As an AIDS activist 30 years ago, Michael Weinstein helped defeat an inflammatory ballot measure that could have quarantined Californians with the disease. Today, Weinstein has turned to the ballot to advance his own controversial vision for public health.

President of the Los Angeles-based AIDS Healthcare Foundation, which has clinics around the world, Weinstein is the architect of two initiatives Californians will vote on in November: Proposition 60, which would require actors in adult films to use condoms, and Proposition 61, which would cap the price state health programs pay for prescription drugs.

The drug measure – which would limit the state to the discounted price paid by the U.S. Department of Veterans Affairs – taps into widespread frustration about expensive medication, an issue that plagues the state budget and has surfaced in the presidential campaign. A condom requirement was popular with Los Angeles County voters, who approved a measure backed by Weinstein on their local ballot four years ago.

Yet both statewide propositions have sparked concern in segments of the communities they purport to help. Some patient advocates question whether the drug-pricing measure could really contain costs for people whose health depends on expensive medicine, while many porn actors say the condom proposal would kill their business or drive it underground.

Similar fights have already occurred in the state Capitol, where bills have stalled that would have required condom use on adult movie sets and mandated more disclosure from drug companies in an effort to curb rising prices (a different pricing measure is pending). Weinstein said he’s taking the issues directly to voters because lawmakers have kowtowed to the porn and pharmaceutical industries.

“I have a hard time remembering any issue where the public was so strongly in one direction and the political system was so strongly stuck in inaction,” Weinstein said of his effort to cap drug prices.

The condom issue is related, he said, because of “inaction by government.”

The initiatives mark the latest iteration of Weinstein’s long advocacy career, one that has made him a maverick to some, anathema to others.

Michael Weinstein, center, at an AIDS march in 2012 with comedian Margaret Cho, right, and musician Wyclef Jean, left. Photo by Elvert Barnes/Creative Commons

Weinstein, 63, said he experienced his political awakening in 1986, when, as a budding gay-rights activist, he campaigned against an initiative that would have barred AIDS patients from schools and some types of jobs.

He went on to open an AIDS hospice that eventually grew into the AIDS Healthcare Foundation. Today the organization spans 36 countries, operating health clinics, thrift shops and pharmacies that sell some of the high-priced drugs Weinstein is campaigning against.

“The more prices go up, the more we earn,” he said. “That’s the irony of this situation…. People say, ‘What’s in it for you?’ Nothing, from a financial point of view.”

Although Weinstein runs a global AIDS organization, he has publicly clashed with AIDS activists over his criticism of an HIV-prevention drug. He says broad use could result in infection from unprotected sex, although most of the medical community recommends it to people at risk for the disease.

On the adult film issue, performers who say they contracted sexually transmitted diseases on the job rally behind him. Those who believe existing protections are adequate see him as a meddlesome nanny.

He is embroiled in planning disputes in Los Angeles, where he lives, and in San Francisco, where his effort to open a pharmacy in the famous Castro district put Weinstein – a gay man – at odds with the heavily gay community.

“He is an outlier, and in many corners he is a pariah,” said San Francisco Supervisor Scott Wiener, who represents the Castro neighborhood and was sued by Weinstein’s foundation over the pharmacy dispute. The lawsuit challenges regulations the supervisor authored.

Weinstein’s nonprofit AIDS Healthcare Foundation has spent $11 million so far to support the two measures it put on the November ballot. Opponents in the pharmaceutical industry have poured more than $69 million into fighting Proposition 61. Pornography producers have contributed roughly $60,000 against Proposition 60.

Since Weinstein’s take-it-to-the-people approach proved successful in Los Angeles in 2012, permits for X-rated film production have dropped dramatically – fueling opponents’ arguments about pushing the $9-billion industry out of California.

Some in the adult film industry say they already minimize the spread of disease with frequent testing. Many of them filled a hearing room at the Capitol last month when lawmakers reviewed Proposition 60.

“We are not opposed to regulation itself, but instead [to] this new-age witch hunt perpetuated by the AIDS Healthcare Foundation,” said a performer who introduced herself as Mimosa.

On the other side was Cameron Adams, a former porn actor who said Proposition 60 could save others from her fate.

“Testing doesn’t stop infection,” Adams said through tears, addressing the panel of legislators. “I followed the adult film industry’s self-regulation, and I’m sitting here before you as an HIV-positive woman.”

State Sen. Isadore Hall (D-Compton) has carried bills in the Legislature that would have required condom use in porn movies. He described Weinstein as a “great guy” whose trailblazing work has protected lives and, naturally, made him controversial.

“That’s just the name of the game,” Hall said.

Speakers line up to testify about Proposition 60 at the state Capitol; many opposed the measure. Photo by Laurel Rosenhall/CALmatters

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Laurel covers California politics for CalMatters, with a focus on power and personalities in the state Capitol. She's been included in the Washington Post’s list of outstanding state politics reporters...