This is the first New York Times article reporting on what would later be known as the AIDS epidemic.
Edit: Here's the takeaway quote, in my opinion: "Cancer is not believed to be contagious, but conditions that might precipitate it, such as particular viruses or environmental factors, might account for an outbreak among a single group."
Edit2: "Dr. Curran said there was no apparent danger to nonhomosexuals from contagion.'"
Still much work to be done in informing people, so let this be an opportunity to ask your friends and family whether they know their facts on the matter, as HIV+ people are treated like lepers oftentimes.
Bonus trivia for reading along this far: Andrew Sullivan is HIV+.
The travel bans constitute inappropriate discrimination in my opinion, but they don't imply a misunderstanding of AIDS transmission. People can travel to a country and have sex there.
I suspect you're thinking it's a concession to conspiracy theorists who think that AIDS is caused by something other than HIV. At least, that was my initial reaction. But it's true that they are not the same, because AIDS is the syndrome you develop due to having HIV, but they don't happen at the same time, and AIDS can be put off indefinitely in a person with HIV using modern treatment.
It's an important distinction - and a mistake that many make - but more than anything, I didn't want some asshat to derail the message of my comment by nitpicking about this to appear smart and insightful.
Those people have had positions of power in the South African government and have caused very great harm. Admittedly, this is mostly mid-2000s, and not today, but still. Estimates suggest over 300,000 people died because of delays in introducing anti-retrovirals.
When the overwhelming body of evidence points to something, denialist seems appropriate. e.g. climate change denialist.
There was a reasonable case for HIV is not the cause of AIDS for a while in the 90s, but everything that pointed that way was overturned by further inquiry.
I met an HIV causes AIDS denialist once in university, so I did a bunch of research so find out if he was a crackpot or not. Things may have changed since I looked, but in 2007 there was no credible evidence I could find to suggest that HIV isn't the cause of AIDS.
However, I don't think "denialist" is always referencing holocaust denial... that connection didn't occur to me until you mentioned it. I could only think of "climate change denialist" which may be a reference to holocaust denialism, but that's once removed already.
It doesn't sound crazy, because he spends 90% of the essay more or less arguing semantics. As he says, AIDS isn't a disease. It's a syndrome. And the diseases which do the damage aren't caused by the HIV virus. He just points that out like it's something which no-one else is brave enough to mention, when he's really just attacking strawmen.
The really crazy bits are when he talks about whether or not HIV can damage the immune system, by killing T-Cells. I counted 8 mentions of the word "immune", and 7 mentions of the word "T-cell"; and he only mentions them halfway through the document.
Because of the complicated chain of causality (untreated HIV eventually wipes out the immune system, which causes a whole bunch of weird diseases to take hold), it's easy to write thousands of words about why rare diseases (which are called AIDS, in HIV positive patients) are only correlated with HIV, not necessarily caused by it. But in the middle of the article, the crazy bits are there.
It's like reading a long rambling article about why CO2 doesn't necessarily cause global warming (which has a grain of truth to it - it's a little more complicated than that with the role of positive and negative feedback effects), and halfway through the article the author suddenly mentions the greenhouse effect for the first time, then says it's unfounded (which changes the article from slightly crackpot to stark raving mad) .
Some people have a strong contrarian streak which naturally leads them toward the minority position on many controversial subjects. It's often the exact same people saying that AIDS isn't caused by HIV, that global warming is a fraud, that oil reserves are infinite, that evolution is impossible, etc. etc. I've witnessed this firsthand. I can't explain why they are this way, but it looks like a general attitude of "the popular opinion is more likely to be wrong than right".
You can lump all of your anti-favorite topics together and pretend they are similar. Just know that there are also people lumping you into their groups of crazy people based on one or two things that you believe and they don't.
Humans (scientists, doctors, politicians, internet commenters) like to pretend that we know so much about the universe and we just need to fill in a few details to fully grasp everything. This kind of thinking is dangerous at best.
It seems to me every time mankind fixes one problem they create a new one that they have to figure out how to solve.
There are also some paranoid people who use encryption because secret services could be spying on them. We have no idea how aids causes hiv, cannot even predict weather for next week, but we are 110% sure some theories are right.
In case you wonder why you are being downvoted, it’s because you are, yourself, denying recent (and less recent) news regarding federal monitoring; engaging in HIV/AIDS denialism; reversing HIV and AIDS; conflating weather prediction with scientific understanding; and ending with a non-sequitur.
I think his point is that people who believed that government was constantly monitoring everyone a few weeks ago were also seen as paranoid crazy persons who believed in conspiracy theories, and he is sarcastic about that.
I don't think people using SSL before a few weeks ago due to spying and/or hacking would be considered paranoid or crazy. We've known about domestic spying since 2006, some people just were not paying attention.
Now people on HN can't seem to get enough paranoia for breakfast.
Actually, I think the going medical opinion is that, except for new mutated strains (and they'd have to be heavily mutated), anyone who contracts HIV today is never going to develop AIDS if they have access to modern treatment options (for the rest of their life).
In the movie Forrest Gump, there is a scene taking place in the late 70s or early 80s where Jenny is explaining to Forrest that she is ill and the doctors do not know what it is. She dies a few years later. It is never stated explicitly, but the idea is that she was suffering from AIDS, which she contacted during her years as a promiscuous drug addict groupie.
In my opinion it is one of the most powerful scenes in the movie, in the sense that it does an amazing job with taking the viewer back to that time period where AIDS was a mystery disease.
I thought it was pretty obvious.
Was also a tad annoying as because she was liberal and anti war and was a sexually liberated woman...well then she is a whore that will get her payback by being given aids.
I thought it was a good movie but it had touches of right-wing propaganda.
First, women are just 20% of all AIDS victims. Mind not blown, Mr. Un-PC Dude.
Second, that shows a fair degree of missing the point of fiction. Sure, in real life, where everything happens according to cold statistics, promiscuous women will tend to get more AIDS than non-promiscuous women and non-promiscuous heterosexual men. Granted.
But this is fiction, a work of art which has an audience and a message, where everything happens because the author wants to. Even if you don't want to, even if you're scared shitless of communicating a Message, you are in fact, as an author, putting a point across. It might not be a message that you as an author subscribe to, but the work is there, and the point is made; and you're just a bad author. And people are naturally adept at finding the core message of works of fiction; we as a species seem to like narrative a lot.
We look at those Nazis melting at the end of the first Indiana Jones movie, and we instinctively get it: they were punished because of their arrogance and evilness (in this case Naziness). Even one Nazi got stigmata, as a symbolical punishment and marker of his inherent badness, that is, Naziness. It's all narrative, and a message gets made, namely that being Nazi is kind of a bad deal. Take Elon Musk, he's the hero in a narrative that pits the Startupy Original Innovators (good) against Sclerotic Big Corporations like Boeing (bad); and it's hinted that badness will be punished at the end and good will prevail, as it is defined in the (narrow, a bit unfair) context of that narrative. A very common and crude narrative structure; and very powerful, by the way.
So, this guy watches Forrest Gump in a culture that tends to shame women that have casual sex, and sees that it just so happens a woman that has casual sex then has (is punished with, the mind readily answers, since it's just too much of a coincidence...) AIDS, because this author just decided for it to happen. And this guy then infers the writer has made a moralizing tale where sluts get AIDS. Now, maybe this author was just clueless and didn't think through the implications of his, or her, decisions; but I wouldn't blame the GP for looking at Forrest Gump that way.
lolcraft says some of my thoughts better than I could.
It is funny that after my two sentence post I am accused of being PC (whatever that even means these days) and wanting to deny that some risky behavior and drugs could lead to problems and that I think all anti-war people were angels.
In Forest Gump everyone who is anti-Vietnam war is presented as bad and the woman who choose not to stay in her home town and make house and goes to protests get aids. It does seem like a message.
Some pointed out LT Dan does get his legs blown off. True but it is from no fault of his own, its a random event not him being punished. His gets on prostitutes (who of course are shown an horrible people) drinks a ton, but yet in the end, his life turns out good and he marries an Asian women (you know 'cause he was fighting against them, so this some how is fitting). No punishment for his reckless behavior unlike that slut Jenny.
Yes, unfortunately science is rarely PC. Behavior and genetics are by far the strongest determinants of your risk for acquiring HIV. No parade, protest, or law will change that.
Physician here: maybe you could enlighten us all on studies showing "genetics" are "strongest" determinants of "your risk for acquiring HIV."
Are you actually trying to advance the theory that the "genetics" of a particular minority group is a "determinant", rather than social class?
A lack of socioeconomic resources is linked to the practice of riskier health behaviors, which can lead to the contraction of HIV. These behaviors include earlier initiation of sexual activity and less frequent use of condoms (Adler, 2006).
Unstable housing has been linked to risk for HIV infection, including IV drug use and unsafe sexual behaviors (Aidala, Cross, Stall, Harre, & Sumartojo, 2005).
Individuals who are homeless or in unstable housing arrangements are significantly more likely to be infected with HIV compared to individuals in more stable housing environments (Culhane, Gollub, Kuhn, & Shpaner, 2001).
Lack of socioeconomic resources is also associated with risk factors for neuropsychiatric dysfunction, such as exposure to environmental toxins and injuries. These factors can make persons with HIV more vulnerable to the central nervous system effects of the virus, including more rapid cognitive decline and onset of dementia (Satz, 1993).
HIV status often has a negative impact on socioeconomic status by constraining an individual’s ability to work and earn income. Research indicates that up to 45 percent of people living with HIV are unemployed (Rabkin, McElhiney, Ferrando, Van Gorp, & Lin, 2004).
The effects of HIV on physical and mental functioning can make maintaining regular employment difficult. Patients with HIV infection may also find that their work responsibilities compete with their health care needs. Individuals infected with HIV are often discriminated against in the workplace, leading to their termination or forced resignation (Dray-Spira, Lert, Marimoutou, Bouhnik, & Obadia, 2003; Kass et al., 1994).
Children infected with HIV often exhibit cognitive deficits when compared with their uninfected peers (Martin et al., 2006). These deficits can adversely affect learning and earning ability later in life.
SES status often determines access to HIV treatment. Individuals of low SES have delayed treatment initiation relative to more affluent patients, reducing their chances of survival (Joy et al., 2008).
Patients of lower SES with HIV have increased morbidity and mortality rates. Research suggests a correlation between low SES and earlier death from HIV/AIDS (Cunningham et al., 2005).
Accordingly, individuals of higher SES levels experience slower progression of HIV infection (Schechter et al., 1994).
Decreased access to health insurance and preventive services is a major contributor to health disparities between high- and low-SES individuals. Low-income individuals are not likely to have health coverage or receive optimal treatment and care for HIV/AIDS, such as Highly Active Antiretroviral Therapy (HAART) (Wood et al., 2002)
Actually it's really simple. Risky behavior is called that because it increases the risk of STD transmission. It is also borne out in the statistics that people of certain races are disproptionately affected by HIV.
i don't understand. heterosexual women are way down the list. what are you trying to say? (i haven't seen the film so perhaps i am missing something, but i thought the argument from the original comment was that being a sexually active woman wasn't a major risk factor).
She was a promiscuous drug user. Sharing needles, engaging in high risk sexual activity, etc. The original comment is saying that they were annoyed that the movie perpetuated the stereotype that these activities increase the chances of contracting HIV. Those of us that are annoyed by this person's annoyance are saying that indeed these behaviors are scientifically proven to increase risk of HIV infection.
or that they receive fewer opportunities for education and distribution of said protection (eg, a richer school may have free condom distribution, but a poorer one does not?). Maybe because cultures of "Abstinence" (eg, teach them abstinence and dont give them condoms/protection, then wonder why they get diseases)...
This is all supposition, I'll let others lay down the facts.
Are you saying anti-war protesters can't be women beaters? That liberated women can't get AIDS? That in the late 70's prostitutes were guaranteed ways of getting this disease that wasn't widespread yet?
Forrest Gump had very real characters. Jenny had a shitty life, which continued to be shitty by her choices. This really happens to people from shitty backgrounds because they don't recognize shitty situations as shitty, but as normal. Had she stayed with Forrest, her life wouldn't have been that way, but she still could have been the strong woman that was part of her personality. She just didn't recognize when a good thing came her way.
Lots of people did heroin and hookers before AIDS was everywhere, not all of them contracted HIV. That's the nature of a mystery disease. Lt. Dan also fell into a depression that Forrest helped pull him out of, just by being a good influence. Lt. Dan had the life Jenny could have, Forrest made the lives of people around him better by being a good person. Between that and the rapid changes the world went through from 1950 to ~1985 is what the movie is about.
It's not a propaganda film, despite your strongest wishes that it were.
"Are you saying anti-war protesters can't be women beaters?"
can you really not see the argument being made? the original post was not saying no women got aids, or that no anti-war protesters are wife-beaters. it was arguing that there is a systematic bias.
i don't know if that's true or not, but wilfully misunderstanding or misrepresenting the argument doesn't help anyone.
It's a non sequitur. It does not follow that because the anti-war protester that Jenny hooks up with beats her that the movie is trying to portray anti-war protesters as woman beaters. It can only be a shocking bias if it's so shocking for it to occur.
It also doesn't fit the actual movie. The movie has Jenny making the same poor decisions over and over because that's what her background leads her to. Her personality leads her to protest the injustice of Vietnam, her view of normal gravitates her to the worst of the other protesters. Her personality leads her to being a liberated woman of the 70's, while at the same time drawing her into the culture of abuse and self-abuse that put her in the position to be one of the early contractors of HIV.
There is no bias, this really happens. Jenny was a complex character that was controlled by her demons.
The major characters of Forrest Gump are really portrayed quite realistically.
Propaganda or no, our brains do have a tendency to mix up correlation and causation (most notably because many times, correlation does come from causation), and a tendency to draw conclusions from fiction as well as from reality.
Someone who notices both her AIDS and her left-wing behaviour will likely be a tiny bit more confident that one causes the other.
(Now, I do see her as a prisoner of her shitty situation, and not as a "liberated" woman.)
> Someone who notices both her AIDS and her left-wing behaviour will likely be a tiny bit more confident that one causes the other.
So just because some people are woolly headed, artistic endeavours should show only one-dimensional characters? Reality is filled with Syrian rebels who eat hearts, rapists who were nice to their mothers and computer programmers who pray to god.
To some extent, everyone is "woolly headed" as you put it (did you mean holly headed?). While it's not a good reason to limit artistic endeavours to one-dimensional characters, it is a good reason to pay a little attention to it. I mean, a story full of weak cute girls whose sole purpose is to be saved by strong, muscular, male heroes does kinda sends the wrong message. I mean, girls often can and should defend themselves. Let's not teach them otherwise.
On the other hand, the fact that we tend to see correlations everywhere also mean we should be more forgiving when one happen to irk us. For instance, I once noticed in a season of 24 that "proprietary" was mentioned twice as an excuse for being harder to crack. The Stalman in me translated that by "proprietary -> better", and wondered if there was some kind of agenda behind that. Then, in season 8, I noticed that "proprietary" was used as an excuse for being harder to get used to. Which gives "proprietary -> worse". So much for the agenda. (By the way, 24 features much stronger and much more objectionable correlations. Noticed how human rights stop where Jack Bauer begins? —though again, season 8 doesn't seem to endorse torture any more.)
I'm afraid that if you think PG will continue to tell you to stop after this time, you are wrong. The next step is probably you being hellbanned by one of the admins, or by software.
I wonder if it's the younger YN crowd that is not seeing the connection? I was pretty young when I saw that movie in 1994, but it never occurred to me that it could be anything other than AIDS; the reference was completely unambiguous. I guess things had changed in the 12 years between the coinage of "AIDS" and that movie, but it still resembled the way people talked about it, and I think the memory of not knowing what it was was still fresh in the culture.
It was very obvious to me too, a teenager back then. The thing is, the entire film puts Forrest in the middle of countless major historical and cultural events. He serves in the Vietnam War. He phones in the Watergate Hotel break in. He speaks at the giant peace rally on the Mall. He co-founds the Bubba Gump Shrimp Co. He even invests in Apple ("some fruit company.") Having him witness the early rumblings of the AIDS epidemic is just one more example.
He was named about his relative named Forrest, who was part of a group that wore bed sheets and rode around on horses that also wore bed sheets. - KKK reference.
Forrest was at the U. of Ark. during the time of integration, and picked up the book dropped by one of the Little Rock 9.
He coined the term 'Shit Happens' and the smiley face t-shirt.
He was at the University of Alabama, not Arkansas. George Wallace, the segregationist governor of Alabama is blocking the entrance in a famous scene in American history known as "The Stand in the Schoolhouse Door." [1]
My dad was a professor at the University of Georgia during this time and still talks about what it was like being in the south at that time. Really fascinating to hear him describe it. He actually drove through Arkansas on a university research field trip right when desegregation was beginning to be enforced and saw the National Guard in place to enforce it.
It's probably easier to spot if you're older because absolutely everything in that movie screams reference to past cultural artifact. So you'd be looking for that in every detail. A younger person would be more likely to take the plot elements at "face value", as original or as standard story tropes.
That said I was around 15 at the time I saw it so recent history probably had a lot to do with it. AIDS was in the news a lot more in the 90s.
I saw the movie only a few years ago in my early twenties and I didn't get it. It never occurred to me 'not knowing what it is' meant AIDS back then. I'm not North American so the reference was totally lost on me. Also I didn't think it was an important detail and I never thought about it.
Nice catch. Additional data point: I saw it when it came out, and it was obvious it was AIDS. I guess that's a piece of history that's gradually fading now.
I think it being a movie may have caused people to overlook the reference. I can see how easy it would be to think that Jenny's mystery disease is actually just a made-up plot device to move the story forward, as opposed to a reference to a real disease. I only caught it because my parents are doctors and I happened to be watching it with them - I asked them if she had AIDS and they said that's probably what it was.
My vote for the key quote (from the bottom of the article):
"Dr. Friedman-Kien said he had tested nine of the victims and found severe defects in their immunological systems. The patients had serious malfunctions of two types of cells called T and B cell lymphocytes, which have important roles in fighting infections and cancer.
But Dr. Friedman-Kien emphasized that the researchers did not know whether the immunological defects were the underlying problem or had developed secondarily to the infections or drug use."
It was scientists working on leukemia and white-cell cancers that made the eventual discovery of HIV-1. Initially, the virus was classified as HTLV-IIIb before getting it's own name.
At the time there was also a bit of a dispute between American and French researchers over credit for the discovery and subsequent development of the diagnostic test.
"There is no national registry of cancer victims, but the nationwide incidence of Kaposi's Sarcoma in the past had been estimated by the Centers for Disease Control to be less than six-one-hundredths of a case per 100,000 people annually, or about two cases in every three million people. However, the disease accounts for up to 9 percent of all cancers in a belt across equatorial Africa, where it commonly affects children and young adults."
Is that because GRID already was occurring in Africa, and people getting KS and dying of it, or was it just a common cancer in Africa for unrelated reasons?
We see KS in HIV patients because they are often concomitant infections and because KS is opportunistic, attacking immune-suppressed people. But, this doesn't mean that KS necessarily goes hand-in-hand with HIV infection.
KS may have been 9% of all cancers in equatorial Africa just because of a very high KSHV prevalence and because lower life expectancy = fewer age-related cancers.
An article like this makes you wonder how many different diseases (answer - over 200) get lumped together under the large "cancer" umbrella.
One wonders if we are doing ourselves a disservice maintaining a term more inline with shared symptoms instead of separating the diseases into shared causes.
At any rate I'm digressing, but cancer is a fascinating (while horrible) concept that exists in our reality. When you think about it, it is probably more responsible for what we are today than any other force on the planet, in evolutionary terms.
As for AIDS: The fact that it was a "gay disease" hampered everything about our response to it. I'd like to think that we would be much more in tune with emerging health threats these days, but somehow I doubt it. I really hope we have HIV licked in a few years though, because Africa really, really needs a vaccine before it can do anything else really.
I always though cancer was an umbrella term for when a cell mutates in such a fashion to lose it's reproductive throttle, and consequently starts consuming as many resources as possible, eventually fragmenting and spreading throughout the body.
There are many genetic determinants of whether you will develop a cancer, or a particular type of cancer.
People with FAP, or HNPCC, or other proto-oncogene mutations such as BRCA2 will have a very high probability of developing a specific cancer in their lifetime.
But the mutation that leads to cancer is a spontaneous event, that is allowed to occur due to a failure of cellular regulation.
There are many viral causes of cancer, as OP mentions HPV for cervical and penile cancer. Other strains of HPV are linked to SCc (a form of skin cancer) and throat cancer.
Hepatitis C will cause liver failure and Hepatocellulr carcinoma in approx 20% of infected patients.
Infection with H. Pylori can predispose to gastric carcinoma.
Additionally exposure to various 'environments' can lead to cancer - if you have GORD you can develop Barett's Oesophsgus due to the gastric acid irritating lower oesophageal mucosa, which can predispose to oesophageal cancer. if you are an alcoholic you can develop cirrhosis and later Hepatocellular carcinoma due to prolonged inflammation in the liver.
If you are pale skinned and live in a sunny climate you are at higher risk for melanoma and if you eat a poor diet you have an increased risk of colon cancer.
Smoking and exposure to smoke can give you lung, oropharynx, stomach and bladder cancer.
As of yet we have no idea what, of any, are associations for many of the Brain, bone or Kidney cancers (excluding some toxins for kidney cancer).
Possibly there is no cause.
But in all of these cases, the mutation still arises 'spontaneously'. That is, we all have a probability of developing a mutation that can cause cancer every time a cell divides in our body. In people with Li-Fraumeni syndrome, who have a mutation of p53, almost everyone will develop cancer by the time they are in their 40s. So we know the rate of gene knockout is quite high over our lives, and if it wasn't for immunosurvielance, we would likely fall prey to cancer much faster than we do anyway..
All having a risk factor or infection does is increase the probability that a cell will 'spontaneously' develop a mutation that will make it cancerous, and having more of these mutated cells arising increases the chance that one will evade immunosurviellance and continue to grow and expand.
Bottom line: as a doctor I see all cancers as spontaneous. You could say that x causes y, and in many cases there is a strong association, but in no case is that association as strong as, say, life leading to death, for which there is a correlation coefficient approaching 1.
While I appreciate the information and agree that it's pragmatically spontaneous my point was that I was suggesting we'll find that it won't be the case if and when we gain a deeper understanding, which we may never do.
I don't know but the sarcoma the articles says is a symptom present in the last stages of AIDS, when the body is covered with brown "patches" - mostly in the back.
Other doctors were investigating other issues at the time, like a strong TB. But it took time for all this different specialists see it was one illness.
The first-world people with access to world class health care that contracted it in urban environments were gay. Origins however, are a bit more murky.
Most of the worlds population don't have the financial resources or the proximity to say, the UCSF medical hospital, where such specialty physicians would be to study such a thing.
There's been quite a bit of discussion of how it got to Christopher Street in New York. My pet theory is that the international drug trade had quite a bit to do with it, but I'm just a computer programmer
From Wiki:
At one point, the CDC coined the phrase "the 4H disease", since the syndrome seemed to affect Haitians, homosexuals, hemophiliacs, and heroin users. In the general press, the term "GRID", which stood for gay-related immune deficiency, had been coined.[180] However, after determining that AIDS was not isolated to the gay community,[178] it was realized that the term GRID was misleading and the term AIDS was introduced at a meeting in July 1982.[181] By September 1982 the CDC started referring to the disease as AIDS.[182]
Today is the 60th birthday of a friend who has been HIV+ since 1983. When we met, ca. 1986, I didn't expect him to live long. I am pleased beyond my ability to express that I was completely wrong. The party he and his husband are throwing on Sunday will be epic.
I'm currently reading And The Band Played On which is a detailed account of the rise of the AIDS epidemic and how it was ignored and mishandled back in the 80s. Definitely check it out if this subject interests you.
Curious: if we call t_0 1981, the Kaposi's Sarcoma article, and t_x 1996, the advent of HAART, and consider (t_x - t_0) "the AIDS epidemic" --- ignoring the ongoing epidemics in Sub-Saharan African and India, which are enormous problems but somewhat orthogonal to the problem described by your book --- what comparably lethal disease in human history was more effectively addressed by the medical establishment? How can we quantify the mishandling of AIDS in the 1980s?
It's not a direct comparison, but consider the handling of Ebola, where due to simple epidemiological interventions spread has basically been localized and stopped and no outbreak has killed more than 1000 people. Or consider the regular emergence of new flu strains which are far more contagious and are quickly and effectively contained. Though that comparison isn't great because we have a lot of knowledge when it comes to dealing with the flu.
My impression is (and I have not studied this) the failure in the HIV epidemic (pandemic?) wasn't a failure to develop drugs, it was a failure to perform basic epidemiological interventions to learn about and slow the progress of the disease.
In a sense this is a way of saying that in epidemiology, the failures are noisy and successes are silent, so comparing large epidemics across history might be misleading.
the comparison makes no sense because the diseases are radically different. Ebola kills so quickly and is so infectious that it is self-limiting: patients die before they can spread it very far. Whereas AIDS patients can spread the disease for years, though it is as weakly infectious as as contagious disease can be.
Just to give you an idea, the FDA didn't start screening its blood until 1985 after several documented cases where patients received AIDS from blood transfusions.
Reagan has been criticized for his complete non-response to AIDS as well. He mentioned it in passing in 1985, and didn't actually address the issue until 1987. Since AIDS mostly affected homosexuals and drug users, AIDS wasn't exactly a high priority for the Reagan administration in light of the Religious Right's massive power at the time. The popular rhetoric of the era was more akin to "AIDS is God's punishment for homosexuality" than compassion.
I believe that AIDS wasn't a high priority for Reagan, but from my vantage point it looks like HIV is an instance of an enormously complicated biological challenge being addressed with extraordinary effectiveness and rapidity by the medical establishment.
I take your point (and the sibling commenter's point) about the epidemiologic response to AIDS; I may be over-fixated on the research and development side of the issue.
It's important to remember that AZT (the first effective anti-retroviral treatment for HIV) was invented in the 60s as part of cancer research. It wasn't until the mid-80s that HIV researchers started testing it.
In other words, it's not as if the drug was invented in response to the AIDS crisis. Once the NIH/NCI made AIDS research a priority, it was a rather straightforward matter to start testing known anti-retroviral drugs. One can reasonably argue that if the government had made HIV research a priority in the late 70s and early 80s, the effective treatments would have been found before the epidemic exploded (for example, contrast to SARS or bird flu, where the index patients are chased down and isolated, and immunological research begins before there are even tens of thousands of patients.)
Was HIV even identified in the late 1970s and early 80s though? I thought it was identified as a consequence of looking at the causes of the AIDS epidemic.
The virus was discovered in 1983, but knowledge of the "gay cancer" was around in the late 70s. I shouldn't have said "HIV research" there, but rather, "AIDS research". The medical world's interest in AIDS was pretty limited until it started to break out of the marginalized populations of gay men and drug users.
Ah, OK, makes sense. That's when it was realized that it was not exclusively "GRID" (Gay-related Immune Disorder) and that it was transmitted by virus.
It's been a while since I've read the book but "And the Band Played On" paints a pretty sad picture about all the missed opportunities to save lives in the early years of the epidemic, due to (admittedly complicated) politics. And not just among politicians and government agencies, but among medical doctors and researchers and leaders of the gay community. You can feel rage and frustration coming through the pages--and it's an incredibly heartbreaking book as you see many of the main personalities involved in the fight against AIDS succumb to it themselves. Including the author himself.
What about SARS back in 2003? China first observed SARS in Nov 2002 but didn't report it until February 2003. The responsible virus was identified by April 2003 and the whole disease contained by July. http://en.wikipedia.org/wiki/Severe_acute_respiratory_syndro...
I'm not an epidemiologist so I can't compare the relative complexity of the SARS virus to HIV. But I'm skeptical that HIV presented a massive and insurmountable biologic challenge compared to other viruses.
I also encourage you to look into the epidemiological and sociological aspects of AIDS. It's horrifying, and it colors my above skepticism. The gay community referred to AIDS as a holocaust back in the early 80s, and I would encourage you to read this article at your leisure to see why: http://www.nytimes.com/1988/10/23/books/l-aids-and-the-holoc...
To get some perspective, 1981 was as close to 2013 as it was to 1949.
Edit: Yes, I meant 2013, thanks. Point being: I remember the mid (not early) 80's and it SEEMS so recent and modern but it's as far removed from our life today as 1950's life was then.
Note that HIV/AIDS wasn't altogether distant from Reagan personally: the Reagan's were friends of Rock Hudson, who died of AIDS-related complications in 1985.
There is a difference between effectively managed by the medical establishment and what Reagan / america did in the 80s. I'm at work and I don't have sources readily available, but my understanding is that many older gay people (those still alive) hate reagan and republicans specifically because they slow rolled the response to hiv. Much of America's response wasn't really pushed until the Clinton administration. So how much of the below is the legitimate difficulty of rapidly responding to a new disease is arguable, but I don't think anyone can make a real case that if a new disease had appeared in the 80s that affected straight white men that it wouldn't have gotten a much more vigorous response from the reagan administration/fda/etc. At bare minimum, by the first time reagan mentioned aids publicly, 20,849 Americans had died from it [1]. How he squared his conscience with not mentioning aids until twenty thousand americans had died is amazing.
A brief history mostly off the top of my head
1 - reagan didn't care at all about aids until an actor friend of his died of it;
2 - the strong perception within the fda was that reagan didn't care about aids / didn't want anything done about it;
3 - reagan allowed his staff to delete a mention of ryan white from a speech;
4 - reagan didn't mention aids publicly until mid 1987
Writing in the Washington Post in late 1985, Rep. Henry Waxman, D-Los
Angeles, stated: "It is surprising that the president could remain silent as
6,000 Americans died, that he could fail to acknowledge the epidemic's
existence. Perhaps his staff felt he had to, since many of his New Right
supporters have raised money by campaigning against homosexuals." [1]
5 - act-up, amongst others, fought with the fda about not just glacial drug approval processes, but also the fda denying access to experimental therapies even to patients without other therapeutic options;
6 - I don't remember this as well, but I believe hiv patients also had to fight the fda for early-ending of clinical trials, because they were insisting that people taking placebos should basically die
So some of this is similar to why many gay people of the right age hate Ed Koch, but an aggressive intervention by the reagan administration might have saved many lives.
"The real Reagan record on AIDS is different. AIDS funding skyrocketed in the 1980s, almost doubling each year from 1983 - when the media started blaring headlines - from $44 million to $103 million, $205 million, $508 million, $922 million, and then $1.6 billion in 1988. Reagan's secretary of Health and Human Services in 1983, Margaret Heckler, declared AIDS her department's "number one priority." While the House of Representatives was Democrat-dominated throughout the 1980s, which Democrats would quickly explain was the source of that skyrocketing AIDS funding, Reagan clearly signed the spending bills that funded the war on AIDS.
It's also wrong that Reagan didn't utter the word "AIDS" until 1987. Any reporter who bothered to check facts would find that Reagan discussed AIDS funding in a 1985 press conference, just for starters. But let's turn that around on the rest of Washington. Does that mean no reporter asked Reagan about AIDS in the 1984 presidential debates? And that every interview President Reagan granted to a national or local media outlet failed to solicit Reagan's opinions on AIDS until 1985? Using this phony-baloney spin line - that federal policy hinges exclusively on the presidential bully pulpit - is an exercise in liberal hyperbole over hard data."
It's too bad that you're replying to a comment on a deeply researched book (And the Band Played On) with a link to a shallow and slanted retrospective justification for lack of leadership.
The original book criticizes then-president Reagan, but also the media (specifically including the NYT) and elements of the medical establishment.
It also gets into controversies within the gay establishment, such as whether to make a fuss about the problem (which could attract attention and lead to "outing" of people), and whether to close bathhouses as health risks.
MRC is hardly an unbiased source of information. Their news group's stated goal is to be the "Leader in Documenting, Exposing and Neutralizing Liberal Media Bias."
From the wikipedia page:
Journalist Brian Montopoli of Columbia Journalism Review in 2005 labeled MRC "just one part of a wider movement by the far right to demonize corporate media" rather than "make the media better." Additionally, Montpoli wrote that "false equivalence is at the very root of MRC’s beliefs."
1 - nothing you said disproves my statements; that reagan had the word "aids" dragged from his lips during a press conference does nothing to change his record of disregard, contempt, and disregard of a crisis because he and his donors disapproved of gay people; nor does it change the fact that he didn't voluntarily mention it until 1987
2 - nor does a record of funding disprove reagan's intentional oversight; by 1992 aids was the #1 cause of death for US men ages 25-44 [1] and by 1994 the #1 cause of death for all americans age 25-44 [1]; the funding was wildly insufficient to mount a proper response. And were it not for reagan's homophobia and bigotry, a more vigorous response could reasonably have saved many more lives
3 - while it is true that federal policy doesn't hinge exclusively on what the president says, nice attempt to change the goals. The point was not that the federal government and medical establishment -- despite reagan -- did both their job and their moral duty, but that he intentionally hampered the response. I repeat: it's indisputable that if a disease affecting, well, reagan supporters had killed 20 thousand americans it would have garned a much more vigorous response, one which could be triggered and pushed by the president himself. For example, see the improvement in response under Clinton. I'm sure it's just a coincidence that AIDS was a priority under a president who isn't a homophobe.
4 - brent bozell is a proud homophobe; what a surprise that he manages to find supposed evidence -- though you shouldn't believe a thing he says without consulting a primary source -- finding that reagan didn't intentionally fail a group of americans reagan despised
I don't have the exact citations at hand, but I believe a key difference with AIDS is that professional epidemiologists themselves are of the opinion that the early stages of the AIDS epidemic were mishandled, primarily due to lack of funds and/or power by the Reagan administration.
Similar to early diagnoses of Cystic Fibrosis, where the focus was on symptoms and less on the underlying cause. With CF, it's an issue of NaCl passing through cells, resulting in thick mucus which damages lungs, pancreas, etc. The first cases observed cysts and fibrotic tissues on the pancreas, hence, "Cystic Fibrosis". As there weren't digestive enzymes supplements then to augment the damaged pancreas, patients died of malnutrition. It wasn't until those treatments developed that the lung conditions developed in older patients, which is what CF is known for now. By then, however, the name Cystic Fibrosis had stuck.
I cannot find the article by Peter Collier and David Horowitz, which describes how the public health officials in San Francisco bowed to political pressure and did not do the typical contact-tracing, public announcements, etc. that would normally be done - because they feared getting in trouble if they pointed out that the carriers were almost all gays. But it makes an interesting counterpoint to the idea that there was a lack of concern about it.
Haitians in the US were discriminated against on the belief that they were bringing AIDS into the country. But medical anthropologist Paul Farmer has done a good job of showing that Haitians were only more "susceptible" to the virus than other populations because American sex tourists often visited Haiti and inadvertently spread the disease to Haitian sex workers.
As I understood it, there was a long standing debate about whether the AIDS epidemic spread from Haiti to the US or the other way around, but genetic evidence eventually found that it did come from Haiti: http://www.pnas.org/content/104/47/18566.long
There's a great Radiolab episode, Patient Zero (http://www.radiolab.org/2011/nov/14/), that covers the the spread of AIDS and tracing the disease back to its origin.
Contrast this from recent papers describing the breathtaking molecular capabilities we have these days with the HIV virus (using inactivated/re-engineered HIV to treat T cell lymphomas/leukemias, bone marrow transplants to treat HIV itself), and it's humbling both - how far we've come, and with HIV still a major killer on the global scene, how far we have to go....
So sad to read that article especially seeing that they were giving people chemotherapy right away. As if dying from AIDS weren't bad enough. Yet the article did dance around the core problem in talking about a group of promiscuous people, but the connection was not made. I hope medicine has learned better the signs of a viral outbreak.
Edit: Here's the takeaway quote, in my opinion: "Cancer is not believed to be contagious, but conditions that might precipitate it, such as particular viruses or environmental factors, might account for an outbreak among a single group."
Edit2: "Dr. Curran said there was no apparent danger to nonhomosexuals from contagion.'"