History

In his first year of office, President Reagan introduced a series of conservative reforms that prioritized the military over social services (i.e., “welfare programs”) and medical research.  Reagan reduced taxes through the Economic Recovery Tax Act, and in the years that followed, successfully slashed the budgets of social welfare programs by more than $22 billion, according to history professor Claire Bond Potter.

“Mr. Reagan’s welfare reforms just made the poor poorer,” Bond Potter wrote recently in The New York Times.  “When a three-year recession hit in 1980, six million more Americans fell into poverty. By 1989, employment recovered, but a weak social safety net meant that workers were an illness or an accident away from hardship.”

Under the Reagan administration, public health agencies such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) suddenly faced drastic budget cuts to their research programs.  Such was the situation when, on April 12, 1983, CDC epidemiologist Don Francis raised the issue about the lack of dedicated funding for AIDS research.

“The inadequate funding to date has seriously restricted our work and has presumably deepened the invasion of [AIDS] into the American population,” Dr. Francis wrote to his supervisor.  “It has sandwiched those responsible for research and control between massive pressure to do what is right and an unmovable wall of inadequate resources.”

The Reagan’s economic policy was based on the theory of supply-side economics. The fiscal 1982 budget proposed by Reagan represented a reduction of $44 billion (5.7%) in all programs except national defense, according to the Institute for Research on Policy.  More than half of the budget reduction came from two areas: income security; and education, training, employment, and other social services.

These components of “Reaganomics” created the perfect storm for the millions of people who would be diagnosed with HIV in the next decade and beyond.  By the end of Reagan’s first term in office, at least 7,700 people had received an AIDS diagnosis and more than 3,500 had died of the disease.

Due to the lack of attention from the White House, non-profit organizations led by members of the LGBTQ communities in Los Angeles, San Francisco, New York City and other cities stepped in to provide HIV/AIDS information, support and care.  Gay rights activists undertook initiatives promoting education about safer sex and countering discrimination against AIDS. With no treatment available in these early years, friends and family members could only comfort the dying.

It will be almost one year later, in July 1983, when the first dedicated funding for AIDS research and treatment is approved by Congress.

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Source:

www.HIV.gov, “A Timeline of HIV and AIDS”

Operated by the U.S. Public Health Service, the AIDS Hotline responds to public inquiries about the disease, and by July 28, the hotline has to be expanded from three phonelines to eight to accommodate the high volume of calls.

In 1985, HHS transferred the hotline to the Center for Disease Control and eventually services were expanded in October 1987 to become the National AIDS Clearinghouse, with electronic linkage to computerized referral databases.

Spanish-languages services on the hotline were not included until August 1988. A month later, the hotline adopted TTY services for the hearing-impaired.

By February 1991, the total of calls to the hotline in eight years of service was 5 million.

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Source:

National AIDS Hotline: HIV and AIDS Information Service through a Toll-Free Telephone System by Robert R. Waller and Lynn W. Lisella (CDC’s HIV Public Information and Education Programs, November-December 1991)

In 1983, the AIDS epidemic began to inundate the Shanti Project’s emotional support services program.  The organization responded by shifting its focus to exclusively serve people with AIDS (PWAs) and expanding its services to include assistance with everyday chores for debilitated PWAs and the creation of the first residence program in the U.S.

Shanti Project was founded by psychiatrist Dr. Charles Garfield in 1974 to offer peer support services to people with life-threatening illnesses.  Shanti trained volunteers to provide dying and chronically ill patients with emotional support.

As Shanti transitioned its services to meet the needs of PWAs, Clifford Morrison was among the volunteers who took part in the volunteer training in December 1982.  Morrison was a clinical nurse specialist and founder of the AIDS Ward (Ward 5B) at San Francisco General Hospital, and he immediately knew that Shanti’s emotional care program would fill a large need at Ward 5B.

“I decided we needed to have psychosocial support,” Morrison told the San Francisco AIDS Oral History Project in 1995-1996.  “The nurses were going to be busy taking care of the physical needs of patients, and I wanted them to have an ability to recognize and deal with the psychosocial issues. But they were not going to be able to handle all of that.”

Morrison pitched his idea to Jim Geary, Shanti’s then executive director, and recommended the organization secure the funding for the project from the City of San Francisco’s Department of Public Health.

After some negotiating with city hall, the funding was put into place for Shanti to provide a program of volunteer counselors for Ward 5B.  The result was a place where PWAs could receive both medical care and emotional support.

“All those things did come together, and we did see the advantages right away of having these resources centralized,” Morrison said.  “And almost immediately, what we found was that people from within the system — within the Department of Public Health, within the hospital, from other hospitals — started calling and coming to us and saying, ‘Oh, well, you’ve developed this approach to care, so how can we do it?'”

When Morrison shared Ward 5B’s model of care with healthcare professionals, he often heard excuses why the model wouldn’t work at other hospitals.  It was just “too unique.”

The Ward 5B-Shanti collaboration developed what became to be known as the San Francisco Model of Care, a patient-centered care model that emphasizes interdisciplinary care with a team of doctors, nurses, social workers, case managers, psychiatrists, addiction specialists, nutritionists and so on.

“It wasn’t new, I didn’t invent it,” Morrison said.  “It’s just maybe I’m one of the first people to pick it all up and put it together and see.”

Doctors Renslow Sherer and Ron Sable opened their clinic at Chicago’s Cook County Hospital shortly after they encountered their first HIV/AIDS cases.

“I saw my first AIDS patient in 1982 at Cook County Hospital during my second month as a general physician,” Dr. Sherer told Windy City Times. “He was a young, gay, African American man who could no longer do his daily six-mile run. At first we weren’t exactly sure that it was AIDS, but then he had the Pneumocystis carinii pneumonia, and the rest of his symptoms seemed to fit.”

At about the same time, his colleague, Dr. Sable, told him about treating two people with AIDS symptoms and that they should start preparing to treat a lot more patients infected by HIV.

When they initially launched the clinic, they didn’t refer to it openly as an AIDS clinic.  They were concerned that the stigma surrounding AIDS would cause pushback from hospital administrators, others in the medical center and the surrounding community.

Instead, they quietly directed patients with HIV/AIDS symptoms to be treated at the clinic.  In their first year together, Drs. Sherer and Sable worked with 141 patients.

The doctors not only co-founded Chicago’s first AIDS clinic, but they were also among the founders of the AIDS Foundation of Chicago, which raised private funding for the clinic.

In 1993, Dr. Sable announced in a letter he sent to hundreds of friends and colleagues that he was HIV-positive, according to the Chicago LGBT Hall of Fame. He cut back on most of his organizational activities, and spent more time with his friends and his partner of 12 years, Jose Narvaez.

A large public event was held at the South Shore Cultural Center to celebrate Dr. Sable’s lifetime of achievements. He was weak, but managed to attend.  He died later that year, and soon after he was inducted into the Chicago Gay and Lesbian Hall of Fame.

“I miss him every day,” Dr. Sherer told the Windy City Times. “He was a fabulous person, and if I wanted to go out on a limb, I’d say he was one of the best advocates for LGBT rights that this city has ever seen.  He spent half his time treating AIDS patients and the other half standing up for their rights.”

In 1998, the Sable/Sherer Clinic would be absorbed into Cook County Hospital’s new Ruth M. Rothstein CORE Center.

In his op-ed in the New York Post, Pat Buchanan echoes the Moral Majority position that the AIDS epidemic was God seeking revenge against gay people.

Buchanan concluded his essay by saying homosexuals should be banned from food-handling jobs, and that the Democratic party’s decision to hold its 1983 convention in San Francisco will endanger delegates and their families.

Visitors to the city, he writes, will be at the mercy of “homosexuals who belong to a community that is a common carrier of dangerous, communicable and sometimes fatal diseases.”

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Source:

ThinkProgress, “Flashback — Buchanan: AIDS is Nature’s ‘Awful Retribution’ Against Homosexuality” by Igor Volsky, May 24, 2011

At the hearing, members of Congress heard testimony from researchers, heathcare officials, and three AIDS men with AIDS who described their personal experiences.

Here is the testimony of Michael Callen of New York:
(born April 11, 1955, died December 27, 1993)

In December of 1981, I had some blood testing done by my private physician, and those tests indicated that I was immune deficient. In December of 1981, there was very little known about this disease, but there was in the gay press beginning to be reports of increased instances of very unusual diseases, and they outlined some of the symptoms. I was very concerned because I had some of these symptoms — fevers, night sweats, general lymphadenopathy, swelling of the lymph nodes, malaise, fatigue.  So I had myself tested and, as I indicated, in December of 1981, I was told I was immune deficient.

The effect of being told that I was immune deficient was devastating.  I called my parents and said, “I am going to die.”

I was not hospitalized until the summer of 1982, when I was diagnosed with cryptospordiosis, which is one of the qualifying opportunistic infections, according to the CDC definition of this syndrome.

I was hospitalized for over a week with what is known as the wasting syndrome.  It was the lowest point of my life.  I was convinced from everything I read and heard that I was going to die.

But I recovered from that specific infection, and I was rehospitalized in the fall of 1982.  They suspected pneumocystis pneumonia. I had a bronchoscopy performed and other tests.  It turned out to be bronchitis.  But my story really illustrates one of the consistent stories for people who have this syndrome.  So little is known.

When my doctor indicated to me in December of 1981 that I was immune deficient, I said, “What does that mean?”

And he said, “We don’t know.”

So now a lot of people who are being told they are immune deficient are simply waiting, waiting for the next infection.

Now, I have come to believe that I am going to beat this disease.  I no longer think that I am going to die.  But it is very difficult when you pick up newspapers or turn on the television, and you hear that no one has fully recovered from this syndrome, and that 80% of those diagnosed with the syndrome are dead after two years.

So I guess that is my story — waiting around for infections, checking myself every morning for Kaposi’s sarcoma lesions and waiting for information about this disease to be forthcoming.

Here is the testimony of Roger Lyon of San Francisco:
(born September 30, 1948, died November 4, 1984)

I was diagnosed with Kaposi sarcoma on February 3 of this year.  Prior to that time, I was having absolutely no AIDS-related symptoms whatsoever.  On physical exam at that time, three lesions were found internally.  Prior to that, I was being treated for an amoebic disorder, no real symptoms of AIDS.

February 3, basically 100, I think more exactly 180 days ago, I became aware I had a life-threatening disease.  On February 4, I entered UC, I went to University of California without an appointment, at the suggestion of my doctor, and started what is called their staging process — a battery of tests to determine the extent of this disease.

At that time, I was basically numb.  I had no feeling.  I was just moving.  UC has been — they have been very kind and helpful.

However, it is a matter of day-to-day waiting, waiting for something to happen, living in constant fear that I am going to wake up one morning to find lesions, waking up finding that I have some other opportunistic infection, cryptospordiosis, possibly pneumocystis pneumonia.

At this time, I am basically living in fear of what is to come. Other than that, it is a day-to-day wait-and-see process.

Statement of Anthony “Tony” Ferrara of Washington, DC to Congress
(born in 1954, died June 4, 1984

The first idea there was something wrong with me was last summer.  I had lymphadenopathy, swollen lymph glands especially around the jaws and throat and under the arms.  That continued for a few months, but the whole time I felt quite good.  I continued to run and jog, and I experienced no fatigue, no night sweats, no fevers.  In fact, in November, I finished the Marine Corps marathon, when I was supposedly very, very ill.

The lymphadenopathy went away.  So I thought nothing further of it.  But all along, I had been reading about AIDS, and of course, as every conscious gay man should be, was very worried about it.

In February, I saw two small purple lesions, one on the inner aspect of each of my lower thighs, and I knew what they were, or I knew what they could be, and I said I would wait a month, and if they were still there in a month, I would seek treatment or seek a diagnosis.  Well, in the beginning of March they were still there.

I belong to the George Washington University HMO.  I went there and told them that they really should biopsy one of these lesions to see what it was, gave them my sexual history, and told them that there was a good chance I did have AIDS.  They biopsied it, and the diagnosis was Kaposi’s sarcoma. That was March 8.

Obviously, the first day I was very, very upset, and I went into a deep depression for about a month.  I came home that night and my significant other held me in his arms, and I said to him, “Why do I feel like Ali McGraw, it is just like a movie, it is really terrible, it is the most horrible thing that ever happened.”

My depression lasted a month, and I decided if there was any chance I was going to get over this, if I had any chance of surviving at all, I would have to have a more positive attitude and just continue on, live my life as best I can, and try not to worry about it too much.

I was very lucky. I had the choice of being treated at GW by a very good cancer specialist there, who instilled a great deal of confidence in me, or I had the choice of being treated at the National Institutes of Health.

I think it was an easy choice, because I think — NIH wanted me, because I was so healthy at that point.  I was a good specimen for research I think.  And also, I felt that if I have the disease and no one knows anything about it, the best place to be treated would be where they are doing the research.

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Source:

Morgan MacDonald, 27, of Vero Beach, Florida, was brought to San Francisco in a chartered Lear jet after being discharged from Shands Hospital at the University of Florida at Gainesville.  MacDonald told Dr. Mervyn Silverman, San Francisco’s public health director, that he was transported to California against his will.

Shands Hospital in Gainesville, Florida, spent $7,000 for a private jet to fly MacDonald to San Francisco last week and leave him on a stretcher at the office of a city-funded AIDS foundation.  He was immediately transferred to the AIDS ward at San Francisco General Hospital.

Dianne Feinstein, then-Mayor of San Francisco, sent a telegram to Gov. Bob Graham of Florida, asserting that a hospital there dumped an unwanted AIDS patient by having him flown to San Francisco.  She called the incident “outrageous and inhumane.”

Gov. Graham’s press secretary said Florida’s Department of Health and Rehabilitative Services would investigate the matter.

Virginia Hunt, Shands’ public relations director, defended the hospital’s actions, saying MacDonald no longer needed hospital care and the hospital was unable to find a Florida nursing home for him.  She contended that the AIDS Foundation in San Francisco agreed to give Mr. MacDonald 30 days’ free housing.

But Dr. Silverman said the Florida hospital had made contact with both the City of San Francisco and the AIDS Foundation and ”played us one off against the other.”

Silverman said MacDonald was free to return to Florida, but said his condition was acute and it was essential that he receive proper care.

MacDonald would die 21 days later at San Francisco General Hospital’s AIDS Ward.  MacDonald was said to have no family. Before his hospitalization, he lived in a religious commune in Florida.

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Source:

The task force reviewed several pilot tests performed at blood banks in areas with donors at high risk for hepatitis B core antibody (anti-HBc), which appears at the onset of symptoms in acute hepatitis B and persists for life.  Scientific data suggested that anti-HBc was found commonly in HIV-infected individuals.

Data showed:

• 5-18% of blood and plasma donors had a positive test for anti-HBc;
• 84% of homosexual males tested positive for anti-HBc; and
• 96% of IV drug users tested positive for anti-HBc.

The discussion at the December BPAC meeting had stipulated that ”cost-benefit analysis and disease prevalence must be considered in the decision regarding whether or not to use the test,”  However, the task force could not agree upon the true cost of the test, with estimates as low as $2.50 per test for plasma collectors and as high as $12.00 per donation for whole blood collections

Additional costs were the blood that would be discarded and the recruitment of new donors.  With the task force unable to agree on the costs and the benefits of using the anti-core test as a surrogate for high-risk donors, the majority decided to oppose the adoption of screening procedures.

In his State of the Union address, President Ronald Reagan talked about the need for the U.S. to provide military support to anti-communist guerrillas and resistance movements in an effort to restrain pro-communist governments in Africa, Asia, and Latin America — what became to be known as the “Reagan Doctrine.” He also spoke about domestic policy but omitted any reference to the new virus that was spreading across the country.

At one point in his speech, President Reagan said, “Mr. Speaker, I know we agree that there must be no forgotten Americans.”

And yet, he neglected to mention the thousands of Americans who were living with and dying from AIDS-related illnesses.  By the end of that year, the number of AIDS cases would rise dramatically, with more people becoming infected with HIV in 1985 than in all of the four previous years combined.  The population groups experiencing the greatest rise in infection were infants, transfusion recipients, IV drug users, and homosexual/bisexual men.

Sources:
U.S. Centers for Disease Control & Prevention, Morbidity and Mortality Weekly Report, January 17, 1986
Washington Post, January 16, 1986 edition
Ronald Reagan Presidential Library & Museum

In its suit against the State of Alabama’s Department of Corrections, the ACLU’s National Prison Project charged prison officials with creating a “leper colony” for inmates living with HIV, including those who didn’t exhibit any symptoms associated with the disease.  The suit was the first involving prisoners as a class, rather than case by case, in a challenge to incarceration policies and procedures regarding HIV-positive inmates.

One of the 139 inmates represented by the ACLU’s lawsuit was 30-year-old Carmen Harris, who upon her arrival at Julia Tutwiler Prison for Women in Wetumpka, Alabama, received the news that she had tested positive for HIV.  Harris told The Washington Post that the prison first put her in solitary confinement and then moved her to the facility’s Death Row.

“It was like they were punishing me not for my crime but for my diagnosis,” Harris told WaPo.

Another HIV-positive inmate was Michael Marsh, a 40-year-old convict confined to Dorm 7 at the Limestone Correctional Facility in Capshaw, Alabama.  Dorm 7 was where Alabama housed the majority of its inmates who were living with HIV, regardless of whether they exhibited any HIV-related symptoms.

“You know the phrase in the Bible about the Valley of the Shadow of Death?  That’s what this is like,’ Marsh told a reporter from The New York Times.

Limestone was a minimum-to-medium security prison, but state officials also transferred into Dorm 7 violent offenders who tested positive for HIV, grouping them with less dangerous inmates.  In contrast with Limestone’s general population, Dorm 7 inmates were restricted from educational, vocational and recreational activities, including those that would allow them to earn credits toward early release.  The very fact of their segregated status made it known to other inmates that they were HIV positive, making impossible any attempt to keep their condition private.

J.D. White, Limestone’s warden, defended the segregation policy to the NY Times.

”It boils down to whose civil rights get violated,” White said.  ”Do you violate the rights of 132 people who test positive, or do you violate the rights of the 12,000 who don’t?”

The lawsuit was the first of many filed against state prison systems across the U.S., seeking to end discriminatory practices against HIV-positive inmates.  This lawsuit would fail, be appealed, and then brought to the U.S. Supreme Court. But in January 2000, the Justices would decline to hear the case.

It would take until 2012 before a federal judge would decide that Alabama’s policy of segregating HIV-positive inmates violated the federal Americans with Disabilities Act (ADA).

The study also finds that some employers are requiring gay men to present medical documentation proving that they do not have the AIDS virus, and that gay men are experiencing verbal harassment that is generated by AIDS paranoia and ignorance.

A coalition effort of the San Francisco Human Rights Commission, the San Francisco AIDS Foundation, the Shanti Project, and the San Francisco Department of Public Health’s Aids Activities Office, the AIDS Discrimination Reporting Project released a report of its study of AIDS-related discrimination complaints.  Participants in the survey were largely gay men, some of whom were living with HIV/AIDS and some of whom were not but still experienced AIDS-related discrimination.

“Discrimination ranged from employers requiring a physician’s statement denying that an employee had AIDS to actual termination and eviction,” the report stated.

The report was authored by Chris van Stone and Jackie Winnow of the San Francisco Human Rights Commission.

Dr. David Blatt and Dr. David Moore — known in the Chicago medical community as “the two Davids” — founded Unit 371.  The HIV/AIDS unit became renowned for its compassionate approach to care.

Dr. Moore modeled Unit 371 after San Francisco General Hospital’s Unit 5A.  During a visit to Unit 5A, he noticed that AIDS patients were “clustered” in one unit of the hospital, which allowed the patients to receive treatment and care from professionals trained in their specialized needs.

Dr. Moore thought this was a novel and efficient approach to HIV/AIDS healthcare, and much better than the standard approach of having to educate healthcare professionals in individual units across the hospital about how to care for AIDS patients.

In October 1982, Dr. Moore was still new to practice when he saw his first patient, a personal friend who had come to him with the symptoms of AIDS. What followed were, in his words, “13 years of slow-motion carnage,” according to Health ENews of Advocate Aurora Health.

A gay man himself, Dr. Moore and his medical and life partner, Dr. Blatt, decided to spearhead what would be the first dedicated AIDS unit in the Midwest.

“It was a different time. There was so much fear then,” Dr. Blatt says. “The news media was calling it the ‘gay cancer’ and there was very little knowledge or education on what it was or how it was transmitted. There was a lot of panic and discrimination.”

Dr. Moore says they felt compelled to do something.

“This was us. This was our community and neighborhood. We were in this risk group. It was affecting our friends, our patients and we needed to take action,” he said.

For Unit 371, Drs. Moore and Blatt also incorporated the policy of San Francisco’s Unit 5A of allowing partners, family, and friends unlimited visitation time with patients, according to America 250.

“Within the Illinois Masonic Medical Center, Unit 371 became the preferred unit for HIV-positive patients who did not need to be admitted to the intensive care unit,” wrote Jade Ryerson in America 250.

The unit started with 23 beds, with nine rooms dedicated to hospice care.  But when the AIDS crisis worsened and the number of patients swelled, many of the single rooms were converted to accommodate two patients. Staff reserved private rooms for patients who were dying or could pass on an infection.

“But what really set Unit 371 apart were the personal relationships between staff and patients,” according to Ryerson.  “It was common for Unit 371 staff to sit on patients’ beds, offer hugs, joke around, or become friends and socialize outside of the unit. This closeness was especially meaningful for patients who were rejected by family and friends after being diagnosed.”

Drs. Blatt and Moore, who met while doing their residencies at Chicago’s Cook County Hospital, continued to oversee Unit 371 for about fifteen years.

Straight from nursing school, M.K. Czerwiec became a Unit 371 nurse in 1994.

“The death rate on Unit 371 was higher than any other hospital unit because, for so long, AIDS was a fast-moving, terminal disease,” Czerwiec told Windy City Times in 2011. “In a month, we could lose 30 patients.”

In 2017, Czerwiec would publish a graphic novel, Taking Turns, about her experiences working at Unit 371.

By the end of 1984, AIDS had already ravaged the United States for a few years, affecting at least 7,700 people and killing more than 3,500. Scientists had identified the virus that caused AIDS and the U.S. Centers for Disease Control and Prevention (CDC) identified all of its major transmission routes.

This is why it is notable that it took until September 1985, four years after the crisis began, for Reagan to first publicly address the subject of AIDS.

Exchanges between the Reagan administration and journalists in the early 1980s demonstrate that Reagan and his staffers didn’t take the epidemic very seriously, for which the Reagan administration is still heavily criticized.

Reagan’s successors in the White House eventually acted, albeit often very slowly, on the crisis — leading to much more research, programs like the Ryan White CARE Act that connect people to care, and the development of antiretroviral medication that increases the life expectancy of a person living with HIV by decades.

HIV/AIDS had a significant impact on the City of West Hollywood due to the disease’s elevated infection rate among gay men, which caused a devastatingly high number of deaths among the city’s population.

Following the City of West Hollywood’s incorporation as a city on November 29, 1984, elected officials and city staff begin working on a plan to address the epidemic in their own backyard.

In October 1985, the city launches an AIDS awareness campaign, one of the first in the country.  The City of West Hollywood also becomes one of the first government entities to create a program for awarding social services grants to local HIV/AIDS organizations.  The city’s response to the AIDS crisis would go on to be recognized as a model for other cities, nationally and globally.

Also during its first year of cityhood, West Hollywood would adopt landmark legislation to establish rent control and prohibit the discrimination against people with HIV and AIDS.  Today, many of the city’s landmark ordinances have been duplicated and have become mainstream policies nationally and globally.

Michael Felton was being treated for hemophilia when he became infected with HIV from contaminated factor VIII blood. Much like Ryan White, his white counterpart in Indiana, Felton wanted to live a normal teenage life — going to school, hanging with friends, collecting comic books and participating in sports — but his HIV status came with stigma and discrimination from the local school district.

When Felton was diagnosed with HIV, he was one of only six people in Mississippi with HIV or AIDS, and one out of only 164 children under 13 nationwide, according to Change the Pattern, an initiative of the National AIDS Memorial, Southern AIDS Coalition and Gilead Sciences.

Felton died less than a month before Bolivar County officials were scheduled to meet to decide if the 14-year-old would be allowed to attend his freshman year of high school.

In September 2022, Felton’s panel on the National AIDS Memorial Quilt was one of select panels brought to Mississippi for an exhibit honoring Black and Brown lives lost to AIDS.  The exhibit, representing the largest display of the Quilt in Mississippi to date, was part of Change the Pattern‘s program to use the power and beauty of the AIDS Memorial Quilt as a call to action to disrupt systemic issues that impact health equity and continue to disproportionately impact communities of color and marginalized populations.

In Mississippi, new HIV diagnoses have remained high year after year with the state having the sixth-highest rate of HIV in the country.

The long-simmering transatlantic feud over who will receive royalties on a test for the AIDS virus has erupted into a legal battle, with French scientists seeking recognition in the U.S. courts for their claim that they discovered the virus before their American counterparts.

The Pasteur Institute ‘s suit also seeks the right to grant permission to sell the blood test without being sued by the U.S. for counterfeiting, and the right to share in royalties collected by the U.S. for sales of blood tests by U.S. licensees.

The French scientists were the first to publish a paper on the virus, said Dr. Robert C. Gallo, the U.S. scientist credited with discovering HIV. But he asserts in an interview with the Los Angeles Times, “I was the first to suggest it was a retrovirus.”

“We had this virus in 1982. We didn’t publish on purpose because we didn’t understand it well enough to stick our necks out. To me, ‘discovery’ is a complicated word. Who first reported discovery of a virus?  They did.  But if the idea comes first — that was us.”

In July 1994, U.S. health officials would concede for the first time that American researchers used a virus obtained from French competitors to make the first American AIDS test kit. At that time, the U.S. would announce the signing of an agreement that would give the French a bigger share of royalties from worldwide sales of AIDS tests.

The contract would end the long-standing and sometimes acrimonious dispute that strained relations between the two countries.

Under the heading “Critical Steps in Combating the AIDS Epidemic,” Buckley writes:

“Everyone detected with AIDS should be tattooed in the upper forearm, to protect common-needle users, and on the buttocks, to prevent the victimization of other homosexuals.”

Buckley, founder of National Review magazine, also proposes that everyone seeking a marriage license must “present himself not only with a Wassermann test but also an AIDS test.”

He goes on to write that the couple could marry only after “the intended spouse is advised that her intended husband has AIDS, and agrees to sterilization.”

Looking back at this time, Michael Spector would write in The New Yorker in 2021, “Several years into a harrowing epidemic, gay Americans were told that an act of consensual sex could not only infect them with a fatal disease; it could also, at the will of a state, send them to prison. The fears of internment were not easily dismissed as hysteria.”

Buckley would later withdraw the proposal, because “it proved socially intolerable.”

At the time of his death in early 2008, Buckley would no longer be considered a journalist of any repute, although conservative circles would continue to champion his ideas.  When he died, he was working on a book about President Ronald Reagan.

The majority opinion, by Justice Byron White, reasoned that the Constitution did not confer “a fundamental right to engage in homosexual sodomy.”  A concurring opinion by Chief Justice Warren E. Burger cited the “ancient roots” of prohibitions against homosexual sex, quoting William Blackstone’s description of homosexual sex as an “infamous crime against nature,” worse than rape, and “a crime not fit to be named.”

The case arose on August 3, 1982, when a police officer who had been admitted to the home of Michael Hardwick in Atlanta witnessed him and a male companion in a bedroom engaging in sex.  The officer had been executing a warrant for Hardwick’s arrest for failing to appear in court on a charge of public drinking (it was later determined that the warrant was invalid because Hardwick had already paid the $50 fine).  The officer promptly arrested both men for violating Georgia’s antisodomy statute.

In its decision, the Court ruled that while the “right to privacy” protects intimate aspects of marriage, procreation, contraception, family relationships, and child rearing from state interference, it does not protect gay sodomy because “no connection between family, marriage, or procreation on the one hand and homosexual activity on the other has been demonstrated.”

In the first Congressional hearing to address anti-gay violence, Kevin Berrill of the National Gay and Lesbian Task Force (now called the National LGBTQ Task Force) told members of the House Subcommittee on Criminal Justice that in addition to battling the AIDS epidemic, the gay community was also contending with rampant and deadly antigay violence.

“There is disturbing evidence that the AIDS and antigay violence epidemics may now be following the same menacing curve,” Berrill said.  “For inasmuch as AIDS has spread, so has the fear and hatred that spawns violence.”

Berrill went on to criticize the federal government for viewing widespread violence against gay men and lesbians as “just a gay problem and therefore not of concern to all society.”  He bitingly referred to this passive policy as the same one the government has adopted to address HIV and AIDS.

In its study on antigay violence, the Task Force surveyed more than 2,000 community members in eight cities.  Berrill also presented data from local governments which confirmed the Task Force’s findings.  At the time, the federal government did not collect data on violence against LGBTQ community members.

“The toll of antigay violence cannot be measured solely in terms of these statistics,” Berrill told the Congress members.  “These numbers do not measure the anguish, fear and loss experienced by Dee, who is still recovering from burns caused by acid thrown at her face when she was leaving the Los Angeles Gay Community Center.  Or by Robert from New Jersey, where assailants beat him, extinguished cigarettes in his face, and then tied him to the back of a truck, dragging him in tow.  Or by the family and friends of Charlie Howard of Maine, who was thrown off a bridge to his death by three teenagers.”

Berrill called on Congress to initiate federal studies on antigay violence and pass tougher laws to combat violent crimes targetting gays and lesbians.  He also urged the repeal of all sodomy laws (which were still on the books of most states), and called for the passage of legislation prohibiting discrimination on the basis of sexual orientation.

Also testifying that day was Diana Christensen, executive director of the Community
United Against Violence in San Francisco, who told the subcommittee the following:

“Is the increase in antigay violence an indicator of an AIDS-related backlash?  At this point, I believe that AIDS and homosexuality have become synonymous in the American public’s mind.  For the homophobic mind, AIDS is simply another justification for violence.”

David Wertheimer, executive director of the New York City Gay and Lesbian Anti-Violence Project (which would become the NYC Anti-Violence Project) also provided the highlights of his 20-page testimonial submitted to the subcommittee.  Founded in 1980 to provide support services to lesbian and gay survivors of homophobic violence, the organization became a city-wide, nonprofit service
provider in 1983.

Wertheimer reported that between 1984 and 1985, reported cases of violence “began to mushroom,” and the organization’s caseload increased 41%.  In the current year — 1986 — violence was reported even more frequently, with between 40 and 60 new cases each month.

He explained that in the past, cases typically were in the form of antigay and antilesbian verbal harassment in a public place, or in the form of menacing behavior or even assault.  A new form of violence had emerged recently, Wertheimer said, one that now represented 28% of the Anti-Violence Project’s caseload.

“AIDS-related violence — that is violence that may begin with verbal and menacing acts that are specifically related to AIDS,” he said.  “For example, someone might start an attack by saying, ‘I hate faggots. You faggots give us AIDS.’  Or a lesbian might find notes on her door saying ‘Lesbians, dykes, you give us AIDS. Get out of the building.'”

Wertheimer told the Congress members that antigay violence can result in death.  The organization reported seven antigay homicides in 1985, and 15 such homicides in the first nine months of 1986.

Also providing testimony was Dr. Gregory M. Herek, assistant professor of psychology at
the City University of New York and a member of the American Psychological Association’s Committee on Lesbian and Gay Concerns.

“A growing body of scientific data, including my own empirical research, shows that individuals’ irrational fears surrounding AIDS — such as fear of transmission through casual contact — are highly
correlated with their level of homophobia,” Dr. Herek said.  “I interpret this finding to mean that reducing AIDS hysteria requires confronting its roots in homophobia, and that eliminating homophobia will require education about AIDS. Unfortunately, the U.S. Justice Department has sanctioned discrimination based on fears of AIDS-contagion, and has thereby fueled fears about AIDS
and probably contributed to public homophobia.”

Rep. Barney Frank (who in 1987 would become the first member of Congress to be openly gay) also spoke for the Congressional record in support of raising awareness about anti-gay violence.

The report, issued by U.S. Surgeon General C. Everett Koop, M.D., also calls for a nationwide education campaign that includes early sex education in schools, increased use of condoms, and voluntary HIV testing.

“By the end of 1991, an estimated 270,000 cases of AIDS will have occurred with 179,000 deaths within the decade since the disease was first recognized,” Dr. Koop states in the report’s preface.

“In the year 1991, an estimated 145,000 patients with AIDS will need health and supportive services at a total cost of between $8 and $16 billion.”

The two main functions of WHO’s program were: (1) to provide global leadership and ensure international collaboration
and cooperation; and (2) to provide support to national programs to prevent and control AIDS, according to The Fourth Ten Years of the World Health Organization.

WHO established a global commission on AIDS and a management committee to support and guide the program.  As part of the new program, a special public information service was launched to satisfy the increasing media interest in HIV/AIDS and to ensure that accurate and timely information was being disseminated to the public.

Specifically, the Special Programme on AIDS sought to:

• raise awareness;
• formulate evidence-based policies;
• provide technical and financial support to countries;
• initiate relevant social, behavioral, and biomedical research;
• promote participation by nongovernmental organizations; and
• champion rights of those living with HIV.

With technical and financial support from WHO, AIDS programs rapidly began to be established in nations throughout the world.  WHO puts forth the idea that a global response was vital not only for national interests but also because “ultimately AIDS cannot be stopped in any one country unless it is stopped in all countries.”

At the global level, the program was responsible for strategic leadership, developing consensus, coordinating scientific research, exchanging information, assuring technical cooperation and mobilizing and coordinating resources.  During 1986 and 1987, a total of 127 countries sought WHO’s collaboration on a national response to AIDS, according to The Fourth Ten Years of the World Health Organization.

Founded in 1948, WHO is the United Nations agency that connects nations to promote health, keep the world safe and serve vulnerable populations.  On January 1, 1996, the UN would launch UNAIDS to consolidate its global AIDS response.

In a few months, the FDA would go on to issue treatment IND (investigational new drug) regulations on May 22 to permit new drugs to be used to treat patients before clinical trials are completed where no alternative therapy exists for a “serious disease.”

In its explanation of the regulations, the FDA mentions advanced cases of AIDS as the first example of an immediately life-threatening disease, but did not include AIDS in its list of examples of serious diseases.  It explained that some diseases, like multiple sclerosis, are not serious at earlier stages, and that the Treatment IND regulations would not apply to drugs intended to treat those earlier stages of disease.

The workshop kicks off with a large press conference, where Dr. Koop announces that AIDS is a growing menace to the nation’s children and reiterates his call for early sex education as part of the general effort to halt its spread.  He recommends that sex education start in kindergarten and include information about AIDS.

”It’s the responsibility of parents, and it should begin before children go to school,” Dr. Koop says.

He mentions that parents are often reluctant to discuss sex with their children, and so the burden falls upon schools, churches and synagogues to teach children and youth about sex and AIDS.

The new AIDS Commission would replace the three-year-old AIDS task force formed by Supervisor Ed Edelman and Los Angeles Mayor Tom Bradley.  The Supervisors said they would appoint to the commission activists in the fight against AIDS as well as county officials.

The unanimous vote by the five-member LA County Board of Supervisors followed an April 14, 1987 editorial by the Los Angeles Times calling for the supervisors to approve the proposal for a county AIDS commission.

“Such a commission could be of great assistance to the Board of Supervisors in the weeks ahead when major budget decisions and major policy shifts will be before the board,” wrote the LA Times editorial board.  “And the commission could reassure the community that the AIDS problems in this region are being addressed.”

Supervisor Ed Edelman told the Los Angeles Times that the new commission would help to coordinate efforts by various county departments in the local effort to prevent the spread of HIV/AIDS.  At the time, local efforts were concentrated in educational, mental health and hospice programs.

According to the LA Times, the total number of confirmed AIDS cases in Los Angeles County in May 1987 was 2,965, making the county the third most impacted region in the U.S.  Only San Francisco and New York had more AIDS cases.

In its editorial, the LA Times criticized LA County for failing to organize “the basic services required to handle the rapidly rising caseload of AIDS patients.”

The LA Times pointed out that while in-patient care was available at some of the larger county facilities, there were virtually no home-care, day-care, nursing-facility or hospice programs offered by the county.  As time ticked by of the lives of people living with AIDS, the county supervisors were withholding funds from critical programs until there was more state and federal money to supplement the county budget.

“With the advice of the task force, the AIDS Project Los Angeles and other professionals, the supervisors can quickly organize an effective commission to see that not another minute is wasted,” the LA Times wrote.

Rabbi Allen Freehling would be the first Chair of the AIDS Commission, and the appointed commissioners would include Rand Schrader, an openly gay Los Angeles Municipal Court judge who would serve as Chair of the Commission from 1989 to 1991.

amFAR event attendees “boo” Reagan when he says he asked the Department of Health and Human Services “to add the AIDS virus to the list of contagious diseases for which immigrants and aliens seeking permanent residence in the United States can be denied entry.”

Attendees also shout out their opposition when the president says he is ordering testing for active members of the military, those seeking care at veterans’ hospitals, applicants for marriage licenses, and federal prisoners.

Among the event attendees are amfAR Founder and National Chairperson Elizabeth Taylor and amfAR President Dr. Mervyn Silverman.

After Reagan speaks, Taylor tries to move ruffled feathers by telling the audience, “While there are differences of opinion on AIDS testing,” Reagan’s remarks are ”basically in concurrence with what we all hope and pray for,” namely a cure for the disease.

AmfAR advocates for voluntary, confidential testing accompanied by intense counseling, adds Dr. Silverman.

After the event, U.S. Surgeon General Dr. C. Everett Koop said he ”found no fault with the speech” and that he considered it reasonable to test Federal prisoners and immigrants and to offer the test to marriage applicants.  He also said he was embarrassed by the reaction of some in the audience.

“I never heard anyone boo the President before,” Dr. Koop said.

The study, commissioned by the 10,000-member Chicago-based organization, also predicts that future life insurance policies could add $30 billion to $60 billion to the total, depending on whether applicants are screened for the AIDS virus.

The study bases its findings on statistics from the Centers for Disease Control, which suggests that 15% of those infected with the AIDS virus develop the fatal disease after five years and up to 36% are stricken after seven years.

Manufactured by MicroGeneSys of West Haven, Conn., the vaccine would move forward to clinical trials supervised by the National Institute of Allergy and Infectious Diseases.  Just months ago, NIAID Director Dr. Anthony Fauci said that the FDA was considering several candidate vaccines and that human trials could begin in 1987.

In early 1993, MicroGeneSys would pull the vaccine, called VaxSyn, from National Institutes of Health trials because the pharmaceutical company could not agree with the NIH over the dosing schedule. The vaccine has already been selected for inclusion in a $20 million U.S. army trial program.

Today, there is no vaccine available to prevent HIV infection or treat those who have it.

However, scientists are still working to develop one. NIH is investing in multiple approaches to prevent HIV, including a safe and effective preventive HIV vaccine. These research efforts include two late-stage, multinational vaccine clinical trials called Imbokodo and Mosaico.

From her convention podium, Thatcher declared:  “Children who need to be taught to respect traditional moral values are being taught that they have an inalienable right to be gay, ” she said.  “All of those children are being cheated of a sound start in life. Yes, cheated.”

In less than a year later, Thatcher would usher in the passage of Clause 28, anti-gay legislation to stop all discussion of homosexuality in British schools.   An amendment to the 1988 Local Government Act, Section 28 would effectively ban local authorities and schools from “promoting” homosexuality.  Government funds could no longer go toward of books, plays, leaflets, films, or other materials showing same-sex relationships, while teachers weren’t allowed to teach about gay relationships in schools.

In the shadow of the AIDS epidemic, the United Kingdom in the 1980s was a place of renewed LGBT activism and a forward movement toward equal rights.  New progressive legislation opened the door for the Greater London Council to fund LGBT groups, and some local authorities in London and Manchester began to employ officers to counter homophobia.

There were also alliances between LGBT organizations and labor unions, such as the one between the mineworkers union and a lesbian-gay support group.   And in 1985, Margaret Roff became the mayor of Manchester, making her the first openly lesbian woman to hold such a post in the UK.

But all this progress was made while the UK media was using the outbreak of AIDS/HIV to demonize gay and bisexual men.  Thatcher and her Conservative Party saw this as an opportunity to activate their base and even win some votes from “the Labour left.”

At the start of her third term as prime minister, Thatcher gave the speech that made her intentions clear, in front of the audience she knew would praise her pronouncements.

“AIDS is one of those critical issues, like nuclear weapons, global development, and environmental pollution, which affects the future of all peoples in all countries,” says UN Secretary General Javier Pérez de Cuéllar in his address.

“It is, in many senses, a global combat, and it threatens us with all the consequences of war – not only of massive death tolls and even greater an numbers of disabled,” he said, “but of orphans, of mass displacements, of loss of productivity, of overwhelming and bankrupting demands on financial, administrative and human resources, of fear, anger and panic, and of social instability.”

In closing, Pérez de Cuéllar says:  “We must combat fear with knowledge, panic with reason and isolation with compassion. We must affirm through solidarity that we are but one human family.”

After the World Health Organization gives a presentation on the global status of AIDS, the UN General Assembly designates WHO to lead the worldwide effort to end HIV/AIDS.

Section 28 targets the teaching of school children, with the bill prohibiting the promotion or “acceptability of homosexuality as a pretended family relationship.”  It also banned government funding that supported LGBT events, services and programs.

Paul Fairweather, who worked for Manchester’s city council, recalls how he helped organize for what would become one of the largest LGBTQ+ demonstrations in the country’s history.

“There was a sense that the whole community was under threat,” Fairweather told The Guardian.  “There were also lots of questions about Section 28’s possible impact on gay bars and clubs, as well as concerns about the attitude of the police force.”

Concerns about police hostility deter people from joining the demonstration.  About 20,000 people marched, and the event revitalized Manchester’s LGBTQ+ movement.

Florida Gov. Bob Martinez called for the quarantine of AIDS sufferers who risk infecting others.

“AIDS carriers who refuse to inhibit their contacts, who refuse to stop spreading this fatal disease, should no more be allowed to roam free than criminals armed with a deadly weapon,” Gov. Martinez declared during a joint session of the Florida Legislature.  ‘The time has come to quarantine those whose character and conduct are a clear threat to society.’

The legislation pending in the state House and Senate was introduced to provide $1.1 million to the Florida Department of Health and Rehabilitative Services, which would use the funds to lock up six juveniles and up to 22 adults who tested positive for the virus and were deemed by state officials to “behave in ways likely to spread the disease,” according to United Press International (UPI) reporting.

If passed, the legislation would permit confinement of any person with AIDS whose behavior was considered dangerous to public health.

“What [Gov. Martinez] is doing is sending up a trial balloon for the nation,” AIDS activist Bob Kunst told UPI.  “We’ve got to knock it down real fast.”

Kunst added that state legislators should instead award $1.1 million to AIDS service providers and education campaigns.

State Senator William Myers, chair of the Senate Select Committee on AIDS, endorsed the quarantine proposal. A similar but more modest bill was introduced in the House, but it was expected to be quashed by House leaders who opposed the large detention facilities sought by the Social Services Department.

Representative Lois Frankel, chair of the House Select Committee, told UPI, ‘That’s not how we’re going to stop the spread of AIDS.  We know that education of high risk groups, education in the schools — that’s how we’re going to stop the spread of AIDS.”

The clause in question prohibited “the teaching in any maintained school of the acceptability of homosexuality as a pretended family relationship.”

Margaret Thatcher, Britain’s Prime Minister, said at the time: “Children who need to be taught to respect traditional moral values are being taught that they have an inalienable right to be gay. All of those children are being cheated of a sound start in life.”

Section 28 arose within a wider social and political landscape that sought to disenfranchise members of the LGBTQ community.  In 1983, 50% of those surveyed agreed that “sexual relations between two adults of the same sex” were “always wrong.”  By 1987, the figure had risen to 64%, perhaps fuelled by fears associated with the spread of HIV — which was often characterized as “the gay disease.”

One of the original sources of complaint was from someone who objected to Jenny Lives with Eric and Martin, a children’s storybook by the Danish author Susanne Bösche and published in England by Gay Men’s Press. The author’s intention was to give children knowledge about different types of family relationships and she seemed stunned by the subsequent uproar in the U.K.

In 1986, the book was discovered in a library of the Labour-controlled Inner London Education Authority. A National Council for Civil Liberties pamphlet revealed there was only one copy, located in a teachers’ resource centre where access was controlled. Yet an atmosphere of media-stoked paranoia soon arose.

Many LGBT+ people who came of age during the era of Section 28 felt vulnerable to physical and verbal abuse and, because of Section 28, teachers would not step in to protect them.

“School was hard,” said Divina De Campo, a contestant on RuPaul’s Drag Race UK in the 2019 season.  “I got a lot of flak from pretty much everybody in the school. Growing up for everybody was hard, but then you add on being gay and it was just a whole other level.”

Following the zoning board’s decision, supporters of the hospice declared the ruling a victory for the rights of the terminally ill.  Many of them wore pink buttons bearing the words “There’s no place like home.”

Ron Wolff, executive director of Hospice Los Angeles-Long Beach, the nonprofit group that runs Hughes House, said the hospice acts as a surrogate family for dying patients during the last three or four weeks of their lives.

The ruling of the zoning board ended a months-long attempt by residents to remove the hospice from their neighborhood.

Area residents filed complaints with the city, accusing Hughes House of operating a medical facility.  In response, city inspectors visited the hospice three times and concluded that the facility was not violating zoning laws.

Then neighbors began to keep detailed logs of activity at Hughes House, according to the Los Angeles Times, and they reported to the city every occasion they observed of medical supply trucks making deliveries and new patients arriving.  In June 1988, the chief zoning administrator sided with the neighbors, agreeing with their portrayal of the hospice as a medical facility, and ruled that Hughes House could not continue to operate in its location.

In the end, however, the zoning board found the residents’ complaints to be lacking in substance when compared to the needs of the people staying — and dying — at Hughes House.  Ultimately, members of the zoning board were won over by the fact that Hughes House was providing a service — care for those dying of AIDS — that sadly was much in demand and that few other organizations in Los Angeles could provide.

The AIA funds projects to support moving the children into foster care or other more traditional living arrangements.

As the first comprehensive federal AIDS bill, it establishes the Office of AIDS Research at the National Institutes of Health (NIH) and the AIDS Clinical Trials Group.

California Proposition 96  would give people reporting crimes of sexual assault — as well as police officers, firefighters, and emergency medical personnel who have been assaulted in their official capacity — the right to request that the defendant be tested for HIV.

Upon receiving the request, the court would hold a hearing to determine whether
probable cause exists to believe that a transfer of body fluids from the defendant to the victim occurred during the assault or altercation. If probable cause is found, the court would order the defendant to undergo HIV testing.

Proposition 96 is deceptive because it uses the term “probable cause” to justify a search of an individual’s blood, according to a 1990 review of mandatory AIDS testing laws in the Vanderbilt Law Review.

“This term seems to suggest that the statute authorizes a criminal search,” wrote legal scholar Paul H. MacDonald.  “The statute, however, does not authorize a court to issue a testing order based on probable cause to believe that a crime has been committed, but instead on probable cause to believe that there has been an exchange of body fluids between defendant and victim.”

With the approved FDA licensing, Intron A and Roferon A (human alpha interferon injection) can now be medically administered to patients for the treatment of KS.

The FDA reported that up to 45% of KS patients receiving large doses of alpha interferon ”responded with a significant reduction in the size of their tumors.”  Dr. Kathryn C. Zoon, an F.D.A. official, said that alpha interferon works best in people in the early stages of the disease.

Under the coordination of National Institute of Allergy and Infectious Diseases, the program would issue contracts to doctors for the treatment and data collection regarding thousands of AIDS patients, health officials said.  The program has received a $6 million budget for its first year.

Dr. Anthony S. Fauci, director of NIAID, told the New York Times that the program’s aim was to expand federal research opportunities to doctors and patients who were not affiliated with existing clinical trials.  Dr. Fauci said the program was seeking to involve more Black and Hispanic people, as well as intravenous drug users and sex workers.

In the program, patients using potentially effective but unapproved therapies would be monitored.  The opportunity for patients to receive access to experimental drugs in community settings would be another component of the program, according to health officials.

The legislation, proposed by anti-gay Republican Sen. John Doolittle, include:

• Penalties — SB 1007, which adds three years to prison sentences of those convicted of some sex crimes if they know they are HIV-positive when they commit the crime;
• Prostitutes—SB 1007, which makes it a felony for a prostitute to continue working after knowing he or she has been exposed to the AIDS virus; and
• Donors—SB 1002, which makes it a felony to donate blood, semen, breast milk or body organs to another person if the donor knows that he or she is infected with the AIDS virus.

Also going into effect is Democratic Sen. Gary K. Hart’s bill, SB 2847, which allows physicians to tell other medical personnel if a patient has AIDS so they can protect themselves.

Speaking from the Oval Office in the White House, President Ronald Reagan focused his farewell speech on the following topics:

– the Economic Recovery Tax Act (1981), which cut taxes for workers and corporations but also grew the federal deficit from $70 billion to $175 billion;

– the series of U.S.-Russia summits, which took steps toward ending the cold war; and

– the U.S. invasion of Grenada in 1983, the first military action since the Vietnam War.

In his speech, Reagan took credit for the country’s economic recovery from the 1981-82 recession and for raising the profile of the U.S. on the world stage.  With underlying themes of global power, patriotism and “what it means to be an American,” Reagan spoke about many threats and challenges the country faced during his eight years in office.  But he neglected to mention one of the biggest threats facing the U.S. population:  the AIDS crisis.

From 1981 to 1989, a total of 26,223 people in the U.S. died of AIDS, and 102,706 people were diagnosed with HIV.  More than 95% of those diagnosed with AIDS between 1981 and 1987 died.   And on this day when Reagan left office, the U.S. was no closer than it was eight years ago to announcing a cure or vaccine.

Reagan took office for his first term in January 1981, and immediately set about cutting the federal budget in all areas except defense.   In 1982 and 1983, the Reagan administration would continue its attempts to shrink the federal government by imposing major funding reductions for the National Institutes for Health, the Centers for Disease Control and Prevention, Department of Health and Human Services and Medicaid.  As a result, several public health programs were eliminated just as the AIDS crisis was gaining ground.

From the start, the Reagan administration kept the new disease at arm’s length, avoiding any public acknowledgement of it.  In the first years of the epidemic, researchers at the CDC referred to the disease in reports and media accounts as “Gay Related Immune Disorder,” or GRID, which caused many — including political operatives in the Reagan administration — to believe that this was an exclusively gay disease.

Some religious leaders used this as an opportunity to condemn homosexual activity and suggest that the disease was punishment.  Jerry Falwell, founder of the ultra-conservative Moral Majority, proclaimed AIDS to be “the wrath of God upon homosexuals,” a view that spread into public opinion.

“The sexual revolution has begun to devour its children,” said Catholic columnist Patrick Buchanan, who would work in Reagan’s White House from 1985 to 1987.

Influenced by religious leaders and his own conservative advisors, Reagan decided that AIDS was a moral issue and one that would not impact his supporters — even after the CDC retitled the disease “AIDS” in September 1982 and started reporting on cases in populations outside the gay community.

Meanwhile, the U.S. Surgeon General — who was charged with the responsibility of “providing Americans with the best scientific information available on how to improve their health and reduce the risk of illness and injury” — was prevented from addressing the nation’s most urgent health crisis, according to the NIH’s tribute to C. Everett Koop, M.D..

“If ever there was a disease made for a Surgeon General, it was AIDS,” said Dr. Koop, who served two terms as U.S. Surgeon General under President Reagan.

According to the NIH, President Reagan and his domestic policy advisers held the view that homosexuals and intravenous drug users brought the disease upon themselves by engaging in conduct they deemed immoral.  Those afflicted with the disease were, in their view, “in greater need of moral reform than of new health information or policies.”

From 1983 to 1985, Koop was excluded from the Executive Task Force on AIDS established by his immediate superior, Assistant Secretary of Health Edward Brandt.  In advance of press conferences, Brandt instructed journalists to not ask Dr. Koop about AIDS and that the Surgeon General would not answer questions about it.

First Lady Nancy Reagan and her son, Ron Reagan Jr. both tried to convince the president to take a more active approach, according to Karen Tumulty, a political columnist for The Washington Post who wrote The Triumph of Nancy Reagan, in 2021.

“We’d start mentioning it, bringing it up as a topic, starting to get it into his head,” Ron Jr. was quoted in Tumulty’s book, which was excerpted in The Atlantic.

The First Lady knew more about the AIDS crisis than her husband, likely because she was kept informed by her son, a dancer with the Joffrey Ballet in New York City.

“I’m in New York; I’m dancing; I know people who are HIV-positive,” Ron Jr. told Tumulty.  “Dancers, fashion designers, people like that.  I would talk to her about people, how many people, who these people were. And she began to understand that this is a big deal. This is a crisis. She began to sense that pretending this isn’t happening is not a good way to go.”

In the summer of 1985, the epidemic hit close to home when actor Rock Hudson, a longtime friend of the Reagans, went to France to seek treatment for AIDS-related illnesses.

On July 24, Hudson’s publicist sent a telegram to the Reagans at the White House, asking for their help in getting Hudson admitted to the hôpital d’instruction des armées Percy (“Percy Training Hospital of the Armies”), a military hospital near Paris.  The hospital had initially refused to admit Hudson because he was not a French citizen, according to various reports.  The White House referred the matter to the U.S. embassy in France.

Months later, on September 17, 1985, President Reagan finally mentioned AIDS publicly when responding to a reporter’s question, calling it a “top priority.”  He called for Congress to allocate $120 million in funding for AIDS research, and Congress responded by upping the budget to nearly $190 million.

On October 2, 1985, Hudson died of complications from AIDS at the age of 59.  Amid growing calls from the public for Reagan to do more about the disease, the president began asking his White House physician to provide him with information about AIDS, according to Tumulty.

“Some of the president’s more conservative advisers contended that AIDS should be viewed as the consequence of moral decay rather than as a health issue,” Tumulty wrote.  “Many of Reagan’s allies on the right were more concerned with identifying and isolating those who had AIDS than treating and caring for them.”

On May 31, 1987, President Reagan delivered the keynote address at the amfAR dinner before hundreds of people, some of whom were living with AIDS.  His speech was repeatedly interrupted by catcalls and hissing.

“There was good stuff in it, but not enough,” Parvin told Tumulty.

In late June 1987, Reagan created the President’s Commission on the HIV Epidemic.  But the 13-member panel nearly collapsed in its first few months because of poor leadership and internal feuding.  Packed with conservatives whose views did not conform with mainstream scientific thinking about the disease, the commission also included Frank Lilly, an openly gay geneticist at Albert Einstein College of Medicine and a board member of the Gay Men’s Health Crisis, and members of the medical community.

“Time went by, and nothing happened,” Glaser wrote later.  “It was almost unimaginable, but the White House took the report and put it on the shelf.  Hope for thousands of Americans and people around the world sat gathering dust in some forgotten corner of some forgotten room.”

When Reagan left office on this day in 1989, he left behind the slashed budgets of public healthcare programs and a public largely bewildered by the nature of AIDS and the ways in which people could protect themselves.  In the eight years he was president, a total of 56,223 people died of AIDS-related illness and 102,706 people were infected with HIV.

Jaserson’s civil action against the salon, a test case for the West Hollywood’s new HIV discrimination ordinance, is on appeal, with support from Los Angeles, Santa Monica and the American Civil Liberties Union.

At the meeting, witnesses testify on the problems facing AIDS patients and what the government is doing in response.

The meeting is facilitated by June Osborn, M.D., who would chair the commission from its inception through 1993.  Dr. Osborn, who serves on WHO’s Global Commission on AIDS, has extensive experience advising the CDC and the FDA on vaccines for diseases such as influenza, hepatitis, and polio.  Osborn would go onto write numerous articles and give many speeches on AIDS and HIV public healthcare policy.

The National Commission on AIDS consists of 15 members: five appointed by the Senate, five by the House, two by President George W. Bush, and the secretaries of Health and Human Services, Defense, and the Veterans Administration.

Perhaps the most recognizable member of the National Commission on AIDS, is former NBA star Earvin ‘Magic’ Johnson.  However, Johnson would resign from the commission in September 1992, writing to President Bush:  “I cannot in good conscience continue to serve on a commission whose important work is so utterly ignored by your administration.”

Johnson’s resignation is preceded by another six months earlier of Harlon D. Dalton, a Yale Law School professor who is the only other African American appointed to the commission.  In March 1992, Dalton would complain about the lack of action from black politicians, saying, “Any high-visibility politician can point to the one time a year where [AIDS] is mentioned. But there haven’t been any votes there. Gay black men don’t exist, black men don’t vote and babies don’t vote.”

At its first meeting, Chair Osborn gives recognition to Rep. J. Roy Rowland, who she refers to as “the Father of the Commission.”  Rep. Rowland is the principal sponsor of the legislation that created the commission on Nov. 4, 1988.

Other members include:

• Dr. David E. Rogers, head of the New York City Mayor’s Task Force on AIDS and New York State’s AIDS Advisory Council
• Diane Ahrens, Minnesota local government official
• Rev. K. Scott Allen, a Baptist minister, coordinator of the AIDS Interfaith Network in Dallas
• Don C. Des Jarlais, a NY physician who advocates for needle-exchange programs
• Eunice Diaz, community affairs director of White Memorial Medical Center in Los Angeles
• Mary D. Fisher, appointed by Bush to replace Magic Johnson in October 1992
• Donald S. Goldman, New Jersey attorney, author on ethical issues involved in AIDS treatment
• Larry Kessler, executive director of AIDS Action Committee of Massachusetts
• Charles Konigsberg, Jr., director at the Kansas Department of Health and Environment
• Belinda Mason, journalist who dies of AIDS-related illnesses in September 1991

The commission was established by a statute enacted November 4, 1988, with the aim of “promoting the development of a national consensus on policy concerning AIDS.”. It produced several reports over the next 4 years.

The commission approaches its work through numerous hearings, covering the following topics:

• healthcare, treatment, and international aspects of the HIV epidemic;
• Federal, State, and Local responsibilities;
• the Southern California epidemic;
• social and human issues;
• Executive and Legislative branch issues;
• current research and clinical trials;
• HIV epidemic in the Commonwealth of Puerto Rico;
• African American communities;
• Pediatric and Adolescent HIV;
• Lesbian, Gay, and Bisexual communities among Asians, Asian Americans, and Pacific Islanders;
• Women and HIV disease and civil rights;
• religious communities response; and
• risks of transmission in healthcare settings.

In its supporting report, the Health Resources and Services Administration notes that only six states have Medicaid program waivers for the treatment and care of people with HIV/AIDS: California, Hawaii, New Mexico, New Jersey, Ohio and South Carolina.  The waiver services cover case management, personal care and adult day care in five of the six states.

States with these programs report that the AIDS-specific waiver enables them to establish a uniform system of services, a network of treatment options, and greater access to home and community-based care for people with AIDS, the report states.

Perhaps most importantly, the programs expand financial eligibility for those needing care and treatent.

The newly announced HRSA grant program provides funding so that all states can adopt and strengthen programs that target AIDS-specific services to those who need them.

Initially, investigators doubted that the 19-year-old patient could have been infected during the dental procedure, however invasive.

“For one thing, she developed AIDS just two years after the surgery, and only 1% of patients go from infection to full-blown illness that quickly,” wrote Stephen Barr, a researcher specializing in microbiology and immunology, for The New York Times in 1994.

Dr. Acer’s former patient was Kimberly Bergalis, a 19-year-old who told her parents and CDC officials that she was a virgin.  Without any other leads , the CDC moved forward with an investigation of the dentist, who had left his practice the year before to tend to his declining health.

On March 29, 1990, a CDC investigator met with Dr. David Acer at his home in Stuart, Florida, and informed him that a former patient had AIDS but no apparent risk factors for infection.  She asked Acer for a sample of his blood, explaining that she wanted to compare the former patient’s virus with Dr. Acer’s.  He complied.

Using an experimental procedure to compare the genetic strains of DNA, the CDC established a match between Dr. Acer and Bergalis.  Even so, one investigator who was Florida’s top AIDS official, Dr. John J. Witte, called the evidence of transmission “scientifically inconclusive.”

The CDC would publish its findings of the DNA match in July 1990 without further verification, pointing to Dr. Acer and his dental practice as the source of Bergalis’ deadly disease.  In its report, the CDC suggested that during the dental procedures, “higher titers of virus may have been present in the dentist’s blood and he may have been more likely to transmit virus than earlier in the course of his HIV disease.”

According to medical records, Dr. Acer was diagnosed with symptomatic HIV infection in late 1986 and AIDS in September 1987.  While he was in practice, he had no record of peripheral neuropathy, dementia, thrombocytopenia or other bleeding disorder, hand dermatitis, or injury.

Dr. Acer closed his practice in 1989 after his T-cell (CD4 lymphocyte) count dropped under 200.  He would die on Sept. 30, 1990 at the Hospice of Palm Beach County at West Palm Beach with his parents at his side.  Bergalis would die of AIDS-related illness on Dec. 8, 1991 at the age of 23.

Titled the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, the legislation is named for the Indiana teen who became infected through treatment for his hemophilia and died in April 1990.

This creates the nation’s largest HIV-specific federal grant program, and the U.S. Health Resources and Services Administration is charged with managing the resources,

British government papers released in December 2015 show Thatcher tried to reign in Health Secretary Norman Fowler’s AIDS awareness campaign in the mid-1980s by urging the elimination of precise explanations of which sexual practices were most likely to lead to HIV infection, according to The Guardian.

In 1985, Fowler submitted a memorandum to the prime minister’s office that provided details about “Don’t Die of Ignorance,” a country-wide public health campaign that included explicit health warnings in large advertisements in the Sunday papers.

Thatcher expressed her opposition in her trademark blue felt pen comments on the memo: “Do we have to do the section on risky sex? I should have thought it could do immense harm if young teenagers were to read it.”

She was particularly alarmed by references to anal intercourse in the campaign’s section titled “What is risky sex?”

When the privy council committee coordinating the government response to AIDS decided to move forward with Fowler’s campaign, Thatcher continued to voice opposition.

“I remain against certain parts of this advertisement,” she wrote to the committee.  “I think the anxiety on the part of parents and many teenagers, who would never be in danger from AIDS would exceed the good which the advertisement might do … To place advertisements in newspapers, which every young person could read and learn of practices they never knew about, will do harm.”

Following her objections, the language in the media ads were subsequently amended.

In a 2021 interview the National HIV Story Trust, a British organization that seeks to preserve the history of the AIDS epidemic in the U.K., Fowler said the late Thatcher and her party chairman, Norman Tebbit, “were both neurotic about getting too associated with [AIDS] and too associated sometimes with the people in it.”

Fowler described how the Conservative Party leader expressed concerns about the increasing rates of HIV infection and death, but held “no great sympathy for the subject,” according to Pink News.

In her 2018 book People Like Us, Caroline Slocock provided an alternative view of the prime minister.  Slocock recalled that during her time as private secretary to the prime minister, Thatcher eventually visited an AIDS hospice to visit patients dying of illnesses related to the virus.

Thatcher arranged the visit without any media notice, in part because she did not wish to draw focus from the work already being done by Diana, Princess of Wales, according to Slocock.

Slocock, who accompanied Thatcher on this trip, wrote about her recollection of the prime minister’s encounter with an AIDS patient:

“I have never been at the bedside of a dying person before and I feel strongly that family and friends should be there at this moment, not us … [Thatcher] responds by taking a seat by his side, asking questions, expressing sympathy, connecting in a simple and genuine way, to which he responds sweetly. She comes across as more of a mother than a Prime Minister… 

“After about ten minutes, we leave him and go into the second room. Inside, sitting in a chair beside his bed, is a young American man, also extremely thin. The virus has attacked his brain too, as it does in the final stages, we are told afterwards, and he is excited and confused. At first he thinks she must be a creation of his own mind, a delusion. But then he begins to believe that she really is Margaret Thatcher, but sent to him miraculously to hear his thoughts and to pass them on to President Bush. He tells her to ring the president. It is imperative that action is taken now to help people like him – that is his message. He is overexcited, it is very difficult to know how to respond, and it is very, very sad.

“Margaret Thatcher is unfazed and behaves as if she has all the time in the world. She places her hand on his arm, asks him a few questions about his life and listens, in a way that demonstrates that she is real, not a phantom, and is there because she cares and wishes him well. He calms down in response. It is simple, human stuff, but I am in awe of it.

“When we leave them, we ask the staff about [the patients’] families. It turns out that neither have felt able to tell their parents that they are gay, let alone that they have AIDS, and so they are dying alone.”

The CDC’s report ecommends that healthcare workers who are HIV-positive “should not perform exposure-prone procedures unless they have sought counsel from an expert review panel and been advised under what circumstances, if any, they may continue to perform these procedures.”

The CDC goes on to say that HIV-positive healthcare workers should notify prospective patients of the worker’s HIV status before they undertaking exposure-prone invasive procedures.

The report cites the case of Dr. David Acer, a dentist with AIDS who likely transmitted HIV to five of his 850 patients.

Although this was the only cluster of health care worker-to-patient transmissions of HIV in the U.S., the report concerning Dr. Acer immediately set off public debate on the effectiveness of existing safeguards of the public’s health, whether it was appropriate for HIV-positive health care workers to practice, and the public’s right to know the HIV status of their physicians.

Harvard University, which is co-sponsoring the conference with the World Health Organization, announces that because of “continuing uncertainty” of the country’s policy toward HIV-positive individuals, it will not hold the 1992 conference in Boston.  Weeks later, Harvard would announce that the next conference would be held in Amsterdam.

The Boston site of the meeting is canceled, because of Bush Administration requirements that short-term visitors to the U.S. declare whether they are infected with the AIDS virus.  The policy bans travel to the U.S. by foreigners infected with the virus, unless they get a waiver.

Two months earlier, the 1991 International AIDS Conference in Florence closes with officials and participants marching to the U.S. Consultate to protest the American travel ban.

Almost 20 years later, the ban on HIV-positive immigrants and travelers to the U.S. would be lifted by an executive order by President Barack Obama.

As fierce fighter for HIV/AIDS policy for 10 years, Haddon is credited with shepharding the creation of the California AIDS Advisory Committee in 1983 and writing legislation supporting a coordinated approach to local HIV/AIDS programs and services in 1985.

According to Stephen Colbrook’s paper “Clandestine Networks and Closeted Bureaucrats: AIDS and the Forming of a Gay Policy Network in California,” Haddon was a key player among policymakers who jumped into action when the AIDS crisis unfolded.  When Hadden learned that a new deadly disease was spreading through San Francisco’s gay community, he brought the epidemic to the attention of his boss, David Roberti, who was the president of the California senate.

Colbrook wrote:

“Hadden quickly emerged as a pivotal figure in California’s response to the AIDS crisis. He was affable, forthright, and pragmatic, burnishing a well-deserved reputation as the AIDS Tsar of California.  By 1987, his monthly AIDS newsletter had 25,000 subscribers, and his correspondence reached beyond California to activists in Texas, Illinois, and New York.”

Sen. Roberti provided Hadden with a significant degree of autonomy, with which Hadden used to craft a large portion of California’s early AIDS legislation, including Senate Bill 1215, which expanded the state budget for prevention education by $11 million.  Passed in 1985 by an overwhelming bipartisan majority in both the Assembly and Senate at a time when budget funds were thin, SB 1215 cemented California’s leading role in addressing the HIV/AIDS crisis.  In 1985, nearly half of the total state spending on the AIDS epidemic was attributed to California, according to Colbrook.

Hadden’s leadership also throughout the 1980s also helped steer California’s action on the epidemic toward a focus on patient confidentiality and individual rights.  This focus was not always adopted by other states in their approach to the AIDS crisis.  On the other end of the spectrum was Texas, whose political leaders created policy centered on the disease’s perceived threat to the heterosexual population.

Hadden was one of only a few in the 1980s Sacramento political scene who were open about their LGBT identity, journalist Karen Ocamb would later write in The Pride.  Scores of administrative and political aides to California legislators remained in the closet, fearful that open knowledge of their sexual identity would end their professional careers.  Elected officials and potential candidates who identified as LGBT also remained silenced by the very real fear of ruination.

In the final two weeks of his life, Hadden received round-the-clock nursing care as part of a hospice program.  Sacramento AIDS Foundation spokeswoman Patty Blomberg noted that the AIDS care Hadden received might not have existed if it were not for his influence and persistence.

Blomberg told the Sacramento Bee that Hadden had slipped into a coma early that morning and then died at about noon at his farmhouse along the Sacramento River, surrounded by friends and family who had flown in from as far away as Michigan.

Hadden’s funeral would bring in friends and colleagues from around the state, including Ocamb and John Duran, then President of the Board of LIFE AIDS Lobby who would become Mayor of the City of West Hollywood.

“In a gesture unheard of for the suits of Sacramento, a huge rainbow flag was unfurled and solemnly marched down the street to the Capitol,” Ocamb recalled.

“Stan’s memory will go on, because he made a contribution to this state that many of us can only dream of making,” Senate President Pro Tem Roberti said during Hadden’s memorial service at St. Francis Church in midtown Sacramento.

* * * * * * * *

Photo of quilt panel from the AIDS Memorial Quilt

As part of a new movement in the criminal justice system toward “problem-solving courts,” the Manhattan Criminal Court Project sought to curb the spread of the AIDS virus by sex workers and intravenous drug users by providing them with information about HIV and ways to avoid infection and transmission.

Low-level misdemeanor offenders sentenced to the program would meet in Room 1600-A of the Manhattan Criminal Court to learn about HIV transmission and addiction recovery.

Of the initial the 200 participants in the pilot project, 92% completed the classes, called the Treatment Readiness Program, according to The New York Times. In addition to sessions informally titled “AIDS 101” and “Drugs 101,” the program included field trips to longer-term substance-abuse programs.

As part of the study, some people convicted of prostitution and minor drug violations still received the traditional sentence of community service along with the opportunity to participate in the Treatment Readiness Program — but only 70% of them attended the first day of classes and less than 50% appeared for the second.

The project was, in part, the brainchild of Justice Gustin L. Reichbach, a radical night court judge who was elected to the bench in 1990.  After three months of presiding over a court that saw an endless stream of prostitution cases and minor drug offenses, Reichbach became concerned that every night he returned to the streets sex workers who appeared to be sick from AIDS, drug use, or both, according to The Times.

He reached out to the Gay Men’s Health Crisis and arranged for the organization to set up a table outside the courtroom to distribute condoms, conduct HIV testing and provide counseling.  More importantly, the GMHC connected Reichbach to someone who was far more focused than GMHC on the spread of HIV among sex workers: Dr. Joyce Wallace.  The infectious disease specialist operated a “care van” that travelled the sex work districts of Manhattan and Brooklyn, and provided an array of services for sex workers, from HIV and sexually transmitted infections (STI) testing and clean needles to basic primary care and food coupons.

Dr. Wallace became an enthusiastic participant in Reichbach’s plan to get sex workers to HIV and drug recovery resources.  In early March, Reichbach began ordering women convicted of prostitution to “36 hours off the street to think about what we’re doing here,” according to The New Yorker.  He also offered the offenders the opportunity to have an on-the-spot meeting with Dr. Wallace, receive free condoms, and learn about AIDS prevention and addiction recovery.  Many of the sex workers would agree to sit down with Dr. Wallace, and then proceed to her van, which was parked outside the courtroom, to receive a free HIV test.

Soon after, on March 28, 1991, The Daily News published a front-page story about it under the headline “The Condom Court.”  Displeased with the media attention, Reichbach’s supervisors transferred him to the civil courts.  (There, he continued to generate headlines by sentencing a slumlord to be confined to one of her properties until she successfully addressed a list of dangerous violations.)

Meanwhile, Dr. Wallace continued what she and Judge Reichbach started and, with  a $115,000 grant from the Medical and Health Research Association of New York, she created an alternative sentencing program for offenders at-risk for HIV.  Fourteen months later, on May 28, 1992, the Manhattan Criminal Court Project was launched.

The Business Responds to AIDS program is designed to help large and small businesses meet the challenges of HIV/AIDS in the workplace and the community.

In an interactive teleconference originating at its Atlanta headquarters, the CDC introduces business leaders to the BRTA program and releases resources to assist them with initiating their own HIV-education programs in the workplace.

Participants in the teleconference include the American Red Cross, the U.S. Department of Health and Human Services, the New England Corporate Consortium on AIDS, and the business and labor communities from several sites throughout the U.S.

The CDC encourages businesses to develop written HIV policies and provide employee education about preventing HIV transmission.

In three years, the CDC would follow up BRTA with the Labor Responds to AIDS program in 1995.

The CDC’s definition of AIDS had been — and still is — used as a surveillance definition to monitor trends in the incidence and prevalence of AIDS over time, to:

* characterize persons with end stage HIV disease,
* to identify risk factors and modes of transmission, and
* to predict the future course and impact of the AIDS epidemic.

In addition to being used for surveillance, the AIDS definition has been used as a clinical definition by physicians, a definition for research, and a measure of disability in benefits programs.

In a 53-page ruling that strongly rebuked the Bush and Clinton administrations, Judge Sterling Johnson Jr. of the Eastern District of New York also ruled that Immigration and Naturalization Service (INS) officials acted illegally when they tried to process the Haitians’ claims for asylum without allowing their legal counsel to participate in the process.

The trial followed a year of hunger strikes by the refugees at Camp Bulkeley and collaboration with human rights activists and lawyers, according to The Washington Post‘s coverage of the ruling.

During the trial, U.S. officials conceded that the medical facilities at Camp Bulkeley were not equipped to treat patients with HIV or AIDS “under the medical care standard applicable within the United States itself.”

Still, INS officials repeatedly refused requests to transfer HIV-positive refugees to U.S. hospitals, one official actually saying to members of the media, “They’re going to die anyway, aren’t they?”

Judge Johnson’s opinion claimed the HIV detention center at Guantanamo Bay violated federal law.  He characterized the attitude held by INS officials — that there is “no value in providing adequate medical care when a patient’s illness is fatal” — as “outrageous, callous and reprehensible.”

The long-awaited victory for the Haitian refugees happened just one week before the start of the 1993 World Conference on Human Rights, and by this time, the country had a new president, Bill Clinton.  During his campaign for president, Clinton had promised to shut down the Haitian refugee camp and reform the asylum application process, but after taking office in January 1993, he decided to a continue the Bush Administration’s policy of forcibly returning Haitians who try to emigrate to the U.S.

Now he risked embarrassment before world leaders gathering at the human rights conference.

So days after Judge Johnson’s ruling, President Clinton announced that it would comply with the order. All 158 Haitians held at Camp Bulkeley were flown to states in the U.S., where they were allowed to take up residency.

The Life AIDS Lobby, also known as the Lobby for Individual Freedom and Equality, was formed in 1986 in California to coordinate, develop and promote the statewide legislative agenda for providing compassionate and comprehensive healthcare for the HIV/AIDS impacted community.

More than 100 organizations, from LGBTQ and political clubs to unions and religious groups, joined together to represent the HIV/AIDS community and provide guidance to California legislators in crafting HIV/AIDS policies.

The San Diego affiliates of the Life AIDS Lobby were the AIDS Foundation San Diego, Being Alive San Diego, the First Unitarian Church of San Diego, the Greater San Diego Business Association, the Lesbian and Gay Men’s Community Center, and the San Diego Democratic Club.

During the conference, President Clinton talked about the toll the HIV/AIDS epidemic was taking on parents, families and communities.

The President also set goals to accelerate progress toward a vaccine and a cure.  He urged Congress to maintain the Medicaid safety net; Medicaid paid for the care of nearly half of Americans living with AIDS in 1995, including more than 90% of children with AIDS.

Some conference attendees were disappointed, however, that the President failed to voice support for government-sponsored needle distribution and exchange programs.

More than 250 participants from 37 states and Washington D.C. were invited to attend the White House conference. In the morning, participants assembled into nine working groups for in-depth discussions on research, substance abuse treatment, transmission prevention, international issues, discrimination, housing and services.

Following lunch, participants gathered for  a plenary session in the Cash Room of the Treasury Building for a roundtable discussion with President Clinton; Patsy Fleming, Director of the Office of National AIDS Policy; Donna Shalala, Secretary of Health and Human Services; and Dr. Scott Hitt, Chairman of the Presidential Advisory Council on HIV/AIDS.  Also included in the roundtable were two community representatives, Sean Sasser of Atlanta, who tested positive for HIV at age 19 (best known for his relationship with activist and reality TV star Pedro Zamora), and Eileen Mitzman of New York, who lost her 26-year-old daughter Marni to AIDS in 1991.

Based in Geneva, Switzerland, UNAIDS was initially cosponsored by six organizations: United Nations Children’s Fund (UNICEF); United Nations Development Programme (UNDP); United Nations Population Fund (UNFPA); United Nations Educational, Scientific and Cultural Organization (UNESCO); World Health Organization (WHO); and the World Bank.

UNAIDS assumed the lead in the UN’s global response to HIV/AIDS, which was known as the Global Programme on AIDS, overseen by the World Health Organization from 1986 to 1995.

The need for a more comprehensive UN program on AIDS was confirmed by a resolution of WHO’s World Health Assembly in 1993 and was later endorsed by the governing bodies of the other prospective cosponsors and by the UN’s Economic and Social Council. By early 1996, the six cosponsoring organizations had signed a Memorandum of Understanding to collaborate under the new program, according to UNAIDS: The First 10 Years by Lindsay Knight.

UNAIDS located its main office in Geneva, Switzerland, where it oversees its network of advisers
in approximately 50 countries.  The program is governed by a board of representatives from 22 governments from all geographic regions, with a rotating government membership.  Also represented are the six cosponsoring organizations, and five nongovernmental organizations, including associations of people living with HIV/AIDS.

The legislation grants the funding needed for the U.S. Health Resources and Services Administration to continue its public health response to HIV.

President Clinton would dedicate the new Dale and Betty Bumpers Vaccine Research Center on June 9, 1999.

In 1993, 200 Haitian asylum-seekers were confined to Camp Bulkeley at the American naval base at Guantanamo Bay.  Under a judge’s order, they were finally allowed into the U.S., with most of them settling in Miami and New York City.

According to reporting in The New York Times, the vast majority of them had not won the political asylum they sought.  Twenty of them had already died, while others lived lives of quiet desperation, unable to get work and dependent on dwindling social programs.

Earlier in 1998, three New York social service agencies lost a total of $600,000 in federal grants that were used to fund housing, health care, counseling, and legal counseling for Haitian refugees, wrote reporter Garry Pierre-Pierre for the NYT.

“The pie is getting smaller, and people are less sympathetic toward refugees and immigrants,” Gabrielle Kersaint told the NYT.  Kersaint oversaw the Haitian Women’s Program, one of the organizations whose financing was eliminated.

The initiative invests an unprecedented $156 million to improve the nation’s effectiveness in preventing and treating HIV/AIDS in racial and ethnic minority communities.

The funding is spread across three broad categories: technical assistance and infrastructure support; increasing access to prevention and care; and building stronger linkages to address the needs of specific populations.

The majority of the funding would be sourced from the omnibus federal budget passed the week before, and the remainder “was redirected from other discretionary spending programs,” according to President Clinton in his announcement.

The move came in response to a call from Rep. Maxine Waters (D-CA), chair of the Congressional Black Caucus, who argued that “AIDS is a public health crisis in the black community.”

Although blacks constitute only 12% of the population, they comprise more than one third of all HIV/AIDS cases and 43% of new cases, according to the Kaiser Family Foundation.

In May 1998, the Congressional Black Caucus called on Health and Human Services Secretary Donna Shalala “to declare an AIDS state of emergency because of the unchecked spread of the disease in the nation’s minority community.”

“This is a national crisis,” said caucus chair Waters. “We will not rest until it is understood as one, until it is considered as one and worked on as one.

When a Congressional body declares a “state of emergency,” it typically results in raising public awareness about the issue and alerts government leaders that more money and energy should be directed toward addressing the issue.

Sources:
California Healthline, May 12, 1998 and October 28, 1998
Photo courtesy of the William J Clinton Presidential Library & Museum

WHO estimates that 33 million people are living with HIV worldwide, and that 14 million have died of AIDS.

In his address, President Clinton calls for concerted international action to combat infectious diseases in developing countries.  The President asks for foundations, pharmaceutical companies, international agencies, and other governments to join in this task.

Firmly planted at the center of AIDS activism for 15 years, Gendin is credited for having promoted constructive changes in government policy that would improve the lives of HIV-positive people. His activism was pivotal in reforming the FDA drug approval process to expedite HIV and AIDS patients’ access to more effective anti-retroviral treatments.

He was involved with ACT UP (New York and Rhode Island chapters), Sex Panic!, Community Prescription Service, and the Radical Faeries.  He also wrote a widely read column in POZ magazine. In this column, he shared the toll AIDS took on his body in graphic details and other personal experiences.

“Stephen was a willing guinea pig, his body a non-stop experimental laboratory for new treatment strategies.  His curiosity and courage contributed to what we have all learned about anti-retroviral treatment,” wrote Sean Strub, POZ Magazine’s founder and advisory editor.

Strub said he met Gendin in 1988, shortly after Gendin graduated from Brown University.  In ACT UP/New York, they worked together on the fundraising committee.  In 1990, Strub hired Gendin to work for his company, and for ten years they collaborated on various projects, including fundraising for community non-profits, publishing POZ magazine and launching the Community Prescription Service.

As a co-founder and the chief executive of the Community Prescription Service, Gendin oversaw the organization’s mail-order pharmacy service that distributed medication and information for people with HIV and AIDS, according to the New York Times.

Following Gendin’s death, POZ posted this video tribute to the legendary activist.

The meeting also calls for the creation of an international “global fund” to support efforts by countries and organizations to combat the spread of HIV through prevention, care, and treatment, including the purchase of HIV medications.

In April of 2002, The Global Fund approves its first round of grants to governments and private-sector organizations in the developing world. The grants total $600 million for two-year projects.

Created in 1998 by President Bill Clinton in response to urging from the Congressional Black Caucus, the Minority AIDS Initiative (MAI) originally focused on building organizations and infrastructure in communities of color to address the epidemic.  In the 1990s, people of color continued to be disproportionately impacted by HIV, according to the Los Angeles Times.

Starting in 1999, the MAI under President Clinton received an annual budget of $156 million dedicated to raising awareness of HIV and improving access to treatment programs in minority communities, according to the U.S. National Institutes of Health. The program was part of a larger $865 million increase in government spending on anti-AIDS programs.

But in 2003, the U.S. Supreme Court decided to take on Affirmative Action.  And President Bush used the public awareness raised around the hotbed issue to take a side in the case, urging for SCOTUS to rule unconstitutional any public policies that favored minority individuals or groups.

Even though the Supreme Court would in Grutter vs. Bollinger (2003) decide in favor of student admissions policies that prioritize underrepresented minority groups, President Bush moved forward with new policies to curtail federal funding to minority-led projects, including those prioritized by Clinton’s MAI.

“That simple change decimated many of the minority-led HIV organizations. To this day, it is still being used as the reason change is impossible,” said Paul Kawata, the executive director of the National Minority AIDS Council.

Kawata added: “An unintended consequence is that 10 years after the MAI was gutted, people of color became the majority of new cases and the majority of people living with HIV.”

The conference involves nearly 1,000 participants from the American Indian, Alaska Native, Native Hawaiian, First Nations, and U.S. Territorial Pacific Islander communities.

The WHO/UNAIDS guidelines state that in addition to expanding access to HIV testing, “equal efforts must be made to ensure that a supportive social, policy and legal framework is in place to maximize positive outcomes and minimize potential harms to patients.”  The recommended framework includes social mobilization, health care provider training, a strong monitoring and evaluation system and laws and policies against discrimination based on HIV status, risk behavior or gender.

In a response to the WHO/UNAIDS guidelines, Human Rights Watch pointed out that “few countries have strong legal frameworks in place and enforced, and that in many regions and countries resources are inadequate.”

HRW presented the following facts that could undermine the WHO/UNAIDS guidelines:

• Worldwide, less than 10% of injecting drug users have access to HIV prevention.
• About the same percentage of pregnant women living with HIV in Africa has access to the medicine necessary to prevent transmission to their infants.

“The United Nations set a goal of universal access to HIV prevention and treatment by 2010, but currently only an estimated 2 million of the 7 million people living with HIV in urgent need of treatment are receiving it,” HRW stated.

The legislation budgets $48 billion for PEPFAR to operate an additional five years and also contains a rider that gives the U.S. Department of Health and Human Services the authority to admit HIV-positive travellers to the U.S. on a “case-by-case” basis.

In PEPFAR’s first five years, the program helped bring life-saving treatment to more than 2.1 million people and care for more than 10 million people – including more than four million orphans and vulnerable children – around the world

By 2008, PEPFAR was supporting life-saving antiretroviral treatment for more than 2 million people living with HIV/AIDS in Sub-Saharan Africa, a dramatic increase from 2003, when only 50,000 people in all of Sub-Saharan Africa were receiving antiretroviral treatment.

To date, PEPFAR also supported:

• the prevention of mother-to-child HIV transmission for women during more than 16 million pregnancies.
• the prevention of nearly 240,000 infant infections.
• more than 57 million counseling and testing sessions for men, women, and children.

Bush’s announcement that he would loosen restrictions on HIV-positive travellers to the U.S. was seemingly in response to pressure from members of Congress.  Nearly 60 House Democrats, including Henry A. Waxman (California), chairman of the Committee on Oversight and Government Reform, sent President Bush a letter urging him to “take swift action on the issue.” according to The Washington Post.

During its reauthorization of PEPFAR, Congress voted to repeal the ban imposed on people living with HIV seeking to travel or immigrate to the U.S.  However, the ban remained in place while the U.S. Department of Health and Human Services stalled on whether to rewrite its rules to allow the admission of people living with HIV/AIDS.

In an editorial, The Washington Post urged the HHS to “act soon to end a de facto form of discrimination that puts the United States in the company of countries such as Libya, Saudi Arabia and Sudan.”

The travel restrictions were first imposed in 1987, at the height of AIDS hysteria, by then-Senator Jesse Helms, a Republican from North Carolina known for his anti-gay stances on a variety of issues.  Helms inserted language into a bill that directed the Secretary of Health and Human Services to add HIV to the list of medical conditions barring immigrants and visitors to the U.S.  In protest of the ban, the International AIDS Conference began boycotting the U.S., holding its annual conference in other countries.

Massachusetts Congressperson Barney Frank told The Out Traveler, “I appreciate the fact that the president is acknowledging that this is a very imperfect policy in his request for some regularized exceptions.  But exceptions to a bad policy are not enough.  The time has come to abolish it.”

Two months later, The Atlantic would report that people living with HIV/AIDS were still being denied the ability to travel to the U.S.  In fact, the travel ban would remain in place throughout the duration of Bush’s term in office. Lifting the ban then fell to newly elected President Barack Obama, who in his first year of office, began working on changing the law.  The ban officially ended on January 4, 2010.

The a multiyear Act Against AIDS campaign is designed to reduce HIV incidence in the U.S. through raising awareness about HIV prevention.

The CDC simultaneously launches the Act Against AIDS Leadership Initiative (AAALI) in an effort to increase HIV-related awareness, knowledge, and action within Black communities across the U.S.

FDA announces that it has approved the 100th antiretroviral drug under the President’s Emergency Plan for AIDS Relief (PEPFAR).  Of the more than 100 products that have received either full or tentative FDA approval under the program, 29 are branded drugs and 71 are generics.

This achievement reflects a five-year-old regulatory process designed to fast-track the delivery of cheap HIV drugs to the developing world through the PEPFAR program.

The FDA process was launched in May 2004, in response to a call from activists, clinicians and members of Congress to use the WHO’s pre-certification drug list to make purchases of generic medications for PEPFAR-funded programs.  Instead, a process was devised to allow the FDA to certify generic antiretrovirals (ARVs) for PEPFAR purchase, even if the branded drug was still protected by U.S. patent laws.

HHS Secretary Kathleen Sebelius said in a statement, “This milestone exemplifies the dedication, caring, and hard work of all who strive to better the lives of those infected with or affected by HIV/AIDS.”

When applicable, Federal funds may be used for personnel, equipment, syringe disposal services, educational materials, communication and marketing activities and evaluation activities, and evaluation. Some HHS programs may still contain partial or complete bans on the use of funds for needle exchange programs.

“The Affordable Care Act is one of the most important pieces of legislation in the fight against HIV/AIDS in our history,” according to The Centers for Disease Control and Prevention.

Historically, people living with HIV and AIDS in the U.S. had a difficult time obtaining private health insurance and had been particularly vulnerable to insurance industry abuses.  Consistent with the goals of the Obama Administration’s National HIV/AIDS Strategy, the Affordable Care Act made considerable strides in addressing these concerns and advancing equality for people living with HIV and AIDS.

As of this day, insurers were no longer able to deny coverage to children living with HIV or AIDS.  The parents of as many as 17.6 million children with pre-existing conditions no longer had to worry that their children would be denied coverage because of a pre-existing condition.

Insurers also were prohibited from cancelling or rescinding coverage to adults or children because of a mistake on an application.  And insurers could no longer impose lifetime caps on insurance benefits. Because of the law, 105 million Americans no longer had a lifetime dollar limit on essential health benefits.

These changes to healthcare immediately improved access to insurance for people living with HIV/AIDS and helped people with these conditions retain the coverage they had.

At the 18th International AIDS Conference on July 18-23, the Centre for the AIDS Programme of Research in South Africa’s (CAPRISA) presented the results of its 004 study of antiretroviral-based microbicides, a vaginal gel that significantly reduces a woman’s risk of being infected by HIV and genital herpes.

The study shows the microbicides to be safe and effective in reducing risks of new HIV infections among women by 39%. Women who use the microbicides as directed have even higher rates of protection (54%) against HIV infection.

The microbicide containing 1% tenofovir — an antiretroviral drug widely used in the treatment of HIV — was considered to have the potential to prevent over half a million new HIV infections in South Africa alone over the next decade.

The study involved 889 women at high risk of HIV infection at an urban and a rural site in KwaZulu-Natal, South Africa. Overall, 98 women out of the 889 became HIV positive during the trial — with 38 in the tenofovir gel group and 60 in the placebo gel group.

Out of the 434 women who tested negative for herpes at the start of the trial, 29 became infected in the tenofovir group and 58 became infected in the placebo group. The reduced rates of HIV and herpes infections among the women who used the tenofovir gel were considered statistically significant.

The session recognizes critical milestones, including three decades of the pandemic and the 10-year anniversary of the 2001 UN General Assembly Special Session on HIV/AIDS and the resulting Declaration of Commitment . At the Meeting, the U.S. joined with other partners in launching a global plan to eliminate mother-to-child transmission of HIV and keep mothers alive.

Speaking before the National Institutes of Health, Clinton delivered remarks on the future of the global HIV/AIDS epidemic, reflected on the past 30 years of the epidemic, and outlined a vision for turning the tide on HIV/AIDS.

“Our efforts have helped set the stage for a historic opportunity, one that the world has today: to change the course of this pandemic and usher in an AIDS-free generation,” Clinton said.

“Now, by an AIDS-free generation, I mean one where, first, virtually no children are born with the virus; second, as these children become teenagers and adults, they are at far lower risk of becoming infected than they would be today thanks to a wide range of prevention tools; and third, if they do acquire HIV, they have access to treatment that helps prevent them from developing AIDS and passing the virus on to others.”

Clinton’s speech was considered to be the Obama’s administration’s first effort to publicly set an ambitious goal to eradicate the disease.  Following her remarks, administration officials scrambled to suggest ways that the initiative could be funded, including diplomatic pressure on governments in developing countries to spend more of their own money and political pressure on wealthy nations to contribute more.

During her speech, Clinton also introduced comic performer and talkshow host Ellen DeGeneres as a new Special Envoy for Global AIDS Awareness.

Clinton’s full speech is available here.

Dr. Eric Goosby, the Obama administration’s global AIDS coordinator, said this was only the first of several speeches that administration officials planned to make on AIDS in the next few months.

Conference organizers had refused to convene the event in the U.S. until the Federal government lifted the ban on HIV-positive travelers entering the country.

To mark the 10th anniversary of the U.S. program to combat HIV and AIDS, U.S. Secretary of State John Kerry announced additional PEPFAR funding for Cambodia, Ghana, Nepal, Senegal, Swaziland, and Zimbabwe.

Kerry told Voice of America that 10 years ago, almost 30-million people were infected with HIV and things looked bleak.

“When this disease appeared to be unstoppable, history will show that humanity and individual humans rose to the challenge,” he said.” Action was taken. Innovations were discovered. Hope was kindled. And generations were saved.”

Kerry said PEPFAR’s success is an example of what can happen when people overcome ideologies and politics. Signed into law by George W. Bush, the President’s Emergency Plan for AIDS Relief, known as PEPFAR, was the world’s largest and one of the most successful foreign assistance programs.

Since the start of PEPFAR in 2003, new HIV infections are down nearly 20%. According to U.S. officials, the number of new infections and AIDS-related deaths in Sub-Saharan Africa have dramatically decreased to about one-third.

The State Department ceremony marking the PEPFAR anniversary was attended by Dr. Richard Kamwi, Namibia’s Minister of Health and Social Services.  Dr. Kamwi said that the funding has helped his country develop and implement programs that have slowed down the spread of HIV.  PEPFAR funding is also used to provide treatment and care for those who are infected.

Also present at the ceremony was Tatu Msangi, a nurse from Tanzania who eight years ago gave birth to an HIV-negative daughter.

“When the first HIV test is carried out on a baby and it is negative, it is amazing to see the relief and joy on a mother’s face,” said Msangi. “I remember that feeling so many years ago, fighting so hard to keep my daughter healthy and free of HIV. Today Faith and I have a bright future ahead of us.”

Kerry said this month the one-millionth baby will be born HIV-free because of PEPFAR’s support.

“Where we once saw a situation spiraling out of control, today we see a virtuous cycle beginning to form: more people receiving treatment and fewer people passing on the virus,” he said. “Fewer infections means it is now easier to actually focus treatment efforts. And with fewer people sick and dying we are seeing healthier, more productive populations.”

The HIV Care Continuum Initiative aims to accelerate efforts to improve the percentage of people living with HIV who move from testing to treatment and—ultimately—to viral suppression.

One key message of the conference is that a one-size-fits-all approach may not be suitable for all settings, especially given the diversity of the epidemic’s geographical hotspots and key populations.

Interventions and policies will require target-based strategies and greater support of key populations, especially in countries where discriminatory policies and legislation are hindering prevention and treatment efforts.

In 1983, the agency imposed a lifetime ban on donating blood for all men who have ever had sex with another man.

The updated Strategy retains the vision and goals of the original, but reflects scientific advances, transformations in healthcare access as a result of the Affordable Care Act, and a renewed emphasis on key populations, geographic areas, and practices necessary to end the domestic HIV epidemic.

WHO also recommends daily oral PrEP as an additional prevention choice for those at substantial risk for contracting HIV. WHO estimates the new policies could help avert more than 21 million deaths and 28 million new infections by 2030.

Two weeks later, Florida Governor Rick Scott would sign off on the needle-exchange program, according to The Palm Beach Post.

This was the culmination of a years-long campaign by the Florida Medical Association and HIV/AIDS activists to reverse a Republican-led ban on using federal money for needle-exchange programs.  For many years, Republican members of the state legislature refused to support such a program, but soaring rates of IV drug use, related deaths, and HIV and Hepatitis C infections have slowly convinced them that it would be a good idea to provide clean needles to addicts.

The HIV epidemic was most severe in Miami-Dade and Broward counties, which had the highest rates of new infections per 100,000 residents of any area in the U.S., according to state and federal data reviewed by the Tampa Bay Times.  A study done at Jackson Memorial found that the cost of treating patients with bacterial infections as a result of dirty needles was about $11.4 million a year.

The legislation was spearheaded by Democrats Rep. Katie Edwards of Plantation and Sen. Oscar Braynon of Miami Gardens, and would be funded through donations to the University of Miami, which would oversee the program.  No taxpayer funds would be used.

The university would be allowed to circumvent the state’s drug paraphernalia laws to use a mobile unit to serve addicts in areas where they are commonly found, providing them with clean needles in exchange for used needles.

Still, 20 Republican members of the Florida House continued to withhold their support, including Michael Bileca of Miami, who for years refused to allow the legislation before his committee for a vote, according to The Gainesville Sun.

Rep. Bileca claimed he had read many studies about effective needle exchange programs and objected to the provision that allowed the needle exchange to occur through a mobile unit, and not at a fixed site.

The funds can now be used to support a comprehensive set of services, but they cannot be used to purchase sterile needles or syringes for illegal drug injection.

The announcement coincides with the 36^th anniversary of the Centers for Disease Control and Prevention’s first report of the initial cases of what would become known as AIDS.

U.S. Department of Health and Human Services made the website name change to reflect major scientific advances transforming a nearly always fatal disease to a condition that can be controlled and prevented from progressing to AIDS.

In its announcement to the public, HHS points out the fact that there were more people living with HIV in the U.S. than people living with AIDS.

In the lead-up to the name change, the U.S. Department of Health and Human Services gathered the following input from community organizations:

• “NMAC (National Minority AIDS Council) applauds the name change from AIDS.gov to HIV.gov, which honors the past while recognizing the power of words and acknowledging that their meanings change over time… The name change reflects the program’s longstanding and ongoing commitment to listen to the HIV community.”
• “Changing its name from AIDS.gov to HIV.gov is a reflection of AIDS.gov’s commitment to respond to the changing dynamics of the HIV/AIDS epidemic and an acknowledgement of the many scientific and treatment advances we’ve made in recent years. This name change is consistent with the forward thinking we’ve come to expect and depend on from this site.”
  — Phill Wilson, President and CEO, Black AIDS Institute
• “The Latino Commission on AIDS welcomes renaming AIDS.gov to HIV.gov to focus on preventing the spread of HIV and reaching people at risk for, and living with, HIV with love and compassion.”
  — Guillermo Chacón, President, Latino Commission on AIDS, and Founder of the Hispanic Health Network

HHS also collected input from its federal partners:

• Anthony S. Fauci, M.D., Director of the National Institute of Allergy and Infectious Diseases:
  “Much progress has been made in HIV/AIDS research since the disease was first recognized in 1981.  The website AIDS.gov has been a valuable resource for those seeking information about HIV/AIDS, and its name change to HIV.gov appropriately reflects our evolution in transforming the pandemic, even as work remains to bring about an end to HIV.”
• Laura Cheever, M.D., Sc.M., Associate Administrator of HRSA’s HIV/AIDS Bureau:
  “The shift to HIV.gov is important because the face of the epidemic is changing.  What was once a deadly disease is now a manageable, chronic condition, if there is access to testing, high-quality HIV primary medical care, medication, and essential support services, such as those provided by the Ryan White HIV/AIDS Program.”
• Jonathan Mermin, M.D., M.P.H., Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention:
  “The shift to HIV.gov is proactive and inclusive, and it sends a strong, supportive message to the 1.1 million people across America who are living with HIV.  The number of annual HIV infections in the U.S. fell 18% between 2008 and 2014, but progress has not been the same for all communities. HIV.gov will deliver current science, accurate information, and links to effective resources for the people who need them most.”

Rep. Price was in a House healthcare committee meeting when she asked a state health official whether people with HIV could legally be quarantined.

“I don’t want to say the quarantine word, but I guess I just said it,” she said during the meeting, which was recorded on video, according to NBC News.

During the meeting, Rep. Price also expressed fear at the high number of people living with HIV, suggesting that the public health risk has intensified because people testing positive for HIV are living longer.

“It’s almost frightening the number of people who are living that are … carriers with the potential to spread,” she said during the hearing. “Whereas in the past, they died more readily, and then at that point, they’re not posing a risk.”

Health advocates and LGBTQ activists responded to Rep. Price’s comments with accusations of feeding fear and stigma around the virus.

“It’s very troubling to hear comments like that,” Jeff Graham, executive director of the LGBT advocacy group Georgia Equality, told NBC News.  “It shows the amount of work that still needs to happen to educate elected officials on the reality of the lives of people living with HIV.”

In a statement shared with the Atlanta Journal Constitution, Rep. Price claimed her comments at the meeting were “taken completely out of context” and that she was merely being “provocative.”

Rep. Price, a Republican elected in 2015 to represent the northern Atlanta suburbs of Roswell and Alpharetta, did not win her re-election bid in 2018.  She lost in a tight race to Mary C. Robichaux, a Democrat who previously worked with hospitals, physicians and other providers to improve patient outcomes.

The explosive information in the NYT article was widely repeated by media outlets, although the two sources for the White House meeting were kept anonymous by request.  According to NYT reporters Michael D. Shear and Julie Hirschfeld Davis, their sources were a White House staffer who attended the meeting and another person who was briefed about it by a different person who was there.

Trump’s comment about Haitian immigrants having AIDS came after he read aloud from a report listing the number of people from outside the U.S. who had received visas to enter the country in 2017.

When members of his administration tried to explain that many were short-term travelers making one-time visits, Trump responded by angrily berating his senior advisors for allowing too many foreigners to enter the country.

Although the White House subsequently denied that Trump made any such comments, ABC News would counter this by noting that Trump made a similar, albeit softer, comment about Haitians in a recent Fox News interview: “Take a look at what’s happening in Haiti. A tremendous problem with AIDS.”

In response to the report on Trump’s comments about Haitians and AIDS, Congresswoman Maxine Waters (CA-43) issued the following statement:  “Donald Trump has proven that there is no limit to his hatred, bigotry, and vulgarity.  As a longtime friend of Haiti who has traveled to the country numerous times, I am especially appalled by Trump’s racist and ignorant comments about Haiti.”

For Haitian author Edwidge Danticat, Trump’s reported comments opened an old wound from a time when Haitian immigrants had to endure the stigma of being a “high risk group” for HIV/AIDS.  For several years, Haitian immigrants were not permitted to donate blood in the U.S.

In an article for The New Yorker, Danticat wrote, “At the junior high school I attended, in Brooklyn, some of the non-Haitian students would regularly shove and hit me and the other Haitian kids, telling us that we had dirty blood.”

Of the four groups the CDC identified as “high risk” for the disease in 1983, Haitians were the only ones identified by nationality.  The other three groups were intravenous drug users, homosexuals, and hemophiliacs.  Members of all these group were stigmatized by the association with AIDS.

Just a few weeks later after the NYT article exposed the goings-on behind Oval Office doors, racist comments from Trump would surface again in reports of a January 11 meeting with senators in which the president referred to Haiti and African nations as “shithole countries.”

“Why are we having all these people from shithole countries come here?” Trump said, according to  people briefed by The Washington Post.

The U.S. alone pledged up to $4.3 billion to the Global Fund, which was created in 2002 to address the AIDS, TB and malaria epidemics, which claimed 4 million lives that year alone, mostly in poor countries.

The Global Fund mobilizes and invests billions of dollars each year to support programs run by local experts in more than 100 countries.  In partnership with governments, civil society, technical agencies, the private sector and people affected by the diseases, the Global Fund seeks to overcome funding barriers.

Following the announcement from the G8, the Bill and Melinda Gates Foundation released a statement supporting the funding commitment.

“There is now a critical test for G8 governments: to follow through on the commitments announced this year, and in previous years, by translating what they have agreed into actual financial outlays that support the efforts of poor countries and communities to overcome poverty and disease,” the foundation said.

In 2018, the Global Fund helped finance the distribution of 131 million insecticide-treated nets to combat malaria, provided anti-tuberculosis treatment for 5.3 million people, supported 18.9 million people on antiretroviral therapy for AIDS, and since its founding saved 32 million lives worldwide.

G8 members make up most of the world’s largest economies and include: Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States.

Operating under the U.S. Department of Health and Human Services, the Office of HIV/AIDS and Infectious Disease Policy hosted its first “listening session” at the 2018 U.S. Conference on AIDS in Orlando, Florida.

The call for input was part of the HHS plan to receive ideas on priorities and issues to be addressed as it begins work to update the National HIV/AIDS Strategy and the National Viral Hepatitis Action Plan, both of which are set to expire in 2020.

Joined by colleagues from the HHS Office of HIV/AIDS and Infectious Disease Policy, the listening session was convened at a special event during the U.S. Conference on AIDS.  Among the many comments offered during the session, the HHS staff heard about:

• The importance of addressing housing, incarceration, and other social determinants of health;
• The need to be strategic in the scale-up PrEP;
• Concerns that issues of aging and HIV be addressed;
• Concerns that adequate funding be provided to enact strategies contained in updated plans;
• The importance of focusing on HIV and hepatitis disparities if we are to end the epidemics;
• Expectations that funding and support for programs currently in place will be continued, particularly the Ryan White HIV/AIDS Program; and
• A desire for new forms of accountability for progress.

The Ending the HIV Epidemic: A Plan for America proposed leveraging new biomedical prevention and treatment options and data to reduce the number of new HIV infections in the U.S. by 75% in 2025 and by 90% in 2030, said Brett P. Giroir, M.D., HHS Assistant Secretary for Health.

“In short, we will diagnose all people as early as possible, treat rapidly and effectively, protect those at highest risk, respond to any outbreaks with an overwhelming force, and we’re going to create a public health workforce throughout this country with a specific goal of reducing new diagnoses by 75% within 5 years and 90% within 10,” Giroir said.

Experts on the subject expressed skepticism based on the administration’s attitude in the past toward HIV/AIDS.

“This pledge is nothing more than an empty gesture following a series of actions that have ignored the needs of the communities most affected by HIV,” said Scott Schoettes, HIV project director at civil rights group Lambda Legal.

Claiming the Trump administration had left HIV risk groups more exposed, activists pointed to the president’s recent acts of cutting research funding for HIV/AIDS and attempts to roll back healthcare access for vulnerable groups.  Trump also had publicly stated his support for medical staff who wanted to refuse treatment to LGBT+ patients on religious grounds.

“President Trump once again presented a broad-strokes narrative that people with HIV and AIDS, including LGBTQ Americans, simply can’t trust,” tweeted Sarah Kate Ellis, chief executive of U.S. LGBT+ advocacy organisation GLAAD.

The city’s “HIV Zero” initiative also seeks to ensure no members of the community have an elevated risk for acquiring HIV or encounter discrimination based on HIV status, sexual orientation or gender identity.

The four goals of the initiative are to:

1. Expand access to healthcare for people living with HIV and people currently at an elevated risk
   for acquiring HIV;
2. Reduce new HIV infections;
3. Reduce HIV-related disparities and health inequalities; and
4. Slow disease progress from HIV to Stage 3 (AIDS).

West Hollywood’s “HIV Zero” strategic plan is primarily focused on Los Angeles County Public Health Department surveillance data related to West Hollywood residents in order to determine the success
in meeting epidemiological benchmarks. However, progress is also informed by data sources that may
expand beyond West Hollywood’s boundaries.

Of the 2014 West Hollywood population of 35,053, more than 2,500 residents were people living with HIV.  Of those HIV-positive in the city, 87% were over 35 years old, 99% were male, and 68% were White.  New HIV diagnoses were concentrated almost exclusively among men who have sex with men.

For men in West Hollywood, the number of diagnosed per 100 (0.4) and living with HIV per 100 (12.9) was extremely high, compared to Los Angeles County, where HIV diagnoses was 0.03 per 100 men and living with HIV was 0.9 per 100.

These disparities help clarify why the West Hollywood HIV Zero Initiative was so critical.

In its final recommendation statement, the U.S. Preventive Services Task Force urges clinicians to screen for HIV in everyone aged 15 to 65 years and all pregnant people.  In addition, younger adolescents and older adults at increased risk for HIV should also be screened.

The Task Force additionally recommends that clinicians offer PrEP (pre-exposure prophylaxis) to people at high risk of HIV.

In its report, the Task Force notes that while HIV infection rates have been going down, rates among some groups are on the rise, most notably among young adults.

Created in 1984, the U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.

The Task Force makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms.  It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The Task Force does not consider the costs of providing a service in this assessment.

The report provides the results of a CDC analysis of HIV trends in America from 2010 to 2016 and shows that after about five years of substantial declines, the number of HIV infections began to level off in 2013 at about 39,000 infections per year.

The data analysis suggests that the number of new HIV infections remained stable from 2013 (38,500) to 2017 (37,500).  However, in 2017, an estimated 85.8% of infections were diagnosed.

The CDC researchers conclude that accelerated efforts to diagnose, treat, and prevent HIV infection are needed in order to achieve the U.S. goal of at least 90% reduction in the number of new HIV infections by 2030.

In a comprehensive review of federal data, the U.S. Health Resources and Services Administration reported the outcomes of all clients served by RWHAP Parts A–D during from 2014 through 2018.  The report provided a strong level of positive outcomes and a hopeful look at the challenges of reaching certain populations in the U.S.

Among the hardest populations to reach are those living at or below 100% of the federal poverty line (32% of clients), lacking in healthcare coverage (20%) and housing that is temporary or unstable (13%).

Serving more than half a million people each year, the Ryan White HIV/AIDS Program (RWHAP) was created in 1990 and currently is funded annually at more than $2 billion.

HRSA’s Ryan White HIV/AIDS Program is divided into five parts:

• Part A funds medical and support services to counties/cities that are the most severely affected by the HIV/AIDS epidemic:
• Part B administers funds for states to improve the quality, availability, and organization of HIV health care and support services, and includes grants for the AIDS Drug Assistance Program:
• Part C administers funds for community-based organizations to provide comprehensive primary health care and support services in an outpatient setting for people with HIV through Early Intervention Services program grants;
• Part D administers funds for community-based organizations to provide outpatient, ambulatory, family-centered primary and specialty medical care for women, infants, children and youth with HIV; and
• Part F funds support clinician training, dental services, and dental provider training, as well as the development of innovative models of care to improve health outcomes and reduce HIV transmission.

The HIV Surveillance Annual Report for 2019 released on this day presented statistics that included that an estimated 57,700 persons were living with HIV (PLWH) in Los Angles County, with about 11% of them (an estimated 6,400 people) unaware of their status of being HIV positive.*

The county’s annual HIV report also included statistics showing:

• Of the newly diagnosed cases in 2019, the largest gaps in knowledge of HIV-positive status existed for younger persons (about 50% of persons aged 13-24 years and 33% of persons aged 25-34 years were not aware of their HIV-positive status);
• HIV diagnoses rates increased between 2015-2018 for persons experiencing homelessness;
• About 16% of newly diagnosed cases were determined to be Stage 3 HIV (i.e., AIDS).
• Compared with the year before, the overall number of newly diagnosed cases of HIV dropped slightly in 2019;
• Overall death rates for people in LA County with diagnosed HIV have also declined over time;
• The following disparities in HIV diagnosis by population and location exist in LA County:
  • Rates of new HIV diagnosis are higher among males than females; and
  • Black people had higher rates of HIV diagnosis compared with other race/ethnicity
    groups, and also higher rates of transmission risk due to unmet need for HIV treatment.

Black males are disproportionately impacted by HIV in LA County, compared with males in other race/ethnicity groups, according to the report.  According to county health department statistics, Black men represented approximately 4% of the county’s population, but represent 17% of people living with HIV (PLWH). In contrast, Latinx men represented 24% of the population and 40% of PLWH; white men represented 16% of the LAC population and 24% of PLWH.

The county also reported that 75% of persons newly diagnosed with HIV in 2018 were linked to care within one month of diagnosis. Among persons diagnosed through 2018 and living at year-end 2019, 7 in 10 were engaged in care, 5 in 10 were retained in care, and 6 in 10 were virally suppressed.

HIV-infected persons who achieve sustained viral suppression have effectively no risk of passing HIV to others (i.e., undetectable = untransmissible).

“Several steps are required to achieve viral suppression among HIV-infected persons beginning with HIV diagnosis, timely linkage to care, engagement in care, retention in care, and adherence to HIV antiretroviral drugs,” the report states.

The HIV Surveillance Annual Report 2019, which is published by the Division of HIV and STD
Programs in the county’s health department, also included HIV surveillance data reported to the health department since the beginning of the HIV epidemic through December 31, 2019.  This HIV surveillance data is used by the county and area organizational partners in HIV healthcare to inform prevention, care, and treatment programs.

_ _ _ _ _ _ _

*The number of people living with HIV was determined using a mathematical model developed by the Centers for Disease Control and Prevention.

Healthcare insurance companies are now barred from discriminating against customers with pre-existing conditions, and they can no longer impose annual limits on coverage.

Goals set by LA County’s EHE initiative aligned with federal goals set by the HHS Office of Infectious Disease and HIV/AIDS Policy, including targets to reduce new HIV transmissions and acquisitions in the county by 75% in five years (by 2025) and by 90% in ten years (by 2030).

To reach these ambitious goals, county officials stated it would work with “critical contributors, partners and stakeholders” on increasing access to HIV care.  The county also said it would adjust its HIV data collection efforts to better track deliverables around the federal EHE initiative’s “four EHE pillars,” which are:

1) Diagnosing people living with HIV as early as possible;
2) Treating people living with HIV rapidly and effectively to achieve viral suppression;
3) Preventing new HIV transmissions using proven interventions; and
4) Responding quickly to HIV outbreaks and delivering prevention and treatment services to people
who need them.

“We are also guided by an overarching strategy to ensure that the interventions address and eliminate health inequities, that considers long-standing racial inequities that contribute to HIV-related disparities, that focuses on the communities and sub-populations most impacted by HIV, and
prioritizes a client-centered, people first approach to this endeavor,” said Mario L. Perez, the director of the county’s Division of HIV and STD Programs in the Department of Public Health.

The Ending the HIV Epidemic Plan for Los Angeles County followed specific goals and guidelines set by the HHS Office of Infectious Disease and HIV/AIDS Policy, which updated the country’s HIV/AIDS strategy in 2020 in the absence of a Presidential Advisory Council on HIV/AIDS (PACHA) under the Trump administration.

From its founding in 1995 until Trump dissolved the council in 2017, PACHA advised the White House on HIV/AIDS policies.  Council members offered recommendations on the National HIV/AIDS Strategy, a five-year plan responding to the epidemic.  The 2015 strategy was due to expire in 2020, so the HHS Office of Infectious Disease and HIV/AIDS Policy stepped in to update the HIV National Strategic Plan with new short-term goals.

On January 15, 2021, the HHS released the HIV National Strategic Plan for the United States: A Roadmap to End the Epidemic 2021-2025.  This plan was replaced by the National HIV/AIDS Strategy (2022-2025) in December 2021.

According to data released by the Health Resources and Services Administration’s Bureau of Primary Health Care, 93% of the nearly 200 health centers throughout the U.S. participating in the Ending the HIV Epidemic initiative were able to hire staff dedicated to HIV outreach, testing, linkage to care and treatment, and PrEP services.  These advances were made in the first eight months of the program, which allocated a total of $54 million to the health centers in February 2020.

“The early results achieved by these health centers are truly encouraging,” said Harold J. Phillips, Senior HIV Advisor and COO of the Ending the HIV Epidemic (EHE) Initiative in the HHS Office of Infectious Disease and HIV/AIDS Policy. “The work of these health centers on three of the four EHE pillars – prevent, diagnose, and treat – will support each of their communities in moving toward the goal of reducing new HIV infections by 75% by 2025 and by 90% by 2030.”

Between March and November 2020, more than 573,000 individuals were tested for HIV; 2,260 individuals tested positive for HIV and received follow-up within 30 days; and nearly 50,000 individuals at health centers were prescribed PrEP, according to the HRSE.

The HRSE data also indicated that:

• 93% of the health centers hired dedicated staff for a total of 389 full-time equivalent employees working on HIV outreach, testing, linkage to care and treatment, and PrEP services;
• Over 573,000 individuals were tested for HIV;
• 2,260 individuals tested positive for HIV and received follow-up within 30 days; and
• Nearly 50,000 individuals at health centers were prescribed PrEP]

These nine Los Angeles County-area health centers received grant funds for the EHE Initiative:

• APLA Health & Wellness ($261,233),
• AltaMed Health Services ($417,912),
• The Clinic Inc. ($263,355),
• Los Angeles LGBT Center ($278,196),
• St. John’s Well Child & Family Center ($305,039),
• Venice Family Clinic ($264,541),
• Valley Community Healthcare ($274,893),
• Watts Healthcare ($288,576), and
• Bartz-Altadonna Community Health Center ($256,071)

A total of 35 health centers in California received awards, totaling $9,972,545 in funding.

President Joe Biden, HHS Secretary Xavier Becerra, and Secretary of State Antony J. Blinken release messages recognizing the 40th anniversary. Other events and activities are held across the country to remember the lives that were cut short by this terrible disease and celebrate the resilience and dignity of the more than 38 million people with HIV worldwide.

On this day, the Foundation for The AIDS Monument held its ceremonial groundbreaking at the future site of STORIES: The AIDS Monument in West Hollywood Park.  Among the community members who attend the event is Dr. Michael Gottlieb, one of the authors of the June 1981 CDC report announcing the first five cases of an illness subsequently defined as acquired immunodeficiency syndrome (AIDS).

The five men described in the report were between the ages of 29-36 and resided in the Los Angeles area, and by the time the report was published, two had already died.  The relatively brief report gave scant information about this new medical phenomenon, including the following:

• The patients did not know each other and had no known common contacts or knowledge of sexual partners who had had similar illnesses.
• Two of the five reported having frequent homosexual contacts with various partners.
• All five reported using inhalant drugs, and one reported parenteral drug use (i.e., injected or implanted drugs).

According to 2020 data released by Los Angeles County’s health department, there was still a long way to go before the county could meet its Ending the HIV Epidemic (EHE) targets for the years 2025 and 2030.

Earlier this year, LA County set goals of no more than 450 new HIV diagnoses in 2025 and no more than 180 new HIV diagnoses 2030, according to the HIV Surveillance Annual Report 2021 released on this day.  The most recent number of 1,505 new diagnoses shows that LA County still had much work to do.

The county’s annual HIV report also included statistics showing:

• An estimated 57,005 persons were living with HIV (PLWH) in 2020, with about 9% of them (about  5,100 people) unaware of their status of being HIV positive*;
• Of the newly diagnosed cases in 2020, the largest gaps in knowledge of HIV-positive status existed for younger persons (about 40% of persons aged 13-24 years and 20% of persons aged 25-34 years were not aware of their HIV-positive status);
• HIV biobehavioral surveys conducted by the county confirmed that transgender women had the highest HIV positivity rate (1 in 3 were HIV positive) compared to other risk populations; and
• Though the number of HIV-positive pregnant women had decreased over time, the number of perinatal HIV transmissions is increasing (four infants who acquired HIV perinatally in 2020).

County statistics also revealed disparities in HIV diagnosis by population and location.  Rates of new HIV diagnosis are higher among males than females; and young males aged 20-29 years had the highest rates of new HIV diagnosis.  Also, Black people continued to have higher rates of HIV diagnosis compared with other race/ethnicity groups.

Also, the COVID-19 pandemic complicated access to HIV healthcare and treatment for many, according to the report.

Access to routine HIV care services decreased in 2020, and consequently, the county saw a reverse in progress along key steps in the HIV care continuum for people living with diagnosed HIV. Compared with 2019 achievements, the percentages decreased for people diagnosed with HIV receiving care and becoming virally suppressed in 2020.

The new data showed that LA County was behind in meeting goals set up by the National HIV/AIDS Strategy for linkage to and retention in HIV care.

For linkage to HIV care within one month for newly diagnosed people, the federal goal for 2020 was set at 85%, while LA County fell a bit short with only 77% linked to care in 2019.  If the county were to meet the federal targets for 2025, it would need to raise this number to 95% in five years.

For retention in HIV care for persons with diagnosed HIV, the federal goal for 2020 was set at 90%, while the county was able to retain in care only 44% of people diagnosed with HIV — significantly below the NHAS target.

The county also recorded an estimated 39% of priority populations to be prescribed PrEP in 2020, with a long way to go in order to achieve its Ending the HIV Epidemic (EHE) goal of 50% in 2025.

Created in 2020, Ending the HIV Epidemic in the U.S. is a federal plan that aims to reduce new HIV infections in the US by 75% by 2025 and by 90% by 2030. In February 2020, the U.S. Department of Health and Human Services awarded 57 high-burden states and counties (including LA County) with hundreds of millions of dollars to expand HIV prevention and care activities.

_ _ _ _ _ _ _

*The number of people living with HIV was determined using a mathematical model developed by
the Centers for Disease Control and Prevention.

Up until this day, the vaccines available in the U.S. — made by Pfizer and BioNTech, Moderna, and Johnson & Johnson — have been authorized on “an emergency basis” but had yet to be fully approved.

A fully approved COVID vaccine was particularly important to members of the HIV community, because people with HIV have higher rates of certain underlying health conditions, particularly if they are aged 50 or older.

Older age and underlying health conditions can make people more likely to become seriously ill if they get COVID-19, according to the Centers for Disease Control and Prevention. This is especially true for people with advanced HIV or people with HIV who are not on treatment.

While the CDC determined that COVID-19 vaccines are safe for people with HIV, concerns about the general safety of the vaccine were common.

The Pfizer-BioNTech vaccine, which was marketed as Comirnaty, was the first COVID-19 vaccination to receive full review and approval from the U.S. regulatory agency. The FDA would approve the vaccine’s use in children aged 5-11 the following October.

The company’s clinical trial included approximately 44,000 participants and found the vaccine to be 91% effective in preventing COVID-19 disease.

Comirnaty was developed from technology licensed from the National Institutes of Health, according to a U.S. government website.

“National Institute of Allergy and Infectious Diseases (NIAID) inventors and their collaborators had already developed a stabilized prefusion coronavirus spike protein that could be used as a vaccine antigen to cause neutralizing antibody responses,” stated the NIH in its feature on Comirnaty.  “NIH’s ongoing research allowed for BioNTech/Pfizer to quickly develop a vaccine and bring it to market based on NIH technologies.”

Previously, in December 2020, the Pfizer-BioNTech vaccine was granted emergency use authorization by the FDA in response to the public health emergency posed by the coronavirus pandemic. That authorization involved a review of safety data on over 37,000 participants in a randomized, placebo-controlled study.

“While millions of people have already safely received COVID-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated,” said Dr. Janet Woodcock, the then acting FDA Commissioner. “Today’s milestone puts us one step closer to altering the course of this pandemic in the U.S.”

The FDA’s approval came amidst the spread of the highly contagious COVID-19 delta variant across the country. It also represented a turning point in U.S.’s response to COVID-19, as more private and public entities began instating vaccination requirements to stem the spread of COVID-19.

“The new vaccine was the result of months of work, robust data evaluation and a thorough, comprehensive review process that has protected more than 100 million Americans from severe COVID-19 complications,” said the American Medical Association in its newsletter.  “It is a milestone and major step forward in the worldwide effort to end this pandemic.”

Among those who adopted vaccine mandates for employees in the wake of the Pfizer-BioNTech vaccine’s FDA approval were the Pentagon and the New York City school system.

The ruling of Judge Leonie Brinkema of the U.S. District Court for the Eastern District of Virginia in the case Roe & Woe v. Austin effectively put in legal jeopardy a long-standing Pentagon policy that forbid enlisted military service members testing positive for HIV from deploying in active duty outside the U.S. and being commissioned as officers.

Judge Brinkema ruled that the Department of Defense policy of categorizing HIV as a chronic condition requiring a waiver was scientifically outdated.  Furthermore, her ruling declared that the policy unfairly treated people with the virus differently from other service members living with chronic health conditions requiring routine medication.

In Roe & Woe, the two airmen (who filed their suit under pseudonyms) were allegedly informed of their dismissal after testing positive for HIV.

A second case, Harrison v. Austin, was also included in the judge’s decision.  Sgt. Nick Harrison filed suit against the D.C. Army National Guard when they denied his application to serve in the Judge Advocate General’s Corps (JAG Corps), because he had tested positive for HIV in 2012 while serving.

“It’s nice to see the court make a decision placing science over stigma,” Harrison said of the judge’s ruling.

“This is the first decision securing the rights of people living with HIV that is rooted in the equal protection clause of the Constitution,” attorney Scott Schoettes, who was co-counsel in both cases, told NBC News.

Kara Ingelhart, a senior attorney at Lambda Legal, said the judge’s ruling would end discriminatory practices against “approximately 2,000 service members currently serving while living with HIV.”

In defending the two cases, the military argued that HIV-positive service members posed a theoretical risk to others.

Through an award from the U.S. Health Resources and Services Administration, Los Angeles County received $6,168,850 to help implement its initiative Ending the HIV Epidemic (EHE) in Los Angeles County.

The county’s EHE initiative was aligned with the federal EHE initiative, which sought to reduce the number of new HIV infections in the U.S. by at least 90% by 2030.  At the time, new HIV cases in LA County represented more than 5% of the total number of cases in the country.

“With this investment, we’re increasing our efforts to end the HIV epidemic,” said HHS Secretary Xavier Becerra. “Today’s awards reaffirm our Ryan White HIV/AIDS Program work in communities that need it most as we continue to ensure everyone with HIV receives the care they need to thrive.”

The funding arrives through the federal Ryan White HIV/AIDS Program, which provides services to low-income people living with and at risk for HIV, according to an HHS press release.  About 560,000 people with HIV in the U.S. receive services through the program.

“That’s nearly half of the 1.2 million people with the virus,” Trent Straube wrote in POZ magazine. “What’s more, 88% of people receiving care through the Ryan White program attain viral suppression. People with an undetectable viral load not only enjoy longer and healthier lives but also do not transmit HIV through sex.”

Through its Ending the HIV Epidemic (EHE) initiative, Los Angeles County set goals of no more
than 380 new infections in 2025 and no more than 150 new infections in 2030, according to the HIV Surveillance Annual Report 2021 released on this day.  The 2021 number of 1,400 new infections shows that LA County still had much work to do.

The county’s annual HIV report also included statistics showing:

• An estimated 59,400 persons were living with HIV (PLWH) in 2020, with about 11% of them unaware of their status of being HIV positive*;
• Of the newly diagnosed cases in the last year, the largest gaps in knowledge of HIV-positive status existed for younger persons (about 42% of persons aged 13-24 years and 25% of persons aged 25-34 years were not aware of their HIV-positive status);
• About 20% of the people newly diagnosed in the last year had stage 3 HIV (i.e., AIDS) upon diagnosis;
• Compared with the year before, the total number of newly diagnosed cases of HIV dropped (1,560 new HIV cases in 2019 and 1,401 cases in 2020);
• Overall death rates for people in LA County with diagnosed HIV have also declined over time;
• The following disparities in HIV diagnosis by population and location exist in LA County:
  • Rates of new HIV diagnosis are higher among males than females; and young males aged 20-29 years had the highest rates of new HIV diagnosis;
  • Black people had higher rates of HIV diagnosis compared with other race/ethnicity
    groups;
  • In 2021, molecular HIV surveillance identified high-priority clusters where recent and rapid HIV transmission were occurring among persons aged 20-29 years living in the areas of Compton, Lynwood, South Gate, San Antonio, Lancaster, and Palmdale;

Nearly 9 out of 10 persons living with HIV in LA County in 2021 were male, according to the report.  Within the male population, Black males are disproportionately impacted by HIV compared with males in other race/ethnicity groups.

According to county health department statistics, Black men represented approximately 4% of the county’s population, but represent 17% of people living with HIV (PLWH). In contrast, Latinx men represented 24% of the population and 41% of PLWH; white men represented 14% of the LAC population and 24% of PLWH.

The HIV Surveillance Annual Report 2021, which is is published by the Division of HIV and STD
Programs in the county’s health department, also included HIV surveillance data reported to the health department since the beginning of the HIV epidemic through December 31, 2021.  This HIV surveillance data is used by the county and area organizational partners in HIV healthcare to inform prevention, care, and treatment programs.

_ _ _ _ _ _ _

*The number of people living with HIV was determined using a mathematical model developed by
the Centers for Disease Control and Prevention.

The White House Office of National AIDS Policy (ONAP) released the National HIV/AIDS Strategy Federal Implementation Plan, detailing more than 380 programs and other activities that dozens of federal agencies would take over the next four years.

The Strategy’s introduction stated four goals:

• Prevent new HIV infections,
• Improve HIV-related health outcomes of people with HIV;
• Reduce HIV-related disparities and health inequities; and
• Achieve integrated, coordinated efforts that address the HIV epidemic among all partners and stakeholders.

“This approach reflects a commitment to accelerate and focus efforts on the populations, places, and actions that will have the
greatest impact in achieving that goal,” the White House stated in its 76-page strategy.  “While striving to take the steps described in this plan, Federal agencies also will work collaboratively across the federal government and with nonfederal partners to capitalize on new opportunities that may arise and respond to unanticipated obstacles.”

“Achieving these goals will require the engagement of stakeholders from all sectors of society in a coordinated and
re-energized national response to end the HIV epidemic and support people with HIV,” the White House stated in its 76-page plan. “Utilizing a whole-of-nation approach, the Strategy assumes the active participation of not only federal agencies, but also state, tribal, local, and territorial health departments, health plans and health care providers, schools and other academic institutions,
community-based and faith-based organizations, researchers, private industry, and people with and at risk for HIV.”

The White house referred to HIV/AIDS as “part of a syndemic that involves sexually transmitted infections, viral hepatitis, and substance use and mental health disorders, all of which intersect with stigmatization and social determinants of health.”

Addressing this syndemic requires “contributions from all of us,” according to the White House.  “That is why the Strategy is a national one, not just a federal one. Contributions from stakeholders from all sectors of society are needed. Fresh approaches, new partnerships, and shared commitments to equity, better coordination, and following the science will help us move forward.”

“Celebro mi salud” (“Celebrate My Health”) was developed by the Department of Health and Human Services to motivate people with HIV who are not in health care to seek and stay on HIV treatment (antiretroviral therapy or ART) and achieve viral suppression.

Providing information in Spanish helped the campaign reach community members at-risk for HIV who might not be inclined to engage with the English-language version of the campaign.

Ending longstanding discriminatory policies that excluded gay and bisexual people from donating blood, the U.S. Food & Drug Administration updated its guidelines for blood donor eligibility.

The FDA’s new recommendations for assessing blood donor eligibility included a set of individual risk-based questions to reduce the risk of transfusion-transmitted HIV. The questions will be the same for every donor, regardless of sexual orientation or gender identity.

According to a news release by the FDA, the new guidelines would expand the number of people eligible to donate blood, while also maintaining the appropriate safeguards to protect the safety of the blood supply.

The updated policy was one that public health experts and gay rights activists said had been a long time coming.  It followed several other Western countries that recently dropped bans or eased restrictions, including the United Kingdom, France, Greece and the Netherlands.

When Congress authorized PEPFAR in May 2003, it included a formal process that linked PEPFAR’s funding to the semi-annual collection of results at the request of then-President George W. Bush.  In his State of the Union address just four months earlier, President Bush announced the PEPFAR program with the goal of creating a comprehensive response to the spread of HIV by combining prevention, treatment, and care for the first time.

“The law codified the president’s goals of reaching 2 million people with lifesaving treatment for AIDS; preventing 7 million new infections; and caring for 10 million children and adults either living with or affected by HIV, including orphans and vulnerable children who had already lost parents to the disease,” stated George W. Bush Institute fellow Deborah L. Birx, M.D., who led PEPFAR’s efforts from 2014 to 2020. “Linking dollars to specific results enabled a swift humanitarian response to the devastation of AIDS around the globe.”

At the time, PEPFAR was the largest health program worldwide created to address the spread of a single disease.

“We Americans owe George W. Bush thanks for his leadership in saving 25 million lives in our name,” wrote New York Times Opinion columnist Nicholas Kristof in April 2023.  “PEPFAR didn’t benefit Bush politically, and even after two decades and all those lives saved, many Americans have never heard of it.”

Kristof, who is a self-proclaimed liberal, asked, “How is it that the leading humanitarian initiative of our lifetime was engineered not by a globalist progressive but rather by a guy with whom we disagree on almost everything?”

When Bush announced PEPFAR in 2003, less than 50,000 people living with HIV in sub-Saharan Africa had access to antiretroviral therapy. Today, PEPFAR has saved an estimated 25 million lives and operates in more than 50 countries, according to the U.S. National Institutes of Health.

In the two decades since its launch, PEPFAR has received bipartisan congressional support to provide more resources — around $100 billion — than any other nation in history toward relief efforts for a single disease.   However, in the fall of 2023, Republicans in Congress added abortion bans to a one-year reauthorization of PEPFAR, which has forced the legislation to stall in the Senate, according to the non-partisan Center For American Progress.

“Now, what should be another routine five-year reauthorization of PEPFAR has become an anti-abortion soapbox: A small group of extreme right-wing members of Congress are holding captive PEPFAR’s reauthorization — and the welfare of millions of adults and children in Africa and other parts of the world—to advance a radical anti-abortion agenda,” said Sarnata Reynolds, a senior director at the Center for American Progress.

A long-time activist in the HIV/AIDS and recovery communities, Rev. Pieters was a pastor and later a field director for the AIDS Ministry for the Metropolitan Community Church (MCC) denomination, according to the Los Angeles Blade.

In October 1985, Rev. Pieters agreed to be interviewed by Pentecostal televangelist Tammy Faye Bakker, of the Charlotte-based PTL Television Network, about what it was like to live with AIDS. Bakker was then at her peak popularity, with more than 13 million viewers.

Rev. Pieters said his friends tried to dissuade him from doing the interview.  Bakker and her then-husband, Jim, were influential leaders of a conservative Christian movement which promoted ideas sharply at odds with the LGBTQ community.  But he saw the show, Tammy’s House Party, as a chance to discuss AIDS and spirituality before an audience he would normally never encounter.

His instincts proved to be right. From the start of the interview and throughout, Bakker showed empathy and asked him thoughtful questions about his life.

“The 25-minute segment became a watershed in public perceptions about AIDS,” wrote Brian Murphy in The Washington Post.  “Rev. Pieters also emerged as an eloquent and nationally renowned spokesman for those facing AIDS, which at the time was considered not only a likely death sentence but also put patients at high risk for experiencing shame and humiliation.”

Prior to his diagnosis with AIDS, Rev. Pieters was a leading gay rights activist and served as the pastor of the Metropolitan Community Church of Hartford, Connecticut.  According to his biography in the LGBTQ Religious Archives Network, he resigned his position in Hartford in 1982 and moved to Los Angeles, where he began to experience a series of illnesses that were diagnosed as AIDS-Related Complex (“ARC”).

In April, 1984, after being diagnosed with AIDS/Kaposi’s Sarcoma and stage-four lymphoma, he was told by one health professional that he could expect to die within the year.

But he lived to see 1985, and became “patient number 1” on the first anti-viral drug trial, taking Suramin for a total of 39 weeks. While on Suramin, both cancers went into remission, but the drug was highly toxic and was soon discontinued as a treatment for AIDS-related illnesses.

For the next 11 years, Rev. Pieters served as Field Director of AIDS Ministry for the MCC denomination. He traveled the world, teaching and preaching about hope, grief, and surviving AIDS. He also volunteered as a chaplain at an AIDS hospice in Los Angeles.

In 1993, Pieters was one of twelve invited guests at a Prayer Breakfast at the White House with U.S. President Bill Clinton, Vice President Al Gore, and National AIDS Policy Coordinator Kristine Gebbie prior to World AIDS Day. The President talked about Rev. Pieters in his World AIDS Day speech.

He served on the Los Angeles AIDS Task Force, as well as the Boards of Directors of AIDS Project Los Angeles (APLA) and the AIDS National Interfaith Network. He was featured in Life, Time, and Omni magazines, as well as the Los Angeles Times. He regularly appeared on CNN, and was profiled by Jane Pauley to mark the 10th anniversary of the first diagnosis of AIDS.

In 2007, and over the next six years Rev. Pieters battled a number of illnesses, including pancreatitis, which nearly killed him in 2012.  At the time of his death, he was writing his memoirs for a book titled My Journey Through AIDS (I Keep on Dancing).

Dr. Pieters’s interview with Tammy Faye Bakker was recreated in the 2021 film The Eyes of Tammy Faye.  Click here to hear an audio recording of actor Jessica Chastain, who portrayed Tammy Faye Bakker in the film, talking about Dr. Pieters and his impact.

In the two decades since its launch by then-President George W. Bush, PEPFAR has saved an estimated 25 million lives around the world and has been reauthorized by the Congress every five years.  However, in the fall of 2023, the Republican-majority Congress added abortion bans to the PEPFAR reauthorization bill and restricted the funding to one year.  This has caused the legislation to stall in the Senate, according to the non-partisan Center For American Progress.

“Now, what should be another routine five-year reauthorization of PEPFAR has become an anti-abortion soapbox: A small group of extreme right-wing members of Congress are holding captive PEPFAR’s reauthorization — and the welfare of millions of adults and children in Africa and other parts of the world—to advance a radical anti-abortion agenda,” said Sarnata Reynolds, a senior director at the Center for American Progress, an independent, nonpartisan policy institute dedicated to improving the lives of Americans.

When then-President George W. Bush announced PEPFAR in 2003, less than 50,000 people living with HIV in sub-Saharan Africa had access to antiretroviral therapy. Today, PEPFAR operates in more than 50 countries, according to the U.S. National Institutes of Health.

The Republican-led strategy to link the PEPFAR reauthorization to abortion bans began earlier in the year, when PEPFAR was in the news for its 20th anniversary of saving lives worldwide.  The plan was put forth by “a coalition of right-wing, religio-political organizations, then by a think tank influential in extreme MAGA Republican circles, and finally by the leading House Republican anti-abortion crusader, Congressman Chris Smith (R-NJ),” according to Population Action International (PAI), a non-profit organization that uses research and advocacy to improve global access to family planning and reproductive health care.

“The organized campaign featured a flurry of letters, press releases and a deeply flawed report purporting to expose the Biden administration’s misuse of PEPFAR to ‘promote its domestic radical social agenda overseas’ and calling for a complete overhaul and restructuring of the program,” PAI stated in its 2023 World AIDS Day “Washington Memo.”

A U.S. State Department official told Time magazine that non-reauthorization will “limit PEPFAR’s ability to conduct longer-term procurement of critical commodities, reducing our ability to ensure the lowest possible prices and will hinder our ability to support timely scale-up of new product innovations, all of which would risk the lives of the clients that PEPFAR supports.”

Many global health practitioners and advocates have expressed concern that even if PEPFAR is eventually reauthorized, the uncertainty of future funding created by Congress could ultimately increase program costs and inefficiencies as well as harm the U.S.’s diplomatic interests.

“Our appeal to the U.S. Congress is to reauthorize PEPFAR in order to sustain the gains we have achieved,” said Ummy Ally Mwalimu, Minister of Health of Tanzania, at a United Nations roundtable discussion.

The National HIV/AIDS Strategy 2023 Interim Action Report is a roadmap for stakeholders in their efforts to end the HIV epidemic in the country by 2030.

The report shows that thanks to the efforts of community, state, and federal partners, our nation is making important progress toward the Strategy’s goals.

“This NHAS Interim Action Report does not declare victory, but serves as an ongoing call to action, highlighting the good work done by federal and community partners to energize and invigorate our collective national work to end the HIV epidemic and to ensure that no population or region is left behind,” wrote Harold J. Phillips, Director of Office of National AIDS Policy, in the Foreword of the report.

In a post for POZ magazine, Phillips urged stakeholders to recommit to taking necessary steps “to achieve our ultimate goal of ending the HIV epidemic in the United States.”

Since 2019, federal agencies and local communities have taken action as part of the Ending the HIV Epidemic initiative. The EHE initiative aims to scale up prevention and treatment strategies to reduce new HIV cases by 75% by 2025 and 90% before 2030 for an estimated 250,000 total HIV diagnoses averted.

The initiative targets 48 counties; Washington, D.C.; and Puerto Rico, which make up half of new HIV cases, as well as seven states with significant rural HIV incidence.

In a statement released by U.S. officials, require non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to cover, without the imposition of any cost-sharing requirements, evidence-based items or services that have a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force.

PrEP as an effective antiretroviral therapy to persons who are at high risk of HIV was assigned an “A” rating in June 2019, resulting in a requirement that plans and issuers cover PrEP according to the recommendation for plan (or policy) years beginning on or after
June 30, 2020.

The guidance issued in October 2024 clarified PrEP’s inclusion in the list of preventive treatments covered by the Affordable Care Act.