The surprising death of American composer and lyricist Michael Friedman reverberated throughout the Minnesotan — and the American — theater community.

Friedman died Sept. 9, just days before “The Abominables” opened at Minneapolis’ Children’s Theatre Company. The 41-year-old who wrote the music and lyrics for the hockey-themed show also is known for the musicals “Bloody Bloody Andrew Jackson,” nominated for two Tony awards, and “Love’s Labour’s Lost.”

Children’s Theatre director Peter Brosius described Friedman as “utterly unique.”

That Friedman died so young is tragic. That he died from complications of HIV/AIDS was an eye-opener. Apparently I assumed, incorrectly, that nobody dies from this devastating disease anymore.

While we can celebrate great progress, including earlier diagnosis and effective treatments that allow people to live almost as long as those who are not infected, the fact remains there is no cure.

And complacency can spell trouble.

“Before the mid-’90s, a diagnosis with HIV, a lot of times, was a death sentence,” said Andy Birkey, spokesman for Minnesota AIDS Project (

“So, we’re very fortunate now that we have medical options for folks that provide the opportunity for long, normal, healthy lives. That’s been a godsend. But … there are problems we still encounter.”

Birkey recalls two cases in the past few years of Minnesotans who already had full-blown AIDS at the time of their first diagnosis. One was in his 50s, another in his late 20s. One lived in outstate Minnesota, the other in the Twin Cities.

The deaths, he noted, “spanned ages and geography.”

What the men shared, Birkey said, was an intense fear of the seemingly intractable stigma they would face should they step forward, “the kind of negativity they perceived our society would put on them,” he said.

“That means some people don’t get tested and even when they do get tested they don’t access medical care because that shame is so powerful.”

HIV stands for human immunodeficiency virus. It is spread through semen, blood, breast milk and vaginal fluids — but not through saliva, sweat or tears, the latter a stubborn myth that is hard to bust, Birkey said.

The virus attacks the body’s immune system, making it increasingly difficult for a person to fight off infection and disease. AIDS is the last stage of HIV infection.

In 2016, Minnesota reported 290 new cases of HIV, a slight yet hopeful decrease over 2015, according to the Minnesota Department of Health.

But those living with HIV are disproportionately people of color, women of color, gay and bisexual men of all races and ethnicities, and an alarming number of the very young.

Forty-two percent of 2016 Minnesota cases were among people age 29 and younger.

Another troubling trend: an 86 percent increase in two years of Minnesota HIV cases attributed to injection drug use.

In essence, those most affected by HIV already are at the greatest risk, and the least likely to have health insurance.

Medication can cost “thousands and thousands of dollars a month,” Birkey said. “If you don’t have insurance, it’s very difficult.”

Nathan Aaron Place can speak to that. He is grateful that his HIV drugs are covered by MNsure.

Place, 50, returned to the Twin Cities from San Francisco in 2013 and now studies accounting full time at Minneapolis Community & Technical College.

He has lived with HIV for 12 years.

In San Francisco for 23 years, Place danced professionally, acted in film and stage, and was a noted visual artist. He knew Friedman and describes him as “vibrant, creative and focused.”

Returning to the Twin Cities from San Francisco, where one in three men was living with HIV, was a bit of a shock.

“The [HIV-positive] community here is relatively small,” he said.

He sought out MAP, where he volunteers as a “Positive Leader,” championing the organization’s programs and advocating at the Capitol.

In his openness about HIV, he often is met with “the pancake face” — a weighted pause followed by questions, such as, “Are you all right?”

But he assures people that there is no wrong question, “even if it’s couched in a way that carries a little fear. Let them know you’re surviving, that you’re moving through this.”

MAP’s Birkey also is happy to focus on successes. One of his friends, he noted, gave birth to healthy children, as she continues to be treated for HIV.

Side effects of newer HIV drugs are more manageable, too, he said. “Most people tolerate the medication just fine. They don’t notice nausea or headaches. The advances have gotten really good.”

And he’s proud of Minnesota, which is “really good with services for people living with HIV,” including medical assistance and help with housing.

Still, the loss of Friedman is a reminder to remain vigilant.

“It still is really rare for someone to die from AIDS-related causes, particularly at age 41,” Birkey said. “We don’t know the circumstances.

“But we really need to increase awareness and interest in preventing new HIV infections, and making sure that everyone has access to medical care.”

He is concerned that MAP and other organizations with similar missions, including the Aliveness Project (, report shrinking donations and fewer volunteers.

“We can end the HIV epidemic in Minnesota — and end it pretty quickly — if people would just do a few simple things,” he said.

“Get tested. Talk to friends, family and co-workers about HIV.

“And get involved in the fight.”