As details emerge, Marr finds his lifestyle converging with that of Hasler, and he becomes increasingly involved in intense sexual encounters with homeless men, despite his growing awareness of the risks of HIV.

Scenes in The Mad Man occur during "wet night" at the Mineshaft, a gay bar that actually existed in New York's meat-packing district in the '70s and '80s and indeed held such a monthly event.

Other scenes detail visits to the pornographic movie theaters in the 42nd Street area, where much gay activity occurred from the sixties until they were shut down in the mid-nineties.

All three editions conclude with the article "Risk Factors for Seroconversion to Human Immunodeficiency Virus Among Male Homosexuals," by Kingsley, Kaslo, and Renaldo et alia, as published in the Lancet, Saturday, 14 February 1987, which statistically supports the theory that AIDS cannot be transmitted orally.

(Brodkey's series of articles about dying of AIDS was reprinted in revised form as a book, This Wild Darkness: The Story of My Death (Henry Holt and Company, 1996)).

I have not been exposed since the nineteen-seventies, which is to say that my experiences, my adventures with homosexuality took place largely in the nineteen-sixties, and back then I relied on time and abstinence to indicate my degree of freedom from infection and to protect others and myself."

Delany discusses some of the background behind the novel in "The Phil Leggiere Interview: Reading The Mad Man", which appears in his essay collection Shorter Views.