After 40 years, a look at how the AIDS epidemic spreads in America


Dubai, United Arab Emirates (CNN) – On June 5, 1981, a curious report appeared in the weekly public health summary of the US Centers for Disease Control and Prevention, about the diagnosis of five gay men in Los Angeles, USA, with an unusual lung infection , known as Pneumocystis carinii pneumonia, which caused the death of two of them.

This was the first time that acquired immunodeficiency syndrome (AIDS), the devastating advanced stage of HIV infection that would kill more than 32 million people globally, was reported in the United States.

Days after the initial report was published in the newspapers, the CDC learned of several such cases in gays. Not only did they develop Pneumocystis carinii pneumonia, but they also developed other secondary infections, including a rare and severe cancer known as Kaposi’s sarcoma.

About a month after that first report, the CDC’s Weekly Illness and Death Report counted 26 homosexuals across New York and California with these diagnoses, a number that will increase exponentially.

Saturday marked the 40th anniversary of the first AIDS cases in America. More than 700,000 people in the United States have died from the disease since then.

Although medical advances have fundamentally changed the prognosis of HIV patients, there is no cure for it to this day.

US President Joe Biden issued a statement marking the anniversary, noting the work the United States has done to combat the disease in the country and around the world.

Biden said he has asked Congress to provide $670 million to combat new cases of HIV by increasing treatments, expanding the use of PEP drugs, and ensuring equitable access to treatment.

“In honor of all those we have lost, all those affected by the virus, the dedicated caregivers, advocates, and loved ones who helped bear the burden of this crisis, we must rededicate ourselves to reducing HIV and AIDS-related deaths,” the US president said in the statement.

He added, “We must continue to empower researchers, scientists and health care providers to ensure equitable access to prevention, care and treatment in every community, especially communities of color and LGBT people.”

Here’s a look back at how the AIDS epidemic spread:

Activists led the early response

The early years of the AIDS epidemic were an unsettled and unsettling period, and LGBTQ communities were losing friends and loved ones to disease, one by one, with few ideas of how and why. And all the while, society seemed to have turned a blind eye.

The administration of US President Ronald Reagan did not pay much attention to the epidemic, as four years passed before Reagan mentioned AIDS publicly.

Exchanges between Reagan’s press secretary and reporters between 1982 and 1983 indicate that the country’s top officials and mainstream society view the disease as a joke, not an issue of great concern.

This arose from the perception of AIDS as the “gay plague”, a condition believed to be linked to gay men’s lifestyles and behaviors, although cases have also been reported in women, infants, hemophiliacs, and people who inject drugs.

In a recent interview published with the New England Journal of Medicine, AIDS researcher Alexandra Levine spoke of “the horror of watching society as a whole turn its back on this suffering, and the horror of seeing so many of my colleagues refuse to help, refuse to care, and refuse to work as professionals as they are supposed to be.” “.

As politicians and government agencies have proven slow to act, activists have taken matters into their own hands, doing what they can to combat homophobia and stigma and ensure that their communities receive the public health information they need.

Among those efforts was a pamphlet from a 1982 edition, “How to Have Sex in an Epidemic: One Approach,” by Michael Kalin and Richard Berkowitz, in which gay men were advised to use condoms during sex with other men, according to an exhibit of the National Library of Medicine. .

Although the authors are widely regarded as pioneers of safe sex, many homosexuals of the time criticized their work as “sex negative”.

Meanwhile, black gay organizations have fought back through poster campaigns against misconceptions that AIDS primarily affects white gay men.

Scientists struggle to understand AIDS

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, talks to his team about HIV/AIDS during a meeting in 1990.Credit: GEORGE TAMES/THE NEW YORK TIMES/REDUX

In the early 1980s, HIV/AIDS was considered a death sentence.

Scientists and doctors have been struggling to understand the cause of the disease and how it spreads, making the process of finding a cure even more difficult.

Dr. Anthony Fauci, who became director of the National Institute of Allergy and Infectious Diseases at the height of the AIDS epidemic, refers to that period of his career as the “dark years”.

During a recent interview with CNN, Fauci said, “I went from seeing patients with other illnesses and developing treatments for them in the early part of my career, to looking after people every single day who would inevitably die, usually within a short period of time.”

It was an experience shared by many doctors who cared for early AIDS patients, feeling as if there was nothing they could do to stop the suffering.

“We’ve been using bandages on the bleeding for a while,” Fauci added.

In the absence of viable treatments, Gerald Friedland, who worked on early AIDS cases at Montefiore Medical Center in the Bronx, remembers how he focused on empathy.

“The death suffered by young men and women was beyond normal professional obligations and was very difficult,” he said in a recent interview with the New England Journal of Medicine. “But I learned how to become adept at providing a decent death for people.”

Treatments appeared in the late eighties and nineties

The situation began to change for the better in the late 1980s and 1990s, as more effective treatments became available and changed what it meant to live with HIV.

On March 19, 1987, the US Food and Drug Administration approved an antiretroviral drug known as “AZT” to treat HIV infection.

Another important change also occurred that year.

After pressure from activists fighting for the survival of their community, the US Food and Drug Administration issued new regulations on clinical drug trials, giving patients access to potentially life-saving experimental treatments without having to wait years for official agency approval.

Princess Diana visited AIDS patients at a hospital in Rio de Janeiro on April 25, 1991. Her prayers and sympathy for people living with HIV/AIDS helped remove the stigma of the disease and change public perception.Credit: TIM GRAHAM/TIM GRAHAM PHOTO LIBRARY GETTY IMAGES

By the late 1980s and 1990s, public perception of HIV had also begun to shift, thanks in part to prominent activists and celebrities.

Princess Diana played a key role in shattering stigmas and myths about the disease, as her famous visit to HIV/AIDS patients in hospital wards and her handshake without gloves was documented.

In 1991, NBA star Irvin “Magic” Johnson revealed that he had been diagnosed with HIV, and his identity as a straight black man helped prove that anyone could catch the disease.

In 1996, the Food and Drug Administration approved the first protease inhibitors, and this development brought what is known as highly effective antiretroviral therapy, turning HIV/AIDS from a fatal diagnosis into a controllable condition.

“Now we’re giving drugs to people with HIV, and it’s not only basically saving their lives and giving them a normal life, but you can prevent them from infecting other people,” Fauci told CNN on June 1.

The 21,000-panel AIDS Memorial on October 10, 1992, in WashingtonCredit: SHAYNA BRENNAN/AP

And in 2010, researchers reported another exciting development: a study found that taking a daily dose of HIV drugs reduced the risk of infection in men who had sex with other men.

And in 2012, the US Food and Drug Administration approved the use of pre-exposure prophylaxis for adults at high risk of infection, one of the most important discoveries to combat the epidemic.

As new HIV/AIDS treatments make diagnoses more manageable and help prevent infection, public health challenges remain.

About 1.2 million people in the United States were living with HIV at the end of 2018, according to the Centers for Disease Control and Prevention.

There are also disparities in access to treatment, and Hispanics and blacks are disproportionately affected by HIV. HIV/AIDS drug resistance is also becoming increasingly common.

After the losses during the early years, some researchers and clinicians began to shift their attention and efforts elsewhere, according to the New England Journal of Medicine. Although the United States set a goal in 1997 to find a vaccine for HIV within 10 years, four decades later, there is no vaccine or cure for the disease yet.


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