It took nearly 30 years for a national audience to see a film adaptation of Larry Kramer’s semi-autobiographical The Normal Heart, a play about the early days of the AIDS epidemic in New York City. The new HBO film, which premiered Sunday evening, is a fine interpretation for the medium, visually emphasizing the gay 70’s sexual liberation on Fire Island, the harsh juxtaposition of 20-somethings at a dance club with walkers and I.V. poles, and the grotesque Kaposi’s sarcomas and other symptoms that mark the story’s accumulating victims to the epidemic. Still, the three-decade delay leaves the film feeling a bit like a period piece biopic, a relic of a time now past instead of the call to arms Kramer still believes it to be. Indeed, it resonates as much with the modern-day fight to curb the spread of HIV as it did then.
When The Normal Heart debuted in 1985, it was anything but a period piece, portraying events that had just taken place in the years prior. The epidemic was far from peaking, and Kramer hoped that the play would be a wake-up call for how urgent the crisis was. By the end of that year, there would be 15,527 reported cases of AIDS and 12,529 deaths, more than double 1984’s numbers and barely half of 1986’s numbers.
Through the character Ned Weeks (Mark Ruffalo), Kramer’s representation of himself, The Normal Heart offers a candid portrayal of two strategies for countering the epidemic. The firebrand Weeks aggressively seeks recognition from the public that AIDS is a gay issue while simultaneously calling on gay men to relinquish their sexual liberation for their own well-being. Bruce Niles (Taylor Kitsch), president of the Gay Men’s Health Crisis (based on the real original GMHC president Paul Popham), takes a “good cop” closeted approach, trying to make nice with the government by de-emphasizing the group’s gay identity and trying to placate the liberation that the community felt it had achieved in the decade since the Stonewall Riots. Though Kramer believed his own approach was right — and Ryan Murphy, director of the new film, has said that he agrees — The Normal Heart invited those still fighting to consider both tactics.
The new film offers up this same tactical juxtaposition with the gloss of Hollywood. Rather than names solemnly projected on the wall of a set as more people die over the course of the play, the movie references the growing toll in dialogue, conveying the onset of the epidemic a bit more subtly. Bruce’s long, trembling monologue about attempting to fly his dying partner home to Arizona is trimmed, but supplemented with an horrific portrayal of the trip. So too is Dr. Emma Brookner’s (Julia Roberts) angry plea for AIDS research funding truncated and reduced to an empty classroom, seemingly lowering the stakes while perhaps more accurately portraying the futility of her efforts. And something similarly felt lost in the close-focus direction of Ned’s final confrontation with his dying lover Felix (an impressive Matt Bomer), though perhaps nothing in film can replicate the visceral impact of the iconic carton of milk smashed upon a wide naked stage, staining it through the play’s final scene.
Though it depicts a very different moment in the epidemic, the arrival of The Normal Heart in living rooms across the country is timely. Thanks to years of improved testing procedures, antiretroviral therapy, and general improvements more broadly to education and care, AIDS mortality is on the decline and HIV infection rates have at least stabilized (though not declined). Still, new prevention methods are resurrecting the same debates as to how to proceed that activists wrestled with three decades ago.
Some AIDS activists believe the technology now exists to contain the spread of the virus and possibly even eliminate its pervasiveness within two generations, and it’s a compelling case. Studies show that for individuals who’ve been diagnosed as HIV-positive and who maintain a regiment of medication and medical supervision to ensure that their viral loads remain at undetectable levels, it’s virtually impossible for them to infect others. Likewise, a new treatment known as PrEP (pre-exposure prophylaxis), now recommended for general public use by the CDC, allows individuals who are HIV-negative to take antiretrovirals, which have been found to be more than 90 percent effective at preventing infection. If both strategies were successfully implemented writ large, they could hypothetically halt infection rates — at least domestically — but even that remains a tall order, both culturally and financially.
And Larry Kramer continues to be a vocal contrarian in the debate. In a recent New York Times interview, he suggested that anybody who would voluntarily take Truvada (the brand name for PrEP) “has got to have rocks in their heads.” “There’s something to me cowardly about taking Truvada instead of using a condom,” he told the Times. “You’re taking a drug that is poison to you, and it has lessened your energy to fight, to get involved, to do anything.”
Peter Staley, another veteran of the early AIDS fight, countered Kramer’s remarks last week in an interview with Slate: “Telling people that they’re cowards for not wearing condoms — I don’t think that’s going to create a mass movement of putting condoms on.” He suggested that without the “death and dying” that prompted the “safe-sex condom code” of the 1990s, such messaging simply isn’t effective. “The goal is not condoms on dicks,” Staley explained, “The goal is fewer HIV infections.” Using PrEP certainly doesn’t preclude using condoms, but it does provide an effective prevention measure for the many men who simply don’t to use condoms consistently despite all of the education that has taken place.
And that’s why the new interpretation of The Normal Heart can’t be viewed as simply a relic of the past. Though HIV now reaches many populations beyond men who have sex with men (MSM), that population continues to exhibit high infection rates, particularly among men of color. The fight that Kramer and others started back in the 1980s rages on today, and it continues to be one with significant implications for both the culture and health of gay and bisexual men. Even thirty years later, The Normal Heart can still be the call to action that Kramer always intended it to be.