The Denver Principles

It was June 1983. The Fifth Annual National Lesbian and Gay Health Conference and National AIDS Forum was underway in Denver, Colorado.^[1] AIDS had a name — barely. The virus that caused it (what we now call HIV) had not yet been identified; that discovery was still months away.^[2] By the CDC's own count that June, the disease had already killed hundreds of Americans, and the number was climbing fast.^[3] The federal government's response was, by any honest measure, a failure.

At the conference, a small group of gay men with AIDS from cities across the country gathered — many meeting each other for the first time.^[4] Until then, AIDS activism had been a local, neighborhood-level effort — a few people in the West Village, the Castro, West Hollywood. These men had never sat in the same room before. They came to Denver to compare notes, share what they were living through, and figure out how to make sure their voices were heard.

They spent days in a hotel room writing. Debating. Arguing about how to talk about a disease that was killing them while much of the world looked away. The San Franciscans and the New Yorkers didn't always agree. They found common ground anyway.

Then, on June 12, 1983, as the conference drew to its closing session, they did something no one expected. Carrying the "Fighting For Our Lives" banner — first raised months earlier at candlelight vigils in San Francisco and brought to Denver for this moment — eleven of them walked to the front of the room and read portions of the document they had written aloud to the entire assembly.^[5] A rare photograph held by Cornell University's library captures Richard Berkowitz and ten other men standing behind that banner as they read.^[6]

It was among the first times in modern public health that people who shared a diagnosis organized collectively to assert their right to a political voice in the decisions that would determine whether they lived or died.^[7]

The document they read would come to be known as the Denver Principles. It would reshape how the world responds to HIV — and how patients everywhere are treated — for the four decades that followed, and counting.

The Denver Principles were shaped most visibly by two men from opposite coasts who had never met before that week: Bobbi Campbell from San Francisco and Michael Callen from New York City. Both took charge of drafting the document, and it reflects a careful synthesis of their sometimes conflicting perspectives.^[8]

They worked alongside Dan Turner, Richard Berkowitz, Bill Burke, Bob Cecchi, Artie Felson, Phil Lanzaratta, Tom Nasrallah, Bobby Reynolds, Matthew Sarner, Gar Traynor, a man remembered only as "Elbert from Kansas City by way of Houston," and a person with AIDS from Denver whose name history has not preserved.^[9] All of them were living with AIDS at the time. All of them understood they might not survive it.

History has not kept a perfect record of everyone in that hotel room. What survives is a partial list of names — Richard Berkowitz, Bill Burke, Michael Callen, Bobbi Campbell, Bob Cecchi, Artie Felson, Michael Helquist standing in for Mark Feldman, Phil Lanzaratta, Tom Nasrallah, Bobby Reynolds, Matthew Sarner, Gar Traynor, Dan Turner, a man known only as Elbert, and at least one Denver-based person with AIDS whose name was never recorded.^[15] That gap in the record is itself part of the story: in 1983, disclosing an AIDS diagnosis publicly could cost someone their job, their housing, or their family. Some of the people who helped write the Denver Principles chose, understandably, not to have their names attached to it at all.

The Denver Principles are short — a few hundred words. But every line carries weight, and many of the ideas they contain were considered radical in 1983. Some of them still are.^[16]

The Denver Principles didn't just change HIV advocacy. They changed healthcare.

The next time your doctor consults you about a change of medications. The next time you're given full information about a procedure and asked to consent. The next time your medical records are treated as confidential. The next time someone uses person-first language — "person living with HIV" instead of "AIDS patient" — you are living in the world the Denver Principles helped build.^[17]

Person-first language. The Denver Principles introduced "People With AIDS" — rejecting "victim" and "patient." This wasn't just semantics. It was a declaration of agency. The concept has since become standard across all of healthcare, and is echoed in the CDC's own current style guidance on person-first language for HIV.^[20]

Patient self-determination. The idea that patients should be consulted about changes in care, have equal voice in treatment decisions, and be able to refuse procedures without losing access to care — all of this was asserted in Denver before it was standard practice anywhere.

Nothing about us without us. The demand that people with AIDS serve on the boards of organizations that served them — and be included at every level of decision-making — created the template for the GIPA/MIPA principle (Greater and Meaningful Involvement of People with AIDS/HIV), formally adopted at the 1994 Paris AIDS Summit, where 42 national governments signed the Paris Declaration on AIDS.^[21]

The right to sexuality and intimacy. In 1983, with a new sexually transmitted disease in full bloom, a group of people living with it demanded the right to "as full and satisfying sexual and emotional lives as anyone else." That was extraordinary. It is still not universally accepted. It is still necessary.

In the months after Denver, the men who wrote the Principles — and the networks they built — founded People With AIDS organizations across the country. Campbell and Callen flew to New York together after the conference, organizing and planning on the plane. They built a PWA organization in the city despite initial resistance from the Gay Men's Health Crisis. The Patient Advisory Committee that had convened at the Denver forum went on to establish the National Association of People with AIDS (NAPWA) that same year, 1983, giving the movement a permanent national organization. Two years later, in 1985, Callen became a founding member of the People with AIDS Coalition in New York, the first organization to spring directly from the AIDS self-empowerment movement.^[22]

The Denver Principles laid the groundwork for ACT UP, for the Treatment Action Group, for every community advisory board at every clinical trial site, and for every patient advocate who has ever demanded a seat at a table where decisions were being made about their own body and their own life.

They also influenced the World Health Organization's 1986 Ottawa Charter for Health Promotion, which declared that people "cannot achieve their fullest health potential unless they are able to take control of those things which determine their health." The echoes of Denver are in that sentence.

Then, in 1994, the principle the Denver drafters had insisted on eleven years earlier — that people with AIDS belonged in the room where decisions about them were made — was formally adopted on the world stage. At the Paris AIDS Summit, 42 national governments signed the Paris Declaration on AIDS, committing to the Greater Involvement of People Living with HIV/AIDS (GIPA).^[23] Richard Berkowitz, the last living author of the Denver Principles, has noted that the document has since been "celebrated by the United Nations, the World Health Organization and governments around the world" — a reach the drafters could hardly have imagined from that hotel room.^[24]

The principles traveled far beyond HIV, too. Cancer patients, disability rights advocates, and people living with chronic illnesses of every kind have all drawn on the model the Denver Principles established: that the people most affected by a condition hold the most important expertise about it, and that their voices belong at the center of every response. On June 12, 2023, advocates gathered in Denver to mark the document's 40th anniversary — a milestone that drew renewed attention to both how far the response has come, and how much of the original fight remains unfinished.^[25]

The Denver Principles are 43 years old in 2026. The science of HIV has been transformed since that hotel room in Denver. We have effective treatment. We have U=U. We have PrEP. People living with HIV today can expect to live full, long lives.

And yet.

Stigma has not disappeared. HIV criminalization laws still punish people who pose no actual risk of transmission. People living with HIV are still, too often, excluded from the conversations and decisions that shape their own care. In many communities — particularly across the American South, in Black and Latino communities, among transgender people, and among people who use drugs — the promise of the Denver Principles remains unfulfilled.

The Denver Principles were written by people who knew they were dying, and who insisted — while dying — on their right to participate in decisions about their own care and their own lives. In 2026, that fight is not over. People living with HIV are once again facing major policy changes that will be decided by others, largely without them at the table.

Three changes now underway make the Denver Principles' central demand — a seat at the table — as urgent in 2026 as it was in 1983:

Medicaid work requirements arrive January 1, 2027. The 2025 federal reconciliation law (H.R. 1 / Public Law 119-21, signed July 4, 2025) requires 44 states plus Washington, D.C. to impose work requirements on adults in the ACA Medicaid expansion group.^[26] Many people living with HIV who rely on ACA-expansion Medicaid will be affected — and, as with so many policies before it, the people most affected had little voice in designing it.

ACA premium subsidies have shrunk. The enhanced premium tax credits that lowered Marketplace insurance costs expired December 31, 2025, and have not been renewed by Congress.^[27] For people relying on ADAP premium assistance or paying out of pocket for Marketplace coverage, this means higher monthly costs in 2026.

Ryan White funding held — but the fight to keep it never stops. The Ryan White HIV/AIDS Program's FY2026 appropriation landed at a stable $2.571 billion, restoring funding that had originally been proposed for cuts.^[28] That stability took organized advocacy to secure, and it will take the same organized advocacy to protect going forward.

Most of the men who wrote the Denver Principles did not survive the epidemic they were fighting. Bobbi Campbell died in 1984 at 32.^[10] Dan Turner died in 1990 at 42, after nearly eight years living with an AIDS diagnosis.^[12] Michael Callen died in 1993 at 38.^[11] Bobby Reynolds, Phil Lanzaratta, Tom Nasrallah, Artie Felson — gone. Mark Feldman, who coined "person with AIDS," died before the document was even read aloud.^[14]

They wrote it anyway. They wrote it knowing they might not live to see what it became. That is what makes it matter — not just as a historical document, but as a living instruction for everyone who comes after: form your own caucuses, choose your own representatives, and insist on being in every room where decisions about your life are made. "Nothing about us without us" was not a slogan the Denver drafters invented, but they translated it into HIV policy — and it has never been more urgent than now.

We are People With AIDS. We are People Living With HIV. We are not victims. We are not passive. We are still here. And so are the principles.