1981: Dr. Michael Gottlieb and his colleagues at the University of California, Los Angeles, note five cases of a rare Pneumocystis pneumonia in gay men and alert the Centers for Disease Control (CDC), which publishes a noticein itsMorbidity and Mortality Weekly Report (MMWR) on June 5, 1981. This is the first publication of what would come to be known as AIDS. By the time the report is published, 250,000 Americans are already infected.
The report does not mention the race of the five men. “The first five patients were white,” remembered Gottlieb. “The next two were black. The sixth patient was a Haitian man. The 7th patient was a gay African-American man, here in Los Angeles. Most of those first patients died within months. We had no information and no treatment.”
Gottlieb told FRONTLINE that not mentioning the race of the first patient was “an omission on our part.”
Emphasis ours. From the same timeline:
In July [1982], the CDC publishes a notice in the MMWRof 34 cases of the new disease among male and female Haitians living in five states. An accompanying editorial says, “It is not clear whether this outbreak is related to similar outbreaks among homosexual males, IV drug abusers, and others, but the clinical and immunologic pictures appear quite similar.”
In a January [1983] MMWR notice, the CDC describes two cases of AIDS in females – one Black and the other Hispanic — who had no other risk factors except that they had been having sex with infected males.
In a second MMWR, the CDC details 16 cases of AIDS found in prisoners in New York and New Jersey. In New York, four of the men are black, four are white and two are Hispanic. In New Jersey, three are black and three are white. While most of the men report they are heterosexual, most have also used IV drugs.
The CDC and other health organizations’ shorthand for “risk factors” that might put someone at risk for AIDS was “the 4-H club”: homosexuals, heroin addicts, hemophiliacs and Haitians. This dangerous language set a precedent that was not only inherently homophobic, classist and racist but led to a widespread misunderstanding (still hampering prevention efforts today) that HIV transmission was based on “who you are, not what you do.”
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Have stories to add? Submit a post, send us an ask, or post your own tagged #normalheart-history and #POC and hiv/aids
I just wanted to say what a fantastic idea this is and what a fantastic job you’re doing carrying it out. I work in public health (in training to become an epidemiologist), and was spurred to do so by learning about the AIDS epidemic and the failure to act by both the Canadian and American (and global, but I don’t work there) governments. I felt the need to do something, to dedicate my life to preventing something like this from ever happening again. Thank you so much for putting together such a wonderful resource and educational tool. It is truly inspiring to see this kind of dedication and work, and is sure to inspire more people the way Larry’s work inspired me.
Love,
Olivia
Thanks, Olivia, this means a lot.
In working on this Tumblr, I (shana) was reminded again how the entire idea of wanting to be an epidemiologist or to study immunology was pretty rare/obscure as a career path pre-AIDS, and how many friends (gay men especially) I had who have pursued those fields since. And how much better prepared (if still underfunded) public health is now as a result.
We’ve spent the last week putting up histories and resources on the context of the early AIDS epidemic.
Visit our archive for more information on women and AIDS, people of color and the HIV epidemic, the controversies around safe sex, how AIDS activism changed medical care, and just a few of the artists whose work was shaped by the epidemic. And more on Larry Kramer, activist and artist, as well.
Now that you’ve seen the movie, we want your input too. What are your questions? What can you add to the conversation?
We’ve already had some great discussion with knowledgeable commenters about AIDS activism and the disability rights movement, and learned the story of a Normal Heart performance 25 years ago in Missouri that led to local controversy and even arson.
We’d love to know what confused you, what enraged you, what you want to learn more about, and what you in turn can teach us.
HBO’s adaptation of The Normal Heart airs tonight. We’ll be watching, and we hope you will be too.
We’ve collected these resources over the last week—with lots of help—in hopes of providing more context to the story of the early AIDS epidemic than what we’ll see on the screen.
But it doesn’t stop there.
Please, help us spread the word about normalheart-history by reblogging this and our other posts.
Encourage anyone who’s watching the movie to ask us anything about the people and stories portrayed in the film.
And submit your own story about the epidemic so we can post that, too.
High resolution 12” x 18” poster of HIV/AIDS-related issues that affect Indigenous communities. This poster coincides with #WORLDAIDSDAY&#DAYWITHOUTART. As with all our posters, feel liberated to, share, print out, wheatpaste, and disseminate at will!
HIV/AIDS Among American Indians & Alaska Natives (CDC wedsite).
Fast Facts:
HIV affects AIs/ANs in ways that are not always obvious because of their small population sizes.
Over the last decade, annual diagnoses increased 63% among AI/AN gay and bisexual men.
AIs/ANs face HIV prevention challenges, including poverty, high rates of STIs, and stigma.
HIV is a public health issue among American Indians and Alaska Natives (AIs/ANs), who represent about 1.2%a of the U.S. population. Overall, diagnosed HIV infections among AIs/ANs are proportional to their population size. Compared with other racial/ethnic groups, AIs/ANs ranked fifth in rates of HIV diagnoses in 2015, with a lower rate than blacks/African Americans, Hispanics/Latinos,b Native Hawaiians/Other Pacific Islanders, and people reporting multiple races, but a higher rate than Asians and whites.
The Numbers: HIV and AIDS DiagnosescOf the 39,513 HIV diagnoses in the United States in 2015, 1% (209) were among AIs/ANs. Of those, 73% (152) were men and 26% (55) were women.Of the 152 HIV diagnoses among AI/AN men in 2015, most (79%; 120) were among gay and bisexual men.dMost of the 55 HIV diagnoses among AI/AN women in 2015 were attributed to heterosexual contact (73%; 40).From 2005 to 2014, the annual number of HIV diagnoses increased 19% (from 172 to 205) among AIs/ANs overall and 63% among AI/AN gay and bisexual men (from 81 to 132).In 2015, 96 AIs/ANs were diagnosed with AIDS. Of them, 59% (57) were men and 41% (39) were women.
Living With HIV and Deaths
Of the 3,600 AIs/ANs estimated to be living with HIV in 2013, 18% (630) were undiagnosed. By comparison, 13% of everyone living with HIV were undiagnosed.
Of AIs/ANs diagnosed with HIV in 2014, 78% were linked to medical care within 1 month.e
At the end of 2013, 53% of AIs/ANs who had been living with diagnosed HIV for at least a year were retained in care (receiving continuous HIV medical care), and 52% had achieved viral suppression.
During 2014, 51 AIs/ANs died from HIV or AIDS.
Prevention Challenges
Sexually transmitted diseases (STDs). From 2011 to 2015, AIs/ANs had the second highest rates of chlamydia and gonorrhea among all racial/ethnic groups. Having another STD increases a person’s risk for getting or transmitting HIV.
Lack of awareness of HIV status. Almost 1 in 5 AIs/ANs who were living with HIV at the end of 2013 were unaware of their status. People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly pass HIV to others.
Stigma. AI/AN gay and bisexual men may face culturally based stigma and confidentiality concerns that could limit opportunities for education and HIV testing, especially among those who live in rural communities or on reservations.
Cultural diversity. There are over 560 federally recognized AI/AN tribes, whose members speak over 170 languages. Because each tribe has its own culture, beliefs, and practices, creating culturally appropriate prevention programs for each group can be challenging.
Socioeconomic issues. Poverty, including limited access to high-quality housing, directly and indirectly increases the risk for HIV infection and affects the health of people living with and at risk for HIV infection. Compared with other racial/ethnic groups, AIs/ANs have higher poverty rates, have completed fewer years of education, are younger, are less likely to be employed, and have lower rates of health insurance coverage.
Alcohol and illicit drug use. Alcohol and substance use can impair judgment and lead to behaviors that increase the risk of HIV. Injection drug use can directly increase the risk of HIV through sharing contaminated needles, syringes, and other equipment. Compared with other racial/ethnic groups, AIs/ANs tend to use alcohol and drugs at a younger age and use them more often and in higher quantities.
Data limitations. Racial misidentification of AIs/ANs may lead to the undercounting of this population in HIV surveillance systems and may contribute to the underfunding of targeted services for AI/AN.
What CDC Is Doing
CDC and its partners are pursuing a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy, maximize the effectiveness of current HIV prevention methods, and improve HIV data collection among AI/AN. Activities include:
Working with the Indian Health Service (IHS) and tribal leaders of the CDC Tribal Consultation Advisory Committee to discuss methods for developing and implementing scalable, effective prevention approaches that reach those at greatest risk for HIV, including young gay and bisexual AI/AN men.
Providing support and technical assistance to health departments and community-based organizations to deliver effective prevention interventions.
Ensuring that capacity-building assistance providers incorporate cultural competency, linguistics, and educational appropriateness into all services delivered.
Providing capacity building assistance directly to the IHS so it can strengthen its support for HIV activities, including HIV testing capacity; We R Native, a comprehensive health resource for Native youth; and the Red Talon Project, which works to achieve a more coordinated national and Northwest tribal response to STDs/HIV.
Raising awareness through the Act Against AIDS campaigns, including
Doing It, a national HIV testing and prevention campaign that encourages all adults to get tested for HIV and know their status;
Let’s Stop HIV Together, which raises HIV awareness and fights stigma among all Americans and provides many stories about people living with HIV; and
HIV Treatment Works, which highlights how men and women who are living with HIV have overcome barriers. The campaign provides resources and encourages people living with HIV to Get In Care,Stay In Care, and Live Well.
In addition, the Office for State, Tribal, Local, and Territorial Support (OSTLTS) serves as the primary link between CDC, the Agency for Toxic Substance and Disease Registry, and tribal governments. OSTLTS’s tribal support activities are focused on fulfilling CDC’s supportive role in ensuring that AI/AN communities receive public health services that keep them safe and healthy.
a Percentage of AI/AN reporting only one race. b Hispanics/Latinos can be of any race. c HIV and AIDS diagnoses indicate when a person is diagnosed with HIV infection or AIDS, but do not indicate when the person was infected. d The term gay and bisexual men, referred to as men who have sex with men in CDC surveillance systems, indicates how individuals self-identify in terms of their sexuality, not a behavior that transmits HIV infection. eIn 32 states and the District of Columbia (the areas with complete lab reporting by December 2015).
World AIDS Day Observed on December 1st of every year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection, and mourning those who have died of the disease. Government and health officials, non-governmental organizations and individuals around the world observe the day, often with education on AIDS prevention and control.
As of 2013, AIDS has killed more than 36 million people worldwide (1981-2012), and an estimated 35.3 million people are living with HIV,[2] making it one of the most important global public health issues in recorded history. Despite recent improved access to antiretroviral treatment in many regions of the world, the AIDS epidemic claims an estimated 2 million lives each year, of which about 270,000 are children.
Day With(out) Art Day Without Art (DWA) began on December 1st 1989 as the national day of action and mourning in response to the AIDS crisis. To make the public aware that AIDS can touch everyone, and inspire positive action, some 800 U.S. art and AIDS groups participated in the first Day Without Art, shutting down museums, sending staff to volunteer at AIDS services, or sponsoring special exhibitions of work about AIDS. Since then, Day With(out) Art has grown into a collaborative project in which an estimated 8,000 national and international museums, galleries, art centers, AIDS Service Organizations, libraries, high schools and colleges take part.
In the past, Visual AIDS initiated public actions and programs, published an annual poster and copyright-free broadsides, and acted as press coordinator and clearing house for projects for Day Without Art/World AIDS Day. In 1997 we suggested Day Without Art become a Day WITH Art, to recognize and promote increased programming of cultural events that draw attention to the continuing pandemic. Though “the name was retained as a metaphor for the chilling possibility of a future day without art or artists”, we added parentheses to the program title, Day With(out) Art, to highlight the proactive programming of art projects by artists living with HIV/AIDS, and art about AIDS, that were taking place around the world. It had become clear that active interventions within the annual program were far more effective than actions to negate or reduce the programs of cultural centers.
