“A Better Way”: The Evolution of Community-Based AIDS Health Services in Birmingham, Alabama, 1985-2000

Abstract

In 1992, the AIDS Task Force of Alabama (AFTA) secured a $1.8 million federal grant from the US Department of Housing and Urban Development (HUD) to open Agape House, Birmingham, Alabama’s first community-maintained AIDS boarding house for adults. Although AIDS boarding houses existed all over the country throughout the 1980s and 1990s, they have received little attention from scholars. The goal of this project is to understand the rise of Agape House and resources that were wielded to make it possible. Beyond help from a federal institution, Agape House received considerable support from local religious organizations. This analysis of AIDS boarding houses offers a local look at how the AIDS epidemic was thwarted. Popular queer history often emphasizes the work of national organizations, like AIDS Coalition to Unleash Power (ACT UP) to explain queer resistance to AIDS and responses to the lack of federal intervention. While important, the centrality of larger organizations to our understanding of AIDS resistance has obfuscated the work of local grassroots organizations. Ultimately, this project aims to answer the following, how did changes in knowledge surrounding AIDS impact the evolution of care? What motivated groups, specifically religious ones, to participate? And how did Agape House survive while similar houses closed?

Introduction

In 2019, the Alabama Department of Public Health’s HIV Survey Program released an annual report on the number of AIDS cases and the spread of AIDS in the state. At its time of publication, 22 302 cases had been reported in the state since 1982, the first year the state started monitoring AIDS cases. As of December 31, 2019, 14 345 HIV positive individuals lived in Alabama with 635 cases being diagnosed that year [1]. Finding secure housing is a key issue for this population due to difficulties with employment and labor, familial issues, or because they cannot live in a house with another immunocompromised person. Presently, there are several resources available to those who might be struggling, but this infrastructure had to be built over several decades. One institution stands out because of its longevity in Birmingham, Alabama. Today, Agape House is an 18-unit one-bedroom apartment complex with a sister complex, Agape II, a 12- unit, one-, two-, and three-bedroom facility. Both facilities specialize in providing housing for those suffering with HIV or AIDS and Agape House has been doing so since 1995. Prior to the establishment of community-maintained AIDS boarding houses, there were no housing facilities like this in the state for adults with HIV/AIDS. These facilities did not pop-up overnight and took the efforts of several individuals to establish. In response to the AIDS epidemic, queer and non-queer individuals across the US mobilized to combat the spread of AIDS and provided care. In doing so, individuals and organizations relied on novel methods of prevention and care and may have even borrowed ideas across state lines from other queer organizations, though there is little concrete evidence to suggest this. Regardless, historians have not yet explored the importance of these groups and the institutions that they formed to combat AIDS.

Federal and Local Support

Community-based AIDS boarding houses existed all over the country throughout the 1980s and 1990s, and yet they have received little attention in the historical record regarding their importance as local institutions. Further, popular queer history often emphasizes the work of national organizations, such as AIDS Coalition to Unleash Power (ACT UP) or the individuals in them, to explain queer resistance to AIDS and responses to the lack of federal intervention. While important, the centrality of larger organizations to the popular understanding of AIDS resistance has obfuscated local grassroots organizations that did not ascend to the national stage. By centering local queer organizations in Alabama, this project seeks to understand how queer community-based institutions formed and survived in the South. Evidence shows these institutions received federal funds despite longstanding claims on a lack of federal intervention. Some community-based AIDS boarding houses were able to procure funding from institutions like the Federal Emergency Management Agency (FEMA) and HUD even before the Ryan White CARE Act passed in 1990 [2-4]. Beyond the national level, these boarding houses give insight into the local and regional politics of the area they existed within. Although Agape House is in Birmingham, Alabama, a state seen as holding conservative values, it survived longer than other community-based boarding houses were able. How then could an institution that supports queer individuals and is concerned with AIDS survive in the American South, a region often tied to ideas of white supremacy, the New Right, and Christianity? This study aims to answer this question while illuminating other aspects of the AIDS epidemic that are often excluded from the literature including evidence of support from outside groups and women’s roles during the epidemic.

Queer Networks in Birmingham

Although there were other projects to curb the spread of AIDS in different cities in Alabama that existed before 1985, this project will largely focus on specific efforts made in Birmingham. However, a full investigation into Alabama’s response to AIDS should be undertaken as networks of organizations formed across the state. While Birmingham was not the only city in the state of Alabama to have an active queer community, it did have the largest presence in queer Alabama during the AIDS epidemic. The city of Birmingham possessed institutions like Lambda, Inc. which printed the Alabama Forum, but also contained other queer organizations or businesses like bars, sports teams, bookstores, and more [5]. Birmingham also housed an important medical research school, the University of Alabama Birmingham (UAB). Over the course of the AIDS epidemic, UAB was pivotal not only in local education, but also for broader research on the AIDS epidemic. According to a report from the Alabama Forum in 1987, the National Institute of Health (NIH) awarded UAB and Southern Research Institute (located at UAB) a $7 million grant that would last for five years. The grant was awarded on the basis that it would be used for drug development [6]. Additionally, there was a Metropolitan Community Church in the city. These were religious organizations who focused on opening their doors and services to as many people as possible, including queer individuals. When combined, these institutions help to form queer Birmingham.

Starting in 1985, the queer community of Birmingham relied on increasingly novel methods to stop the spread of AIDS. These methods evolved over the years through a better understanding of AIDS, access to resources, and through the help of other Alabamians. Through three distinct institutions and phases, the Birmingham AIDS Outreach (BAO) hotline, the BAO buddy program, and Agape House, the queer community was able to wield local and federal resources as a means of curbing the spread of AIDS through community outreach and education. Hotlines were early sites of anonymous care and information exchange, the buddy system was a model that emphasized intimate, community-based support, and Agape House was both a medical and political intervention. While these are not the only methods of bringing awareness to AIDS and the community it affected the most, they demonstrate a logical progression in care. One of the earliest examples of these methods would be this hotline which served as a source for information on HIV/AIDS. Although hotlines are and can be intimate, the methods used to care for persons with AIDS (PWAs) became increasingly intimate as the needs of PWAs were better understood. This resulted in more people gaining a better understanding of AIDS through interactions with PWAs.

Through an examination of these institutions and how they came to be, this study also aims to highlight the local queer communities that existed in Alabama. During the AIDS epidemic, several queer organizations combined forces to provide opportunities for care that previously were not there while others acted as an intermediary between queer Alabamians, local organizations, and information relevant to AIDS. The primary intermediary in this study is the Alabama Forum, a local queer newspaper that started reporting on the AIDS epidemic in 1982. The Alabama Forum was also a tool for spreading awareness of local resources like the BAO hotline, buddy programs, and AIDS boarding houses. It also reported on local, national, and international news pertaining to queer life and AIDS. However, before analyzing these institutions and what necessitated them, it would be appropriate to discuss the history of queer spaces in southern urban areas and the historiography of the AIDS epidemic.

American Southern AIDS Historiography

In 1999, John Howard published the first monograph on southern queer history with Men Like That, an investigation into queer desire, space, and practices in Mississippi from the 1940s to the 1980s [7, p.xviii]. Howard points to two events that pushed Mississippi homosexuals into “the closet”: the murder of John Murrett in 1955 which symbolized a violent rejection of homosexuals and the mass arrests of white gay men in 1965 spurred by attempts to break up social networks [7, p.xiv-xv]. Howard concludes his text in 1985 because “that’s when the human immunodeficiency virus took hold in Mississippi to such an extent that queer lives and queer networks were irrevocably altered [7, p.299].” While this is true, responses to the AIDS epidemic, particularly in Alabama and Mississippi, led to a rise in organizations founded by queer individuals or that supported queer individuals. Howard’s omission of queer life during AIDS in the South creates an obvious gap in the literature that few historians have attempted to fill.

Several texts on the AIDS epidemic in the South are memoirs, with few academic texts illuminating this period of queer history in this region. As historian Stephen Inrig noted “historians, policymakers, AIDS activists and health professionals had largely directed their attention to other foci of the epidemic while southern AIDS went unaddressed [8].” In his 2011 book, North Carolina and the Problem of AIDS, Inrig focuses on exploring the difference in experience between Whites and Blacks, how North Carolina went about limiting the spread of AIDS, and how effective these methods were. Other texts include Ashamed in Silence, an attempt to recover the lives of those lost in Clover, South Carolina to the epidemic and the silence surrounding their deaths, by journalist Andrew J. Skerritt, and The Secret Epidemic by journalist Jacob Leveson, a similar venture, follows three individuals as they straddle the color line while struggling against AIDS. There is also You’re the First One I’ve Told by professor of public policy and global health, Kathryn Whetten-Goldstein, and professor in public health, Trang Nguyen, who take a highly personal approach in their work concerned with the generation that comes after the first generation that dealt with AIDS and is an exploration of the sexual and health practices of this new generation. To explore this, they followed 25 individuals which later unfolded into a much larger case study [9]. Lastly, Dying Inside by sociologist Benjamin Fleury-Steiner, with lawyer Carla Crowder, explore the experiences of Alabama prisoners in Limestone Prison, “the sole institution for incarcerating all male prisoners in the state who were infected with the HIV [10].” Sadly, there has been little work done by historians to understand the spread of AIDS in the South or the response to it. This creates fertile ground for an analysis of the organizations and groups who fought against AIDS as none of these works focus exclusively on the transformation of the community-based AIDS medical model wielded by organizations across the nation. While recovering the voices of those lost in the epidemic is integral to understanding this period, it is also necessary to broaden the scope of academic research on AIDS in the South by focusing on these organizations. The following is an attempt to open the doors for continued research on AIDS in the deep South to form a better understanding of how AIDS impacted individuals, institutions, and health care networks. Having discussed the regional queer historiography, the focus will now shift to specific medical practices, the history surrounding them, and the first methods of preventative care.

Community-based AIDS Medical Model

In 1977, Lambda, Inc., a non-profit queer organization based out of Birmingham that focused on building community and offering resources, was formed [11]. This was a public-facing grassroots queer organization that would help to fight the AIDS epidemic. However, this was not their main concern upon forming as it would be with later groups who formed in the early 1980s. One such group was the Gay Men’s Health Crisis (GMHC) which was formally established in 1982 by a group of gay men in New York. This was the first mobilization against AIDS and acts as framework for a community-based queer education and health service [12, p.1]. Members of GMHC began to receive phone calls from across the nation from individuals who had questions concerning AIDS, and in 1982, this became the first AIDS hotline. In that same year, “… GMHC psychologists and social workers laid the groundwork for both an inventive crisis intervention protocol and a supportive ‘buddy system’ for PWAs [12, p.4].” According to professor of sociology Philip M. Kayal, “a major concern was defining and directing the burgeoning social movement that they had unwittingly inspired [12, p.3].” Again, though there is little evidence that points towards a conscious effort to replicate these care models, it seems implicit that groups were copying models that allowed them to care for their local community members. BAO’s buddy system mirrored other buddy programs as they were aware of similar programs and sought advice on how to operate from another local group.

In December of 1984, the Alabama Forum reprinted an article from the Jefferson County Department of Health monthly Disease Surveillance Report. It noted that “as of mid-October 1984 there have been 10 persons with [AIDS] hospitalized in Jefferson County,” the same county where Birmingham is seated [13]. Of these 10, seven of the men were identified as falling under the risk group of homosexual or bisexual. In May of the following year, Lambda held a meeting on AIDS with the head of the Jefferson County Health Department, Dr. James Alexander. This is one of the first local initiatives headed by Lambda beyond articles published in the Alabama Forum. One month later, the Forum published an article about how the number of AIDS cases in Jefferson County had increased to 15, with five PWAs dead, and an article on the formation of Birmingham AIDS Outreach [14]. BAO’s mission was “fighting for unbiased medical care, for legal assistance, as advocates to attain SSI [(Supplemental Security Income)] coverage, Medicare, food stamps, Veterans’ benefits and any other assistance we can get [14].” The members of BAO asserted themselves into the fight and immediately established a hotline concerning AIDS.

AIDS Hotlines

In 1984, actor Rock Hudson was diagnosed with AIDS. Before his death, he appeared on an episode of Doris Day’s Best Friends where viewers noticed that Hudson’s appearance had changed. He was a tall man with nice build, but viewers noticed he looked sickly and tired. Two months after the filming of the episode, Hudson passed away at 60. The episode aired after the death of Hudson, and Day inserted a clip talking about Hudson and AIDS. Originally, there was no mention of the disease until Day inserted the clip. According to Day, “I know that life is eternal and that something good is going to come from this experience [15].” According to medical researchers Robert R. Waller and Lynn W. Lisella, Hudson’s death “increased call volume significantly” for AIDS hotlines [16]. Journalist Randy Shilts posited that the AIDS epidemic could be understood through two phases, there was AIDS before Rock Hudson and AIDS after [2, p.xxi].

It is unknown how many calls resulted from Hudson’s death, but people had access to information because of hotlines whether they suffered from the disease, or friends and family did. According to historian Hannah Zeavin, “beyond the conducive distance they offer, hotlines and other forms of teletherapy work because they are available when and where no one else is […] if contacting crisis support doesn’t help, or doesn’t feel right, the caller can simply hang up [17, p.2].” Hotlines allowed for anonymous care by those with knowledge, or access to resources, and due to the nature of homosexuals’ standing in society during the onset of AIDS, hotlines would become a staple in fighting against the AIDS crisis. According to historian Heather Murray, “anonymity has been especially ubiquitous for gay men and lesbians seeking advice – or relationships – and both gay liberation and lesbian community groups aimed to provide these sorts of anonymous social circles [18, p.106].”

Hotlines are a part of a much longer trend of distance therapy and telehealth. Zeavin placed the idea of “speech as cure” into a much longer history of Western tradition, “from Socrates’ idea that the cure of the soul is “fair words,” and Aristotle’s notion of catharsis in Poetics [17, p.4]. Over time, these types of hotlines would evolve to serve a variety of populations while trying to tackle a myriad of issues, including ethical. AIDS hotlines faced specific issues because of historical forces that demonized homosexuals.

On October 1st, 1985, BAO began operating their AIDS Information Helpline [19]. BAO’s hotline was “staffed from 5-9 p.m. Monday-Friday” and the phone number for the line was added to the Alabama Forum’s monthly directory [20]. The explicit local focus of BAO made it easier to call and to find accessible resources in the area, although a national AIDS hotline was also included in the directory prior to BAO’s. BAO was active through other forms of community outreach as well. They held charity events and worked with other organizations in the state to facilitate broader outreach [21]. An example of this would be a grant proposal, from BAO and the AIDS Task Force of North Central Alabama, that would develop a statewide toll-free AIDS hotline. This would become a larger collaborative effort known as the AIDS Task Force of Alabama (ATFA) [22,23]. The Birmingham News reported in 1986 that BAO’s hotline received an average of “20 to 30 calls a week” while 1988 reports by BAO noted that they had received hundreds of calls with many of the callers asking about information on the transmission of AIDS [24-26]. Moving into the 1990s, BAO was able to continue operating their hotline and placed multiple ads in local newspapers about the need for volunteers.

This hotline generates larger questions about the AIDS epidemic and due to its importance in BAO’s development in local AIDS care. For example, who has authority on knowledge production and dissemination during the AIDS epidemic? Although the general population may have had little information on AIDS, groups like BAO were conduits of knowledge and acted as a local authoritative figure on this knowledge and the resources available to PWAs. Considering the misinformation surrounding AIDS, it is easy to see how an institution like a hotline would be pivotal in teaching others and humanizing PWAs while providing anonymity. These three concepts, education, humanization, and anonymity were important steps to take so PWAs could receive proper and robust care at the local level. Interestingly, an article in the Alabama Forum described this hotline as offering a buddy program though it’s unclear if these interactions would have happened exclusively over the phone [19].

Buddy Program

In 1985, filmmaker Arthur J. Bresson, Jr., released Buddies, the first feature-length drama about the AIDS epidemic in America [27]. Buddies follows the story of David, a gay man who is sent by the “Gay Center” to be a buddy to Robert, who is dying of AIDS. The men progressively become closer to each other as evidenced by a close-up, at the beginning of the film, of these two men shaking hands while David is wearing surgeons gloves. Eventually, we see David touch Robert without gloves, two years before Princess Diana shook hands with an HIV patient. Bresson, who also wrote the film, was intentional in his messaging and imagery as his characters talk about the need for federal intervention and denouncing the idea that God created this epidemic. The movie also analyzes what it means to be “out” during this time and explores the sexual desires of the terminally ill. Bresson maintained a very small cast focusing on four men, while any female voices, specifically the hospital or facility staff, are only heard off-screen. The film ends with Robert dying and David fulfilling his wish of picketing outside of the White House demanding intervention with a sign that reads “America, AIDS is not a gay illness[.] It’s everybody’s problem[.] Release all the money for research and care [28,29][.]” Buddies demonstrates one of the unique approaches wielded, by queers and others, during the epidemic to support those with the illness. It is uncertain if other programs were inspired by it but, they did appear, and they led to some radical transformations in early AIDS care in Alabama.

Although hotlines offered a form of anonymity, combatting AIDS and assisting those who had it required the use of additional intimate care with more direct community support. BAO’s buddy program offered PWAs assistance in their daily lives using trained volunteers evolving into housing opportunities for PWAs. This program and similar ones mark a development in the local queer AIDS healthcare model where care centered personable community support, more directly helped PWAs access resources, and spread awareness of AIDS.

In the same year that they established their organization and hotline, BAO created a local “buddy program.” The members of BAO attended the Southeastern Conference of Lesbians and Gay Men and as a result, began to focus on “[putting] people with AIDS back in control of their lives, to improve the quality of life, to educate the public, and to help prevent the spread of the disease [30].” The concerns touch on the importance of a buddy program where hotlines had their limitations. These programs offered autonomy to PWAs despite working directly with a buddy. According to one article, “each volunteer will be matched with an AIDS patient, offering assistance like physical or transportation…and to communicate the patient’s service and informal needs to AIDS Outreach [30].” The autonomy came in the form of mobility that AIDS patients may have lacked prior access to by helping PWAs get to doctors’ appointments, support groups, and work [31]. Together, the access to transportation and health services or work, allowed AIDS patients to receive the care they required while also being able fulfill other needs. Further, they provided emotional support to their clients. While they could not cure AIDS, buddies help shoulder the emotional burden experienced by PWAs. According to one article, “buddy volunteers are helping clients to dream again, to show them that is more to life than coping with their illness. Buddies are providing hope [32].” One of the most important aspects of this program was the sense of community that volunteers tried to create with their buddy as “people who didn’t have support because friends and family members turned their backs on them…” were the individuals this program centered around [33].

In 1988, they sought to appoint a “Buddy Program Coordinator” to further establish and maintain the program [34]. Unfortunately, aspects of the program had not reached the level of consistency that organizers had hoped for, so they met with another buddy program based in Mobile, Alabama to receive training and advice [35]. It’s important to note that BAO’s buddy program is the result of shared knowledge regarding how to care for PWAs. According to Tracy Sullivan, the executive assistant for BAO, “people were aware that other cities and communities had a buddy system” which in turn inspired this program [33].

Despite the initial setbacks, the BAO buddy program ran into the 2000s. Through projects like this, BAO served “over 450 individuals and families living with HIV and AIDS through a variety of services,” with the buddy program being one of those services [32]. This program was also an inspiration for the community-based healthcare that shaped housing projects for PWAs. One Alabamian, Frank Romanowicz, is a strong example of how the buddy program transitioned into larger projects that focused on issues like housing.

Agape House

In 1992, Romanowicz was awarded in the volunteer category of the first United Way of Central Alabama AIDS Action Awards. He was recognized for his work with the AIDS buddy program and for recruiting others to help. He was also recognized for his efforts in raising funds for Agape House [36]. Romanowicz began volunteer work with PWAs in 1987 after RCA [Radio Corporation of America] had been bought out and Romanowicz was laid off. Around the same time, he, a member of Advent Episcopal Church, met another parishioner who was HIV-positive which initiated Romanowicz volunteer work with this population. Romanowicz would go on to be a founding member of the “AIDS Task Force of the Episcopal Diocese of Alabama, a board member of the National Episcopal AIDS Coalition, a coordinator of the 1992 Names Project Quilt Display in Birmingham, and a Birmingham AIDS Outreach ‘buddy’ of three people with AIDS, all of whom died while Romanowicz helped them navigate the social service network [4].” According to a later report in 1992 by the Birmingham Post-Herald, Romanowicz had envisioned a facility where those suffering from AIDS could live without fear of going homeless due to AIDS and could also receive the necessary care needed. According to a government study from 1992, 30 Birmingham residents had been disabled with AIDS and could not afford housing [36]. As AIDS Task Force Alabama’s head of the housing committee, his “better way” way became concrete as ATFA was able to secure “a $1.8 million federal grant from the U.S. Department of Housing and Urban Development [4].” According to reports, this would have been “the first of three such federally funded apartments to open across the state [37].” St. Andrew’s Foundation, a part of St. Andrew’s Episcopal Church ministries, also helped in gaining the grant while the Catholic Diocese of Birmingham donated the “Agape House Catholic retreat center [4].”

In September of 1988, members of ACT UP brought an AIDS quilt to Montgomery, Alabama after Lawrence Jetton received a permit to display the quilt in a public place. The quilt commemorated the lives of those lost at Bailey House, “a hospice for homeless AIDS patients in New York City [38].” Again, although there is little physical evidence to suggest that people were borrowing models of care from other places, but those who viewed this quilt were certainly aware that institutions like Bailey House could and did exist.

In 1986, the AIDS Task Force of Alabama, originally the Jefferson County AIDS Task Force, was founded by Joan Turner, an educator and nurse working at the Birmingham School of Nursing. She originally was operating a hotline similar to BAO’s that was “the first such one in Alabama to be staffed by professional health experts [39].” Hoping to open the doors to Agape House in fall of 1993, these groups were tackling a specific problem with a necessary remedy. According to Olivia Hill, the director of the Office for Black Ministry of the Catholic Diocese, who conducted a survey on public health needs of Alabamians, found that “there was no shelter provided in the state of Alabama for people who were infected with HIV and with AIDS [4].” After meeting with Hill, members of the diocese agreed to lease Agape House to Hill and ATFA’s executive director, Brian Sturdivant, and Romanowicz wanted to participate. In preparation, the Agape Foundation was created to oversee the project. Its board was comprised of seven members, three from ATFA, three from the St. Andrew’s Foundation, and one from the neighborhood association. The board also required that one of its members be a PWA [40]. For residents to stay at Agape House, they did have to meet the income guidelines outlined by HUD and “for those who are able, they must pay up to 30 percent of the rental cost of $227 per month. If they [couldn’t] then the government will cover the rent [41].” Organizers assumed residents would fit the profile of PWAs in Jefferson County, “13 percent will be female and 87 percent male, and 51 percent will be black. Ages will probably be 25 to 40 [41]…”

To receive the federal grant, ATFA raised $30,000 in seed money and in less than a month they were able to procure $40,000 [42]. Two years later, in the summer of 1994, HUD awarded ATFA with two grants totaling $1.5 million [43]. An article in The Birmingham News posited that “some in the homosexual community have questioned using so much money to house only about 18 people [42].” Unfortunately, it appears the opening of Agape House was delayed until July of 1995 as “a series of bureaucratic delays [had] pushed back the opening [44,45].” However, these setbacks allowed ATFA to raise more money to open Agape House. By 1995, $95,00 had been “pulled together […] in support from 16 Birmingham foundations [43].” Following the opening, according to a report from the Dothan Eagle, ATFA was paying a $1,000 lease on the property to the diocese, which the diocese later donated in 1998. According to the article “the church can’t build a housing facility like the one the task force has but wants to show the church supports effort to help those infected [46]…” It’s possible that a motivation for donating the space was due to the closure of St. Anthony’s Catholic Church where Agape House was situated [47].

This action may seem odd considering the Vatican released a letter in 1986 decrying homosexuality as it “may seriously threaten the lives and well-being of a large number of people [48].” The church argued that “increasing numbers of people today, even within the church, are bringing enormous pressure to bear on the church to accept the homosexual condition [48].” How then could such a collaborative effort be spurred between a group like ATFA and the Catholic Diocese of Birmingham beyond Romanowicz’s connection between the two institutions? Given that AIDS was often linked to actions that could be considered deviant or immoral, drug abuse and homosexuality, this relationship seems curious. However, in Alabama during the AIDS epidemic, multiple faith-based communities and organizations gathered resources and volunteers to help PWAs. While negative perceptions of PWAs existed in religious circles, there were groups who saw this as a chance to put faith into action [49]. In early 1988, the National Conference of Catholic Bishops held a meeting where a committee wrote a statement on AIDS [50]. This led to the creation of a roughly 30-page pamphlet where they concluded “the crisis continues, but it can be met with understanding, justice, reason, and deep faith [50].” While there are early examples of positive responses, most of them appear starting in the late eighties and persist into the 1990s. Responses included attending vigils, holding prayer services, meeting PWAs, and facilitating charity for PWAs [51]. There are multiple examples of care being administered to the sick in scripture that allowed religious leaders to create parallels between AIDS and biblical illnesses. Joe Bob Mizzell, the director of Christian life and public affairs for the Alabama Baptist Convention, compared AIDS to the Bible’s most destructive disease, leprosy. He noted that “the whole idea is that Jesus touched the leper. We can touch the leper… [52].” Despite initial conceptions about the relationship between homosexuality and religion, religious organizations, even in a southern environment, responded to the needs of those suffering by calling on churchgoers to be Christ-like through an engagement with a group that was also seen as social outcasts. However, this does not mean the rhetoric of their statements was always aligned with the call for compassion or methods of prevention. As Ed Smith, minister at Oxford Church of Christ, pointed out, “it’s never been my lot in life to try to kick a sick dog… But there are some moral issues that have caused AIDS in many cases – in most cases – and those moral issues are expressively taught in the Bible [52].” Although Smith does not advocate for the harassment of PWAs, he leaned into the idea that homosexuals were deserving of the illness because of their actions. An example of the rejection of practical preventive measures came from the National Conference of Catholic Bishops who argued that “medically and morally sound programs” should be used to fight AIDS. They stated, “the church rejects the use of condoms and needle-exchange programs as preventative measures [53].”

Although it is unclear how, Agape House received pushback from neighborhood residents. Local papers do give an idea to who was pushing back and why they changed their minds, but even articles on this topic disagree on how the neighborhood responded. In an article from 1993, the interim director of ATFA, Randy Russell and others, were concerned about backlash, but said the housing project had “been met with open arms [40].” Contradicting this article is one from 1994 where the Ensley Neighborhood President, Earlene Hunter was interviewed. In the article, Hunter notes that two years prior, the neighborhood was opposed to the house, but “several of us attended seminars and the (Jefferson County) Health Department came to our meetings and explained the diseases to us [37].” In honor of World AIDS Day in 1993, on December 1st, AFTA held an open house for Agape House, so the public could see what the facility might look like though renovations were still under way. This exhibition likely served to ease the concerns of neighborhood residents with attempts being made to maintain the historic nature of Agape House despite renovations. The building was originally constructed in 1929, so maintaining the historic appearance could also be seen as a method of integrating this project into the neighborhood [54]. According to Hunter, community members opinions changed once they became more informed on AIDS. Unfortunately, the discussions that took place between the neighborhood group and boarding organizers does not appear in any newspapers.

Another example of pushback appears in 2001 from Birmingham City Council member Lee Loder. The neighborhood president, Angelee Williams, credited Loder for standing with the neighborhood by preventing a proposal to expand Agape House from passing [55]. Members of the queer community also served as a source of pushback. According to one article, “the agency once was sneered at in the gay community for its insistence on focusing on housing. A lot of these sneers came from Birmingham AIDS Outreach, whose members felt any cash should be used for services that help the greatest number of people [43].” Dr. Mike Saag, the director of the University of Alabama Birmingham’s AIDS clinic noted that “on occasion, there have been conflicts perhaps due to personality, perhaps due to poor communication that have led to unnecessary strife [56].”

Into the turn of the century, Agape House continued working with religious organizations through their fundraising efforts. In the summer of 2000, an annual event, “March for Jesus,” was held to celebrate Pentecost Sunday. Agape House was a recipient for donations and according to the event’s city coordinator, Lois Olena, “probably the majority of people in the March for Jesus are evangelicals and Pentecostals [57].” Housing projects that centered the experiences and comfort of PWAs continued to open in Birmingham. In 2001, AIDS Alabama, previously ATFA, planned on opening a new house called JASPER House [58].

Unfortunately, much of the historiography on AIDS in the South and local responses to it are lacking. Scholars from other fields have entered the fray to help explain this phenomenon, but historians would benefit from studying the AIDS epidemic as it intersects with multiple different identities that the field of southern queer history has not been able to appropriately analyze. Historians could get a better understanding of the entire queer community regardless of race or gender because of AIDS wide sweeping impact on the queer community. Scholarship on private responses to the AIDS epidemic have been overlooked in AIDS scholarship, as Morgon Newquist points out in her newly published digital exhibit, “Called to Care: Faith-Based AIDS Responses in 1980s/1990s Alabama [51]”. In it, she posited that “in scholarship about the 1980s and 1990s, there is an emphasis on direct action, public protest, and other aspects of public life. This emphasis caused much of the caregiving work done to combat HIV/AIDS to pass unnoticed, despite its impact at the time [51].” Through her project she highlighted how integral faith-based organizations became in the fight against AIDS. Related to this idea, this project has aimed to serve as a roadmap for the progression of community-based and maintained AIDS organizations in Birmingham. While it is not all encompassing as many organizations arose even in Birmingham, it does show how care for PWAs changed over time as people began to understand HIV/AIDS, and the needs of PWAs, better. Future scholarship should work towards investigating the formation of AIDS boarding house across the nation and the recovery of the lives of those who lived in them. While researching for this project, data has been gathered on the real and potential locations for over 125 AIDS boarding houses in 34 different states. As of writing this, this list is incomplete, so it possible there are more that existed. The houses stand at the intersection of several different scholarly concerns from medicine, urban studies, history, geography, and religious studies. By bringing these subjects into conversation this epoch of southern queer history could be better understood.

Glossary

ACT UP

AIDS Coalition to Unleash Power

HUD

Department of Housing and Urban Development

UAB

the University of Alabama, Birmingham

BAO

Birmingham AIDS Outreach

PWA

persons with AIDS

GMHC

Gay Men’s Health Crisis

ATFA

AIDS Task Force of Alabama

Author note: Recommended Works

• Examples of text that focus on ACT UP or its members as an anchor for the narrative: Deborah B. Gould’s Moving Politics (2009), Anthony M. Petro’s After the Wrath of God (2015), David France’s How to Survive a Plague (2016), Avram Finkelstein After Silence (2017), Benita Roth’s The Life and Death of ACT UP/LA (2017), Rita Santos’s Act Up! (2018), and Sarah Schulman’s Let the Record Show (2021).

• List text on AIDS in the South that are memoirs: Abraham Verghese’s My Own Country (1995), Ruth Coker Burks and Kevin Carr O’Leary’s All the Young Men (2022), Catherine Wyatt-Morley’s AIDS Journal (1997), and Freda Wagman’s Snippets from the Trenches (2007).