the early to mid-1980s through his involvement with 
 gab ( gay advice bureau ) a counselling service providing support for gay people or people 
 exploring their sexuality . at that time gab was not dealing with many hiv - positive people 
 but one of brouard s colleagues was diagnosed with aids so gab established an informal 
 support system for him and his partner . after his death , gab launched an unsuccessful 
 support group for people living with hiv . while completing his master s degree brouard volunteered at the aids centre at the saimr , 
 which opened to the public in january 1988 . it offered an evening counselling and testing clinic where brouard did pre- and 
 post - test counselling with the predominantly  white , gay clients . he and a friend also 
 established an hiv support group attended by a small number of gay men , which allowed 
 brouard and his friend  to explore what it means to be positive , and what support one 
 needed , and what was out there. 
  during his internship year as a master s student in 1989 , brouard volunteered at the hiv 
 clinic at joburg gen doing informal counselling and support work , and acting as a  resource 
 person. he recalls that  people like ruben sher , dennis sifris and steve miller ran the 
 clinic  and it was a fascinating period because it was very other. 
  while the hospital was still racially segregated and primarily served the needs of other because of their sexual 
 orientation or because of the demands that they made on the hospital on behalf of gay 
 people : suddenly this group of gay men who were feeling more entitled in some ways , or more 
 informed , or more empowered , were coming in and it created some envy and resentment among 
 the medical fraternity because why was there a need for a special clinic ? aids was still 
 very much a disease of gay men , it was still stigmatised , and dennis , ruben and steve had to 
 really fight to get staff , to get funds . they had constant battles with hospital 
 management . 
  in the context of apartheid ideology that sought to categorise people in unambiguous ways 
 and thereby create specific , often binary , identities , white gay men were  problems as 
 they not only transgressed accepted heteronormative identities , but were also criminalised . they were men and so were expected to occupy a particular place in patriarchal structures , 
 and they were race. they were , 
 however , gay men and therefore their privileged status in terms of masculinities could be 
 called into question . 
  instead of being shamed into silence by their sexual orientation , these men took 
 advantage of the social capital they had as  white elite medical professionals , and 
 challenged hospital authorities . unsurprisingly they antagonised others in positions of 
 privilege both within , and beyond , the health sector . brouard recalled how the accessibility of arvs at joburg gen highlighted the class dynamics 
 inherent in a health care system divided into public and private sectors . he felt 
 ineffectual at the clinic  because it seemed to be an overwhelming problem and you just saw 
 so much death and dying , and just sadness and grief. sifris and miller saw patients who 
 could afford arvs at their private practices , but there was no hope of this at the joburg 
 gen . by the early 1990s both sifris and miller had left the clinic and worked predominantly 
 in their private practices . brouard in the meantime , continued to volunteer at joburg gen 
 and got a job in hillbrow at the esselen street clinic with mary crewe and clive evian , who 
 were starting up the johannesburg city council aids programme . despite being state - funded , and having to negotiate the complexities of national and local 
 budgetary funding processes , brouard maintains that he , evian , crewe and others pioneered 
 several innovative programmes relating to sexual health and stis at the esselen street 
 clinic . brouard , for instance , started a closed support group along strict psychotherapeutic 
 lines for hiv - positive gay men which ran for three years . with so little access to azt the primary focus of the group was on how to adapt to 
 living with hiv and preparing to die of aids . brouard 
 remembers those years as his  most significant immersion into counselling people who were 
 dying or confronting mortality. 
  brouard recounts that the clinic was not a specific aids or hiv clinic but rather provided 
 comprehensive sexual health services with an aids training and support component . it had 
 family planning services , a tb clinic , an sti clinic that incorporated hiv antibody testing , 
 and an outreach programme focused on sex workers and gay men . brouard remembers the clinic 
 being used by all sectors of the hillbrow community and being told by clients that it 
 developed a reputation for meeting the needs of all people in the community and for being 
  gay friendly. 
  brouard knew many of the people who came to the clinic for help , and , despite minimal 
 resources , recalls that they never turned people away . the clinic became a space where 
 community members or groups could collaborate and develop new aids intervention strategies 
 such as drama productions , comic strips and other innovative education materials . aids weeks , and in 1991 piloted aids 
 education adverts on public buses . brouard maintains that they also developed interesting training models and 
 counselling courses hailed as innovative by other health care centres , and provided 
  non - judgemental testing services and sti treatments . in addition , brouard suggested the background and politics of the staff and a guiding 
 assumption that responses to stis required a multi - disciplinary rather than a solely 
 medico - scientific approach influenced the integrative outlook of the clinic . brouard 
 referred to the  interesting mix of people and the variety of skills that coalesced at the 
 clinic , with clive evian bringing a community medicine perspective while mary crewe applied 
 her academic knowledge to understanding the sociological roots of aids to provide a 
 foundation for implementing programmes at the clinic . while sexuality organisations or gay professionals could exert pressure on policy makers in 
 the uk and usa , or influence the aids policy - making process itself , there was less 
 opportunity for this in south africa . 
  in the 1980s the criminalisation of homosexuality and the government s homophobic 
 stance made engagements between sexuality activists and government officials complicated . the political transition in the early 1990s created more opportunities for sexuality 
 activists to engage with decision - makers but the focus for sexuality activists was no longer 
 only on fighting legislation , or even raising awareness about aids , but rather on securing 
 citizenship rights and equality for people of all sexual orientations . 
  in the late 1980s and early 1990s the clinic built more alliances , both nationally and 
 locally with progressive organisations in the gay communities like the gay and lesbian 
 organisation of the witwatersrand ( glow ) and the tap . alliances were also built between 
 progressive organisations involved in aids work ; and between gay organisations , activists , 
 and the clinic . simon nkoli was involved in glow and tap , and with brouard ran hiv prevention 
 workshops in hillbrow for black , gay men based on sex - positive , risk reduction 
 approaches . in addition to providing information and distributing condoms , they used the 
 workshops to explore relationships , sexuality and identities . brouard and nkoli criticised 
 the  abstain , be faithful , use condoms (  abc ) programmes and messages that were most 
 prominent at the time , concluding that gay communities would not be receptive to the 
 moralistic , conservative messages . nkoli had an office in esselen street and started an 
 organisation for hiv - positive  black , gay men . brouard recalls how  you would walk into his 
 office and there were all these explicit posters of naked black men so he was 
 fantastically subversive. 
  nkoli , brouard and sifris , as well as organisations like the gay peoples health forum , and 
 gasa-6010/aset , were responsible for subverting the conservative , homophobic , moralistic 
 narratives about sex and sexuality by virtue not only of their sexual orientation and 
 politics , but also because of the safer sex material that they distributed or produced . in 
 stark contrast to the government s abc messages , the aids education material developed by 
 gay organisations or aids support groups in the mid-1980s , was radically different in both 
 messaging and in assumptions about the intended audience . as the examples pictured below 
 reveal , images and messages from gay organisations treated the audience as sexually active 
 and did not assume that abstinence was realistic . instead , the images and words encouraged 
 safer sex practices as a normalised part of enjoyable , erotic , healthy , sexual activity , and 
 depicted sex across colour lines. brouard was on an editorial board that produced a comic pamphlet called  keep it hot , safe 
 and gay which featured two characters , hot shot and safe sex  a lycra - clad super hero and 
 a condom  who delivered unabashed information about anal sex , oral sex , thigh - sex and 
 mutual masturbation ( figure  1 ) . information about hiv 
 infection and transmission was underscored by a central message that  playing safe with the 
 one you love puts the fun back in and takes the danger out. 
  the comic provided contact information for the esselen street clinic and gay 
 organisations . figure  1:panels from  keep it hot safe and gay. 

  panels from  keep it hot safe and gay. 
  safer sex cards from the johannesburg - based gay peoples health forum ( gphf ) were designed 
 as actual postcards with writing space , and included the organisation s contact information . 
 some of the cards showed a white man and a  black  man in intimate poses and reminded 
 recipients to protect their partners and declared that healthy sex was not boring 
 ( figure  2 ) . the gay peoples health forum s safer sex postcards . 
  the significance of these media needs to be considered in light of homosexuality being 
 illegal , and interracial hetero(sex ) only having been decriminalised in 1985 . producing 
 and distributing these education materials was socially ( and legally ) subversive and the 
 content of their sexual health messages was radical by the standards of the day . much like the  keep it hot pamphlet and the gphf postcards , safer sex cards distributed by 
 aset in cape town combined basic facts about hiv transmission with contact information for 
 the organisation . the cards also used frank language and ( for the time ) explicit images , 
 such as a the photographic credits 
 indicate that some images were reproduced from the terence higgins trust in london , while 
 others were created for the organisation . 
  in 1991 john pegge , the director of the organisation , confirmed the importance of 
 information exchanges between international organisations : we run a large safer sex campaign 
 amongst the gay [ sic ] minority and for this purpose we use safer sex 
 posters donated to us by gay aids service organisations in other countries . we have a wide 
 selection from australia , new zealand , the united kingdom , the netherlands , canada and the 
 united states of america . 
  these images depicting a sexuality that was still criminalised flew in the face of south 
 africa s conservative pornography laws which organisations managed to circumvent . the state 
 of transition in the country was such that aset was able to receive such material , despite 
 it  running foul of pornography legislation , because authorities no longer appeared certain 
 of quite which legislation was applicable . when apartheid laws were being more rigorously 
 implemented , pornography received by mail did not result in criminal prosecution if the 
 recipient could prove that they had not solicited the material . nonetheless , pegge urged 
 caution :  i would suggest that you send any materials that might be deemed pornographic in a 
 separate envelope without a covering letter. 
  despite the caution urged by pegge , the socio - political milieu of the country seemed 
 to be changing . in the early to mid-1990s , brouard witnessed a change in clinic clients . rather than the 
 initial client base of predominantly black south africans returnees who had either lived in exile communities or 
 travelled to other countries . one womyn that he counselled frequently had been involved with 
 a senior operative of the armed wing of the anc umkhonto wesizwe ( mk ) . the 
 mk soldier attended counselling only once and later died of aids . yet , this time also saw a renewed sense of hope derived both from the country s political 
 transition to a constitutional democracy and from developments in arv treatments . at the 
 same time , progressive health organisations became increasingly involved in aids work and 
 approached the clinic to obtain training materials and discuss mobilising health workers . othered in south africa  it was the build 
 up to  94  and the whole nacosa ( national aids convention of south africa ) process had 
 generated an incredible amount of coming together and talking and debating a first national 
 ( aids ) plan . people were pulling together more  it was  a fascinating time to be living 
 through . the space for gay health care professionals to influence national aids programmes and 
 policy throughout the 1980s and into the early 1990s was , brouard suggests , hampered by the 
 level of homophobia in public health structures . while gay men , like brouard himself , were 
 involved in the government - funded aids training and information centres ( atics ) , they worked 
 within  a conventional public health paradigm  ( doing )  testing , counselling training , 
 community prevention , ( and ) fairly dull  aids in the workplace stuff. within this 
 conventional paradigm , it was difficult for gay activists to bring about radical changes in 
 aids education messaging or campaigns , so their influence would have been primarily at the 
 individual level , with people they counselled , or , possibly , within the atic structures . brouard maintains that even people such as ruben sher , as an aga member , would have had 
 limited opportunities to make substantive changes to national aids policies or programmes . 
 with aids ring - fenced as something other and outside the public health care system , it was 
 seen as a challenge to existing health care systems and structures . brouard recalls that 
 even at the clinic , which championed an integrated approach to sexual health , nursing and 
 other staff who were less involved in aids work saw  the aids people as different. 
  brouard noted that the perception of aids as when interviewed for this project , brouard remarked that he was struck by the irony that 
 state resources for aids programmes amongst lgbti communities were not available either 
 during or after apartheid . brouard had met rina venter ( the last np national minister of 
 health ) in the early 1990s and he recalled that she had made it clear that because aids was 
 a minority issue the gay community  needed to look after itself. this attitude , combined 
 with the criminalisation of homosexuality , meant that state resources were not made 
 available to gay people . similarly , in the post-1994 period , when the focus of government 
 interventions shifted to heterosexual people and pregnant womyn and people started claiming 
 their constitutionally - guaranteed rights to health care and treatment ( in this instance arv 
 therapy ) and demanding responses from the anc - led government , gay communities were again 
 sidelined as minority groups . this continued marginalisation has resulted in a lack of basic 
 information about hiv transmission and infection rates amongst gay communities in 
 post - apartheid south africa . 
  of the early years of the epidemic brouard primarily recollects death :  there was a lot of 
 death  that s what i remember of those years the number of funerals one went to , the 
 number of people who disappeared , it was just horrible. 
  while in 2013 the funerals continue , the option for a longer life is now available 
 to people if regular and sustained access to arvs can be maintained by the state , and in 
 2013 south africa has what is possibly one of the largest arv rollout programmes in the 
 world . brouard continued working at the clinic until 1997 and then joined the centre for the 
 study of aids ( csa ) in 1999 . as the deputy director of the csa , brouard continues to 
 conceptualise and develop training methods and materials , and contributes to academic 
 publications and other fora on topics such as psychosocial issues , gender , sexuality , human 
 rights , testing and tertiary responses to hiv and aids . brouard s work still involves the realities of aids - related deaths , but now also 
 includes components that address prolonging and living life fully , regardless of hiv 
 status . personal and professional relationships and networks organised around sexual identity were 
 important to the first responses to aids in south africa in both medical and social spheres . sexuality organisations had to take responsibility for addressing the aids epidemic in the 
 face of government inaction , but much of this response was limited to specific sections of 
 the gay community , individuals , and to specific geographic areas . while aids provided a point of mobilisation and support in south africa , as this article has 
 explored , sifris and brouard were active in both sexuality organisations and in two key 
 public health sites involved in addressing aids . their accounts of the time provide insights 
 into the experiences of two gay men at the start of an epidemic  written on and around gay 
 men s bodies . their stories , as reflected here show how even within hostile 
 government - aligned health care spaces , they were able to provide support and treatment to 
 some people , and to engage in , what were for the time , socially subversive activities . the 
 different contexts and professional fields in which they found themselves mediated their 
 individual experiences , but in both men s case , the hegemonic aids narratives about 
 homosexuality influenced and shaped their responses even as they challenged them . homophobic beliefs , conservatism , or any other invisible or unquestioned ideologies that 
 influence understandings of epidemics and practical responses to them , have tangible 
 repercussions . these repercussions may be evident in the lack of legal protection or in the 
 emotional costs of prejudice and intolerance . brouard , like miller and sifris , challenged 
 hospitals to provide care for people with aids . joburg gen was often reluctant to admit 
 people with aids , as providing palliative care was seen as a  waste of resources and of 
  limited value for instructional purposes . even when places could be found for people it was difficult to get staff members to 
 treat them with dignity ; and many staff members did not deal well with gay men , young men , 
 coming in infected and dying of this strange disease ( where ) dementia complicated the death 
 process further. 
  for the partners of the men who died the trauma of loss was aggravated by their lack of 
 legal status or recognition as partners of the deceased . brouard , for instance , recalls 
 counselling loving partners who were not able to claim the bodies of the deceased men . he 
 witnessed both the deaths and the grief of survivors during this time . in the early phases of the epidemic sifris challenged homophobic responses to gay men with 
 aids , but did not necessarily challenge the then dominant narrative that initially linked 
 aids to being gay . given that the professional and personal spaces he occupied bore out the 
 narrative that gay men were the ones dying of aids , this is perhaps not surprising . brouard 
 worked within gay communities he most identified with , but his professional and personal 
 spaces seemed to have presented a more complex narrative about aids and its association with 
 sexual identity and broader identity politics . the socio - political evocation of stereotypes , or constructions of gender ,  race , and 
 sexual orientation  have long shaped experiences of ( ill)health and epidemics . this article 
 has focused on the micro - narratives of individuals and their responses to the epidemic as 
 individuals and as part of communities . it serves as a reminder of the intricate and 
 intimate relationships between ideologies , illness and identities , but also that behind each 
 aids avatar evoked in hegemonic narratives are complex , embodied people .