members' talents in politics, media relations, advertising, and law have been harnessed in an effort to bring public attention to the needs of persons with AIDS and to change the direction of AIDS policy. The tactics of ACT-UP, which frequently involve civil disobedience leading to arrest and the individuals ACT-UP has chosen to target and vilify as enemies of persons with AIDS have sparked an ongoing debate within and without the activist community (see Cohen, 1989; Spiers, 1989). ACT-UP protests—"zaps"—have been mounted against government and public health officials, church leaders, drug company executives, clinical researchers, and science reporters. ACT-UP attacks can be scathing; prominent government clinical researchers, for example, have been labeled Nazis by some ACT-UP protestors.
ACT-UP has waged its fight on a variety of fronts, frequently garnering national attention in the electronic and print press. Protests have included picketing the offices of Cosmopolitan magazine to protest the publication of what was claimed to be misleading information on heterosexual transmission of HIV; campaigning for needle and syringe distribution to intravenous drug users; protesting "mainstreaming" persons with HIV infection into New York City homeless shelters; and demonstrating against sodomy laws in Atlanta, Georgia. Some protests have been directed at particular policies, others at general consciousness raising. Two examples of the latter in San Francisco were protesters' snarling traffic on the Golden Gate Bridge, keeping commuters stranded for hours and disrupting the opening night of the 1989 opera season. In perhaps the most notorious ACT-UP zap, protestors disrupted a mass being celebrated by Cardinal John J. O'Connor at New York City's St. Patrick's Cathedral. During the protest, one activist crushed a communion wafer, which provoked a cry of protest and condemnation from a range of commentators, including New York Governor Mario Cuomo and President George Bush. The President decried ACT-UP tactics in an interview with religious broadcasters.
Much of ACT-UP's energy has been focused on the Food and Drug Administration, where protestors have charged that outmoded regulations and bureaucratic intransigence have impeded the development, licensing, and marketing of drugs to treat HIV infection and associated opportunistic infections. ACT-UP members have also locked themselves in the offices of Burroughs-Wellcome, accusing the drug company of gouging in the pricing of zidovudine (AZT), and they have occupied the offices of clinical researchers at the National Institutes of Health in Bethesda, Maryland.
Such very public protests have been supplemented by more quiet, "inside" work in policy-making councils. A few ACT-UP members have become exceedingly well schooled in the complex and often arcane details of drug development and regulation and the design of clinical trials. ACT-UP representatives have participated in the Institute of Medicine's Drug and