How to Survive a Plague

Movie review by
Barbara Shulgasser-Parker, Common Sense Media
How to Survive a Plague Movie Poster Image
Moving doc follows AIDS scourge and history of gay activism.
  • NR
  • 2012
  • 110 minutes

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Positive Messages

Never give up. A life or death situation can give people the courage to do what they otherwise might lack the confidence to accomplish.  

Positive Role Models & Representations

Gay men and their advocates teamed up to create ACT UP and later TAG, two activist organizations that led the way in creating protocols for researching, creating, and distributing new treatments for AIDS. Their model would pave the way for other equally passionate and motivated groups to make their voices heard. A retired chemist supported ACT UP, offering to teach members how the FDA and governmental health bureaucracy works. Some researchers were inspired to work harder after encountering the determination and drive of activists.


Protesters clash with police. A police officer on horseback walks a horse into a demonstrator, then hits her with a baton. AIDS sufferers call politicians who aren't dedicating sufficient funds to AIDS research their own "murderers." Politicians claim that AIDS is a disease caused by "behavior," suggesting that if gay people stopped having gay sex, there would be no need for urgent and expensive research. This was before AIDS became a worldwide, heterosexual epidemic. Emaciated patients are seen in hospital beds. Key actors in the movement die before life-saving treatments are found. Prejudice against gays and fear of contagion show society at its worst, as hospitals refuse to take AIDS patients and reportedly wrap the dead in black trash bags. Some treatments do more harm than good.


The movie focuses on widespread discomfort in the heterosexual world with gay sexual practices. Senator Jesse Helms decries gay sex on the senate floor and advocates celibacy. Then-president George H.W. Bush blames gay men's sexual behavior for giving them AIDS and he suggests they change that behavior. The Catholic Church comes out against condom use at the height of the AIDS crisis, even though condom use could help prevent the spread of the disease. A closeted gay man quits his Wall Street job and joins AIDS activists after a higher up at work suggests that gay men deserve AIDS because "they take it up the butt." 


"F--k," "s--t," "damn," "ass," "faggot," "hell," and "schmuck."


In the 1980s, gay AIDS sufferers and family and friends of the community formed ACT UP and later TAG, to loudly and relentlessly advocate for drug companies and the federal government to step up research, development, and release of drugs to fight AIDS. Rather than wait for products already available in other parts of the world to receive federal approval, activists designed protocols for research and demanded to work side by side with government and corporate players, which resulted in life-saving treatments.

Drinking, Drugs & Smoking

Adults smoke cigarettes. Much of the movie focuses on insufficient government AIDS research and slow federal approval and distribution of new medications that might have helped control AIDS symptoms or disease progression.

What parents need to know

Parents need to know that How to Survive a Plague is a 2013 Oscar-nominated documentary about the grassroots activism that the AIDS epidemic first spurred in the 1980s. In the United States, the early epidemic largely targeted the gay male population, with New York City hit especially hard. This may raise questions from younger viewers as to why gay men were the first to be hit by the epidemic, and teens may have questions about what gay sex practices made that population most vulnerable early on. The movie displays archival footage showing how devastated victims and their supporters created ACT UP, an organization dedicated to spurring the government and pharmaceutical companies into releasing existing treatments and creating new ones. Images of emaciated and dying AIDS patients are part of the movie's landscape. Police brutality and political and religious anti-gay bias are on full display. Language includes "f--k," "s--t," and "faggot."

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What's the story?

According to federal data, in 1995 AIDS was the leading cause of death among Americans aged 25 to 44. But 15 years before, as shown in HOW TO SURVIVE A PLAGUE, the AIDS epidemic largely targeted the gay male population. At that time, the death rate of sufferers was nearly 100 percent. How to Survive a Plague chronicles the story of how mostly gay men formed ACT UP to fight for the release of drugs that were being delayed by bureaucratic red tape owing to archaic policies that didn't address the urgency of a deadly epidemic and, almost certainly, also homophobia. Some gay ACT UP members who had previously been closeted recognized the need to come out and protest in order to change the way pharmaceutical companies were looking for treatments and cures. The movie doesn't specifically make the connection between the emergence of vocal AIDS activists and subsequent strides made toward acceptance of the LGBTQ community, including gay marriage. But the inference is unavoidable. 


Footage of protests in front of the White House, at the FDA, at pharmaceutical companies, at a Catholic cathedral during Mass, and other sites show throngs of advocates bearing signs protesting federal research budgets, poor coordination of research at the National Institutes of Health and a general lack of sufficient action by the federal government in the face of thousands of AIDS deaths. ACT UP's grit, passion, intelligence and determination led to treatments that ultimately changed AIDS from a death sentence to a chronic, controllable disease. ACT UP became a model for community activism, with success achieved without the use of social media or the internet. Some surviving members remained active and went on to advocate for making treatments available to impoverished men, women and children with the disease worldwide. 

Is it any good?

First-time director David France expertly weaves together footage from the 1980s and '90s to create a moving narrative in which advocates for a cure were themselves sufferers of the disease. The urgency of their quest is palpable as some activists make the point that cures may not be found in time to save them. The movie follows many ACT UP members as they grow thinner and paler over their years of struggle, and we learn that some don't survive the disease's ravages. France had covered the epidemic as a journalist and his partner died of AIDS-related pneumonia in 1992. Although he maintains a professional view, his own connection to the material may be part of what imbues How to Survive a Plague with an urgency and a sense of appropriate outrage that will resonate with viewers. 

Talk to your kids about ...

  • Families can talk about how societal biases have pressured many in the gay community to remain closeted. How do you think it would feel to worry that friends and family won't accept you the way you are?

  • Families can also talk about how they feel as a family about gay issues. Do you object when people use anti-gay language at school? 

  • AIDS was once viewed as a gay disease, and its proliferation was used to vilify and marginalize the gay community. As of 2015, around 35 million men, women, and children had died of it and another 35 million were living with it. Do you think the social climate has changed for gay people and people with AIDS since the era this movie depicts?

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