Sexuality - Two Decades Of Aids

On June 5, 1981, doctors reported a strange and deadly disease that had begun to show up in gay men in Los Angeles. A peculiar aspect of the cases was that the men were the victims of the types of infections traditionally found in cancer patients, transplant patients, and those with severely compromised immune systems. It would not be until 1984 that doctors and researchers would be able to link AIDS to the human immunodeficiency virus (HIV). Over the 20 year period, we have lost 457,667 men and women to AIDS, and 900,000 are thought to be living with the AIDS/HIV at the end of 2001 (a fraction of the 40 million worldwide). Where have we been? Where are we headed?

Some scientists believe HIV made the jump from monkeys to humans somewhere between 1926 and 1946. The earliest case appears to have been in 1959. Scientists recently discovered a blood sample from an adult Bantu male from what is now the Democratic Republic of Congo that tested positive for HIV-1.³ The graphic shows how quickly the disease spread: a year after the first 335 cases were diagnosed in 1981, cases rose 841% to 3,153 in 1983, and then 281.4% to 12,026 in 1985. That same year, the blood supply was screened for the virus for the first time (284 people were exposed to HIV through transfusions in 2000, down from a peak of 1,098 in 1993). Also in 1985, Rock Hudson announced he had the disease. In 1987, the FDA approved AZT, the first drug to treat

AIDS. In 1988, the National Institute of Health established the first Office of AIDS Research. There were other attacks on the spread of the disease, some more controversial: the first comprehensive needle exchange program for IV drug users began that year as well.

How did the homosexual community respond to the crisis? There was grieving to be done, to be sure. In 1986, the first panel of the AIDS Memorial quilt was created. This quilt features panels sewn by family members and friends to commemorate the deceased. It currently has more than 44,000 panels and is the length of 16 football fields. Some gay men did not just grieve, however; they got angry. In 1987, the Aids Coalition to Unleash Power (ACT UP) was formed, a group of activists who called attention to the disease in dramatic (and, some may argue, counter-productive) protests. The phrase Silence = Death is associated with this organization.

Other public figures brought visibility to the disease. After being criticized for his silence on the issue, President Reagan spoke of AIDS for the first time in 1990. In 1991, Magic Johnson announced he was HIV positive. A year later Arthur Ashe announced he had AIDS. Also in 1992, Mary Fisher, who is HIV positive, addressed the Republican National Committee. The year 1993 saw the highest reported number of cases: 79,752. AIDS was killing 14.5 per 100,000 people, a rate higher than suicide (12.1), homicides (10.1), and nearly as many as motor vehicle accidents (16.3). By 1994, AIDS was the leading cause of death for all Americans 25 to 44. More than 335,000 Americans were living with the disease.

Prevention strategies and drug therapies have helped to reduce the spread of HIV and to extend the life of those with AIDS. Deaths fell dramatically in the middle 1990s. Indeed, the drug cocktails were so effective that those with AIDS had to start worrying "not about dying but about living" to quote one source — paying rent, finding a job, getting insurance policies. People were starting to ask: is AIDS finally over? Journalist Andrew Sullivan wrote a 1996 piece in the New York Times Magazine called "When Plagues End — Notes on the Twilight of an Epidemic." Newsweek 's cover asked: "The End of AIDS?"

AIDS may no longer be a plague as long we keep it (and ourselves) under control. The number of new infections in the United States has leveled off at roughly 40,000 annually — still an enormous number. Mortality is dropping as well, from 22,067 cases in 1997 to 15,300 in 2000. But the disease is far from over. The number of Americans living with the disease increases by about 25,000 a year. The CDC is in the process of launching programs to halve the rate by 2005. Plans include education about high risk behaviors and on-the-spot testing. But will we listen?

Sources: Chart data from United States of America Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections, 2002 Update, HIV/AIDS Surveillance Report, Vol. 11 no. 2, table 22. 1980 figure is actually for total cases pre-1980. Zhu, Tuofo; Korber, Bette T.; Nahinias, Andre J.; et al. "An African HIV-1 Sequence from 1959 and Implications for the Origin of the Epidemic." Nature, February 5, 1998, p. 594. Sternberg, Steve. "AIDS Approaches Grim Anniversary." May 29, 2001, p. 8D. Charlene Laino. "1 in 4 Infected with HIV don't know." Retrieved July 24, 2002 from http://www.msnbc.com/news/715645.asp.