And yet, in this city of shadows, there is hope.
June 20, 1979, is an anniversary date for painter Rob Anderson, the day HIV first showed up in the blood that, running through his veins, gives him life. The windows of Anderson's painting studio on Third Street are almost as tall as the room is high, and light from those slices of sky falls onto the large canvas in the center of the room, tracing the sinews and tendons of a young man's leg. Anderson was 25 when he gave blood as part of a hepatitis B vaccine study at the old City Clinic south of Market; the blood, stored, was tested in 1985 as scientists tried to retrace the path of the new epidemic. Anderson is 42 now. His immune system is not impaired. He has no symptoms of disease.
"When there was this talk of everyone who gets HIV is going to die, I already had six years under my belt to let me say, 'Well, I don't know,' " says Anderson. "People like me were not even considered. We were like flukes."
As we enter into the second part of the second decade of AIDS, scientists around the country and the world are showing increasing interest in people who, like Anderson, test positive for HIV but don't get sick. At the San Francisco Department of Public Health, an ongoing study -- called the Clinic Study -- has monitored a group of HIV-positive people, primarily gay and bisexual men, who have lived for a decade and more without falling ill. The research has shown a side to HIV infection once thought impossible: that a positive result on an antibody test doesn't mean instant or certain doom, and that some HIV-positive people are living much longer than expected -- perhaps as long as anybody else. And as scientists search for the reasons behind long-term survival, the stakes are significant: the secret of how HIV operates, and what works to treat it, and what will work as a vaccine, and a cure.
There is no false hope, Rob Anderson says. Hope is not false. To say it is -- well, that's a contradiction to him.
On the day in 1985 when Anderson received the news that his stored blood from the 1979 hep B vaccine study had tested positive for HIV, he walked home through San Francisco and told his lover the news.
"I said, 'Do you think I'm going to die from AIDS?'
"He said, 'No.'
"I said, 'You're right,' " Anderson says.
For 17 years, Anderson has been a healthy positive. His HIV is something that's never very far from his mind, but it isn't the center of his world. "Maybe once a day, I say, 'Yes, I am HIV-positive,' but I don't live my life around being HIV-positive," he says.
But, he says, being HIV-positive has changed his life, if not his health. "How hasn't it changed my life?" he asks. "It's dispelled a lot of fear about living for me because it's the sense that I've been confronted with this form of potential death and it hasn't taken me. I certainly don't feel like I'm immortal or anything like that, but I feel like I've beaten the odds and had greater strength from it."
Anderson has never taken any antiretrovirals or other drugs intended to combat the effects of HIV. "I'm pretty opposed to it all, a little less now than I used to be. I've become a little more conscious of individuals needing to make their way through this thing. For some people, using the drugs gives them hope. But I think it probably would have killed me. I believe strongly that it would have killed me than helped me," he says.
Ask him if he follows any particular health regimen, and he says he does not. But his diet sounds pretty clean -- "I don't drink coffee, I don't smoke or drink alcohol, I limit my intake of things like sugar and fat and red meat. Not too much salt," he says. But he adds, "I'm not, like, a fanatic about it. I'm certainly willing to have a good piece of cheesecake once in a while."
And he meditates. He has practiced meditation since 1979, he says. The practice has given him a spiritual quality, a depth and stillness, like a lake in the morning, that's readily apparent. "I firmly believe that we all make our own choices in life," Anderson says. "That's not to say that somebody who is ill with AIDS is weaker or less ill, but I think their spirit has made that choice in their life experience -- I always think I'm a chicken because I won't go through that. I admire, I have tremendous admiration for my friends who have died from AIDS."
He says that being HIV-positive has not been without its benefits -- "in just discovering the joy in day-to-day living, seeing the wonder of life in everything around me. Even when I'm in a bad state of mind, just looking at that as an aspect of life. I guess it's just made me amazed."
And for those who are just finding out that they're HIV-positive, Anderson says, he has this advice: "In my position I would say don't give into the doomsayers, and listen to your own inner being. That's where I think you'll find the clearest guidance."
In 1982, Paul O'Malley, a researcher at the Department of Public Health, endured the death of one of his closest friends from the new, as-yet-unnamed disease that was making paths through San Francisco's gay community. Mourning his friend, O'Malley remembered something: that the man had taken part in the hepatitis B study the Health Department ran for two years, from 1978 to 1980, out of the old City Clinic. O'Malley had worked on the hep B study, which had recruited 6,705 gay and bisexual men to test the efficacy of a new hepatitis vaccine.