Letterman Hospital and the HIV Epidemic

Parklands of Golden Gate National Recreation Area incorporate San Francisco, San Mateo and Marin counties. All of which, envelope overlapping military histories, and social movements that influenced each other. This included military bases and the Presidio’s Letterman Army Hospital. LGBTQ military personnel faced the military ban, discrimination and in 1981: the HIV/AIDs epidemic. As of 2019, Over 1.1million people in the United States have had HIV.1

Gilbert Baker holds the first Rainbow Flag as it begins to fly at the United Nations Plaza in San Francisco.

Photo by James McNamara, Gilbert Baker Foundation.

An Epidemic Begins

Established in 1899, Letterman Hospital was an important site for many military personnel and veterans. Located in the Presidio, Letterman Hospital pioneered research and provided indispensable care to many. Thousands of soldiers who served in the Pacific came through the Presidio and were treated there. At the end of WWII in 1945, Letterman saw more than 73,000 patients. The Medical Center trained one fourth of the medical specialists in the military during the Vietnam War. During the 1980s the hospital mostly served veterans and their dependents.

The 1970s saw an increase in LGBTQ+ activism in San Francisco. Many people leading the charge were veterans like Gilbert Baker, Ken Jones, Harvey Milk, and more. Activists, and writers Barbara Cameron and Pat Parker demanded intersectionality in the movement. Veteran Pat Norman pioneered LGBTQ+ representation in health care as the first openly gay employee with the San Francisco Health Department from 1978-1987 and as the first Coordinator for Lesbian/Gay Health Services. The fight for better health care for LGBTQ people became even more crucial when the HIV epidemic began.

At the beginning of the HIV epidemic in San Francisco no one understood what was making people ill. On April 24th 1981, in San Francisco, Ken Horne was the first patient in the United States to be diagnosed with Kaposi’s sarcoma (KS), a rare cancer. KS is considered a sign that an HIV positive individual has transitioned into having AIDS. In December 1981, Bobbi Campbell became the first person with KS to publicly announce his illness when it was published in the San Francisco Sentinel. Campbell began advocating for more awareness around this illness in the LGBTQ+ community. By 1984, San Francisco’s rate of infection was the highest per capita in the nation. Public funds, research, and government aid was still inconceivably low.

When the HIV epidemic began, the military was still discharging individuals for their sexuality. In 1982, the Department of Defense doubled down on their stance and released an official policy that said, “homosexuality is incompatible with military service.”2 The military banned anyone who tested positive for HIV from entering military service. A policy also existed that required medical confidentiality. People who tested positive were not supposed to be discharged based on their diagnosis. However, after a positive test result, many servicemen admitted their sexuality to medical professionals. Their admissions used as justification for other than honorable discharges. If HIV positive people were able to keep their position, their status was often leaked and the resulting harassment would force many to leave.

Rights and Awareness

In May 1983 thousands of people walked from the LGBTQ+ neighborhood, The Castro, to the Civic Center with a banner that read, “Fighting for Our Lives.” This demonstration was the first major protest against the lack of attention and medical research. Ken Jones became president of San Francisco Pride in 1985, making him the first Black president of Pride. Jones, alongside others, pushed for the desegregation and equitable treatment opportunities for Black HIV patients.

The NAMES Project AIDS Memorial Quilt panels displayed at San Francisco City Hall during San Francisco Lesbian and Gay Freedom Day Parade.
Image Courtesy of the AIDS Treatment News records, MSS 94-28. Archives and Special Collections, University of California, San Francisco.

In November 1985 Cleve Jones used art to illustrate the impact of the epidemic by creating the NAMES Project AIDS Memorial Quilt. At the time 1,000 people had passed in San Francisco. In 1987 the Quilt was displayed on the National Mall in Washington DC during the National March on Washington For Lesbian and Gay Rights, which Pat Norman co-chaired and organized. The Quilt included 1,920 panels and as the epidemic went on unfortunately the panels only increased. The international display humanized the victims of the epidemic and brought awareness to the devastating impact of AIDS.

Letterman Army Medical Center

Letterman Army Medical Center was a 550-bed hospital

NPS

No one could evade the AIDS epidemic, not the military or the Presidio personnel. Between 1985 and 1987 Letterman Hospital provided HIV testing for military personnel. The hospital also performed medical evaluations for HIV positive service members.4 From 1986 to 1988 Letterman Hospital published Safety and Health Brochures with sections on “What you should know about HIV & AIDS” and “Safer Sex - Prevent AIDS & Other STDs”.5 In 1988 many San Francisco Medical Centers, including Letterman Army Hospital, sought out volunteer massage therapists for people with AIDS.

On October 23rd, 1987 Jesse Anthony Maldonado passed away from complications from AIDS at Letterman Hospital. His obituary reads, “Among the physicians on staff at Letterman Army Hospital his courage, optimism and vitality amazed all. Among other patients he was caring and supportive of them, loving unconditionally.”6 Letterman Hospital lost a team member to the disease when Marcus “Marc” T. Thompson passed away on November 26th 1990. He had served as a Navy Medic in Japan in the 70s and was working as a property clerk at Letterman Army Hospital.

The 1970s through the 1990s saw incredible change in San Francisco. From an LGBTQ+ rights movement to a devastating epidemic, the art and protest of this time connected the city. While the military did not create a safe space for LGBTQ+ or HIV positive individuals, many veterans took up the fight for their community. Letterman Hospital, much like other health care facilities at the time, was on the front lines until it closed in 1994.

In 1991 volunteers broke ground on the AIDS Memorial Grove in Golden Gate Park as a way to channel their grief. In the epidemics single deadliest year, the United States lost 50,000 Americans to the AIDS epidemic in 1995. The following year, the AIDS Memorial Grove was designated as the nation’s AIDS Memorial site. As of 2021, even with major advances in medicine, individuals who are HIV positive still can not enter the military. Positive personnel often can not move up in the ranks or are deemed unfit for combat. Many service members are still denied promotions or discharged from service.7

2 “A Brief History of LGBT Military Policy and Improving Acceptance, Integration and Health among LGBT Service Members.” USC Suzanne Dworak-Peck School of Social Work, 28 Aug. 2018.

3 Connie Johnson, “Disco Singer Sylvester Confronts AIDS without Any Regrets.” Los Angeles Times, 10 Sept. 1988.

4 United States General Accounting Office Defense Health Care Effects of AIDS in the Military. February 1990.

6 “Deaths.” Bay Area Reporter, Volume 17, Number 46, 12 November 1987. P. 18.

7 Lalwani, Nikita. “Unsafe and Unsound: HIV Policy in the U.S. Military.” The Yale Law Journal , Apr. 2021.