infected, but also because those still at risk had modified their behaviors. Young gay men were not getting infected at the rates that characterized the age cohort that came of age between 1975 and 1985. This period marked a major transition in the New York gay community. The volunteer agencies had emerged as a potent political force. Voluntary efforts had been the primary force in staying the epidemic of transmissions within the gay community and had also supplied most of the social support resources of those who were ill. The reduction in new infections and steady increase in the numbers of persons needing health care and other services caused the major volunteer agencies to turn their attention to issues of treatment and care. This attention extended to both the delivery of care and attempts to mobilize the governmental sector.
The Gay Men's Health Crisis (GMHC) is probably the largest central volunteer agency in New York providing supportive care to the gay community in New York City. Their activities included buddies; crisis intervention; support in securing and preventing discrimination in housing, health care, and employment; and providing educational services. By June of 1991, it had served 11,362 clients and had a current caseload of 3,266 persons. GMHC has taken stands on most of the major issues facing the gay community and attempted to extend its outreach to nongay-identified and other men who had sex with men throughout the city.
Although recognizing GMHC achievements, some within the gay community thought its political strategies were too moderate. The perceived need for a more radical political effort gave birth to ACT-UP (AIDS Coalition to Unleash Power). ACT-UP was created as a nonhierarchical direct action organization that made decisions concerning demonstrations ("actions" or "zaps") or policies on the basis of an open democratic forum. Although a committee structure developed around specific issues, the town meeting format has sustained itself in the face of substantial increases in membership. There are now ACT-UP groups in many cities across the country, and there is still no central office.
ACT-UP/New York has been an important player in conflicts within the city in a variety of areas and has extended its interests well beyond the gay-identified community. ACT-UP has been visible in a number of New York City conflicts, including those over the reduction in estimates of numbers of persons with HIV in New York City (Bayer, 1991); the appointment of Woodrow Meyers as Health Commissioner (Purdum, 1990; Bayer, 1991); the dispute about condoms in the schools; a continuing conflict with Cardinal John O'Connor about various positions of the Roman Catholic Archdiocese of New York related to AIDS and gay life; and attempts to improve police practices in dealing with the gay and lesbian community (ACT-UP/New York, 1991). On the national scene, ACT-UP/New York has played both an insider's and outsider's role in putting pressure on the National