Niki de Saint Phalle: Art Advocacy and the AIDS Crisis

At the Cimetière du Montparnasse in Paris, two graves stand out from the rest. A smiling mosaic cat sits on the grave of a man named Ricardo Manon, decorated with rainbow stripes and red flowers. A silver bird with its wings spread perches on the grave of Jean-Jacques Goetzman, along with an engraved phrase in gilded lettering: “À mon Ami Jean-Jacques un oiseau qui s’est envolé trop tôt” (“To my friend Jean-Jacques, a bird who flew away too early”).

Both sculptures were crafted by the French-American artist Niki de Saint Phalle to honor two of her friends who had died from autoimmune deficiency syndrome. The artist had previously written and illustrated the 1986 book “AIDS: You Can’t Catch It Holding Hands,” in collaboration with the Swiss immunologist and AIDS specialist Silvio Barandun. At a time when little was known about AIDS and much was assumed, Saint Phalle allied herself with the artists and healthcare professionals working to communicate the truth and urgency of the health crisis.

“I realized a few days ago that when Ricardo died, it was the beginning of a long depression for me,” Saint Phalle wrote after the death of Manon, who had been her assistant for a decade. “I was simply crucifying myself, identifying with my young friends who had died from AIDS.”

Saint Phalle’s Afflicted Life

By the time she began losing friends to AIDS in the 1980s, Saint Phalle had experienced several mental and physical health problems of her own. Born Catherine Marie-Agnes de Saint Phalle in 1930 in Neuilly-sur-Seine, France, she was raised primarily on East 88th Street in New York City by abusive parents who lost their fortune in the Great Depression the year she was born.

As she revealed in her 1992 book “My Secret,” her father raped her when she was 11 years old. This childhood trauma, compounded by struggles with autoimmune thyroiditis and the infidelity of her first husband, Harry Mathews, led the 22-year-old Saint Phalle to have a self-proclaimed “mental breakdown” in 1953. She attempted suicide and spent 6 weeks in an asylum in Nice, where she was treated with electroshock therapy and then, effectively, art therapy, per The New York Times. She “learnt how to translate emotions, fear, violence, hope and joy into painting,” as she recalled later, “[and] discovered the somber depths of depression, and how to overcome it.”

The lone woman in the Nouveau réalisme movement, Saint Phalle quite literally colored her work with feminist fury and an anti-establishment ethos. From 1961 to 1963, she routinely shot a .22-caliber rifle at balloons that burst and bled paint over pieces of plaster, and for her controversial 1963 piece “Heads of State,” over sculptures of prominent politicians. She became known primarily for her “Nanas,” voluptuous feminine sculptures that towered over their beholders.



The sculpture “Head of a Woman Wearing a Bathing Cap” resides in Saint Phalle’s Tarot Garden, a sculpture park in Italy.

Ironically, Saint Phalle’s use of toxic art materials contributed to her own lifelong health problems. She was hospitalized in 1968 due to severe breathing difficulties caused by polyester fumes. In 1982, the artist began long-term treatment for rheumatoid arthritis with prednisolone and antimalarials, as noted by Joint Bone Spine. Recurrent respiratory infections, asthma, and pulmonary disorders haunted her for the rest of her life. Saint Phalle’s maladies sparked her fascination with health science, which went on to shape one of the most vital projects of her career.

“AIDS: You Can’t Catch It Holding Hands”

In 1984, Saint Phalle paid a visit to her longtime friend, Swiss immunologist Silivio Barandun. “Help me educate [the public] as a humanitarian effort,” Saint Phalle recalled him asking her (via People), “or else this disease is going to be another plague.”



“Phallus Symbol,” a Swiss stamp created by Saint Phalle as part of the movement to help educate the public about AIDS.

Their resulting collaboration, “AIDS: You Can’t Catch It Holding Hands,” was composed as a letter to Saint Phalle’s young son. The book describes AIDS in plain terms, as a condition “caused by a virus which lives mainly in blood and sperm and vaginal fluids” that can be contracted “through anal, oral, or vaginal sex,” but not from mosquitos, silverware, or toilet seats. Rather than pushing for abstinence from sex and drugs, Saint Phalle and Barandun advised readers to “use a rubber” and “never share a needle,” and encouraged the public not to believe the campaigns of fear against people with AIDS.”There are thousands of people dying with AIDS alone because of ignorance and fear,” they wrote, recommending that readers laugh and cry with those afflicted.

“Her immediate concern was young people who were sexually active, or just about to be sexually active, [and] how could they protect themselves and others while also maintaining a sense of compassion,” Ruba Katrib, curator of the 2021 exhibit “Niki de Saint Phalle: Structures for Life” at MoMA PS1, told Medscape Medical News. “[Her] use of color and symbols worked to draw people in, [and] she also used a clarity and simplicity of language to create an impact [through] directness and honesty. I think this made the book a useful and informative resource, but also something that one could spend time with and even enjoy.”

Saint Phalle worked on the United States edition of the book with the help of Paul Voldberding, MD, a physician and pioneer in HIV treatment from the University of California Medical Center in San Francisco, and William Haseltine, a molecular biologist and virus researcher from Harvard Medical School. Haseltine told People that “AIDS: You Can’t Catch It Holding Hands” was “crucial.”

“It’s not depressing,” Mathilda Krim, MD, then head of the American Foundation for AIDS Research, said of the book (via People). “It’s humorous, affectionate, and accurate.”

Each page is embellished with Saint Phalle’s illustrations of kaleidoscopic condoms, serpents, faces, and hearts. The artist’s whimsical, color-saturated aesthetic sensibility was not an obvious match for the deadly serious subject of AIDS, but she used it to deliver clinical but critical information about the epidemic with unusual exuberance.

“We wanted to give information without moralizing and to stress the positive quality of human relationships,” Saint Phalle told People magazine. “I wrote, ‘Romance is in again.’ “

One of Saint Phalle’s illustrations depicts a female figure holding a psychedelic, forked-tongued monster on a leash. “AIDS is everyone’s problem and no one’s fault,” reads the text on the adjacent page. “If each one of us takes care and is responsible, AIDS will be under control.” Saint Phalle and Barandun acknowledged collective fear side by side with a sense of hope: the hope that AIDS could be prevented if people took care of one another; the hope that treatments could be found; the hope that compassion could speak louder than the vocal groups warning of eternal damnation.

The Privilege of Publication

Saint Phalle’s place in the AIDS art movement tends to be a mere footnote in profiles and biographies on the artist. Some hesitate to celebrate the work of a White woman and lapsed aristocrat while so many gay, disadvantaged men of color were marginalized in the movement despite being the demographic most impacted by the epidemic.

“She’s certainly not the artist that I would take the most seriously,” Amy Converse, PhD, art historian and curator of Woodbury University’s 2021 online retrospective of AIDS-related art, told Medscape Medical News of Saint Phalle. “There was a lot of work like [hers] that was coming out of the ally community…but looking at the prejudice and cultural bigotry that was being faced [by] queer people, all of this stuff is…the sort of back-slapping, charity-function, White-people shit that’s constant within the art world, particularly within [the AIDS art movement].”

As conditions that disproportionately affect gay men, AIDS and the human immunodeficiency virus that causes it were stigmatized in a Western world governed by conservative, Christian leaders like US President Ronald Reagan and UK Prime Minister Margaret Thatcher. Explicit discussions of sexuality, and particularly homosexuality, were taboo and systematically silenced. During the AIDS art movement, artists had to be sly in their allusions to homosexuality in order to get past gatekeepers into top museums and galleries. Saint Phalle was no exception; she and Barandun struggled to get “AIDS: You Can’t Catch It Holding Hands” published due to its frank language.

“The ’80s were terrible,” Saint Phalle told The New York Times in 1993. “Money became king, and even the galleries forgot about the quality of their works…. Bureaucrats are everywhere. What we need in power, above all, is imagination.”

The artist ended up calling on an old friend, the painter Sam Francis, who agreed to publish about 500 copies of “AIDS: You Can’t Catch It Holding Hands” through his small press, Lapis, in 1986. The following year, the book was translated and published in France, Germany, Italy, and Japan. 70,000 copies were distributed for free in schools and medical institutions. All of the proceeds from the book were donated to AIDES, France’s first association for fighting the epidemic. Saint Phalle tapped her social connections to kickstart the book’s circulation, but those connections ultimately made her an effective liaison between major art institutions, the healthcare system, and the LGBTQ+ community.

“What I think [Saint Phalle] did so successfully was to redirect the conversation from the elite art world, and its coded and often oblique terms of reference, to a popular account,” Jonathan David Katz, pioneer of queer art scholarship and co-curator of the exhibit Art, AIDS, America, told Medscape Medical News. “She’s always had that ability to breach the divide between the self-satisfied, high-art elite world and popular culture.”

Saint Phalle’s AIDS-related advocacy did not end with “AIDS: You Can’t Catch It Holding Hands.” In 1987, she worked with her son, Philip Mathews, to create an animated film based on the book. In 1990 and 1991, she created a series of public service announcements about the epidemic for France Sécurité Sociale, and in 1994, she designed a Stop AIDS postage stamp to be sold in Switzerland. When she died of pulmonary failure in 2002, at age 71, the Niki de Saint Phalle Charitable Art Foundation was established to preserve her work and legacy, with plans to translate “AIDS: You Can’t Catch It Holding Hands” into “as many languages as possible.”

Three and a half decades have passed since the book was first published, but the HIV/AIDS epidemic is far from over. According to the World Health Organization, 37 million people around the world are living with HIV, including 22 million who are being treated for the condition. About 13% of people living with the virus in the US are not aware they have it, per HIV.gov. Approximately 35 million people have died from HIV in the 30 years since the first outbreak.

The works of art that remain from the early years of the AIDS crisis give eternal form to artists’ feelings of fear, pain, grief, and hope — sometimes all at once, like the silver bird perched upon Saint Phalle’s friend Goetzman’s grave, poised to fly. “Birds have been a constant theme in my work,” Saint Phalle wrote in her 1988 book “The Wounded Animals.” “Immortal birds. Sad birds, triumphant birds…. Birds are messengers from our world to the next.”

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