Josh Sides is the Whitsett Professor of California History and the Director of the Center for Southern California Studies at California State University, Northridge. His most recent book, Erotic City: Sexual Revolutions and the
Making of Modern San Francisco, looks at America’s capital of sexual libertinism and a potent symbol in its culture wars. In the excerpt below Sides introduces the history of AIDS in San Francisco.
Selma Dritz was the last person you would expect to be an expert on the outlandish gay sex scene South of Market. Born in Chicago to Russian parents in 1917, Dritz finished medical school in 1941 and became the chief resident of the Cook County Contagious Disease Hospital before retiring in 1947 to raise her three children. She and her family moved to San Francisco in 1949, where they bought a house in the sleepy southwestern edge of the outer Sunset District, and Dritz became a stay-at-home mom for almost two decades. Once her kids were grown, she got a master’s degree in public health at Berkeley in 1967 and quickly accepted a post as assistant director of disease control for the SFDPH. As a doctor and a mother, she already knew the terrain well. “At first,” she later recalled, the work “was the usual standard chasing down of measles, mumps, whooping cough, making sure that children in school had their proper immunizations.”
Very little in Dritz’s daily work routine changed during her first decade at the SFDPH. To be sure, rates of syphilis and gonorrhea increased, “but that didn’t bother anybody; one shot of penicillin and you were cured.” But by the end of 1977, Dritz remembered, there was a “complete change”: the number of enteric diseases, typically associated with the fecal contamination of food, escalated dramatically. Because virtually all of the patients were men, she knew that “these cases weren’t coming from eating establishments.” Instead, she came to learn, they had been transmitted through the exotic sex taking place in South of Market bathhouses and sex clubs. When she followed up her observations with close research, the findings were alarming: between 1974 and 1979, the annual number of amebiasis cases in San Francisco had risen from 10 to 250; annual cases of giardiasis had risen from fewer than 2 to 85; annual shigelosis and hepatitis A cases had doubled, and hepatitis B cases had trebled. By 1980, she estimated that 70-80% of all the patients at the SFDPH Veneral Disease Clinic were homosexual men. Dritz’s findings paled in comparison to those of Edward Markell, a doctor who conducted research among a sample of Castro District residents in 1982. Almost 60% of the subjects in Markell’s study tested positive for intestinal parasites.
“Too much is being transmitted,” Dritz warned a group of San Francisco physicians in 1980. “We’ve got all of these diseases going unchecked. There are so many opportunities for transmission that, if something new gets loose here, we’re going to have hell to pay.” Dritz was no scold; she was a consummate professional, and she never indulged in moralistic hand-wringing. Instead, she immediately reached out to the city’s prominent gay political clubs, gay business associations, and gay physicians to warn them about the threat. Her professionalism immediately earned her the trust of the gay community, and that of gay physicians in particular. In her early sixties and nearing retirement, Dritz had unwittingly become – as her children joked – “sex queen of San Fr