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The Private War That Killed Spencer Cox

January 2, 2013

Spencer Cox (Photo credit: Walter Kurtz)

Spencer Cox (Photo credit: Walter Kurtz)

"My most courageous self, the best man that I'll ever be, lived more than two decades ago during the first years of a horrific plague… I miss the man I was forced to become."
-- "Once, When We Were Heroes," 2007

AIDS did not kill Spencer Cox in the first, bloodiest battles of the 1980's. It spared him that.

The reprieve allowed Spencer's brilliance as co-founder of the Treatment Action Group (TAG) to forge new FDA guidelines for drug approval and help make effective HIV medications a reality, saving an untold number of lives.

Such triumph by a man still in his twenties might have signaled even greater achievements ahead. Instead, Spencer found himself adrift in the same personal crisis as many of his contemporaries, who struggled for a meaningful existence after years of combating the most frightening public health crisis of modern times.

Gay activists like Spencer were consumed by AIDS for so many gruesome years that many of them were shocked, once the war abated, to see how little around them had changed. Climbing from the trenches, they saw a gay culture that must have seemed ludicrous, packed with the same drug addictions, sexual compulsions and soulless shenanigans that AIDS, in its singular act of goodwill, had arrested for a decade or so.

They found themselves in a world in which no one wants to see battle scars, where intimacy is manufactured on keyboards and web sites, where any sense of community had long since faded from the AIDS organizations and now only makes brief appearances in 12-step meetings, or as likely, in the fraternity of active crystal meth addicts chasing deliverance in a dangerous shell game of bliss and desolation.

The dark allure of meth, a drug so devoured and fetished by gay men today that it is now a leading indicator of new HIV infections, enticed Spencer at some point along the way. The drug is known to whisper empty promises about limitless power and sexual escape, while calming the addict's ghosts and sorrows for miserably brief periods of time.


When Spencer Cox died on December 18, 2012, in New York City, the official cause of death was AIDS-related complications, which is understandable if post-traumatic stress, despair and drug addiction are complications related to AIDS.

Spencer believed that this connection exists. His own writings for the Medius Institute for Gay Men's Health (an organization he co-founded after his work with TAG) focus on exactly the issues that were distressing him personally: Crystal meth abuse. Loneliness. Risk taking. Feelings of confusion after years of accomplishment and purpose.

In retrospect you can read his work and break the private code written between the lines. It spells out "HELP ME."

Spencer's life during this period and beyond was difficult, by many accounts. The Medius Institute failed due to a lack of funding, defeating Spencer's effort to address mental health issues among gay men. His drug addiction spiraled and ebbed and raged again, until he finally retreated to Georgia to live with family for a few years.

When Spencer returned to New York City last September, many of his closest friends had lost track of him. There is uncertainty about his last months, and no evidence that his addiction was active, but what little medication compliance he managed had been abandoned completely, setting the stage for his final hospitalization.

Spencer Cox died without the benefit of the very drugs he had helped make available to the world. He perished from pneumonia, in an ironic clinical time warp that transported him back to 1985. It was as if, having survived the deadliest years of AIDS, having come so close to complete escape, Spencer was snatched up by the Fates in a vengeful piece of unfinished business.

AIDS has always been creative in its cruelty. And it has learned to reach through the decades with the second-hand tools of disillusionment and depression and heart-numbing traumas. Or, perhaps, using the simple weapon of crystal meth, with all of its seductions and deceits.

Yes. There are many complications related to AIDS.

To consider "survivor's guilt" the culprit behind the death of Spencer Cox is a popular explanation but not necessarily an accurate one. That condition suggests surviving when other, presumably worthier people, did not. Sometimes guilt has nothing to do with it.

For many of our AIDS war veterans, the real challenge today is living with the horror of having survived at all.

More From This Resource Center

Undetectable Viral Load and HIV Prevention: What Do Gay and Bi Men Need to Know?

Do HIV-Negative Gay Men Need Condoms if They're on PrEP? Here's What I Tell My Patients

This article was provided by Visit Mark's live blog.
See Also
More Viewpoints Related to HIV/AIDS Among Gay Men

Reader Comments:

Comment by: james f barry (setauket new york) Wed., Jan. 23, 2013 at 8:20 pm UTC
Thank you. And I would like to taahnk Mr. Cox again for everything he did to keep me alive......I only wish I could have helped him.....
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Comment by: James L, (London UK) Thu., Jan. 10, 2013 at 4:13 pm UTC
I survived an AIDs diagnosis back in 2007, a near death ex experience and got myself back together again....or so I thought.
Like Spencer I allowed myself to be seduced by the Meth, only this week to find myself in the very hospital where my life was saved on a come down and suffering a severe infection.
I think James has just sent me a little miracle through this video.
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Comment by: Ken Warnock (Royal Oak, MI) Wed., Jan. 9, 2013 at 11:53 am UTC

I had just watched "How to Survive a Plague" a week before Spencer Cox died. I was saddened by the news and after reading your article, I am somewhat frustrated as well. I have never been a part of the recreational drug culture, so I cannot pretend to comprehend what demons they unleash in a person, but I do know what happens when I stop taking my meds (ART) and that is definitely bad news! I worry about losing ADAP coverage due to cost-cutting measures and remind my Representatives and Senators from Michigan of this. Thanks for this look into Spencer's life. I shared this on FB and Twitter so others may appreciate him, too!!
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Comment by: robert perez (K.C.M.O.) Mon., Jan. 7, 2013 at 6:40 pm UTC
Hmmm,Spencer Cox,seem to hold a very bright light for his afflication{A.i.D.s},but,in the end as well as cancer survivors it seem to this listner that 99%of the truth died with him.Sadly,we sit back and watch a horrible disease take almost every one in its path,lets hope that Spencer Cox and those like him find a cure.
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Comment by: rigo Mon., Jan. 7, 2013 at 7:59 am UTC
crying a little bit here, after knowing this, what else can u say.
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Comment by: Nick (NE) Fri., Jan. 4, 2013 at 12:01 pm UTC
Brilliant man! I enjoyed this article very much, and being a long term survivor myself, it distresses me also to see the backlash from the gay comm. on HIV/Aids...everything from shunning to ignoring. Frightening to see a new wave of Bare-backing in the Gay Community, both porn and real life....its like nothing ever happened! Like magic it just went away...while I'm still trapped!
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