At a time when the once-massive ACT UP movement is a shadow of its former self, some question the relevance of direct action in fighting AIDS. In several cities, small ACT UP chapters still soldier on, but ours has actually grown, regularly bringing hundreds out for demonstrations on issues ranging from drug pricing to syringe access to Medicaid managed-care abuses. Our mission remains the same -- to fight for people with HIV and those at greatest risk of infection. But who are those people now? In Philadelphia, they are primarily people of color, women, drug users and low-income folks of all sexual orientations. At our demos and meetings, you are now more likely to meet a straight, African-American former drug user than a gay, white professional.

Working with a more diverse group has changed the way we design actions. Case in point: Last year, Health Secretary Donna Shalala was coming to speak at a church outside Philadelphia just after rejecting syringe-exchange funding. Longtime ACT UPers, remembering earlier actions done with different constitutencies, imagined a loud confrontation inside the church.

But newer members noted that many people we work with would be outraged by raising hell inside a church. The outcome? Inside the packed sanctuary, hundreds turned their backs on Shalala while whispering in unison: "Donna Shalala, you killed my sister, you killed my brother." The eerie reproach emboldened participants without violating their beliefs. Shalala slunk down in her chair as Joyce Hamilton, an African-American ex-user with HIV, walked up the aisle castigating her action. The protesters then marched outside for a rowdy demo.

Today, as calls for name reporting grow louder, syringe exchangers fight arrests, pharmaceutical price-gouging worsens, and treatments fail for more and more PWAs, direct action remains important -- and effective. Here in Philadelphia, we have won victories, such as restoration of city funding for syringe exchange, specialized HIV docs for those on Medicaid, and free viral load tests for clients of the AIDS Drug Assistance Program. As ever, the key to success is drawing on the strengths of diverse communities of resistance.