A death sentence. That’s what an HIV diagnosis used to be in this country. “How to Survive a Plague” documents the worst years of the epidemic, years in which people were dying apparently without end. The documentary provides a window into an activist group called ACT UP fighting to secure testing and implementation of treatments for HIV/AIDS. This group also focused on the elimination of stigma surrounding the disease.

The film begins in Year 6 of the epidemic. The movie also gives us background information about the disease and the epidemic: AIDS is nearly 100% fatal. Another panel with text reads “panic drives a backlash of blame and anti-gay violence.” This opening frames the narrative of the entire movie, a narrative primarily driven by video footage of ACT UP meetings and protests throughout the years.

“How to Survive a Plague” focuses on many gay men who were part of ACT UP, with present-day interviews with the survivors spliced into the film as well. The film provides an intimate view of many people’s lives, people who believed that they would indeed die before seeing a cure for the disease. Some of the most compelling moments of the film are close-ups portraits that reveal who survived.

Interspersed throughout the movie is footage of childhood movies of one of the focal point activists of the film, Bob Rafsky. The film uses Rafsky’s story to humanize the numbers. “Plague” shows us the death toll and the individual toll, individuals who could have been part of those numbers. While Rafsky’s story is not the only one the film portrays in this way, I found his to be the most compelling and emotional.
ACT UP and “How to Survive a Plague” focus on searching for a cure. This driving interest in seeing a cure for the disease presents an interesting paradox that “How to Survive a Plague” does not examine: reducing the stigma surrounding the disease while intensely searching for “the magic bullet” that prevents people from getting HIV in the first place. Furthermore, the film never explicitly states who composed the movement, but instead contented itself with talking about homophobia as a driving force with stigma to explain this paradox. This, of course, is true, but only partially so. “Plague” ignores the roles of queer people of color and trans people in the fight against AIDS.

The dominant narrative of the film, one of resistance against an unfeeling state and an apathetic people demonstrates the ominous and violent presence of a rampaging illness. Transition points throughout the movie are marked by a counter of AIDS deaths world-wide. In 1987, there are 500,000 deaths worldwide. By the end of the movie, in 1995, there are 8.2 million dead worldwide. Such a stark and terrifying number underscores the movie’s aura of a fight for survival that was often met with apathy.

“How to Survive a Plague” falls short when it prods the audience into seeing a battle between good versus evil. Such a construction of the fight is tempting, but does not reflect the complexity of the movement, one that oftentimes had friction and factions. Indeed, the film shows the split within ACT UP, a schism that resulted in the formation of TAG (Treatment Action Group), another group devoted to fighting AIDS. This complexity betters the film, but the good/evil dichotomy weakens the film’s impact. It would be a discredit and an insult, however, to pretend that there is not an obvious ‘side’ to root for, but to construct it as a fight that was won does a discredit to the many people still suffering and dying from the disease.

Recently, at a national conference about AIDS, trans women interrupted a meeting by going on stage, chanting “We are not gay men.” These chants illustrate an ongoing lack of access to and focus in healthcare for trans people, as well as the erasure of trans people throughout LGBTQ+ history generally. “How to Survive a Plague” contributes to this erasure by failing to acknowledge these truths.

At the end of the film there is a facts-and-figures section that illustrates the prevalence of AIDS’ today; these figures do not acknowledge problems that endure for LGBTQ+ folks who are not white cisgender gay men. The contrast between these narratives shows a continued apathy towards trans people. “Plague’s” deliberate ignorance of trans people and their stories, then, discredits a historical documentary that does not tell a complete history. Using ACT UP as a window into the fight against AIDS is certainly useful, but [we] should not and cannot stop there.