Public opinion reflects new stance
Research suggests that HIV has been around since at least the 1930s, and a number of mysterious deaths in the United States in the early 20th century that were originally attributed to ailments such as pneumonia are now thought to have perhaps been the earliest AIDS deaths.
HIV is contracted through the exchange of sturdy bodily fluids, such as semen, breast milk, or blood, but not through more fragile substances like saliva or sweat. Since HIV itself is a fragile virus, it cannot survive outside the body and cannot become airborne.
As news of the novel and little-understood condition spread, so did the common denominators of its victims: notably, gay men and drug users. The public chose animosity over empathy, and immediately began to blame the epidemic on the lifestyles of its victims, and HIV/AIDS became first known as GRID, or "gay-related immune deficiency."
Once an individual's immune system has been so completely compromised, the symptoms of AIDS can vary widely. Many forms of cancers are able to manifest and act swiftly with little resistance from the body.
In 1982, the Ronald Reagan administration issued a travel ban in an attempt to curb AIDS transmission. Based on a now-defunct theory that claimed the "HIV patient zero" brought the virus from Haiti, Haitians were no longer allowed to travel to the United States. Furthering the bigoted attitude towards the epidemic, the "four H's" were incessantly referenced in the news and common conversation: homosexuals, hemophiliacs, heroin (addicts), and Haitians.
AIDS, which stands for acquired immunodeficiency syndrome, covers a long list of symptoms and ailments caused by the HIV virus. This virus relentlessly attacks the carrier's immune system to the point where the body is no longer able to defend itself.
In the year since the first AIDS-related deaths had been recorded, no steps had been made toward a comprehensive plan of prevention, and animosity towards those most affected was only growing. Activist groups, such as the Gay Men's Health Crisis, founded by Larry Kramer, began to organize demonstrations demanding the government and scientific community invest more urgency in understanding the disease and, more importantly, working towards plans of treatment and prevention.
While Kramer galvanized demographics already sympathetic to the epidemic, Hollywood star and icon of traditional masculinity, Rock Hudson, helped turn the opinion of the rest of the public when he announced his AIDS diagnosis in 1985. According to the US government's official HIV information website, pieces published in mainstream media more than tripled after he announced his diagnosis.
Larry Kramer, an American playwright and screenwriter, was very likely the most important figure in the fight against AIDS. Not only did Kramer found two of the most effective and influential AIDS activism groups in history, Gay Men's Health Crisis and, later on, ACT UP, he inspired millions more people in communities affected by AIDS, and those with loved ones in such communities, to speak out and demand action from the powers in control.
After four years of death and confusion, then-president Ronald Reagan addressed the AIDS epidemic publicly for the first time in September 1985. While Reagan did describe AIDS as a "top priority," he also defended his administration's lack of funding or action towards any treatment or solution.
As the AIDS crisis grew at an alarming rate not only in the United States but around the world, the World Health Organization formed the Special Programme on AIDS in 1987 to provide funding for awareness and research in the fight against the epidemic.
During those four years, 13,278 people had already died from AIDS-related complications, and general mistrust and ostracization towards queer people, people of color, and people who struggle with drug addictions had skyrocketed.
It was Burroughs Wellcome that developed the first drug aimed at AIDS treatment: azidothymidine, or AZT. There was widespread outrage throughout the AIDS community and its supporters when the drug was put on the market with an estimated annual dosage price of US$10,000, or around US$25,000 in 2022. a price extremely prohibitive for the vast majority of those who could benefit from the drug. After ACT UP applied pressure through direct but nonviolent protest, Burroughs Wellcome lowered the price of AZR by 20%
In 1988, Larry Kramer, the playwright-activist who had been the most prominent figure in the grassroots fight against AIDS and government inaction, founded what would become the most influential AIDS activism group in history: the AIDS Coalition to Unleash Power, more famously known as ACT UP. ACT UP would go on to produce direct and immediate results in their demonstrations against government health agencies and against pharmaceutical giants such as Burroughs Wellcome, pressuring them to expedite their clinical trials of potentially life-saving drugs.
That same protest, which occurred on March 19, 1987, and consisted of ACT UP members storming the New York stock exchange and chaining themselves to VIP areas, also successfully pressured the Food and Drug Administration to speed up clinical testing for other drugs apart from AZT, and allowed the use of certain drugs that had not yet been officially approved by the FDA.
President Reagan's first decisive move toward federal support of the fight against AIDS came in June 1987 when he signed an executive order putting the Presidential Commission on AIDS into place. The purpose of this commission was to develop a direct plan of action to confront the epidemic. While many praised the president for exercising his executive privileges for such a just cause, many also criticized the time it took for such action to be taken, and for the lack of gay representation on the commission's board.
As is the case with most national crises, people of color were affected by the AIDS epidemic to a degree much higher than that of their white peers. Not only was the Black nation of Haiti originally blamed for the spread of HIV in the United States, but the long-standing discrepancies in access to healthcare made it more difficult for infected individuals of color to access what little treatment there was during the 1980s, not to mention access to the preliminary testing that would help stop the spread of the virus.
In October of the same year, the largest public art demonstration took place on the National Mall in Washington DC. A 54-ton quilt, with grave-sized squares hand-stitched by friends and family in memoriam of those lost to the vicious condition, was laid out along the lawn for the president and the world to see.
By the end of the decade, after nine years of what activists and allies saw as unacceptably and unnecessarily slow action from the CDC, FDA, and pharmaceutical companies, the national number of AIDS cases reached 100,000.
By the mid-1990s, treatment for HIV and AIDS had improved considerably. In 1995, medications called protease inhibitors, which slow the growth of the HIV virus, marked the beginning of highly active antiretroviral treatments.
After the introduction of HAART treatment, there was an almost immediate decrease in AIDS-related death of between 60% and 80%. While this was of course news for celebration, the expensive treatment shed new light on the racial and class-based gaps endemic in the American healthcare system.
In 1990, the United States Congress enacted the Ryan White CARE Act, named in honor of the 18-year-old child who had become a poster child of AIDS after he was given an infected blood transfusion as a child who died just weeks before the act was passed through Congress. The grant provided US$220.5 million during its first year, and was at the time the largest federal grant in American history.
As treatments became more effective and more convenient throughout the late 1990s, coming to a head in 1997 with the introduction of Atripla, a single pill taken once daily, access to treatments remained prohibitive. The generally more privileged and wealthy white communities, both gay and straight, made up a disproportionate number of the successful treatments of the decade. The more historically oppressed Black queer communities continued to contract HIV and die of AIDS at alarming rates.
In 2005, the number of infections in the US had reached one million, proving there was still much work left to do. When Barack Obama was elected president in 2008, a resurgence in congressional concern made it possible to pass legislation that activists had been struggling to push through a reluctant Congress in the previous years, starting with the long-awaited lifting of the travel ban against HIV-positive visitors from outside of the United States.
While the general situation of the epidemic continued to improve, Black communities continued to come under fire. In the 2000s, bisexual Black men were treated in the media as dehumanized carriers who transmitted HIV from other men to straight women without remorse. Groups such as the National Coalition of Black Lesbians and Gays (not pictured) actively fought against these racist preconceptions.
As treatments continue to grow more reliable, more convenient, and more accessible, the fight against the HIV and AIDS epidemics has made incredible strides. In 2020, about 680,000 people died from complications with AIDS, a stark decrease from the 1.3 million that lost their lives in 2010. But of course, advocacy groups and research centers know that there is always more work to be done until the annual death toll reaches zero.
Sources: (TheBody) (HIV.gov) (The Washington Post)
See also: Deadly diseases you thought were gone... but aren't
Throughout the 2000s, both treatment and policy regarding AIDS continued to improve. Annual HIV testing became commonplace in general medical check-ups, over-the-counter test kits became available, and treatment costs began to decline.
Due to the nature of the substances that HIV piggybacks on, the virus is most commonly spread through sex, contaminated needles commonly used by those who suffer from drug dependency, and it can also be transmitted to children either through breastfeeding or through fluids exchanged during pregnancy, causing children to be born with AIDS. Before AIDS was fully understood, a massive number of hemophiliacs who required frequent blood transfusions would unknowingly be given infected blood.
The first confirmed cases of AIDS-related deaths occurred on June 5, 1981. Five young gay men in Los Angeles died from a rare form of pneumonia, and on the same day a dermatologist in New York described a group of patients who all were dying from Kaposi's sarcoma, which, prior to the AIDS epidemic, was exceedingly rare. All of these patients showed signs of significantly compromised immune systems. By the end of 1981, there were 337 reported cases of deaths related to the autoimmune disease.
In 1983, researchers in the United States and in France independently identified the human immunodeficiency virus, or HIV, that was causing AIDS. With this discovery also came a greater understanding of how the virus was transmitted, and it became established that HIV could not be transmitted through the air, skin-to-skin contact, or ingestion of food or water. While this information was essential to beginning to understand the virus, it only further solidified the already-rampant racist and homophobic preconceptions associated with AIDS.
Just three months after announcing his diagnosis, Hudson died at the age of 59 in October 1985. His will left US$240,000 (nearly US$700,000 in 2020) to found and fund the American Foundation for AIDS Research. Hudson's frequent co-star and close friend Elizabeth Taylor became the first national chairman of the foundation, and remained a loud and effective advocate for AIDS awareness for the rest of her life.
On October 11, 1988, one of ACT UP's largest and most effective demonstrations took place at the FDA headquarters in Rockville, Maryland. Over 1,000 demonstrators surrounded the headquarters in a nonviolent sit-down, protesting the speed at which the FDA conducted clinical trials. Although the demonstration ended in 176 arrests, eight days later the FDA announced that it would expedite its processes in order to release medications quicker.
President Obama made HIV and AIDS truly top priorities. In July 2010, his administration implemented the NHAS, or National HIV/AIDS Strategy, a comprehensive plan designed to end the AIDS epidemic once and for all. Along with the Affordable Care Act of the same year, the glaring disparities in access to affordable AIDS care was coming to an end.
A common visual sign of AIDS is a cancer known as Kaposi's sarcoma. The cells that harbor the cancer multiply at an alarming rate if not fought by a healthy immune system. Kaposi's sarcoma often begins as painless splotches on one's skin. If these lesions spread to the lymph nodes, which it has the ability to do at an alarming rate, the cancer can become fatal extremely quickly.
The federal government, despite President Reagan explicitly labeling AIDS a "top priority," dedicated virtually no funding to AIDS research. Up to this point, privately funded organizations like Hudson and Taylor's American Foundation for AIDS research had been handling the lion's share of the work. In fact, the Reagan administration hit the Center for Disease Control with budget cuts in 1982. According to official government sources, the rate of diagnosis between 1984 and 1985 rose 85%, with a 51% fatality rate in adults.
From cholera to typhoid to COVID-19, the United States has seen its fair share of public health crises and epidemics. One of the worst, most socially polarizing, was the AIDS epidemic that began in the 1980s. While millions died, a war raged on between activist organizations and government institutions, leading to some of the largest and most successful grassroots movements the United States has ever seen. The history of AIDS in America is a history none of us can afford to forget, and as we came out of the era of COVID-19, the events of the 1980s and 1990s can teach us valuable lessons on the importance of unity, hope, and swift action in the face of mortal threat.
Read on to learn the key points of the American AIDS epidemic.
A short history of the AIDS crisis in the United States
It started the biggest and most effective people-powered movements in the history of the United States
LIFESTYLE Activism
From cholera to typhoid to COVID-19, the United States has seen its fair share of public health crises and epidemics. One of the worst, most socially polarizing, was the AIDS epidemic that began in the 1980s. While millions died, a war raged on between activist organizations and government institutions, leading to some of the largest and most successful grassroots movements the United States has ever seen. The history of AIDS in America is a history none of us can afford to forget, and as we came out of the era of COVID-19, the events of the 1980s and 1990s can teach us valuable lessons on the importance of unity, hope, and swift action in the face of mortal threat.
Read on to learn the key points of the American AIDS epidemic.