Acquired Immunodeficiency Syndrome (AIDS), a
disease caused by the human immunodeficiency virus (HIV).In 1981, medical reports first described unusual infections and
cancer previously seen only in severely immunosuppressed patients, such as those undergoing organ transplants. By mid‐1982, epidemiological evidence indicated that the disease was probably caused by a virus transmissible via sexual intercourse, transfusion of contaminated blood or blood products, and intravenous drug injections. Later, it was also determined that AIDS could be passed from mother to baby during delivery or in breast milk.
Homosexual males, including many affluent urban professionals, were the largest initial group affected by the disease in the United States and in other developed countries. After some initial resistance to lifestyle changes recommended by public‐health officials, this group mounted an aggressive response to AIDS, organizing to provide medical care, disseminating information about prevention, raising money, and becoming politically active. In developing countries, especially in Africa and Asia where it has taken a very heavy toll, AIDS afflicts men and women equally and is transmitted primarily by heterosexual intercourse.
In 1984, researchers in Robert C. Gallo's laboratory at the National Cancer Institute (NCI) of the U.S.
National Institutes of Health published papers demonstrating causation by a retrovirus described the previous year by scientists at the Pasteur Institute in Paris. Laboratory tests were quickly developed to confirm individual diagnoses and to screen blood donations for contamination. Subsequent research showing the rapid mutation of the causative microorganism dimmed hope for speedy development of a preventive vaccine.
In 1986, a drug known as azidothymidine (AZT) was identified by NCI researchers as inhibiting HIV activity in laboratory studies. Clinical trials by the drug's manufacturer, Burroughs Wellcome, Inc., proved encouraging, and in record time the Food and Drug Administration approved AZT for AIDS treatment. For nearly a decade, with a few other similar drugs, AZT stood as the only antiviral therapy available. During this time, however, treatment of the opportunistic infections and cancers that characterized AIDS advanced significantly. By 1996, a decade of medical research on AIDS began to produce new therapies that raised hopes that AIDS need not lead inexorably to death.
Because AIDS can be transmitted by sexual contact or intravenous drug use and because of its association with the homosexual community, some conservative religious and political groups in American society stigmatized the disease as shameful or as retribution for sin. During the presidency of Ronald
Reagan, these groups blocked federal action to promote the use of condoms for safe sex. They also opposed the creation of needle‐exchange programs to protect intravenous drug abusers. Widespread fear of the disease prompted some parents to insist that infected children be denied entry into public schools. On occasion, health‐care, police, and fire‐department personnel refused to respond to emergencies that involved infected people. A few insurance companies canceled health policies for persons diagnosed with AIDS, and some employers fired infected employees. In the worst cases, infected people experienced violence against themselves or their property. By contrast, C. Everett Koop, surgeon general of the United States Public Health Service in the Reagan administration, spoke out forcefully about safe sex to prevent AIDS and, in October 1986, mailed a brochure about AIDS written in lay language to every U.S. household.
By 1986, leadership at a national level, knowledge that AIDS could not be casually transmitted, and public statements by prominent people infected with HIV were helping to mitigate societal fears. Tennis professional Arthur Ashe, basketball star Magic Johnson, and AIDS activist Elizabeth Glaser were among celebrities infected with AIDS who spoke publicly about the disease. Actress Elizabeth Taylor led the theater and film communities in efforts to raise money to combat AIDS. Playwrights and filmmakers addressed the social issues raised by AIDS. The Names Project encouraged the friends and families of AIDS victims to create a national quilt in memory of those who had died.
By 2000, AIDS deaths in the United States had surpassed 420,000, and an estimated 650,000–900,000 were living with HIV/AIDS. Along with its direct human cost, the epidemic also forced a reassessment of the sexual revolution that had advocated a variety of sexual practices without fear of disease. Furthermore it illustrated how social attitudes such as homophobia can have important public‐health implications.
See also
Public Health.
Bibliography
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National Research Council, Committee on AIDS Research and the Behavioral, Social, and Statistical Sciences, Panel on Monitoring the Social Impact of the AIDS Epidemic , The Social Impact of AIDS in the United States, eds. Albert R. Jonsen and Jeff Stryker, 1993.
Caroline Hannaway, Victoria A. Harden, and John Parascandola, eds., AIDS and the Public Debate: Historical and Contemporary Perspectives, 1995.
Victoria A. Harden
