As the AIDS crisis took hold in the 1980s, killing thousands of Americans and ravaging gay communities, the deadly epidemic went unaddressed by U.S. public health agencies—and unacknowledged by President Ronald Reagan—for years. In response, a political group called ACT UP emerged, deciding it needed to do something shocking to draw attention to the crisis and jolt government agencies, drug companies and the mainstream media into action.

So it began organizing protest events where masses of people lay down in a public space, feigning death.

“The strongest thing we can do is something in silence,” declared writer, filmmaker and AIDS activist Robert Hilferty at a November 1989 meeting of ACT UP (AIDS Coalition to Unleash Power). “A die-in. A massive die-in.”

Founded in 1987, ACT UP ultimately organized thousands of protests, with die-ins becoming a signature tactic. And while AIDS activists weren’t the first to simulate death to call attention to lethal threats, the action became a powerful tool to show that, because the epidemic was being stigmatized and ignored, bodies were piling up. In ACT UP’s case, “they forced social and cultural institutions to take responsibility for the AIDS deaths by having to physically move the protesters’ bodies,” says Matt Brim, professor of queer studies at City University of New York.

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The AIDS die-ins emerged from a longer history of activism that made bodies the focal point of protest, such as suffragettes chaining themselves to railings and civil rights activists staging sit-ins.

One of earliest known references to the term “die-in” came nearly two decades prior to ACT UP, when environmentalists demonstrated on Earth Day, 1970, in Boston, to raise awareness about the deadly impact of air pollution. About a month later, protesters in Seattle fell to the ground at a busy downtown intersection to oppose dangerous nerve gas shipments.

Since then, public die-in stunts have been used to decry everything from war and weapons testing to police violence and cycling deaths. To ratchet up the visual drama, some protesters have employed fake blood and bandages. Others brought coffins.

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When playwright and LGBTQ activist Larry Kramer took center stage at the New York Lesbian and Gay Community Services Center on March 10, 1987, and delivered the rousing speech that helped launch ACT UP, the epidemic had entered its sixth year. The U.S. government had yet to approve the prescription sale of a single drug to treat AIDS, and the deaths were largely being ignored by the media. “Unless we fight for our lives, we shall die,” Kramer wrote that month for the New York Native, a bi-weekly magazine aimed at the city’s gay community. As a result, ACT UP worked urgently to train as many individuals as possible in civil disobedience tactics. As an unidentified activist in the documentary United in Anger: A History of ACT UP put it, “you don’t always know when it’s going to happen or when you’ll want to do it.”

Die-ins became important for ACT UP, Michael Bronski, author of A Queer History of the United States for Young People and professor of practice in media and activism at Harvard University, told HISTORY.com in an interview. That’s because “there’s a cultural hesitation to think about death—and the protest made it physical.”

And AIDS activists knew their best chance to affect policies was by affecting public opinion—making the media, rather than politicians or chief executives, die-ins’ primary targets. In United in Anger, an activist remembered how ACT UP clearly viewed civil disobediences, like die-ins, as a “safe tactic for making a stronger statement and as a way of getting media attention.”

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In its first decade, ACT UP held thousands of demonstrations across the country and around the world. But not all die-ins focused on the same issue.

On October 11, 1988, ACT UP held its first national demonstration on the doorstep of the Food and Drug Administration, which activists perceived as slow to approve and release new drugs. In front of helmeted police officers guarding the building’s entrances, some activists staged a die-in, holding tombstone-cutouts that read, “DEAD FROM LACK OF DRUGS” and “VICTIM OF F.D.A. RED TAPE.” Less than a year later, the F.D.A approved one other drug and expanded access to another.

Outside the Centers for Disease Control in Georgia, die-ins targeted the narrow definition of AIDS that encompassed diseases observed in gay men, but not those specific to women and IV drug users. “C.D.C. is killing women, redefine AIDS,” activists chanted amid demonstrators sprawled on the sidewalk. In 1993, the C.D.C delivered AIDS activists a victory to their years-long campaign by adding CD4+ T-lymphocyte (T-cell) count to the definition, a count the C.D.C. viewed as having “clinical importance” in categorizing HIV-related conditions. The agency also added invasive cervical cancer to its list of AIDS-indicator diseases, an acknowledgement of the impact HIV was having on women.

Die-ins also occurred on Wall Street, targeting drug prices; at the vacation home of President George Bush, targeting national AIDS funding; at the National Institutes of Health; New York's Grand Central Station; and in Chicago and San Francisco, among other places and locations.

But in the fall of 1992, the theatrically of die-ins gave way to real artifacts of death.

On October 11, in a demonstration known as Ashes Action, activists gathered in Washington, D.C., some carrying the ashes and bone chips of loved ones who had died of AIDS to disperse over the White House lawn. Others carried corpses that rested in open-faced coffins.

Literally bringing real death to activism was the next logical thing to do, says Bronski. “It came out of frustration that things were not getting better quickly—or at all.”

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ACT UP used civil disobedience, like die-ins, not only to vent frustration, but to strategically draw attention to its own proposals and presentations. In the United in Anger documentary_,_ one of the group’s activists succinctly summed up the strategy: “When we get arrested, we usually are aiming to get a meeting set up or deliver a set of demands.”

“Any political movement has to be multifaceted, so that doing aggressive, in-your-face actions have to happen in tandem with people making arguments with politicians,” says Bronski.

Their aggressive actions at the F.D.A. and the C.D.C., for example, helped activists gain meetings that ultimately moved the needle on their pursuit of an AIDS cure.

“Before AIDS and before ACT UP, all experimental medical decisions were made by physicians,” Dr. Anthony Fauci of the National Institutes of Health told New Yorker magazine in 2002. “Larry [Kramer, founder of ACT UP], by assuring consumer input to the F.D.A., put us on the defensive at the N.I.H. He put Congress on the defensive over appropriations. ACT UP put medical treatment in the hands of the patients. And that is the way it ought to be.”

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