Congressman Henry Waxman, whose district includes the gay community of West Hollywood, convenes the first congressional hearings on AIDS at the Los Angeles Gay Community Services Center.Learn More.
“I want to be especially blunt about the political aspects of Kaposi’s sarcoma,” said Rep. Waxman, according to the Washington Blade. “This horrible disease afflicts members of one of the nation’s most stigmatized and discriminated-against minorities…. There is no doubt in my mind that if the same disease had appeared among Americans of Norwegian descent or among tennis players — rather than among gay males — the responses of the government and the medical community would have been different.”
Rep. Waxman made an effort to involve the gay community of his district by holding the hearing at the LA Gay Community Services Center (now the Los Angeles LGBT Center). But the media largely overlooked the event, and the coverage that did appear was within the LGBTQ press.
The San Francisco newspaper The Sentinel published a very short blurb three days later, titled “House Holds Cancer Hearings.” The paper would quote an unnamed subcommittee staffer saying the Centers for Disease Control “should not have to nickel and dime” for research funding.
The short article appeared next to a column written by gay nurse Bobbi Campbell, who wrote about going to the Shanti Project to get emotional support for his KS.
Speaking at the hearing, Dr. James Curran, head of the Center for Disease Control’s Task Force on Kaposi’s Sarcoma and Opportunistic Infections, estimated that tens of thousands of people were already infected by the disease.
On the 40th Anniversary of the CDC’s first report on what would become known as AIDS, reporter Karen Ocamb wrote the Washington Blade article “AIDS @40: White House laughs as gays try to save themselves,” recalling the House hearing chaired by Rep. Waxman.
“Like so many others in California, lesbian feminist Ivy Bottini had high expectations for the federal government to finally intervene in the growing AIDS crisis after the first congressional committee hearing on the mysterious new disease,” Ocamb wrote. “She was upset. Her friend Ken Schnorr had died just before the hearing and Bottini had to explain to Ken’s distraught mother that he had not been abused at the hospital — the purple bruises on his body were KS lesions.”
Ocamb goes on to cite perhaps one of the most egregious examples of the Reagan administration’s homophobic callousness toward people with AIDS, which happened just weeks after Reps. Waxman and Phillip Burton (D-San Francisco) introduced a bill to fund AIDS research.
On Oct. 15, 1982, White House Press Secretary Larry Speakes was holding a press conference, during which reporter Lester Kinsolving asked Speakes about the new disease called AIDS. After indicating that he didn’t know what AIDS was, Speakes dismisses the question and makes light of it, saying, “I don’t have it. Do you?”
When this response elicits chuckles from the members of the press corps, Speakes continues in this vein (“There has been no personal experience here, Lester”) to draw more laughter.
“The exchange goes on like that. For another two years,” Ocamb wrote.
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Washington Blade, “AIDS at 40: White House Laughs as Gays Try to Save Themselves” by Karen Ocamb, June 23, 2021
The Atlantic, “The Heroic Story of How Congress First Confronted AIDS” by Joshua Green, June 8, 2011
Congressmen Phillip Burton and Ted Weiss introduce the first legislation for the allocation of funding for AIDS research. Unfortunately, the resolution dies in committee.Learn More.
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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www.HIV.gov, “A Timeline of HIV and AIDS”
At White House Press briefing, a reporter asks Press Secretary Larry Speakes: “Does the President have any reaction to the announcement — from the Centers for Disease Control in Atlanta — that AIDS is now an epidemic and has over 600 cases?”
Speakes: “What’s AIDS?”
Reporter: “It’s known as the ‘gay plague.’”
“I don’t have it,” Speakes replies. “Do you?”Learn More.
The transcript of the press briefing, which is in the Ronald Reagan Presidential Library, is a sharp reminder of how governmental officials and journalists viewed the LGBTQ community.
On Dec. 1, 2015, Vanity Fair debuted a short documentary by Scott Calonico about this now-infamous exchange.
President Reagan would not mention AIDS until 1985, and then it would be in response to a reporter’s question at a press conference. He would not give a major speech about the epidemic until mid-1987 — at which point 20,849 people in the U.S. would already be dead.
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The Washington Post, “How Attitudes toward AIDS have Changed, in the White House and Beyond” by Juliet Eilperin, December 4, 2013
Washington Blade, “AIDS at 40: White House Laughs as Gays Try to Save Themselves” by Karen Ocamb, June 23, 2021
Vanity Fair, “The Reagan Administration’s Unearthed Response to the AIDS Crisis is Chilling” by Richard Lawson, December 1, 2015
Stan Hadden, a 26-year-old aide to the leader of the state senate, leads the effort in Sacramento to establish the California AIDS Advisory Committee and set up a mechanism for funding AIDS education throughout the state.Learn More.
Hadden would go on to author much of the state’s HIV-related legislation as a staff member of the Office of then-State Senate President Pro Tempore David Roberti.
Most notably, Haddon would shephard the passage of Senate Bill 910, which established the California AIDS Advisory Committee. The bill included an initial appropriation of $500,000, channeled through the Department of Health Services to some of the state’s community programs which desperately needed funding.
In spite of the meager amount allocated for the program, the main accomplishment was getting any funding at a time when the state was attempting to address a financial crisis and most health programs were suffering from budget reductions.
“AIDS is a national emergency,” Senator Roberti told the media in March 1983 when promoting the merits of SB 910. “It is occurring in epidemic proportions among previously healthy homosexual men, Haitian immigrants, and intravenous drug users, but 6% of those afflcted with the disease are neither homosexuals, IV drug users, Haitians or hemophiliacs.”
At that time, it was unusual for legislators to be educated about HIV. The senator’s awareness of the urgent need for AIDS services could be largely attributed to the work and advocacy of his staffer, Hadden, and the location of his district, which was the Hollywood area.
According to Stephen Morin’s chapter “AIDS: Public Policy and Mental Health Issues” in the 1986 book What to Do About AIDS, Senator Roberti’s legislation, which was researched and drafted by Hadden, was the first significant action that California took in the early days of the AIDS crisis.
“SB 910 required a great deal of advocacy,” said Morin, who was an assistant clinical professor at the University of California San Francisco at the time. “In April 1983, on one of my early trips to the state capital to support that bill, I was joined by Gary Walsh, a friend and psychiatric social worker who had been diagnosed with KS in December 1982. Although AIDS had recently been the cover story in Newsweek, more than half of the legislators with whom we met had never heard of AIDS.”
Around the same time, the California Assembly pushed forward $2.9 million in additional funding for the University of California to work on AIDS research. Speaker of the Assembly Willie Brown, whose district was located in San Francisco, introduced an allocation to the UC budget after convening with university researchers working on discovering the cause of AIDS.
“Many of the early breakthroughs in research came from the UC system and were funded through this effort,” Morin wrote. “The discovery of the retrovirus responsible for simian AIDS, for example, was discovered at UC Davis. Later, in Jay Levy’s laboratory at UC San Francisco, a retrovirus responsible for AIDS was isolated.”
In 1985, Hadden would be the staffer behind state legislation to bring a coordinated approach to local HIV/AIDS programs and services. California Senate Bill 1251 allocated about $17 million in funding for AIDS healthcare programs in 1986. In addition, the state directed more than $5 mllion of its federal budget toward research projects and epidemiology studies.
Legislative staffers regarded Haddon as the “unofficial AIDS czar” of California. He was one of only a few in Sacramento 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.
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Los Angeles Times, “Stan Hadden: Roberti Aide Influenced AIDS Policy,” December 26, 1991
What to Do about AIDS: Physicians and Mental Health Professionals Discuss the Issues, editor Leon McKusick (University of California Press, 1986)
California Budget Analysis, 1986-1987, State of California Health and Welfare Budget
The Pride, “California Legislative Caucus Honors LGBT Pioneers” by Karen Ocamb
The U.S. Congress passes the first bill with funding targeted for AIDS research and treatment — $12 million for agencies within the U.S. Department of Health and Human Services.Learn More.
The Sable/Sherer Clinic at Cook County Hospital is created to treat people with HIV/AIDS.Learn More.
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.
Growing numbers of infants infected with AIDS in utero are abandoned in New York City hospitals, according to a New York Times article.Learn More.
On Page 22, the Times gives its report on the alarming cases of babies and young children who are born with the AIDS virus and subsequently left at New York hospitals. The article carries no byline.
The article also exposes the discrepancy between the total number of pediatric AIDS cases nationwide being reported by the Centers for Disease Control (18) and the numbers of infants and children being treated by doctors in the NY metro area alone (more than 63).
In the article, New York pediatric immunologist Arye Rubinstein, M.D., blamed the CDC’s low case number on the federal government’s “unduly strict” definition of AIDS. Because of this narrow definition, the CDC counted only children who had a malignancy or opportunistic infections.
Dr. Rubinstein told the Times that he was treating several patients whose symptoms did not fall within the CDC definition but most definitely were indications of infection by the AIDS virus. The article cites Dr. Rubinstein’s pediatric AIDS caseload as consisting of 44 patients. James Oleske, M.D, of St. Michael’s Hospital and the Newark College of Medicine was cited with a caseload of 18 pediatric patients and six more suspected cases.
In the years to come, Dr. Rubinstein would become very vocal about CDC case totals being undercounted and the need for the CDC to broaden its definition of pediatric AIDS — and he wasn’t the only doctor in the field to do so. Finally in 1985, the CDC would broaden its defnition of AIDS, based on recommendations developed at the Conference of State and Territorial Epidemiologists, and the CDC would modify the definition again in 1987 and 1993.
The Times article also chronicled the plight of young children with AIDS who had been abandoned in NYC hospitals. Doctors said the children have been left in hospitals by mothers who had died or are dying of AIDS.
Since the City did not have a place to house parentless AIDS children, they were left in the hospitals that were treating their conditions. The Times reported that the City’s welfare agency, Special Services for Children, was seeking foster homes for the children, but no one would take them.
This article was among the first to focus on the heartbreaking situation of the population that would become known as “AIDS babies,” children born with the AIDS virus and then orphaned. In the 1980s, most of these children died within two years.
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The New York Times, “Young Victims of AIDS Suffer its Harsh Stigma,” June 17, 1984
Centers for Disease Control and Prevention, “AIDS: The Early Years and CDC’s Response” by Drs. James Curran and Harold Jaffe, October 7, 2011
National Institutes of Health, “Survival of Children with HIV in the United States has Improved Dramatically Since 1990s, New Analysis Shows,” December 18, 2009
Patrick J. Buchanan, President Ronald Reagan’s speechwriter, publishes an op-ed in the New York Post, writing: “The poor homosexuals — they have declared war upon nature, and now nature is extracting an awful retribution.”Learn More.
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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ThinkProgress, “Flashback — Buchanan: AIDS is Nature’s ‘Awful Retribution’ Against Homosexuality” by Igor Volsky, May 24, 2011
Stanford Blood Center institutes the first blood testing program specifically intended to reduce the risk of transfusion transmission of AIDS.Learn More.
Between July 1983 and June 1985, a total of 33,831 blood donations were screened by Standord. Of those donations, 586 were shown to have low CD4 counts and were discarded as possibly infected.
Stanford retained the serum samples from the 586 donations and years later, when a test became available, screened them specifically for HIV. Dr. Engleman found that 1.9% of these donations were HIV positive — which translates to approximately 33 HIV-infections that were avoided.
As the first blood bank in the U.S. to screen donated blood for HIV/AIDS indicators, the new policy eliminated donations from people with low CD4 T cells. The loss of CD4 T cells in AIDS is what renders patients susceptible to a wide range of infectious diseases. Thus, the screening was considered a surrogate test, not necessarily identifying the presence of HIV/AIDS but instead identifying indicators of possible HIV/AIDS infection.
The new screening system came about due to an increasing awareness in the San Francisco medical community of AIDS and a skeptical view toward existing blood protection practices. In the spring of 1983, Stanford Hospital treated two patients with AIDS. Both had received transfusions at Bay Area institutions and neither had been identified as being in a high-risk group.
“At this point, my colleagues and I at Stanford Blood Center felt that the presence of the presumed etiologic agent for AIDS in the local blood supply could not be ignored,” recalls Ed Engleman, MD, of the Stanford Blood Center. “Because of the potential lethality of this infection, we felt that self-deferral should not be relied upon as the sole means of protecting the blood supply.”
The self-deferral practice that Dr. Engleman refers to is the U.S. Public Health Service’s then-recommendation of relying on donors to voluntarily identify themselves as a member of a high-risk group. Blood centers around the country commonly implemented the PHS recommendation with an information sheet provided to prospective donors that described AIDS risk groups and requested that donors exclude themselves if they met the definition of risk.
“It was predictable that this approach wouldn’t work very well,” says Dr. Engleman. “First, it relied entirely on donor self-deferral. Second, the PHS definition of homosexual AIDS risk behavior was vague, making it possible for a prospective donor with a history of homosexual activity to feel that he personally was not at risk for AIDS and to proceed with blood donation.”
Stanford University Blood Bank’s screening procedure was costly and had to be performed manually, but Stanford found it relatively easy to implement because it was already conducting immunological research and had access to a flow cytometer and the appropriate laboratory setting.
Around this time, the American Red Cross, American Association of Blood Banks, and the Council of Community Blood Centers released a joint statement estimating the risk of getting AIDS from transfusion as “one in a million.” This was an overly optimistic view, it turned out.
Just a few years later, when the first HIV antibody test was made available in 1985, an estimated one in 700 units of blood donations in U.S. metropolitan areas were found to be infected with HIV. In San Francisco, the frequency was closer to one in 100.
“We estimate that the total number of transfusion-related HIV transmissions that occurred from 1983 to 1985 was at least 10,000-20,000,” Dr. Engleman says. “It seems evident that most of these cases could have been avoided had our test been used.”
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The Congressional Subcommittee on Government Operations holds hearings to examinethe federal response to AIDS. It would take another four years before the Reagan Administration finally acknowledges the demands of AIDS activists.Learn More.
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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A Florida hospital arranged for a private jet to fly a patient with AIDS to San Francisco, where he was left at a local AIDS foundation with $300 cash.Learn More.
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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Reporter Randy Shilts of the San Francisco Chronicle writes that federal health officials were forced to pull funding from other projects to support important AIDS research in the spring of 1983 due to the lack of federal funding.Learn More.
Top officials in the Department of Health and Human Services were pleading for more federal funds from the Reagan administration for AIDS research in early 1983, all while publicly saying that no more money was needed, according to Shilts’ reporting in The Chronicle.
Reporting from documents obtained under the Freedom of Information Act, Shilts wrote that the Centers for Disease Control in Atlanta ultimately were forced to divert millions of dollars from other important health projects in order to conduct AIDS research.
In that memo obtained by Shilts, Brandt listed a number of important health areas other than AIDS in which work was “postponed, delayed or severely curtailed” because the center was diverting money to AIDS research.
But according to The Chronicle, Brandt also publicly supported the Reagan administration’s position just days before, testifying May 9 to Congress that extra funds to fight AIDS were “unnecessary.”
Dr. William Foege of the Centers of Disease Control sent Brandt a 12-page request for funds in early May, but two weeks later, Thomas Donnelly, Assistant Secretary for Legislation, wrote a Senate staff member that “we are not in favor of additional appropriations” for AIDS research. The Office of the Assistant Secretary for Legislation serves as the primary link between the Department of Health and Human Services and Congress.
The task force created at the December 1983 FDA/CDC conference with the blood services community issues a report with a majority opinion that opposes the implementation of incorporating hepatitis B anti-core testing into the routine screening of plasma, presenting another roadblock to the protection of the country’s blood supply.Learn More.
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.
- 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.
More than 2,000 researchers gathered at the conference to share information and assess prospects for controlling the disease, not yet realizing that the worst was yet to come.
The Atlanta conference featured 392 presentations and generated considerable excitement among participants eager to learn about how this new disease was playing out within specific populations in the U.S.
Much of the news was discouraging, however, as presenters introduced new data that showed that many of those dying in 1985 had been infected before 1981, and that within especially vulnerable populations, the epidemic was becoming entrenched.
At a side meeting before the day the conference opened, gay activists protested Reagan administration proposals to implement mandatory HIV testing policies, arguing that this would do little to halt the spread of the disease and would only intensify discrimination against vulnerable groups.
Research by the AIDS Discrimination Reporting Project finds that gay men living with AIDS are being terminated from their jobs because of their illness.Learn More.
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.
The Pentagon announces that, beginning October 1, it will begin testing all new military recruits for HIV infection and will reject those who test positive for the virus.Learn More.
Two Pentagon officials, who spoke to The New York Times on the condition they not be identified, said the new directive was promoted most vigorously by top Army officials, out of concern about the potential high cost of treating soldiers who are found to have the disease. Pentagon officials said about 50 soldiers are being treated in military hospitals for the disease.
The U.S. military does not universally test potential recruits for any other disease or disorder as a condition of enlistment, although new recruits are usually tested for syphillis and German measles soon after they enlist.
The announcement was condemned by the Lambda Legal Defense and Education Fund, which asserted that the testing would unfairly stigmatize many people who have been exposed to the virus but who do not have the disease.
Timothy Sweeney, executive director of Lambda Legal, also contended that military testing for HIV might become a precedent for AIDS screening in private industry.
Unit 371 opens in Chicago’s Illinois Masonic Hospital and becomes the first inpatient care unit dedicated to HIV/AIDS in the Midwest.Learn More.
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.
President Ronald Reagan mentions AIDS publicly for the first time, calling it “a top priority” and fending off criticism that funding for AIDS research is inadequate.Learn More.
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.
Congress allocates nearly $190 million for AIDS research — an increase of $70 million over the Reagan Administration’s budget request.Learn More.
The House Appropriations Committee also urges President Reagan to appoint a coordinator for the AIDS effort, “in other words, an AIDS czar.”
“Nine agencies have been engaged in this effort. … What we need is a well-coordinated, well-planned effort, with one person running the show,” said Rep. Silvio Conte, (Mass), the senior Republican on the House Appropriations Committee.
The National Institutes of Health would receive $140.6 million, the Centers for Disease Control would receive $45.6 milion and $3.5 million would go to the Alcohol, Drug Abuse and Mental Health Administration.
During debate on the appropriations bill, the House accepted an amendment by Rep. Robert Dornan (R-Calif.), that would allow the surgeon general to use some funds to close bath houses “that may be responsible for transmitting AIDS.”
About one year after West Hollywood is officially incorporated as an independent city, it begins actively addressing the HIV/AIDS epidemic.Learn More.
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.
The New York State Public Health Council empowers local health officials to close gay bathhouses, bars, clubs , and other places where “high-risk sexual activity takes place.”Learn More.
The Public Health Council resolution went beyond recommendations made by Gov. Mario M. Cuomo and State Health Commissioner David Axelrod by defining “high-risk sexual activity” to include oral sex.
Mayor Edward I. Koch announced that the new regulation takes effect immediately and is to be enforced by NYC Health Department inspectors who will enter bathhouses in uniform and undercover.
The National Gay Task Force opposes the regulation, citing discriminatory practices.
“This appears to be an unequal application of law” because many experts say AIDS can be transmitted by heterosexual activity, said Ron Najman, a spokesman for the National Gay Task Force. “They are concentrating on the homosexual aspect.”
The LA County Board of Supervisors introduced new county regulations that could put patrols inside bathhouses to ensure that patrons don’t participate in sex acts considered to be unsafe.
“If someone showed me data substantiating a correlation of the spread of this disease and my club, I would deliver the keys to City Hall tomorrow. But so far it’s only been speculation, hysteria and panic, ” Silver Lake bath house owner Steve Downard told the Los Angeles Times.
“The sexual activity at the club is the same as at the Biltmore Hotel, but there are no health posters, no monthly health screening and no free condoms at the Biltmore.”
Under the new County rules, unsafe sex is defined as anal and oral intercourse between men, with or without a condom. Clubs with repeated violations could face closure.
The fact that the county rules make no mention of heterosexual acts, which also can spread AIDS, is proof, Downard says, that homophobia, not health concerns, are behind the regulations.
The Pasteur Institute files a suit against the U.S. Government in the U.S. Court of Claims in Washington, DC., seeking recognition that French researchers were the first to discover the virus that causes AIDS.Learn More.
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.
The World Health Organization convenes a second meeting of its AIDS task force in Geneva to strategize a global response to the spread of the disease.Learn More.
With representatives from 27 countries attending, the meeting focused on a review of the Global WHO Strategy for the Prevention and Control of AIDS: Projected Needs for 1986-1987, a proposed plan to address the AIDS crisis on a global scale, according to The Fourth Ten Years of the World Health Organization.
Attendees agreed that AIDS and HIV infection represented a mounting international health problem and neither a vaccine nor a therapy effective against HIV was likely to become available for at least several years. Therefore, a global strategy for AIDS and HIV control was needed, according to the meeting report.
WHO’s plan of action, which was based on recommendations from its network of collaborating centers on AIDS, put forth a series of global responsibilities for AIDS prevention and control, as well as activities that individual countries needed to adopt in order for the plan to be effective.
Dr. Halfdan Mahler, WHO’s director who had previously dismissed the immense global implications of AIDS, attended the meeting in its entirety, according to the meeting report.
Following this meeting, WHO took concrete steps to strengthen its activities, including a reallocation of financial and personnel resources to support the new strategic plan. The first meeting of WHO’s AIDS task force was held on April 21-22, 1986 in Geneva.
Bowers v. Hardwick was a landmark decision of the U.S. Supreme Court that upheld, in a 5–4 ruling, the constitutionality of a Georgia sodomy law criminalizing oral and anal sex in private between consenting adults.Learn More.
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.”
The Supreme Court decision would stand for 17 years until 2003, when Lawrence v. Texas would overturn Bowers.
Cuba becomes the only country in the world to impose a policy of universal HIV testing and mandated quarantine of all virus carriers.Learn More.
The Cuban government opened the first of its fourteen sanitariums in Santiago de Las Vegas, located outside the major Cuban city of Havana. It also launched a widespread HIV testing campaign and sent anyone found to be HIV-positive to the sanitarium for life.
By the end of 1988, Cuban authorities would report that 240 people living with HIV — 171 men and 69 women — have been quarantined to date in the facility, according to the Los Angeles Times.
In 1988, the LA Times would report on a U.S. delegation invited by the Cuban government to visit the Santiago de Las Vegas quarantine center.
“We were shown groups of nondescript apartments that looked like typical Cuban suburban housing,” said Ronald Bayer, associate professor at Columbia University’s School of Public Health, in an interview with the LA Times. “It was neither barracks-like nor dungeon-like, although I have to assume we were shown the best.”
Bayer was one of a team of seven colleagues from Columbia University and the Columbia Presbyterian Medical Center who were the first Americans to receive a first-hand glimpse of Cuba’s HIV quarantine system. Their host was Cuba’s deputy minister of public health, Hector Terry.
Bayer said he continued to be disturbed by Cuba’s policy of forcing HIV-positive people into quarantine.
“Even if it all looked as good as what we saw, it does not resolve the moral justification of incarceration based on supposed future behavior,” said Bayer, a medical ethicist whose specialty was HIV/AIDS healthcare and policy.
At the height of Cuba’s quarantine program, around 10,000 people with HIV would be isolated in facilities.
In 1991, Eduardo Martinez tested positive for HIV and was sent to the Santiago de Las Vegas sanitarium. Martinez had been a well-known designer in Cuba, creating costumes for the entertainment industry.
Martinez told NPR reporter Rebecca Sananes what it was like to receive the HIV diagnosis and then be separated from society.
“I didn’t want to go, but they would come for you and take you by force,” he told NPR.
He said that government officials interrogated the sanitarium patients and urged them reveal their sexual partners, so they too could be tested for HIV and quarantined.
Martinez was housed in one of the few air conditioned residences and he could rely on a steady supply of food, but the isolation from his family, friends and career made him fall into a deep depression. After going on a hunger strike, he was moved to a psychiatric ward for a month.
“It was very sad for me, because I didn’t understand why I was infected and why I had to go be interned in that place,” he says. “And on top of this, that was killing my career. I was at the top of stardom at that moment.”
Eventually, he reconciled himself to his situation, dire as it was, and accepted that the sanitarium would be his entire world for the rest of his life. He created a drag persona, “Samantha,” to help him reclaim his passion for fashion design.
“I needed a model in order to continue producing designs, and I just used myself as a model,” Martinez said.
He also encouraged his fellow patients to pursue creative self-expression and built a community of artists. Sadly, Martinez was one of the only people from his sanitarium generation to survive to a time when HIV could be effectively managed through treatment.
He told NPR about how he watched many of his friends die as they volunteered as test subjects for potential cures researched by the Cuban government.
With funds to Cuba from the Soviet Union ending with the 1991 fall of the USSR, the ongoing expense to house HIV patients was deemed too costly, and in 1995, Cuba began to allow HIV-positive patients to leave the sanitariums.
Martinez told NPR that he was one of the first patients to be offered his freedom, but the idea of leaving his home of five years scared him. Cuba was experiencing widespread homophobia and poverty, and his life in Santiago de Las Vega was filled with comfort, safety, friendship and creative purpose.
“I refused to leave, because I said I was too committed to the community inside the sanitarium,” he said.
But by 1996, he decided to return to Havana, where he built a second career as a drag artist. Martinez produces fashion shows and drag performances at one of Havana’s most famous nightclubs, the Tropicana. He said that sometimes, members of the Central Committee of the Communist Party of Cuba come to see him perform as “Samantha.”
One in every five gay men and one in every 10
lesbians report being physically assaulted because of their sexual orientation, according to an eight-city study of antigay violence conducted by the National Gay and Lesbian Task Force.
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 U.S. launches the AIDS Service Demonstration Grants program, allocating $15.3 million in available funding to New York, Los Angeles, San Francisco and Miami.Learn More.
The grant program is run by the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services. As the HRSA’s first AIDS-specific health initiative, program focused its funding on cities hardest-hit by HIV/AIDS.
In the years to come, the HRSA would create the HIV/AIDS Bureau and develop a comprehensive system of HIV primary medical care, medications, and essential support services for low-income people with HIV.
The HIV/AIDS Bureau will oversee the Ryan White HIV/AIDS Program and play a critical role in helping diagnose, treat, prevent, and respond as part of the “Ending the HIV Epidemic: A Plan for America” initiative.
The Surgeon General issues the Surgeon General’s Report on AIDS. The report makes it clear that HIV cannot be spread casually.Learn More.
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 National Academy of Sciences issues a report calling for a “massive media, educational and public health campaign to curb the spread of the HIV infection,” as well as for the creation of a National Commission on AIDS.Learn More.
The report, titled Confronting AIDS: Directions for Public Health, Health Care, and Research, is issued by the Institute of Medicine (IOM), the principal health unit of the NAS. The IOM anticipates that the cost of the public health campaign will reach $2 billion by 1990.
The mission of NAS is to provide scientific advice to the government “whenever called upon” by any government department. The Academy receives no compensation from the government for its services.
The World Health Organization (WHO) launches the Special Programme on AIDS to serve as the architect and keystone of a global AIDS plan.Learn More.
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.
The Food and Drug Administration (FDA) approves the first medication for AIDS — AZT (zidovudine), an antiretroviral drug initially developed to treat cancer.Learn More.
As the only medication available to treat HIV, AZT became a highly sought-after treatment, albeit one fraught with side effects. Studies showed that AZT therapy could lead to the damage of muscle tissues, including the heart, and also the suppression of the production of red blood cells, neutrophils, and other cells in the bone marrow.
In addition, the side effects of fatigue, malaise, and anemia were common. Many patients taking AZT experienced gastrointestinal intolerance, nausea and vomiting. Rarer side effects included lactic acidosis and hepatic steatosis.
The drug’s approval remains controversial to this day, but now that we are in a world where treatment options are so far advanced, it can be difficult to imagine the sense of urgency permeating the medical community in the 1980s.
Today, if someone is diagnosed with HIV, he or she can choose among more than 40 drugs that can treat the disease. And there is an excellent chance that with the right combination of medications, given at the right time, HIV levels can be reduced and kept so low that the person never gets sick and the virus becomes undetectable.
The U.S. Food and Drug Administration issues regulations that expand access to promising new medications that have not yet been approved or licensed by the agency. This accelerates the approval of drugs by two to three years.Learn More.
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.
President Ronald Reagan and French Prime Minister Jacques Chirac end an international scientific dispute when they announce that researchers from the two countries will share credit for discovery of the AIDS virus.Learn More.
The countries agree that patent rights to a blood test that emerged from that discovery will also be shared, with most of the royalties to be donated to a new foundation for AIDS research and education.
This settles a years-long rift between the two countries, each laying claim to the valuable patent for the first HIV-antibody test. The U.S. Department of Health and Human Services claimed virologist Robert Gallo first developed the test, while the Pasteur Institute claimed it was French virologist Luc Montagnier.
Gallo had won the prestigious Lasker Award in 1986 for his share of the work (his second Lasker, having won in 1982 for his work on retroviruses).
Years later, the National Institutes of Health would conduct an investigation that proves Gallo and his colleagues first had isolates of HIV with the exception of one sample that originated from the Pasteur Institute’s lab (which was requested by the Gallo lab and sent to them from Paris).
Gallo and Montagnier later agree to share the title of co-discovers of the virus and they write several papers together describing their work in Science (Dec. 29, 2002) and the New England Journal of Medicine (Dec. 11, 2003).
However, in 2008 when Stockholm would call with the Nobel Prize for Physiology or Medicine, it was only for Luc Montagnier. The scientific world would be shocked to learn that the Nobel Committee was snubbing Gallo’s work, but because those archival records are locked up until 2058, we will not know the precise argument behind this decision for many years.
At a four-day workshop at Children’s Hospital of Philadelphia, U.S. Surgeon General C. Everett Koop draws attention to the plight of the growing number of children who acquire AIDS from their mothers or through blood transfusions.Learn More.
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.
“If parents don’t do it, they’ve abrogated their responsibility and somebody else has to do it,” Dr. Koop says.
Dr. Koop’s stance for early sex education puts him at odds with some of his fellow conservatives.
The workshop brings together families affected by HIV, leading HIV researchers and clinicians, mental health professionals, public health officials, and representatives from the insurance, legal, and nonprofit organizations.
In the last week, the number of children under 13 years old diagnosed with AIDS reaches 471, double the number of cases reported a year ago, according to the Centers for Disease Control. In addition, there are 139 cases among teen-agers.
But Dr. Koop says these figures do not include as many as 2,000 children who have some AIDS symptoms but who do not meet the strict Federal definition of the illness, and he says the number of infected children is expected to continue to increase ”dramatically.”
Dr. Koop also notes that a disproportinate number of children infected with AIDS are members of minority groups: about 50% are black and 33% are Hispanic.
”We have, therefore, a segment of society that is very difficult to reach,” Dr. Koop says.
The U.S. Food and Drug Administration authorizes the sale of male condoms to include HIV prevention as an indication for use, marking a major stride in public health communication and safe sex and HIV/AIDS transmission.Learn More.
AIDS brings condoms back to the forefront for sexually active people of all sexual orientation.
Nevertheless, condom use does not equal 100% protection from HIV, and its effectiveness largely depends on correct and consistent use. Also, some people are allergic to the latex, lubricants, and perfumes.
The FDA also begins to test latex condoms for leaks, resulting in an improvement in the overall quality of condom products.
With the total number of confirmed AIDS cases in Los Angeles County reaching 2,965, the Board of Supervisors vote unanimously to create a 17-member LA County Commission on AIDS to advise on ways the county can combat the epidemic.Learn More.
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.
The U.S. Public Health Service adds HIV as a “dangerous contagious disease” to its immigration and travel exclusion list. The HIV ban will not be lifted until 2010.Learn More.
“It was not the discovery of HIV alone, but the economic and political climate of the 1980s that led to the introduction of the ban,” writes Dr. Susanna E. Winston and Dr. Curt G. Beckwith in AIDS Patient Care STDS.
In the early 1980s, a worldwide economic recession drove immigrants to enter the U.S., fueling American fears of foreigners taking jobs and becoming a burden on the health and welfare systems. This coincided with the explosion of the AIDS epidemic, with fear and misunderstanding about the disease feeding into the growing xenophobia.
It is in this environment that HIV/AIDS is added to the U.S. list of dangerous contagious diseases.
At first, only individuals whose illness advanced to AIDS are excluded from U.S. travel (based on the argument that AIDS affects a person’s wage-earning capacity). But then, under pressure to demonstrate efforts to combat the HIV/AIDS epidemic, President Reagan moves to require all immigrants be tested for HIV, and that HIV infection (with or without AIDS) be included as a disease of public health significance.
This adds HIV to the list of dangerous diseases that includes leprosy, tuberculosis, syphilis and gonorrhea.
The U.S. starts mandatory AIDS testing of the 500,000 applicants seeking permanent residence. The ban includes travellers from other countries who test positive for HIV.
The ramifications of the HIV immigration and travel ban would come to light both domestically and internationally with the case of Hans Paul Verhoef. While traveling to San Francisco to attend the 1989 National AIDS Forum, Verhoef, an HIV-infected Dutch citizen and rising chair of the Dutch HIV Foundation, would be detained and arrested when Immigration and Naturalization Service agents find AZT in his luggage.
Verhoef’s arrest sets off an outcry from the international AIDS community in objection of the ban, with protests and threats of boycotts of the two upcoming international conferences, planned for San Francisco (1990) and Boston (1992). For the 1990 International AIDS Conference (IAS), President George H.W. Bush issues an executive order temporarily waiving the ban for all attendees. But IAS organizers decide to hold no further conferences in the U.S. until the ban is revoked, and the 1992 IAS conference is relocated from Boston to Berlin.
The travel ad immigration ban would be lifted 22 years later, on January 4, 2010. A new federal rule under President Barack Obama’s administration would be heralded as a monumental achievement, accomplished through the hard work of advocates.
President Ronald Reagan makes his first public speech about AIDS at the American Foundation for AIDS Research Awards Dinner.
The epidemic is now six years old; 36,058 people have been diagnosed with the disease and 20,849 have died.Learn More.
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.
President Reagan signs an Executive Order creating the first Presidential Commission on AIDS.Learn More.
Two days later, Reagan would appoint Dr. W. Eugene Mayberry, CEO of the Mayo Clinic, to chair the commission. Jeff Levi, executive director of the National Gay and Lesbian Task Force would object to the appointment of someone with no experience with the disease, but others praise Mayberry’s experience in both medical research and clinical services.
The president also appointed the following people to the Commission:
- Dr. Colleen Conway-Welch, dean of nursing at Vanderbilt University
- John J. Creedon, CEO of Metropolitan Life Insurance Company
- Dr. Theresa L. Crenshaw, a sex educator and opponent of condoms as a means of preventing the spread of HIV
- Richard M. DeVos, president of Amway
- Dr. Burton J. Lee III, a physician at the Memorial Sloan-Kettering Cancer Center
- Dr. Frank Lilly, a geneticist at the Albert Einstein College of Medicine. Lilly served on the board of the Gay Men’s Health Crisis, and is “one of the first openly gay Presidential appointees”
- Dr. Woodrow A. Myers Jr., an African American, the health commissioner of Indiana, and president of the Association of State and Territorial Health Officers
- Cardinal John O’Connor, an opponant of including instruction about condoms in AIDS education programs in schools
- Penny Pullen, an Illinois legislator. advocate of mandatory premarital HIV testing who would go on to found the conservative Christian organization Illinois Family Institute
- Corinna “Cory” SerVaas, editor of the Saturday Evening Post
- Dr. William B. Walsh, president of Project HOPE, a medical relief organization
- James D. Watkins, a retired admiral
Dr. Lilly of the GMHC is considered to be the most controversial appointment, opposed by conservaties including Sen. Gordon Humphrey (R-New Hampshire).
“The President should strive at all costs to avoid sending the message to society – especially to impressionable youth – that homosexuality is simply an alternative lifestyle,” Sen. Humphrey tells The New York Times.
At the commission’s first meeting, Lilly finds himself seated next to Cardinal O’Connor, and they would be observed “chatting cordially.”
A task force of the Society of Actuaries issues a report claiming that the cost of AIDS to insurance companies could exceed $50 billion by the year 2000.Learn More.
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.
The CDC reported there were 8,000 AIDS deaths in 1986, and is projecting that the number to rise to 54,000 by 1991.
The authors of the study, who are actuaries for the State Mutual Life Assurance Company of America, contend that based on the Federal projections, AIDS claims are expected to go up by a factor of 10 by the 1990s.
A federal judge orders the DeSoto County School Board in Florida to enroll HIV-positive brothers Ricky, Robert, and Randy Ray. The school board had refused to allow the three boys to attend the district’s schools in their hometown of Arcadia, Florida.Learn More.
After the court ruling, some town residents would refuse to allow their children to attend school, many would anonymously call the Ray home with threatening messages, and ultimately someone would set fire to the Ray house, destroying it and forcing them to move.
“Arcadia is no longer our home,” their father, Clifford Ray, tells the press the day after the fire. “That much was made clear to us last night.”
Ricky, Robert and Randy, who were 10, 9 and 8 at the time, were all born with hemophilia, a condition that required them to receive blood transfusions. Ricky would go on to become an activist in the fight against AIDS. President Bill Clinton reaches out to him and thanks him for his work raising awareness about HIV/AIDS.
The young teenager would allow camera crews to document his declining health, saying he wanted Americans to see what AIDS did to people. Ricky Ray would die in 1992 at age 15.
Robert would die of AIDS-related causes in 2000 at the age of 22. Shortly thereafter, their father would attempt suicide but would survive. Randy Ray would marry in 2001 and settle in Orlando, Florida, successfully managing his HIV through medication.
FDA sanctions the first human testing of a candidate vaccine against HIV. While the clinical trials do not lead to a vaccine, the FDA’s approval marks an important milestone in the development of HIV/AIDS treatment options.Learn More.
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.
Margaret Thatcher, prime minister of the United Kingdom, sums up her party’s dark views toward the LGBT community in an anti-gay speech, garnering her thundrous applaus at the 1987 Conservative Party conference.Learn More.
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.
In a 94-2 vote, the U.S. Senate adopts the Helms Amendment, which requires federally financed educational materials about AIDS to stress sexual abstinence and forbids any material that “promotes” homosexuality or drug use.Learn More.
The Helms Amendment was incorporated into the $129 billion Labor, Health and Human Resources and Education appropriations bill for fiscal 1988, and contained $310 million for AIDS education efforts overseen by the Centers for Disease Control.
Sen. Jesse Helms (R-North Carolina) initially proposed that none of the money allocated to the CDC could be used for material or activities that promote, encourage or condone homosexuality, illegal drug use or any sexual activity outside marriage. During floor debate, Sen. Helms displayed sex-positive comic books created by the Gay Men’s Health Crisis in New York and announced that federal money helped to pay for GMHC’s education program.
″If the American people saw these books, they would be on the verge of revolt,″ claimed Helms.
The senator said he showed the comic books to President Reagan and complained that the GMHC had received $674,679 in federal funding to produce the pamphlets. According to Helms, President Reagan looked at a couple of pages, ″shook his head, and hit the desk with his fist.″
Helms then admitted that the comic books were not paid for with federal funds, but said taxpayer dollars did pay for a series of educational sessions he contended were equally offensive. He said the sessions included assignments to write a personal ad for publication in a gay newspaper and list alternatives to high-risk sex, as well as instruction in the use of safe sex photos.
″I may throw up,″ Helms announced in the Senate chambers.
Sen. Lowell Weicker (R-Connecticut) and Sen. Daniel Patrick Moynihan (D-New York) are the only two Senators to vote against the legislation. Weicker lectured Helms for moralizing and said his amendment ″means unnecessary lives lost.″
″We don’t have time to get into philosophical or academic or moralistic debates. We’d better do what the experts have told us to do — put our money into research and put our money into education.″
The response from Lori Behrman, spokeswoman for the Gay Men’s Health Crisis, is: ″Jesse Helms, first of all, is playing with the lives of thousands of Americans. It sends a message that the gay community is expendable in this epidemic.″
The Helms Amendment will have a chilling effect on CDC’s ability to stop the spread of AIDS among drug addicts, homosexuals and sexually active heterosexuals, particularly young people.
This is the latest in a long conflict among lawmakers about what federal AIDS education materials should say and how graphic they should be.
At the 42nd convening of the United Nations, AIDS becomes the first disease ever debated on the floor of the General Assembly. The UN resolves to mobilize in the worldwide struggle against AIDS.Learn More.
“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.
The Los Angeles County Board of Supervisors’ decision to offer AIDS hospice and home care services is met with cheers from the audience, which included dozens of people living with AIDS.Learn More.
At the recommendation of the LA County Commission on AIDS, the supervisors and the county Department of Health Services took action at its meeting to expedite $1.5-million in funding for local hospice and home care programs.
The AIDS Commission also recommended March 1 deadline for implementing the program, which would provide those needing care with an alternative to hospitalization. At Supervisor Ed Edelman’s recommendation, the Supervisors ordered county staff to investigate Barlow Hospital as a potential location to house a fully integrated AIDS-care facility, according to the LA Times’ coverage of the board meeting.
Meanwhile, cases of AIDS continued to grow at a troubling rate. The LA Times reported that in October 1987, the county reported 192 new cases of AIDS and most were receiving care from hospitals. Because of the lack of alternative care facilities, most deaths in the county due to AIDS-related illnesses were reported to occur in hospitals, away from home and hospices.
As the conservative government prepares to enact Section 28 to disenfranchise members of the LGBTQ+ community, 20,000 activists take to the streets of Manchester to protest the law.Learn More.
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.
Ryan White, the Indiana teenager who has become a national spokesperson for AIDS education, testifies before the President’s Commission on AIDS about the stigma he has endured.
United Kingdom authorities enact Local Government Act of 1988, which became notorious for its inclusion of Section 28. The vaguely worded law prohibited local authorities and schools from “promoting” homosexuality and funding lesbian and gay initiatives.Learn More.
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.”
C. Everett Koop, the U.S. Surgeon General, launches the nation’s first coordinated HIV/AIDS education campaign. It is the largest public health mailing in history.Learn More.
Between May 26 and June 30, 1988, the Centers for Disease Control mail the pamphlet Understanding AIDS to every U.S. household. Approximately 126 million copies were distributed, reaching at least 60% of the population.
The brochure was produced in Spanish as well as English, and its purpose was 3-fold: to clarify how AIDS is transmitted; to emphasize that behavior, not identification with risk groups, put people at risk; and to stimulate informed discussions about AIDS at all levels of society.
In conjunction with the mailing, the CDC initiated contacts with state health departments and manufacturers of AIDS testing kits. In anticipation of increased requests for information that the brochure would generate, the CDC added up to 1,000 operators to the National AIDS Information Line.
The impact of the campaign on AIDS-related behavior was not fully assessed. Extensive message pretesting and other marketing techniques designed to improve the effectiveness of the brochure, however, helped Understanding AIDS achieve an increase in awareness and concern about AIDS nationwide.
During the process of the campaign, the CDC learned a number of lessons, including the importance of setting a deadline, doing formative research, and achieving a consensus on scientific knowledge.
The U.S. Food and Drug Administration announces it will allow the importation of small quantities of unapproved drugs for people with life-threatening illnesses, including HIV/AIDS.
The U.S. Health Resources and Services Administration awards $4.4 million in grants to 11 states and Puerto Rico for the first pediatric AIDS service demonstration projects.Learn More.
The HRSA-funded projects are expected to demonstrate effective ways to:
- reduce mother-to-child transmission of HIV;
- develop coordinated, community-based, and family-centered services for infants and children living with HIV; and
- develop programs to reduce the spread of HIV to vulnerable populations of young people.
The Abandoned Infants Assistance Act becomes law, addressing the issue of so-called “boarder babies.” These infants, many of whom have been perinatally exposed to drugs or HIV, have been either been orphaned or left at hospitals indefinitely by their parents.Learn More.
The AIA funds projects to support moving the children into foster care or other more traditional living arrangements.
President Ronald Reagan signs the Health Omnibus Programs Extension (HOPE) Act into law, authorizing the use of federal funds for AIDS prevention, education, and testing.Learn More.
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.
The New York City Health Department begins a pilot needle-exchange program to address the growing number of HIV infections among people who inject drugsLearn More.
The program is opposed by many of the city’s black and latinx leaders, who see it as an abandonment of IV-drug-using people of color.
The leaders demand a more comprehensive approach to the issue, proposing more resources for drug-prevention education, addiction treatment, and law enforcement.
The Food and Drug Administration approves the first drug specifically developed for treating Kaposi’s sarcoma (KS), a leading complication of AIDS.Learn More.
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.
The FDA based its approval on studies involving about 500 patients with KS. Alpha interferon joined AZT and pentamidine as the only drugs approved in the U.S. for the treatment of AIDS or its related conditions. Previous treatments for KS were radiation and other cancer drugs.
Alpha interferon was manufactured as Intron-A by the Schering Corporation of Kenilworth, New Jersey, and as Roferon by Hoffmann-La Roche Inc. of Nutley, New Jersey.
The Food and Drug Administration approves ganciclovir, a still-experimental medication for the treatment of cytomegalovirus retinitis in AIDS patients.Learn More.
Issued under the FDA’s treatment investigational drug protocol, the approval allowed for ganciclovir (GCV) to be issued in a clinical setting, with precautions similar to chemotherapy treatment. Manufactured by Roche Laboratories under the brand name Cytovene, the drug was administered to a patient by intravenous infusion over one hour, a time designed to reduce its toxicity.
Some patients taking GCV experienced a range of serious adverse effects, including granulocytopenia, neutropenia, anemia, thrombocytopenia, fever, nausea, vomiting, indigestion, diarrhea, abdominal pain, flatulence, anorexia, raised liver enzymes, headache, confusion, hallucination, seizures, pain and phlebitis at injection site, sweating, rash, itch, and increased serum creatinine. It also could cause bone marrow suppression.
But at the time, GCV was the only FDA-approved treatment for cytomegalovirus retinitis, a condition that in its worst phase caused blindness.
In the years to come, ganciclovir would be followed by other treatments, including foscarnet, cidofovir, and valganciclovir. While these medications were successful in reducing eye infections, their overall effectiveness was often complicated by toxicities and the development of resistance.
The U.S. announces a new program which would engage city doctors, group practices and private clinics in federal AIDS research.Learn More.
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.
December 1st is designated by the World Health Organization as “World AIDS Day.”Learn More.
Supported by the United Nations, World AIDS Day is observed for the first time with the theme “Join the Worldwide Effort.” Today, World AIDS Day continues to be observed.
In 2020, there was a reported 37.6 million people across the globe with HIV. Of these, 35.9 million were adults and 1.7 million were children.
An estimated 1.5 million individuals worldwide would acquire HIV in 2020. This marks a significant decline (30%) in new HIV infections since 2010, but there is still much work to do.
Eight AIDS bills signed into law by Gov. George Deukmejian during 1988 take effect in California, including three that criminalize HIV and one that weakens rules around doctor-patient confidentiality.Learn More.
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.
On a 3-2 vote, the LA County Board of Supervisors tentatively approves an ordinance prohibiting employers, landlords, schools and businesses in the county’s unincorporated areas from discrimination based on AIDS.
In his farewell address to the nation, the president talks about his accomplishments and regrets during his eight years in office. He neglects to mention the AIDS crisis, which has claimed the lives of more than 56,000 people in the U.S.Learn More.
Speaking from the Oval Office in the White House, President Ronald Reagan focused his farewell speech on the following topics:
– 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.”
In February 1986, nearly five years after the outbreak of the epidemic, President Reagan finally instructed his Surgeon General to prepare a report on AIDS, according to the NIH tribute to Dr. Koop. During the next several months, Dr. Koop met with numerous groups and experts involved in the fight against AIDS. He sought input from leaders from organizations like the National Hemophilia Foundation and the National Coalition of Black Lesbians and Gays, and he also reached out to members of the medical research community, Christian fundamentalists, and hospitalized AIDS patients. He spent a considerable amount of time with Dr. Anthony Fauci, then the leader of AIDS research at the NIH.
Dr. Koop drafted the report in the basement of his home on the NIH campus, with only a handful of trusted staff members as advisers, including Fauci. According to the NIH, Dr. Koop sought to treat AIDS as a public health issue, and not as a moral issue.
Concerned that, if given the chance, Reagan’s domestic policy advisers would remove crucial public health information from the report, such as the advocacy of condom use, Dr. Koop would permit members of the Domestic Policy Council to review drafts of the report and then collect all the copies at the end of the meeting.
On October 22, 1986, Dr. Koop released Surgeon General’s Report on Acquired Immune Deficiency Syndrome at a press conference. In his remarks, he emphasized that since education was the best strategy in preventing AIDS and since AIDS was spread primarily through sex, school children from grade three onward should receive sex education.
Members of Congress, public health organizations, and Parent-Teacher Associations would eventually distribute 20 million copies to the public. In plain language, the 36-page report discussed the nature of AIDS and ways in which people could protect themselves, including use of condoms and abstaining from sex.
Reagan’s conservative supporters expressed their shock and dismay at the explicit language in Dr. Koop’s AIDS report, and above all by Dr. Koop’s advocacy for sex education in elementary schools. They said they were outraged by the lack of moral censure in the report. They tried to appeal to Dr. Koop’s conservative views.
But Dr. Koop held firm. In his many speeches on AIDS in 1987-1988, Dr. Koop continued to dispense health advice. He also denounced discrimination against people living with AIDS, calling for fairness and compassion in the workplace, schools, housing, and insurance policies. He publicly denounced the idea of a quarantine for people living with AIDS, calling it unconstitutional and unnecessary from an epidemiological standpoint.
President Reagan continued to remain in the background, content to let Dr. Koop be the mouthpiece for the administration’s policy on AIDS. But the First Lady wanted Reagan to speak out more forcefully, according to Tumulty’s account in her Nancy Reagan biography.
Nancy Reagan believed that she could make this happen when film legend Elizabeth Taylor, whom Nancy had known for many years, asked if the president would give the keynote address at a fundraising dinner for the American Foundation for AIDS Research (amfAR). The event was scheduled to be held in Washington, D.C. in late May 1987, the night before a large medical conference on AIDS.
At Nancy’s urging, the president accepted the invitation. And then, according to Tumulty, the First Lady recruited Landon Parvin, her favorite speechwriter, to write the keynote speech. But when Parvin tried to arrange a meeting with President Reagan and Dr. Koop to gather their thoughts on the speech, White House staff brought in conservative advisors to weigh in.
At one point, Dr. Koop advised the president to make it clear that AIDS could not be transmitted from swimming pools, telephones, mosquitoes, or food prepared by someone infected with HIV, and he was immediately countered by an advisor who claimed that “the jury is still out.” The meeting continued in this vein.
As the event grew near, conservative forces tried to influence the content of the president’s speech. When asked for his input on the latest draft, Robert Sweet, a senior member of the Domestic Policy Council, crossed out language that said victims of the disease should not be blamed, and wrote in the margin, “Homosexuals and drug users choose their lifestyle — it’s the innocent children, hemophiliacs, and unsuspecting spouses who are the victims.”
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.
In the final year of Reagan’s presidency, policy and programs to prevent the spread of HIV/AIDS forged slowly ahead as the infection rate grew exponentially.
In May 1988, Dr. Koop sent a condensed version of his AIDS report to every household in the United States. The distribution of 107,000,000 AIDS pamphlets was the largest mailing in American history and, to the horror of many conservatives, it was the first time that the federal government provided explicit sex information to the public.
Around this time, as the President’s Commission on the HIV Epidemic was preparing to release its report on the federal response to HIV/AIDS, the Reagans met, through a mutual friend, Elizabeth Glaser, the wife of TV star Paul Michael Glaser who had been infected with HIV through a blood transfusion. Glaser, who had not yet disclosed her HIV-positive status to the public, had two children who had also tested positive for HIV.
After Glaser told her story, President Reagan asked her what he should do. According to Tumulty’s account. Glaser said, “I want you to be a leader in the struggle against AIDS, so that my children, and all children, can go to school and continue to live valuable lives; so that no one with AIDS need worry about discrimination. Secondly, you have commissioned a report on the epidemic … I ask you to pay attention to that report.”
Two weeks later, the commission’s report was released. It cited a “distinct lack of leadership” from the federal government and issued 579 recommendations to the president ranging from allocating an annual $3 billion in funding to address the AIDS crisis to issuing human rights protections for people living with HIV/AIDS.
“It was a stunning repudiation of just about every aspect of the Reagan administration’s handling of AIDS, as well as a sweeping battle plan for how the nation might cope with the epidemic in coming years,” wrote Randy Shilts in his book And the Band Played On: Politics, People, and the AIDS Epidemic.
“We criticized the Reagan Administration, suggested attitudes and approaches not comfortable to its leaders, asked for monies that had not been authorized,” wrote Kristine M. Gebbie, who would go on to become President Bill Clinton’s national AIDS policy coordinator in 1993-1994. “It was probably too much to hope that there would be a sudden turn around.”
Despite his assurances to Elizabeth Glaser, President Reagan did not act on the report’s central recommendations.
“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.
Sen. Ted Kennedy, chair of the Senate Committee on Labor and Human Resources, holds a series of five oversight hearings to examine how the federal government is combating AIDS.Learn More.
Education, care, and drug development for HIV/AIDS are key areas of focus of the hearings.
The FDA, CDC, HERSA and Samuel Thier, president of the Institute of Medicine of the National Academy of Sciences, all testify.
The City of West Hollywood settles an HIV/AIDS discrimination case brought by Paul Jasperson, who filed suit against the city and Jessica’s Nail Salon two months earlier, alleging HIV discrimination.Learn More.
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.
Given permission to address the U.S. House of Representatives for one minute on the subject of “Homosexuality,” Rep. William E. Dannmeyer commences on an hours-long diatribe about “the gay agenda.”Learn More.
Apparently upset that gay men are attempting to “delude the public into viewing homosexuality as an innocuous alternative lifestyle,” the six-term Republican Congressman from Orange County, California insisted on reading into the Congressional Record his statement titled “What Homosexuals Do.”
In his statement, Rep. Dannemeyer dove into graphic descriptions of the sex acts he believes all gay men engage in “two or three times a week.” He contrasted these sex acts with the traditional family values he equated to “the heterosexual ethic” evoked in biblical scripture.
He also denied scientific research that indicated that homosexuality is inherent in individuals from birth and advocated for laws that prohibit homosexual sex acts. In Dannemeyer’s view, homosexuality is, psychologically, a “deep pathology,” but one that can in effect be cured because “counseling can steer people away from that lifestyle.”
He closed his very long statement with the following:
“As long as I have the pleasure to serve in the U.S. Congress, I will con- tinue to affirm the heterosexual ethic at every turn, with every subtly, with every bit of imagery I can conjure, with the help of good people across this Nation, as well as with the help of a majority of my colleagues in Congress, and also by the grace of God.”
Dannemeyer’s speech drew fire from several of his colleagues, including Rep. Andrew Jacobs Jr. (D-Ind.), who found it “unspeakable.”
Eric Rosenthal, political director of the Human Rights Campaign Fund, told the Washington Post, “Dannemeyer has opposed every single public health consensus about fighting AIDS from every responsible public health official, from (former surgeon general C. Everett) Koop to the AIDS commission to the National Academy of Sciences. Dannemeyer has been on the other side from day one.”
Rosenthal expressed hopefulness that the majority federal legislators were not like Dannemeyer and would support legislation that funds AIDS research and services.
“People like Dannemeyer and (Senator Jesse) Helms intimidate their colleagues into voting against us, but most members know that’s not what they ought to do, and they really go out of their way to avoid being homophobic,” Rosenthal said. “I think there’s an underlying sense of fairness in the American people. They don’t necessarily understand lesbians and gays very well, but deep down is a strong opposition to discrimination.”
* * * * *
Congressional Record for the U.S. House of Representatives, Thursday, June 29, 1989
Washington Post, “Out of the Cloakroom: The Anti-Gay Crusade” by Phil McCombs, January 25, 1990
The National Commission on AIDS meets for the first time at Ford’s Theatre in Washington, D.C.Learn More.
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.
The Texas Commission on Judicial Conduct issued a public censure of the state judge who told media he gave a lighter sentence to a killer because the victims were gay.Learn More.
The censure order imposed on Texas judge Jack Hampton denounced his remarks to local reporters f0llowing his decision to give the minimum 30-year sentence to the murderer of two gay men, Tommy Lee Trimble, 34, and John Lloyd Griffin, 27.
“The commission finds that Judge Hampton’s comments, per se, were destructive of public confidence in the integrity and impartiality of the judiciary,” the commission’s order said.
Among comments the commission cited:
- “Those two gays that got killed wouldn’t have been killed if they hadn’t been cruising the streets picking up teen-age boys.”
- “Some murder victims are less innocent in their deaths than others. In those cases, a defendant is unlikely to deserve a maximum sentence.”
- “The victims were homosexuals. They were out in the homosexual area picking up teen-age boys. Had they not been out there trying to spread AIDS around, they’d still be alive today.”
Public censure is the strongest action the commission could take short of recommending the 57-year-old Republican’s removal from the bench. Robert Flowers, the panel’s executive director, read a commission report describing public censure as “tantamount to denunciation.”
William Waybourn, president of the Dallas Gay Alliance, commended the rebuke and called for Hampton to step down.
“I believe that it’s certainly a step in the right direction. But Judge Hampton remains on the bench. What is to happen now to gay men and lesbians who come into his courtroom?” Waybourn told the LA Times.
The Dallas Gay Alliance would go onto file a petition with the Texas Supreme Court in an unsuccessful attempt to remove Hampton from the bench. But they, and other LGBTQ+ activists in Texas, would ultimately prevail in November 1992, when Hampton would lose his re-election bid and be replaced by an opponent supported by the LGBTQ+ community and local Democratic Party clubs.
The U.S. grants $20 million for HIV care and treatment through the Home-Based and Community-Based Care State grant program, introducing HIV care and treatment to many states that have no programs.Learn More.
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.
A CDC/HRSA initiative provides $11 million to fund seven community health centers to provide HIV counseling and testing services. This is a precursor to what will be part of the Ryan White CARE Act.
The U.S. Congress enacts the Americans with Disabilities Act. The Act prohibits discrimination against individuals with disabilities, including people living with HIV/AIDS.
The U.S. Congress passes legislation providing $220.5 million in federal funds for HIV community-based care and treatment services.Learn More.
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,
The blood services industry braces itself against more than 300 lawsuits regarding people infected with the AIDS virus through blood transfusions.Learn More.
A small number of the medical negligence lawsuits have been settled for large amounts of money, and another 300 lawsuits are headed to trial, mostly in San Francisco, New York and Los Angeles, the Los Angeles Times reported.
While eight years has passed since the first medical reports made connections between transfusions and AIDS, legal cases are only beginning to surface because of the lag time between becoming infected with HIV and onset of physical symptoms. An estimated 26 million people received transfusions between 1977 and 1985, years when the AIDS epidemic spread largely unchecked.
Legal experts expect thousands more cases to be filed in the courts over the next few years as more people discover that they were given tainted blood during the early years of the AIDS epidemic.
In one case, a 5-year-old Arizona boy was awarded $28.7 million — believed to be the largest such award — and several other jury verdicts have been in the range of $12 million.
“These awards are far higher than in other types of cases, because the jury tries harder because of the disease, because they have all personally felt that fear,” attorney Duncan Barr told the LA Times. Barr had defended San Francisco’s Irwin Memorial Blood Bank in several cases.
Plaintiffs have argued that the blood banks ignored scientific warnings about the threat of HIV-contaminated blood, failed to screen out high-risk donors through questionnaires that identified high-risk behavior, and refused to perform tests for other diseases that were often present in HIV-infected donors.
In Los Angeles County, health officials said 194 adults and 36 children have contracted AIDS through transfusions.
The American Red Cross, which collects half the nation’s blood supply, would not comment to the LA Times on how many lawsuits have been filed against it over allegedly tainted blood transfusions.
The Blood Council of Community Blood Centers released a statement saying that most centers were insured only for $2 million to $5 million a year for the years in question, and if the centers run out of insurance funds, they may be forced to increase the cost of blood sales to hospitals or go bankrupt.
Congress enacts the Housing Opportunities for People with AIDS Act of 1991, the first and only federal housing program solely dedicated to providing rental housing assistance for persons and their families living with HIV/AIDS.Learn More.
Approved as part of the Cranston-Gonzalez National Affordable Housing Act of 1990, HOPWA funds short-term and permanent housing, together with supportive services, for individuals living with HIV/AIDS and their families.
A report by the Congressional Research Service titled “Housing for Persons Living with HIV/AIDS,” describes HOPWA as a way to address the financial vulnerability and likelihood of homelessness associated with AIDS.
“Research has indicated that individuals living with HIV who live in stable housing have better health outcomes than those who are homeless or unstably housed, and that they spend fewer days in hospitals and emergency rooms,” the report states.
The U.S. Department of Housing and Urban Development (HUD) is charged with the administration of the funding, working with state and local community housing programs.
The U.S. Centers for Disease Control and Prevention recommends restrictions on the practice of HIV-positive healthcare workers, prompting Congress to enact a law requiring states to adopt the CDC restrictions.Learn More.
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.
Congress passes legislation to create a network of community-based clinical trials for HIV treatment.Learn More.
The Terry Beirn Community-Based Clinical Trials Program Act establishes a network of community clinical trials to complement the National Institute of Allergy and Infectious Diseases’ university-based research in order to provide increased access to experimental therapies.
The legislation is named for Terry Beirn, a program officer for amfAR who worked on the Senate Committee on Labor and Human Resources on AIDS legislation.
Known as a fierce AIDS activist, Beirn compiled quarterly directories of AIDS treatment for doctors and patients, fundraised for AmFAR and other research organizations, and pushed legislation to fund clinical trials of experimental treatments and drugs.
Following his diagnosis with AIDS in 1984, Beirn began his advocacy work on AIDS policy with Sen. Ted Kennedy, and in 1986, Beirn joined the staff of the U.S. Senate Committee on Labor and Human Resources. During his time there, Beirn garnered support for the first comprehensive piece of AIDS legislation, the HIV Organ Policy Equity Act of 1988, which modified rules regarding organ donation between HIV-positive individuals. In 1990, Beirn would be instrumental in the passage of the Ryan White Care Act, for which he advocates directly with President George H.W. Bush.
Beirn dies of AIDS-related illness in 1991 at the age of 39.
The 8th International AIDS Conference is originally scheduled to be held in Boston in 1992, but conference planners decide to move it to Amsterdam due to U.S. immigration restrictions on people living with HIV/AIDS.Learn More.
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.
After thousands of Haitians try to reach the U.S. by boat, the Coast Guard redirects asylum-seekers to a refugee camp in Guantánamo Bay, Cuba, where they are administered HIV tests. Those testing positive for the virus are retained in separate quarters called Camp Bulkeley.Learn More.
Following the September 30, 1991 military overthrow of democratically elected Haitian President Jean-Bertrand Aristide, the Coast Guard rescued more than 40,000 Haitians traveling to the U.S. by boat during 1991 and 1992. On the orders of President George H.W. Bush, none of the asylum-seekers would be allowed to enter the U.S. and most would be immediately returned to Haiti.
While refugees were detained in Guantánamo Bay in a crowded refugee camp surrounded by barbed wire, they were tested for HIV and their asylum claims were reviewed, according to the Guantánamo Public Memory Project. Those testing positive for HIV were required to meet a higher standard to establish that they had a “well-founded fear” of persecution by the Haitian government.
According to an article in The New England Journal of Medicine by George J. Annas, Immigration and Naturalization Service refused to allow the refugees’ attorneys to be present at the screening interviews.
The HIV-positive refugees who successfully completed the interview were housed at Camp Bulkeley, a separate facility at Guantánamo Bay that had inadequate medical facilities and rustic accommodations. During storms, plastic bags would be hung along the structure to help keep the rain out of the refugees’ living quarters.
That is how Camp Bulkeley became the world’s first detention center for people with HIV/AIDS, incarcerating hundreds of Haitian refugees, many of them women and children. Most of the HIV-positive refugees would endure years of detention under brutal conditions and no medical care, and many of them would die while under detention at Camp Bulkeley.
Responding to orders from President Bush, the U.S. Immigration and Naturalization Service (INS) classified most of the Haitians as “economic migrants” rather than “political refugees,” allowing INS officials to swiftly deport them, despite the political dangers in Haiti. During 1991-1992, the U.S. deported about 25,000 asylum-seekers from Haiti.
Photo courtesy of the U.S. National Archives.
A new criminal justice program in New York City offers people convicted of prostitution and minor drug offenses the opportunity to avoid jail time by participating in a two-day course on AIDS and substance abuse education.Learn More.
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 U.S. Centers for Disease Control and Prevention initiates a long-term, primary prevention program for HIV education directed at business owners and the labor community.Learn More.
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 U.S. Immigration Service refuses to allow four HIV-positive Haitian refugees to receive treatment at a state-side hospital.Learn More.
The asylum-seekers from Haiti were picked up at sea from the U.S. Coast Guard and placed at Camp Bulkeley, a detention camp for HIV-positive people in Guantanamo Bay that did not have appropriate medical care for people infected with the virus.
Despite pleas from military officials at the Guantanamo Bay Naval Base, INS officials rejected the requests to allow four ailing Haitian refugees to leave Camp Bulkeley and come to the U.S. for HIV treatment, according to reporting by Philip J. Hilts of The New York Times.
In Camp Bulkeley were 222 men, women and children who tested positive for HIV; all had passed initial INS interviews in their applications for asylum. Among them, according to the NYT article, were 15 whose T-cell counts were low enough to designate them as having AIDS (which today is called “Late-stage HIV”).
Also in camp were 55 relatives, mostly children, who were not HIV-positive.
Navy Col. Stephen Kinder, the commander at Guantanamo, and camp doctors requested that the INS allow at least four detainees to be released to U.S. hospitals, because Camp Bulkeley could not provide adequate care. Camp doctors expected several patients to die within the next six months.
The U.S. continued to keep the 277 Haitians at the detention camp, because the U.S. Justice Department determined early in 1992 to enforce the Bush Administration’s ban on allowing anyone infected with HIV to enter the U.S.
As one of his first acts in the White House, President Bill Clinton establishes the White House Office of National AIDS Policy.Learn More.
The Office of National AIDS Policy (ONAP) is designed to oversee U.S. efforts to implement the President’s National HIV/AIDS Strategy.
ONAP’s scope would grow over the next twenty years to include coordinating national and global efforts with the National Security Council and the Office of the Global AIDS Coordinator. The group would work closely with international bodies to ensure that the U.S. response to the global pandemic is fully integrated with other prevention, care, and treatment efforts around the world.
ONAP would be featured in the press again in January 2017, when under the new Trump administration, the office’s website would become inaccessible. It is then reported that the office closed with the departure of the previous director, Obama-appointee Amy Lansky, with no clear plans if or when President Trump would reopen it.
When President Trump fails to appoint a new ONAP director by June 2017, six members of the Presidential Advisory Council on HIV/AIDS file letters of resignation, citing that above all things the Trump administration “simply does not care” about the HIV/AIDS situation in the U.S.
In June 2021, President Joe Biden would restore ONAP with the appointment of Harold Phillips, a Black man living with HIV, as Director. News of Phillips’s appointment would arrive June 5, the 40th anniversary of the first reports of AIDS.
A federal judge orders the U.S. Attorney General to immediately release 158 Haitian refugees — most of them HIV-positive — from Camp Bulkeley in Guantanamo Bay, Cuba, saying they are being held in “the kind of indefinite detention usually reserved for spies and murderers.”Learn More.
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.
Congress enacts the NIH Revitalization Act and directs the National Institutes of Health to expand involvement of women and minorities in all research.Learn More.
The Act gives the Office of AIDS Research primary oversight of all NIH AIDS research and requires the NIH and other research agencies to increase the role of women and minorities as research subjects.
The statute calls for outreach to women and members of minority groups for recruitment as subjects in clinical research projects. For clinical trials in which women or members of minority groups are included as subjects, trials must be designed and executed in a manner that allows for researchers to determine whether the variables being studied in the trial affect women or members of minority groups differently than other subjects in the trial.
Slipped into the NIH Revitalization Act is an amendment that codifies the U.S. HIV immigration ban into law, which President Bill Clinton signs.
The first contingent of HIV-positive asylum-seekers from Haiti are released from Camp Bulkeley in Cuba and flown to Miami.Learn More.
Following a court order to close the Guantanamo Bay camp being used to detain HIV-positive refugees, the Navy arranged for a C-130 cargo plane to transport 27 Haitians, including 21 adults and six children, to Miami. In this group, 14 planned to settle in the New York City area, 12 were going to remain in Florida, and one was going onto Massachusetts.
The remaining 113 Haitian asylum-seekers were scheduled to travel from the naval compound in Cuba to the U.S. “in the next 10 days to two weeks,” Col. Raymond A. Barbeau told The New York Times.
The freeing of HIV-positive asylum-seekers followed on the heels of an order by Judge Sterling Johnson Jr. of the Federal District Court in Brooklyn.
As he left the detention facility to board the cargo plane, asylum-seeker Jean Edouard said Judge Johnson’s decision restored his faith in democracy.
“Sometimes I got frustrated, and I thought that I’m never going anywhere,” said Edouard, who planned to join his wife and step-daughter in Brooklyn. “I thought I would probably die in Guantanamo, so the judge’s decision was a dream come true.”
At Camp Bulkeley, detainees lived in barracks-like structures made either of plywood or cinder block and capped with tin roofs. With as many as 27 people housed in a single room, many sought privacy by hanging sheets around their military-issue cots, but this impeded what little ventilation existed to alleviate the stifling tropical heat. During storms, residents placed plastic sheets over the screen windows to help keep the rain out.
The facility was not equipped to provide adequate medical care for people with HIV and AIDS.
“Being sick is not a crime,” asylum-seeker Bob Brutus told The New York Times before joining the contingent bound for Miami. “We have done nothing to deserve this treatment. They’ve kept us in prison for nothing.”
At its highest capacity, Camp Bulkeley housed about 300 asylum-seekers, most of them HIV-positive. After less than two years of operating as a detention facility, 140 remained.
President Bill Clinton establishes his Presidential Advisory Council on HIV/AIDS to provide advice, information, and recommendations to his administration regarding HIV/AIDS.Learn More.
The Council meets for the first time on this day in 1995.
PACHA focuses on programs, policies, and research that address HIV/AIDS, including the consideration of common co-morbidities of those infected with HIV as needed to promote effective HIV prevention and treatment.
The Council continues to exist and provide advice for each successive Presidential Administrations.
The President and Vice President convene the first White House Conference on HIV/AIDS in the history of the epidemic, bringing together more than 300 experts, activists and citizens from across the country for a discussion of key issues.Learn More.
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.
The Joint United Nations Programme on HIV/AIDS is launched to strengthen the way in which the UN is responding to AIDS.Learn More.
UNAIDS takes an innovative approach, bringing together various UN organizations to coordinate advocacy for global action on the epidemic.
The launch of UNAIDS involved “a long series of meetings, reports, working groups, whispered conversations and angry confrontations in corridors and telephone calls around the world,” according to UNAIDS: The First 10 Years.
With a staff of 91 in the Geneva-based Secretariat and 10 in various regions, the fledgling organization quickly learned how to act on its ambitious agenda.
Political advocacy was high on UNAIDS’ list of priorities. By June 1996, UNAIDS staff had met with political, economic and social leaders in more than 50 countries to brief them on UNAIDS’ mandate and work.
Sally Cowal, Director of External Relations at UNAIDS, would be worried about not having a medical background.
“But as I came to understand more about the epidemic,” Cowal says, “it became clear to me that the political motivation around it, the need to overcome denial and complacency, were probably as important as anything we could do.”
The Joint United Nations Programme on HIV/AIDS (UNAIDS) is launched to strengthen the way in which the UN is responding to AIDS, replacing the Global Programme on AIDS.Learn More.
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 U.S. Food and Drug Administration approves several new tests and HIV treatments in a three-month period.Learn More.
Among its fast-track approvals are:
- the first HIV home testing and collection kit (May 14)
- a viral load test, which measures the level of HIV in the blood (June 3)
- the first non-nucleoside reverse transcriptase inhibitor (NNRTI) drug, nevirapine (June 21)
- the first HIV urine test (August 6)
Congress reauthorizes the Ryan White CARE Act, continuing federal funding for primary medical care, essential support services, and medications for low-income people with HIV/AIDS.Learn More.
The legislation grants the funding needed for the U.S. Health Resources and Services Administration to continue its public health response to HIV.
President Bill Clinton announces that the goal of finding an effective vaccine for HIV in 10 years will be a top national priority, and calls for the creation of an AIDS vaccine research center at the National Institutes of Health.Learn More.
President Clinton would dedicate the new Dale and Betty Bumpers Vaccine Research Center on June 9, 1999.
The U.S. Food and Drug Administration approves Combivir, the first one-pill combination of the two most widely used antiretroviral medications for AIDS and HIV infection.Learn More.
A combination of Retrovir (zidovudine or AZT) and Epivir (lamivudine or 3TC), Combivir decreases the number of pills people with HIV have to take daily.
As the first combination agent, the medication significantly simplies HIV therapy. Combivir becomes the gold standard nucleoside “backbone” until the mid-2000s, when the introduction of newer fixed-dose combinations with improved tolerability and toxicity arrive.
Congress enacts the Food and Drug Administration Modernization Act of 1997, codifying an accelerated drug-approval process and allowing dissemination of information about off-label uses of drugs.
Donna Shalala, Secretary of the U.S. Department of Health and Human Services, determines that needle-exchange programs are effective and do not encourage the use of illegal drugs, but the Clinton Administration refuses to lift the ban on use of Federal funds for these programs.
Three Haitian immigrants seeking asylum in the U.S. die of AIDS-related illness within a single week in New York City. They are among the 20 HIV-positive refugees who have died in the five years following their release from Guantanamo Bay, Cuba.Learn More.
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 Congressional Black Caucus urges Health and Human Services Secretary Donna Shalala to invoke a Federal law allowing her to release up to $45 million to combat the HIV epidemic in Black communities.Learn More.
In an initiative led by California Congresswoman Maxine Waters, the Caucus also requested that President Bill Clinton adopt state of emergency measures to address the HIV/AIDS disparities in Black communities. This action followed a March 1989 report by the Centers for Disease Control & Prevention showing that Black Americans are disproportionately impacted by HIV/AIDS.
Although Black people comprised 12% of the U.S. population in 1998, they represented 43% of new AIDS cases. Also, AIDS was cited by the CDC as the leading cause of death for Black people between the ages of 25 to 44.
In the coming days, President Bill Clinton would direct government agencies to examine ways to reduce disparities in health status that affect racial and ethnic minorities.
AIDS Policy Law, May 29, 1998, “Black caucus seeks emergency attention for HIV epidemic”
Photo courtesy of Rep. Maxine Waters
The U.S. Supreme Court rules that the Americans with Disabilities Act covers those in earlier stages of HIV disease, not just those who have developed AIDS.
Congress enacts the Ricky Ray Hemophilia Relief Fund Act, honoring the Florida teenager infected with HIV through contaminated blood products.Learn More.
The Act authorizes payments of $125,000 to individuals with hemophilia and other blood clotting disorders who were infected with HIV by unscreened blood-clotting agents between 1982 and 1987. The funding program also includes payments for individuals who were infected with HIV through perinatal transmission from a hemophiliac parent.
President Clinton declares AIDS to be a “severe and ongoing health crisis” in black and hispanic communities in the U.S. and announces a special package of initiatives aimed at reducing the impact of HIV/AIDS on racial and ethnic minorities.Learn More.
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.
At the urging of the Congressional Black Caucus, Congress funds the Minority AIDS Initiative to address the growing disparity of HIV infection among communities of color.Learn More.
An unprecedented $156 million annual budget is dedicated to improving the nation’s effectiveness in preventing and treating HIV/AIDS in minority communities.
Congresswoman Maxine Waters, a Democrat from California’s 43rd district, led efforts within the U.S. House of Representatives to establish the Minority AIDS Initiative (MAI) during her tenure as Chairwoman of the Congressional Black Caucus.
The establishment of the MAI was announced on October 28, about two weeks prior to the Congressional vote, at an event sponsored by the Congressional Black Caucus. The event featured the participation of President Bill Clinton, Secretary of Health & Human Services Donna Shalala, Congresswoman Maxine Waters and other members of the Congressional Black Caucus, and representatives of HIV/AIDS service and advocacy organizations.
While the number of new AIDS cases in the U.S. began to decline in 1996, AIDS remained the leading cause of death for Black men between the ages of 25 and 44 and the second leading killer of Black women in the same age group.
Though representing approximately 13% of the U.S. population, Black people comprised more than 40% of all new HIV/AIDS cases in 1998, and Black women made up 60% of all new female cases. Likewise, the Hispanic population represented over 20% of new HIV/AIDS cases and only 11% of the U.S. population.
The MAI was the latest in a series of 1998 Clinton Administration initiatives to address racial and ethnic health disparities in the American public, according to the Clinton Digital Library.
In 2009, Congress would codify the MAI within the reauthorization of the Ryan White CARE Act. Today, the Minority AIDS Initiative continues to fills gaps in prevention, treatment, surveillance, infrastructure, outreach and education across communities of color.
Photo courtesy of the Clinton White House Archives: Rep. Maxine Waters with Presidential Advisory Council on HIV/AIDS member Denise Stokes and President Bill Clinton at the Congressional Black Caucus event announcing the creation of the Minority AIDS Initiative on October 28, 1998
William J Clinton Presidential Library
The Congressional Hispanic Caucus, with the Congressional Hispanic Caucus Institute, convenes hearings on the impact of HIV/AIDS on the Latino community.
President Clinton announces the formation of the “Leadership and Investment in Fighting an Epidemic” Initiative, which will provide funding to address the global HIV epidemic.
The World Health Organization announces that HIV/AIDS has become the fourth biggest killer worldwide and the number one killer in Africa.Learn More.
WHO estimates that 33 million people are living with HIV worldwide, and that 14 million have died of AIDS.
he United Nations Security Council meets to discuss the impact of AIDS on peace and security in Africa. This marks the first time that the council discusses a health issue as a threat to peace and security.
In his State of the Union address, President Bill Clinton announces the launch of the Millennium Vaccine Initiative to create incentives for developing and distributing vaccines against HIV, TB, and malaria.Learn More.
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.
President Clinton declares that HIV/AIDS is a threat to U.S. national security.
President Clinton issues an Executive Order to assist developing countries in importing and producing generic HIV treatments.
UNAIDS, the World Health Organization, and other global health groups announce a joint initiative with five major pharmaceutical manufacturers to negotiate reduced prices for HIV/AIDS drugs in developing countries.
Stephen Gendin, an AIDS activist and writer who founded a nationally known mail-order prescription service for people infected with HIV, died of AIDS-related illness in New York’s Roosevelt Hospital. He was 34.Learn More.
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 leaders of the “Group of Eight” (G8) Summit release a statement acknowledging the need for additional HIV/AIDS resources.Learn More.
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.
Congress enacts the Global AIDS and Tuberculosis Relief Act of 2000, which provides assistance to countries with large populations of people living with HIV/AIDS.
As part of its Millennium Declaration, the United Nations adopts the Millennium Development Goals, which include a specific goal of reversing the spread of HIV/AIDS, malaria, and TB.
Congress reauthorizes the Ryan White CARE Act for the second time.
May 18 is the first annual observance of HIV Vaccine Awareness Day.
The United Nations (UN) General Assembly holds its first Special Session on AIDS (UNGASS) and passes the UNGASS Declaration of Commitment and the ILO (International Labor Organization) Code of Practice on HIV/AIDS in the Workplace.Learn More.
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.
Newly appointed U.S. Secretary of State, Colin Powell, reaffirms the U.S. statement that HIV/AIDS is a national security threat.
After generic drug manufacturers offer to produce discounted, generic forms of HIV/AIDS drugs for developing countries; several major pharmaceutical manufacturers agree to offer further reduced drug prices to those countries.
The U.S. Health Resources and Services Administration (HRSA) begins focusing on individuals with HIV disease who know their status and are not receiving HIV-related services. HRSA instructs its grantees to address this population’s “unmet need” for services.
The U.S. Centers for Disease Control and Prevention (CDC) announce a new HIV Prevention Strategic Plan to cut annual HIV infections in the U.S. by half within five years.
The World Trade Organization (WTO) announces the Doha Declaration, which affirms the rights of developing countries to buy or manufacture generic medications to meet public health crises such as HIV/AIDS.
The Global Fund to Fight AIDS, Tuberculosis and Malaria, a worldwide partnership between governments, civil society organizations, the private sector, and affected communities, is established.Learn More.
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.
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.
The United States announces a framework that will allow poor countries unable to produce pharmaceuticals to gain greater access to drugs needed to combat HIV/AIDS, malaria, and other public health crises.
The U.S. National Intelligence Council releases Next Wave of the Epidemic, a report focusing on HIV in India, China, Russia, Nigeria, and Ethiopia.
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.”
President George W. Bush announces the creation of the United States President’s Emergency Plan For AIDS Relief (PEPFAR) in his State of the Union address. PEPFAR is a $15 billion, 5-year plan to combat AIDS, primarily in countries with a high burden of infections.
CDC announces Advancing HIV Prevention: New Strategies for a Changing Epidemic, a new prevention initiative that aims to reduce barriers to early diagnosis and increase access to, and utilization of, quality medical care, treatment, and ongoing prevention services for those living with HIV.
The World Health Organization (WHO) announces the “3 by 5” initiative , to bring treatment to 3 million people by 2005.
In January, the U.S. Congress authorizes the first $350 million for the United States President’s Emergency Program for AIDS Relief (PEPFAR).
UNAIDS (the Joint United Nations Programme on AIDS) launches The Global Coalition on Women and AIDS to raise the visibility of the epidemic’s impact on women and girls around the world.
FDA issues a guidance document for expedited approval of low cost, safe, and effective co-packaged and fixed-dose combination HIV therapies so that high-quality drugs can be made available in Africa and developing countries around the world under PEPFAR.
Leaders of the “Group of Eight” (G8) Summit (Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States) call for the creation of a “Global HIV Vaccine Enterprise,” a consortium of government and private-sector groups designed to coordinate and accelerate research efforts to find an effective HIV vaccine.
During its annual meeting in January, the World Economic Forum approves a set of new priorities, including one with a focus on addressing HIV/AIDS in Africa and other hard-hit regions.
The U.S. Food and Drug Administration (FDA) grants tentative approval to a generic copackaged antiretroviral drug regimen for use under the United States President’s Emergency Plan for AIDS Relief (PEPFAR).
The United Nations (U.N.) General Assembly High-Level Meeting on HIV/AIDS meets to review progress on targets set at the 2001 U.N. General Assembly Special Session on HIV/AIDS (UNGASS).
The “Group of Eight” (G8) Summit focuses on development in Africa, including HIV/AIDS. 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.
March 10 is the first annual National Women and Girls HIV/AIDS Awareness Day in the U.S.
March 20 is the first annual observance of National Native HIV/AIDS Awareness Day in the U.S.
On May 3-6, the Office of AIDS Research, in the National Institutes of Health (NIH), sponsors Embracing Our Traditions, Values, and Teachings: Native Peoples of North America HIV/AIDS Conference, in Anchorage, Alaska.Learn More.
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 United Nations convenes a follow-up meeting and issues a progress report on the implementation of the Declaration of Commitment on HIV/AIDS .
On December 19, the U.S. Congress reauthorizes the Ryan White CARE Act for the third time.
Bob Hattoy, an activist who spoke about AIDS at the 1992 Democratic Convention, dies of AIDS-related illness at UC Davis Medical Center in Sacramento at the age of 56.
[Portrait by Greg Loudon, for an art series for the National Institutes of Health’s National Library of Medicine]Learn More.
Hattoy quit his decades-long job as regional director of the Sierra Club in Los Angeles to join Bill Clinton’s presidential campaign during the 1992 primary. Shortly thereafter, he learned that he had AIDS-related lymphoma and began chemotherapy treatments. That didn’t stop him from stumping for Clinton in front of AIDS and gay and lesbian communities all over the nation.
Political activist and author David Mixner remembered well Hattoy’s groundbreaking speech to the delegates of the 1992 Democratic Convention, made shortly after receiving his diagnosis.
“The hall was in the usual hubbub that passes for normal even when speeches are going on. But as Bob Hattoy mounted the podium, stillness fell over the entire place,” Mixner recalled. “One by one, the delegates stood up, until all 5,000 people were on their feet in respect.”
Hattoy then said the opening words of his speech: “This is difficult.”
“There was not a dry eye in the nation that night,” said Mixner. “Those of us in the hall had black armbands to honor those we knew who had died of ADIS and held onto each other as he spoke. It was as if at last we were finally being heard after a decade of horror, death and abandonment.”
Jackie McCort of the Sierra Club said of watching her former colleague at the convention: “We gathered around the TV together that night, so thrilled and touched that ‘one of our own’ was speaking so eloquently to the American people. Doggone, we were proud!”
Beginning in 1993, Hattoy worked in the Clinton administration as a deputy in the White House Office of Personnel. In the Old Executive Office Building next door to the White House was Hattoy’s office, which he shared with a colleague. On his desk was a rainbow pride flag and on the walls were photos of he and his boyfriend.
There, he spent most of his days overseeing the search and screening process for potential hires for midlevel posts in agencies like the Interior Department and Environmental Protection Agency. But Hattoy also saw his role as largely that of internal agitator, checking up almost every day on the progress of issues with more senior officials and sharing those developments with key members of his network.
“I never think of Bob as someone on the White House staff,” said activist Larry Kramer. “I think of him as our mole.”
In March 1993, when President Clinton said he was considering restrictions on the roles gays and lesbians might be allowed to take in the military, Hattoy compared that to “restricting gays and lesbians to jobs as florists and hairdressers” in civilian life. This public outburst branded Hattoy as unpredictible and potentially problematic to the Clinton administration.
In a June 1993 wine-fueled interview with The New York Times, Hattoy said, “Basically, I’m an activist first and a White House employee second. If they fire me, I’ll go to work in a lesbian bakery. But they won’t fire me. We’ve been in too many wars together.”
The next year, to decrease his visibility, the administration appointed him to the position of White House liaison on environmental matters at the Interior Department, where he remained until 1999. He also served as chairman of the research committee of the Presidential Commission on HIV/AIDS.
“Having been a lobbyist and activist for 20 years, I’d be perfect on the Hill or with community groups or other political coalitions they need to maintain relationships with and keep going — I mean with the progressive community,” Hattoy told POZ magazine in April 1994. “I originally wanted to do that. That didn’t happen, I think, because — well, I know why.”
“For 25 years, I’ve been an outspoken activist, outspoken about what I’ve believed in and cared about. And for a while that fit perfectly into helping to identify who Bill Clinton was as a human being, to show that he meant it when he talked about how there’s no such thing as Them and Us in America,” he explained. “When I continued to speak out after the election, it became off-message, I think a lot of people in the White House didn’t know what to do with me.”
A few years after the White House job ended, California Governor Gray Davis appointed him to the California Fish & Game Commisison, which Hattoy promptly joked he would work to rename the “Swish and Fish Commission.” The post was unpaid and required hundreds of hours of work, with more than a dozen public hearings each year, site inspections, lobbying and other responsibilities.
In the months before his death, he worked on the California Marine Protection Act, creating huge expanses of sea that are like protected state parkland, only underwater. For environmentalists and preservationists, the legislation was an historic victory, for which Hattoy deserved much of the credit. Soon after, he was elected Chairman of the commission.
Throughout the years, Hattoy battled recurrent pneumonia and other complications several times and suffered a bone marrow infection a few weeks before his death, but was generally healthy and extremely productive throughout his years with AIDS.
Following Hattoy’s death, former President Bill Clinton and former Secretary of State Hillary Clinton released a joint statement:
“We have lost a pioneer, a leader, and a friend. Bob Hattoy devoted his life to the fight for civil rights and social justice for the gay community and people living with AIDS. We will always be grateful for his courageous and moving speech at the 1992 Democratic National Convention and afterward, for his years of dedicated service in the administration. He gave hope to a community that feared their voice would never be heard at the highest levels of government.”
In an attempt to increase HIV testing, the World Health Organization and UNAIDS recommend “provider-initiated” HIV testing in healthcare settings.Learn More.
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 Rwandan Government hosts the International HIV/AIDS Implementers Meeting, drawing 1,500 delegates to share data and ideas.Learn More.
Sharing lessons on HIV prevention, treatment, and care, attendees participate in an open dialogue about future directions of HIV/AIDS programs, with a strong emphasis on implementation and identification of critical barriers and best practices.
A session titled “Making care truly comprehensive and providing a preventive care package for people living with HIV” featured lessons on providing comprehensive care, mostly based on the holistic palliative care model deveopled in Cote d’Ivoire, Rwanda, Tanzania, Zambia and South Africa. It was noted, however, that none of the speakers mentioned TB prevention, diagnosis and treatment.
“Do not forget about TB!!” urged WHO in its summary of the conference.
A satellite meeting organized by PEPFAR and the Secretariat of the TB/HIV Working Group at WHO was attended by implementers from 22 countries. The main topic of discussion was how PEPFAR funds can be used to support TB control activities.
Cosponsors include WHO; UNAIDS; the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); The Global Fund to Fight AIDS, Tuberculosis, and Malaria; UNICEF; the World Bank; and GNP+ (the Global Network of People Living with HIV) .
In October, the U.S. Centers for Disease Control and Prevention (CDC) launch Prevention IS Care (PIC), a social marketing campaign designed for healthcare providers who deliver care to people living with HIV.
HIV/AIDS implementers from around the world gather in Kampala, Uganda for the 2008 HIV/AIDS Implementers’ Meeting, where three activists were arrested by Ugandan police.Learn More.
In recognition of the rapid expansion of HIV/AIDS programs worldwide, the focus of the meeting was building the capacity of local prevention, treatment, and care programs; enhancing quality; and promoting coordination among partners.
A total of 1,700 attendees convened at the meeting, representing governments, nongovernmental organizations including faith- and community-based groups, multilateral organizations, the private sector, and groups of people living with HIV/AIDS.
Cosponsors of the four-day conference include the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); The Global Fund to Fight AIDS, Tuberculosis, and Malaria; UNAIDS (the Joint United Nations Programme on HIV/AIDS); the World Health Organization (WHO); the United Nations Children’s Fund (UNICEF); the World Bank; and GNP+ (the Global Network of People Living with HIV).
During the conference, three Ugandan LGBT activists were arrested as they protested the statements made by a Ugandan government official who refused to direct funds toward HIV programs that targeted men who have sex with men.
The Uganda Police Force arrested and detained Pepe Julian “Patience” Onziema, Valentine Kalende and Usaam “Auf” Mukwaya — all members of the LGBT organization Sexual Minorities Uganda (SMUG) — when the three activists took the stage at the conference to distribute leaflets and hold up small placards demanding attention to HIV vulnerability among the LGBT community.
The International Gay and Lesbian Human Rights Commission immediately issued a press release condemning the arrests of the activists and calling for their immediate and unconditional release. The commission expressed concern for the safety of the activists, and noted the Ugandan government routinely discriminated against those speaking up for the LGBT community.
On July 25, a few hours after the activists attended their hearing for their arrest, Kampala police officers abducted one of the activists, Usaam “Auf” Mukwaya, as he returned his hotel.
A patrol car stopped the taxi he was riding in and four men identifying themselves as police officers abducted him and took him to a location where he was held for more than 24 hours without access to a lawyer or any reason provided for his arrest.
Mukwaya told Human Rights Watch that his abductors asked him questions in Luganda, a local dialect, about SMUG’s funders and supporters, and about his own role “among the homosexuals.” They also demanded he give them information about other individuals involved in LGBT rights.
According to Mukwaya, three police officers pushed him through a dark corridor to a room where they sat him on a chair. Mukwaya reported seeing four other men in the room; they were close to his own age and appeared to have been beaten. One appeared to have a broken leg.
One of the abductors scraped his knuckles with a razor-like object. Another tied him to a machine that stretched his arms. After forcing Mukwaya to strip to his underwear, they asked him if he was a man or a woman, and made him walk around the room unclothed.
The following day, they released him, dropping him on the streets of central Kampala.
Human Rights Watch would issue a statement decrying the treatment of government officials of Mukwaya and noting that “torture and ill-treatment is a pervasive problem” for the LGBT community in Uganda.
President George W. Bush signs legislation to extend the President’s Emergency Plan for AIDS Relief and loosen the HIV travel ban.Learn More.
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.
September 18 is the first observance of National HIV/AIDS and Aging Awareness Day .
National Gay Men’s HIV/AIDS Awareness Day is first recognized on September 27.
Newly elected President Barack Obama calls for the development of the first National HIV/AIDS Strategy for the United States.
The Obama Administration and the U.S. Centers for Disease Control and Prevention launch the Act Against AIDS campaign.Learn More.
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.
President Barack Obama’s Global Health Initiative will develop a comprehensive approach to global healthcare in low- and middle-income countries.Learn More.
A six-year, $63 billion effort, the Global Health Initiative received input and involvement from the President’s Emergency Plan for AIDS Relief (PEPFAR).
June 8 marks the first annual recognition of Caribbean American HIV/AIDS Awareness Day.
The Department of Veterans Affairs moves to increase the number of veterans receiving HIV tests by dropping the requirement for written consent.
The U.S. Food and Drug Administration approves the 100th antiretroviral drug.Learn More.
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.”
President Barack Obama signs into law the Matthew Shepard and James Byrd Jr. Hate Crimes Prevention Act, expanding the 1969 federal hate-crime law to include crimes committed because of a victim’s sexual orientation.Learn More.
Named after Matthew Shepard and James Byrd Jr., the measure was conceived as a response to the murders of both men in 1998.
Shepard was a gay college student who was tortured and murdered near Laramie, Wyoming by two men. Shepard’s murderers were given life sentences — in large part because his parents sought mercy for his killers. Byrd was a 49-year-old disabled Black man from Jasper, Texas who was tied to a truck by three white supremacists, dragged behind it, and decapitated. Two of Byrd’s murderers were sentenced to death and executed in 2011 and 2019, respectively, while the third was sentenced to life in prison.
“Prosecutors will have new tools to work with states in order to prosecute to the fullest those who would perpetrate such crimes,” President Obama said, “because no one in America should ever be afraid to walk down the street, holding the hands of the person they love.”
The audience at the White House included Matthew Shepard’s parents Denis and Judy, and the family of the late Sen. Edward M. Kennedy, who championed the legislation but died before the bill was passed.
President Barack Obama signs the Consolidated Appropriations Act, which modifies the ban on the use of federal funds for needle exchange programs.Learn More.
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.
President Barack Obama ends the HIV ban on travel and immigration by removing the remaining regulatory barriers to entry.Learn More.
The lifting of the travel ban was done in conjunction with the announcement that the International AIDS Conference would return to the U.S for the first time in more than 20 years.
“If we want to be a global leader in combating H.I.V./AIDS, we need to act like it,” Obama said at a White House ceremony to announce the cancellation of the ban. “Now, we talk about reducing the stigma of this disease, yet we’ve treated a visitor living with it as a threat.”
The Human Rights Campaign, the nation’s largest LGBT civil rights organization, hailed the announcement that the ban, first established in 1987 by the Reagan Administration, has been lifted. Regulations officially removed HIV from the list of communicable diseases that barred foreign nationals from entering the U.S.
“The United States of America has moved one step closer to helping combat the stigma and ignorance that still too often guides public policy debates around HIV/AIDS,” said HRC President Joe Solmonese. “Today, a sad chapter in our nation’s response to people with HIV and AIDS has finally come to a close and we are a better nation for it.”
Scientific researchers also applauded the end of the travel ban.
“The removal of the immigration and travel ban on HIV-infected persons was a monumental step in eliminating the exceptionalism of HIV and reducing stigma and social barriers for those living with HIV,” Susanna E. Winston, M.D. and Curt G. Beckwith, M. wrote in their 2011 report in AIDS Patient Care and STDs.
The researchers further called for increased alliances between the U.S. and its immigrant communities as well as additional options for testing.
Not everyone celebrated the end of the HIV travel ban.
“You’re running into a huge public expense because most people simply cannot afford the drugs to treat HIV out of their own pockets,” Ira Mehlman, spokesman for the Federation for American Immigration Reform, told ABC News. “[HIV-positive immigrants] will require all sorts of assistance from the government to pay for the drugs that they need.”
President Barack Obama signs the Affordable Care Act, providing historic protections for those living with HIV.Learn More.
“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.
The Obama Administration releases the first comprehensive National HIV/AIDS Strategy for the United States.
An important scientific breakthrough for HIV prevention in women garners attention at the International AIDS Conference in Vienna, Austria.Learn More.
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.
AIDS Action merges with the National AIDS Fund to form AIDS United
On September 20-22, the United Nations (UN) convenes a summit to accelerate progress toward the 2015 Millennium Development Goals
Public debate begins on whether the longstanding ban on transplants of HIV-infected organs should be dropped .
Over 3,000 people participate in the United Nation’s (UN) High-Level Meeting on HIV/AIDS in New York from June 8–10.Learn More.
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.
On the occasion of the one-year anniversary of the White House National HIV/AIDS Strategy, President Obama announces plans to increase efforts to reduce HIV transmission and boost public awareness.Learn More.
In a video presentation, President Obama, doctors, researchers, policy makers, community leaders and advocates speak about the one-year-old comprehensive National HIV/AIDS Strategy on the 30th anniversary of the disease.
Lead Federal agencies release implementation plans in support of the U.S. National HIV/AIDS Strategy.
The U.S. launches the 12 Cities Project, an initiative to accelerate planning and cross-agency response in areas with high rates of HIV infection.Learn More.
Focusing on twelve jurisdictions in the U.S. that bear the highest AIDS burden, the U.S. Department of Health and Human Services rolls out components of the project to cover comprehensive care, treatment and prevention.
Based on an estimate of total AIDS cases reported in December 2007 in cities across the country, HHS selected twelve cities to be included in the initial project. These cities represent 44% of the total cases in the U.S. in December 2007:
New York City, NY (66,426 cases)
Los Angeles, CA (24,727 cases)
Washington, DC (15,696 cases)
Chicago, IL (14,175 cases)
Atlanta, GA (13,105 cases)
Miami, FL (12,732 cases)
Philadelphia, PA (12,469 cases)
Houston, TX (11,277 cases)
San Francisco, CA (11,026 cases)
Baltimore, MD (10,301 cases)
Dallas, TX (7,993 cases)
San Juan, PR (7,858 cases)
Phase I of this project, from October 2010 to April 2011, focused on data collection and planning, with an explicit focus on identifying gaps in coverage in terms of populations, interventions, and services. Phase II, from May to September 2011 “and beyond,” focused on responding to the results of the enhanced planning process, including making recommendations about redirecting resources in order to optimize outcomes.
In September, the Office of National AIDS Policy begins to convene a series of five regional dialogues to focus attention on critical implementation issues for the National HIV/AIDS Strategy.
The “Road to AIDS” town hall comes to San Francisco, the first in a nationwide event series building up to the International AIDS Conference.Learn More.
The San Francisco Town Hall brought together diverse community members to talk about where we are with the HIV epidemic 30 years in, and where we’re going.
The first of fifteen town halls across the U.S., San Francisco’s event included U.S. Congresswoman Barbara Lee (shown in photo), as well as participation from panelists Andrew Forsyth, PhD, HHS, Office of the Deputy Assistant Secretary for Health/Infectious Diseases; Grant Colfax, MD, Director of HIV Prevention and Research, San Francisco Department of Public Health; Herb K. Schultz, Regional Director, HHS, Region IX; Charles Fann, Community Co-Chair for the San Francisco HIV Prevention Planning Council and Health Promotions Program Manager at Tenderloin Health; Sharyn Grayson, Co-Chair at Collaborative Community Planning Council – Oakland TGA; Kabir Hypolite, PhD, Director, Office of AIDS Administration, Alameda County; and Marsha A. Martin, DSW, Director, Get Screened Oakland.
Across the panelists’ responses, several themes emerged including the need to:
- Put patients and communities first
- Enhance collaboration and breaking down of silos
- Align resources (especially when they are limited) with the goals of the National HIV/AIDS Strategy by looking at the data
- Strengthen stakeholder engagement
- Provide a comprehensive and coordinated system of HIV prevention and care
- Work across cultural lines
Each of the fifteen “Road to AIDS” town halls was free and open to the public, and took place over the 11 months leading up to “AIDS 2012,” the XIX International AIDS Conference, on July 22-27, 2012 in Washington, DC.
“AIDS 2012” would be the largest gathering of people working in HIV to date.
Secretary of State Hillary Rodham Clinton shares the U.S. Government’s new vision of creating an AIDS-free generation.Learn More.
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.
On December 1 (World AIDS Day), at the ONE Campaign and (RED) event in Washington, DC, President Obama announces accelerated efforts to increase the availability of treatment to people living with HIV/AIDS in the United States.Learn More.
He challenges the global community to deliver funds to The Global Fund to Fight AIDS, Tuberculosis and Malaria , and calls on Congress to keep its past commitments intact. He calls on all Americans to keep fighting to end the epidemic.
The U.S. Department of Health and Human Services issues new HIV treatment guidelines recommending treatment for all HIV-infected adults and adolescents, regardless of CD4 count or viral load.
The FDA approves the use of Truvada® for pre-exposure prophylaxis (PrEP). Adults who do not have HIV, but who are at risk for infection, can now take this medication to reduce their risk of getting the virus through sexual activity.
The XIX International AIDS Conference (AIDS 2012 ) is held in Washington, DC—the first time since 1990 that the conference has been held in the United States.Learn More.
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.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) celebrates its 10th anniversary.
Secretary of State John Kerry announces that, thanks to direct PEPFAR support, more than 1 million infants have been born HIV-free since 2003.
President Obama issues an Executive Order directing Federal agencies to prioritize supporting the HIV care continuum as a means of implementing the National HIV/AIDS Strategy.Learn More.
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.
President Obama signs the HIV Organ Policy Equity (HOPE) Act, which will allow people living with HIV to receive organs from other infected donors. The HOPE Act has the potential to save the lives of about 1,000 HIV-infected patients with liver and kidney failure annually.
January 1: Major provisions of the Affordable Care Act designed to protect consumers go into effect. Insurers are now barred from discriminating against customers with pre-existing conditions, and they can no longer impose annual limits on coverage—both key advances for people living with HIV/AIDS.
The United Nations Commission on the Status of Women releases a report on the challenges and achievements of implementing the MDGs for women and girls.Learn More.
The Commission concludes that progress on MDG6 (Combating HIV/AIDS, Malaria, and Other Diseases) has been limited, given that the number of women living with HIV globally continues to increase. The report notes several key challenges: adolescent/young women’s particular vulnerability to HIV; the need to increase access to healthcare services; and the challenges of structural gender inequalities, stigma, discrimination, and violence.
Dr. Deborah Birx is sworn in as Ambassador at Large and U.S. Global AIDS Coordinator to oversee the President’s Emergency Plan for AIDS Relief (PEPFAR). She replaces Dr. Eric Goosby.
Douglas Brooks is appointed as the new Director of the White House Office of National AIDS Policy (ONAP). He is the first African American and the first HIV-positive person to hold the position.
Nearly 14,000 delegates attend the 20th International AIDS Conference, travelling to Melbourne, Australia from over 200 nations.Learn More.
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.
CDC releases a new report that finds gaps in care and treatment among Latinos diagnosed with HIV.
FDA announces it will recommend changing the blood donor deferral guidelines for men who have sex with men from permanent deferral to one year since the last sexual contact.Learn More.
In 1983, the agency imposed a lifetime ban on donating blood for all men who have ever had sex with another man.
HHS announces the launch of a new, 4-year demonstration project to address HIV disparities among MSM of color. The cross-agency project, “Developing Comprehensive Models of HIV Prevention and Care Services for MSM of Color,” will support community-based models for HIV prevention and treatment.
HIV diagnosis rates in the U.S. remain stable between 2009-2013, but men who have sex with men (MSM), young adults, racial/ethnic minorities, and individuals living in the South continue to bear a disproportionate burden of HIV, according to the Center for Disease Control’s 2015 DC’s annual HIV Surveillance Report.
The U.S. Department of Health and Human Services announces on May 8 that it will amend the Federal rules covering organ transplants to allow the recovery of transplantable organs from HIV-positive donors.Learn More.
The new regulations will provide a framework for clinical studies on transplanting organs from HIV-positive donors to HIV-positive recipients.
UNAIDS announces that the targets for Millennium Development Goal #6 —halting and reversing the spread of HIV—have been achieved and exceeded 9 months ahead of the schedule set in 2000.
The U.S. Departments of Housing and Urban Development and Justice announce they will collaborate on a demonstration project to provide housing assistance and supportive services to low-income persons living with HIV/AIDS who are victims of sexual assault, domestic violence, dating violence, or stalking.
The White House launches the National HIV/AIDS Strategy: Updated to 2020.Learn More.
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.
At a United Nations summit on the Sustainable Development Goals, the United States announces new PEPFAR prevention and treatment targets for 2016–2017.Learn More.
By the end of 2017, the U.S. will commit sufficient resources to support antiretroviral therapy for 12.9 million people, provide 13 million male circumcisions for HIV prevention, and reduce HIV incidence by 40% among adolescent girls and young women within the highest burdened areas of 10 sub-Saharan African countries.
The World Health Organization announces new treatment recommendations that call for all people living with HIV to begin antiretroviral therapy as soon after diagnosis as possible.Learn More.
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.
Greater Than AIDS launches a new campaign, Empowered: Women, HIV and Intimate Partner Violence, to bring more attention to issues of relationship violence and provide resources for women who may be at risk of, or dealing with, abuse and HIV.
amfAR, The Foundation for AIDS Research, announces its plan to establish the amfAR Institute for HIV Cure Research at the University of California, San Francisco. As the cornerstone of amfAR’s $100 million investment in cure research, the Institute will work to develop the scientific basis for an HIV cure by the end of 2020.
The White House releases a Federal Action Plan to accompany the updated National HIV/AIDS Strategy. The plan was developed by 10 Federal agencies and the Equal Employment Opportunity Commission and contains 170 action items that the agencies will undertake to achieve the goals of the Strategy.
Partly in response to the HIV outbreak in Indiana, which is linked to people injecting drugs, Congress lifts restrictions that prevented states and localities from spending Federal funds for needle exchange programs.
The U.S. Food and Drug Administration announces it will lift its 30-year-old ban on all blood donations by men who have sex with men and institute a policy that allows them to donate blood if they have not had sexual contact with another man in the previous 12 months.
Responding to a surge in HIV cases in South Florida, state legislators approve a bill to create a pilot needle-exchange program in Miami-Dade County.Learn More.
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 U.S. Department of Health and Human Services releases new guidance for state, local, tribal, and territorial health departments that will allow them to request permission to use federal funds to support syringe-services programs (SSPs).Learn More.
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.
UN member states convene to adopt a declaration to end AIDS, but activists walk out of the meeting and take to the streets to protest the discrimination against LGBTQ people by 51 Muslim states.Learn More.
As member states gather at the three-day UN High-Level Meeting on Ending AIDS, the event is marked by controversy after more than 50 nations block the participation of groups representing LGBT people from the meeting.
One goal of the meeting is to adopt the 2016 U.N. Political Declaration on Ending AIDS — a document that lists steps to end the global epidemic by 2030. However, the political declaration is viewed as exclusionary, discriminatory and inadequate.
“This political declaration has fatal flaws,” said Maureen Milanga of Health GAP, which protested outside UN Headquarters in New York. “We welcome the new target of reaching 30 million people by 2020 with lifesaving treatment and the pledge to achieve viral suppression for 90% of people on treatment through scaling up differentiated models of quality care. But unless dangerous donor funding cuts are reversed, millions will be denied access to medicine.”
The final resolution barely mentions those most at risk for contracting HIV/AIDS: men who have sex with men, sex workers, transgender people and people who inject drugs.
The groups excluded from the meeting are nongovernmental organizations (NGOs). Egypt wrote a letter on behalf of 51 members of the Organization of Islamic Cooperation, objecting to the participation of 11 groups. The letter did not give any reasons, but it was noted that the excluded groups appear to focus on gay and transgender advocacy.
“Given that transgender people are 49 times more likely to be living with HIV than the general population, their exclusion from the high-level meeting will only impede global progress in combating the HIV/AIDS pandemic,” wrote Samantha Power, U.S. ambassador to the UN, in a letter to General Assembly President Mogens Lykketoft.
The federal government’s website on HIV/AIDS changes its name from AIDS.gov to HIV.gov, reflecting a new focus on HIV management.Learn More.
The announcement coincides with the 36th 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.”
Gov. Jerry Brown signs a bill decreasing the penalty from a felony to a misdemeanor for knowingly exposing a sexual partner to HIV or donating blood without disclosing the infection.Learn More.
The public health community lobbied the governor to support the legislation (Senate Bill 239), because it put an end to laws that discouraged people from getting tested and into treatment. The new law took a public health approach and recognized the current understanding that with treatment, people with HIV effectively have no risk of sexually transmitting HIV to others.
Prior to this, knowingly exposing a sexual partner to HIV was a felony offense punishable by three to eight years in prison.
“HIV is a public health issue, not a criminal issue,” said Sen. Scott Wiener, co-author of the legislation. “These felonies, which treat HIV differently than all other serious communicable diseases, stigmatize people living with HIV and discourage people from getting tested and into treatment.”
The new law, which took effect January 1, changed this to a misdemeanor, carrying a six-month prison term — the same punishment as knowingly exposing someone to other communicable diseases.
According to Lambda Legal, “If you are living with HIV, you no longer have to live with the threat of felony prosecution as a result of other people’s ignorance or someone’s attempt to harm you through a vindictive prosecution. If you are not living with HIV, you should continue taking responsibility for your sexual health and make appropriate choices regarding the sexual risks you are willing to take. And you can expect that more people living with HIV will be willing to have frank conversations about HIV and other sexual health risks, because they no longer have to fear retribution through the criminal justice system.”
Gilead Sciences announces the launch of the Commitment to Partnership in Addressing HIV/AIDS in Southern States (COMPASS) Initiative, a 10-year, $100 million commitment to support organizations working to address the HIV/AIDS epidemic in the Southern United States.
PEPFAR (the President’s Emergency Plan for AIDS Relief) celebrates its 15th anniversary.Learn More.
When PEPFAR began in 2003, only 50,000 people in Africa were on lifesaving HIV treatment. At the time, it was the largest commitment ever by any nation to address a single disease.
“Over the past 15 years, PEPFAR has transformed the impossible into the possible by rapidly accelerating access to lifesaving HIV prevention and treatment services,” says Ambassador Deborah L. Birx, M.D., U.S. Global AIDS Coordinator. “We have not only saved more than 14 million mothers, fathers, daughters, and sons, but also accelerated global progress toward ending AIDS as a public health threat.”
In this video, one of PEPFAR’s first treatment recipients, John Robert Engole from Uganda tells his remarkable story of survival thanks to PEPFAR’s lifesaving programs.
The “Group of Eight” Summit announcemes new commitments to the Global Fund to Fight AIDS, Tuberculosis and Malaria over the next three years.
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.
In a Northwestern University study, a novel online HIV-prevention program is shown to reduce sexually transmitted infections by 40%.Learn More.
Targeting young men who have sex with men (MSM) between the ages of 18-29, the program, “Keep It Up,” offers video clips, soap operas, and interactive games. It’s the first online HIV-prevention program to record results of a biological outcome.
A month later, the National Institutes of Health would award Northwestern’s Institute for Sexual and Gender Minority Health and Wellbeing with an $8.8 million grant to put its research into practice.
Keep It Up! continues to build its program. So far, it has been delivered to over 1,500 young men in several major cities. The program is preparing to bring KIU! to 44 counties across the U.S., and plans to reach at least 4,000 young men in the next few years.
Community leaders, frontline workers, individuals living with and at risk for infection, and other members of the community from across the nation provide input to leaders from the Office of HIV/AIDS and Infectious Disease Policy.Learn More.
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 U.S. Preventive Services Task Force recommends clinicians to offer PrEP (preexposure prophylaxis) to those at high risk for HIV infection.Learn More.
The Task Force gives its “A” recommendation — the strongest endorsement it can give — to PrEP, stating that when taken as prescribed, PrEP is highly effective at preventing HIV among those at high risk, and concluding with “high certainty” that there is a substantial benefit to the target population. The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine.
In June 2019, the Task Force would upgrade its draft recommendatin to a “Final Recommendation Statement” and present its supporting evidence in a separate report issued to governmental agencies.
In his State of the Union address, President Donald Trump announces his administration’s goal to end the HIV epidemic in the U.S. by 2030.Learn More.
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.
Of the new HIV infections in the U.S. in 2016, the vast majority — about 80% — were transmitted from the nearly 40% of people with HIV who either did not know they had HIV, or who received a diagnosis but were not receiving HIV care.Learn More.
Published on the first day of CDC’s 2019 National HIV Prevention Conference, the Vital Signs report provides the latest data on the impact of undiagnosed and untreated HIV in the U.S.
The report underscores the critical need to expand HIV testing and treatment. A critical part of the proposed “Ending the HIV Epidemic – A Plan for America,” the proposed initiative would strive to end the HIV epidemic in 10 years by focusing first on the geographic areas with the greatest HIV burden, before expanding to reach all areas of the nation affected by HIV.
The City of West Hollywood launches its “HIV Zero” strategic plan, a commitment to making the city a place where people living with HIV have easy access to comprehensive healthcare and social support services.Learn More.
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:
- Expand access to healthcare for people living with HIV and people currently at an elevated risk
for acquiring HIV;
- Reduce new HIV infections;
- Reduce HIV-related disparities and health inequalities; and
- 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.
Gilead Sciences, maker the only drug approved to prevent HIV infection, will donate enough Truvada to supply 200,000 patients annually for up to 11 years, U.S. health officials announce.Learn More.
Truvada is taken once daily to prevent infection with HIV, a strategy called PrEP (pre-exposure prophylaxis). An estimated one million Americans are at risk for infection and should be taking the medication, but only about 270,000 are doing so.
HIV activists and experts had mixed reactions to the news. Some pointed out that the corporate donation with a value estimated in the billions of dollars would fill only 20% of the need in the U.S.
Critics say that the high cost of Truvada ($2,000 a month) has been called a major barrier to stemming the spread of HIV among low-income Americans, and it’s part of the reason the AIDS epidemic has persisted for so long.
“If we don’t make it possible for those that need it to have access to it, we will continue to have new infections of a completely preventable virus,” said Jaasiel Chapman, clinical research community educator at the University of Cincinnati.
While most insurers cover treatment with the pill, patients can get stuck with out-of-pocket costs that make the medicine unaffordable.
“If there is any example of the dysfunction in the American pharmaceutical system, it is this case,” says James Krellenstein, a member of ACT UP New York. “We have the most effective tool for ending the HIV epidemic, and one reason we’re unable to scale up is because it costs so [much] unnecessarily.”
Upon announcing the Gilead Sciences donation, Health and Human Services Secretary Alex M. Azar II said,“Securing this commitment is a major step in the Trump Administration’s efforts to use the prevention and treatment tools we have to end the HIV epidemic in America by 2030.”
An independent, volunteer panel of national experts recommends extensive HIV screening and issues a “Grade A” designation for PrEP treatment.Learn More.
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 65th meeting of the Presidential Advisory Council on HIV/AIDS in Miami, Florida draws focus to the needs of the hispanic community.Learn More.
Also at the meeting, PACHA holds sessions and discussions on the response to HIV in the populations of Florida and Puerto Rico.
The dramatic decline in annual HIV infections has stopped and new infections have stabilized in recent years, according to a CDC report.Learn More.
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.
The Ready, Set, PrEP program is launched in the U.S. to provide free HIV-prevention medications to thousands of people lacking adequate health insurance coverage.Learn More.
Funded by the Department of Health and Human Service, Ready, Set, PrEP expands access to PrEP medications to those unable to afford it.
HHS estimates the number of people who could benefit from PrEP medications at more than 1 million, but less than one-third of them are taking it as prescribed. This program is still active; to apply, click here.
Clients receiving medical care through the Ryan White HIV/AIDS Program were virally suppressed at a record level – 87% – in 2018, according to a new report.Learn More.
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 U.S. HIV/AIDS Bureau expands funding opportunities for service organizations working on stigma reduction, rapid ART initiation, and treatment for HIV-positive black women.Learn More.
An estimated 1,700 new infections occurred in Los Angeles County in 2019, showing that the county still has a long way to go before it can meet its Ending the HIV Epidemic (EHE) goals for the years 2025 and 2030, according to the HIV Surveillance Annual Report for 2019 released on this day.Learn More.
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.
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*The number of people living with HIV was determined using a mathematical model developed by the Centers for Disease Control and Prevention.
The HIV Data Dashboard is launched to provide a clearinghouse of national and local data, allowing stakeholders at all levels to track progress toward meeting goals to reduce HIV transmission.Learn More.
Created by the Health and Human Services Department, AHEAD: America’s HIV Epidemic Analysis Dashboard supports the tracking of goals related to the six indicators for the Ending the HIV Epidemic (EHE) initiative:
- Reduction of new HIV infections in the U.S. by 75% by 2025 and by 90% by 2030;
- Demonstration of the historical movement towards achieving the overall goals of the EHE initiative;
- Diagnosis (number of people with HIV diagnosed in a given year confirmed by laboratory or clinical evidence);
- Linkage to HIV medical care (percentage of people diagnosed with HIV in a given year who have received medical care for their HIV infection within one month of diagnosis.);
- Viral suppression (percentage of people living with diagnosed HIV infection who have an amount of HIV that is less than 200 copies per milliliter of blood, in a given year); and
- PrEP coverage (estimated percentage of individuals prescribed PrEP among those who need it).
You can see how Los Angeles County (and other jurisdictions) are doing toward meetings its goals for 2025 and 2030 by clicking here.
Major consumer protections in the Affordable Care Act (ACA) go into effect, including key advances for people living with HIV/AIDS.Learn More.
The U.S. Department of Health and Human Services (HHS) releases the HIV National Strategic Plan for the United States: A Roadmap to End the Epidemic 2021-2025 with a 10-year goal of reducing new infections by 90%.Learn More.
The HIV Plan, as it would come to be known, was designed to align and complement the Ending the HIV Epidemic (EHE) initiative announced by President Donald Trump on February 5, 2019. It was the country’s third consecutive national HIV strategy and set forth bold targets for ending the HIV epidemic in the U.S. 2030, including a 75% reduction in new HIV infections by 2025 and a 90% reduction by 2030.
It set four goals in all:
– Prevent New HIV Infections
– Improve HIV-Related Health Outcomes of People with HIV
– Reduce HIV-Related Disparities and Health Inequities
– Achieve Integrated, Coordinated Efforts That Address the HIV Epidemic among All
Partners and Stakeholders
In its announcement about the updated HIV Plan, HHS stated that it had adopted the federal EHE initiative as “a leading component” of the HIV Plan.
The first federal HIV/AIDS strategy was released in 2010 and updated in 2015 under the Obama administration. Released under the Biden administration, the 2021 strategy acknowledged that new HIV infections had declined from their peak in the mid-1980s, and people with HIV in care and treatment were living longer, healthier lives.
“However, not all groups have experienced decreases in HIV infections or improvements in HIV-related health outcomes,” the HHS stated in the HIV Plan’s Executive Summary.
The HIV Plan identified the following populations disproportionately affected by HIV in the U.S.:
– gay, bisexual, and other men who have sex with men, in particular Black, Latino, and American Indian/Alaska Native men;
– Black women;
– transgender women;
– youth aged 13–24 years; and
– people who inject drugs
To align with national priorities released on January 15, 2021 by the U.S. Department of Health and Human Services (HHS), Los Angeles County releases Ending the HIV Epidemic Plan (EHE) for Los Angeles County.Learn More.
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.
The Presidential Advisory Council on HIV/AIDS holds its 70th meeting to discuss, among other things, the intersection of COVID-19 and HIV.Learn More.
Other topics addressed at PACHA’s meeting, include the status of the Ending the HIV Epidemic in the U.S. (EHE) initiative and HIV National Strategic Plan, future implementation efforts, and how to better address the needs of women with HIV and of the HIV community.
Formed by President Bill Clinton in 1995 (with each president since renewing the council’s charter) PACHA provides advice, information, and recommendations to the Secretary of Health & Human Services regarding programs, policies, and research to promote effective treatment, prevention and cure of HIV disease and AIDS.
The U.S. makes significant progress in the areas of HIV testing and linkage to care in the first year of its Ending the HIV Epidemic initiative.Learn More.
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.
Underscoring the key role that STD clinics play in HIV diagnosis, prevention, care, and treatment, the Centers for Disease Control re-states its commitment to supporting STD clinics with more than $14 million in funding.Learn More.
In a report, the CDC champions the role that STD clinics play in HIV diagnosis, prevention, care, and treatment. As part of the Ending the HIV Epidemic in the U.S. (EHE) initiative, the CDC releases 43 mllion in funding in August 2020 for seven jurisdictions, including:
- Alabama Department of Public Health (Jefferson County)
- Arizona Department of Health Services (Maricopa County)
- Baltimore City Health Department
- District of Columbia Department of Health
- San Francisco Department of Public Health
- City of Philadelphia Department of Public Health
- Missouri Department of Health and Senior Services (St. Louis County)
In August 2021, the CDC would go on to create a five-year funding stream of an additional $11.1 million for 11 more EHE juridictions:
- California Department of Public Health (Sacramento, San Diego, and Orange County)
- New York City Department of Health and Mental Hygiene
- Chicago Department of Public Health
- Florida Department of Health (Orange County)
- Georgia Department of Public Health (Fulton County)
- Houston Health Department
- Indiana State Department of Health (Marion County)
- Louisiana Department of Health (East Baton Rouge Parish)
- Maryland Department of Health (Montgomery and Prince George’s County)
- New Jersey Department of Health (Essex County (Newark))
- Ohio Department of Health (Franklin County)
- Texas Department of State Health Services (Dallas County)
The world marks 40 years since the first five cases of what later became known as AIDS were officially reported in Los Angeles.Learn More.
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).
The White House announces the appointment of Harold J. Phillips, an out gay man living with HIV since 2005, to lead the Office of National AIDS Policy (ONAP).
[Photo courtesy of the U.S. Department of Health & Human Services]Learn More.
Ambassador Susan Rice, White House Domestic Policy Advisor and head of the Domestic Policy Council, made the announcement in a Twitter thread recognizing the 40th anniversary of the publication of the first reports of what later became known as AIDS. ONAP is part of the Domestic Policy Council.
“I’m thrilled to welcome Harold Phillips to lead the White House Office of National AIDS Policy. Harold brings decades of experience in the battle against HIV/AIDS, and we’re lucky to have him spearheading the Biden-Harris Administration’s efforts to defeat this epidemic … I know Harold and ONAP will be instrumental to that effort,” Rice wrote in her Tweet.
Phillips was a longtime public health official whose most recent position was the Senior HIV Advisor and Chief Operating Officer of the Ending the HIV Epidemic (EHE) initiative in the Office of Infectious Disease and HIV/AIDS Policy at the U.S. Department of Health and Human Services.
Prior to his HHS position, Phillips served as the Director of the Office of HIV/AIDS Training and Capacity Development at the Health Resources and Service Administration’s HIV/AIDS Bureau, where he had previously served as Deputy Director of the Ryan White HIV/AIDS Program and AIDS Drug Assistance Programs.
In addition, he previously worked at NMAC and served on the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment from 2003–2010.
On his first day as Director of ONAP, Phillips told his colleagues, “I look forward to continuing the work we have begun to end the HIV epidemic. President Biden is committed to ending the HIV epidemic and has called for bold and accelerated steps to achieve this aim.”
He shared that as part of those efforts, ONAP would lead the development of a new National Strategy on HIV/AIDS which updates the HIV National Strategic Plan released in January 2021. This new strategy would be released less than six months later and build on the previous administration’s plan.
Members of the HIV/AIDS community largely received the announcement of Biden’s appointment with expressions of relief and renewed hope.
“As a uniquely and unapologetically Black organization that has led the fight to end HIV for 22 years, Harold is just as much a part of our community as he is the highest-ranking Black HIV leader in the federal government,” said Raniyah Copeland, President and CEO of the Black AIDS Institute, in response to the announcement.
“I am hopeful that Harold’s leadership and the Biden-Harris administration’s recognition of racism as a public health issue will be a catalyst to finally center Black lives,” Raniyah said.
ONAP had not had leadership since President Donald Trump took office in 2017. Following the inauguration of Trump, the ONAP website became inaccessible and it was reported the office was closed with the departure of the previous director, Amy Lansky. The office continued to lie dormant for several months, during which time six members of the Presidential Advisory Council on HIV/AIDS (PACHA) filed letters of resignation.
One of the resigning council members, Scott A. Schoettes of Lambda Legal, told Newsweek: “The Trump Administration has no strategy to address the on-going HIV/AIDS epidemic, seeks zero input from experts to formulate HIV policy, and — most concerning — pushes legislation that will harm people living with HIV and halt or reverse important gains made in the fight against this disease.”
The five other members of PACHA who resigned on June 13, 2017 were Lucy Bradley-Springer, Gina Brown, Ulysses W. Burley III, Michelle Ogle, and Grissel Granados, citing that the Trump administration “simply does not care” about the HIV/AIDS situation in the U.S.
In December 2017, Trump fired all the remaining members of the council, and it was more than a year before he would name nine new members to the council.
An estimated 1,505 new infections occurred in Los Angeles County in 2020, according to the HIV Surveillance Annual Report 2020 released on this day.Learn More.
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.
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*The number of people living with HIV was determined using a mathematical model developed by
the Centers for Disease Control and Prevention.
HHS announces the launch of The HIV Challenge, a national competition to engage communities to reduce HIV-related stigma and increase prevention and treatment among racial and ethnic minority people.Learn More.
Giving both pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) to heterosexual couples where one partner has HIV can almost eliminate the chance of infection in the HIV-negative partner, a study presented at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle shows.
The White House releases the National HIV/AIDS Strategy (2022-2025), strengthening and elaborating on the goals set forth in the Trump administration’s 2021 HIV National Strategic Plan.Learn More.
The National HIV/AIDS Strategy (2022-2025) was released on Biden’s first World AIDS Day commemoration as President. During his campaign, Biden pledged to update and implement the nation’s comprehensive HIV/AIDS strategy to “aggressively reduce new HIV cases, while increasing access to treatment and eliminating inequitable access to medical and support services,” according to White House officials.
The National HIV/AIDS Strategy provided the framework and direction for the Biden Administration’s policies, research, programs, and planning through 2025, with the goal of ending the HIV epidemic in the U.S. by 2030.
The new National HIV/AIDS Strategy:
- Incorporated the latest data on HIV incidence, prevalence and trends;
- Expanded the focus on addressing the social determinants of health that influence an individual’s HIV risk or outcomes;
- Encouraged reform of state HIV criminalization laws; and
- Added a new focus on opportunities to engage the private sector in novel and important ways in the nation’s work to end the HIV epidemic.
President Biden also announced that the U.S. would host the 2022 Global Fund to Fight AIDS, Tuberculosis, and Malaria Replenishment Conference. However, the conference would ultimately be hosted by the neighbor to the north, Canada.
The U.S. Department of Health and Human Services (HHS) awards nearly $115 million to 60 recipients with innovative strategies to help people with HIV access care, support, and treatment services. Los Angeles County received one of the largest awards.Learn More.
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.”
The Department of Health and Human Services yesterday launched “I am a Work of ART,” a campaign to encourage people with HIV to seek or continue care and antiretroviral therapy.Learn More.
Part of the strategy to end the HIV epidemic in the U.S. by 2030, “I am a Work of ART” encourages people with HIV who are not in care for HIV to seek care, stay in care, and achieve viral suppression by taking antiretroviral therapy (ART).
The Centers for Disease Control and Prevention estimates the overall viral suppression rate in the United States is 53%. Therefore, a key strategy to prevent new HIV transmissions is increasing the proportion of people with HIV who are virally suppressed.
“When taken as prescribed, ART allows people with HIV to protect their health as well as the health of others,” said Assistant Secretary for Health Rachel Levine, M.D.
The top two EHE grant awards are $13.1 million to New York City (Bronx, Kings, Queens and New York counties), and $6.1 million to Los Angeles County.
Additional counties in California which received EHE grant awards include: Sacramento County ($2.1 million), San Francisco ($2 million), San Diego County ($2 million), Riverside – San Bernardino counties ($2 million), Alameda County ($1.5 million), and Orange County ($1.2 million).
An estimated 1,400 new infections occurred in Los Angeles County in the last year, showing that the county is far from meeting its Ending the HIV Epidemic (EHE) targets for the years 2025 and 2030, according to the HIV Surveillance Annual Report 2021 released on this day.Learn More.
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
- 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.
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*The number of people living with HIV was determined using a mathematical model developed by
the Centers for Disease Control and Prevention.
Figures represent estimated lives lost in the year.
For the years 1982-1986, data is based on estimates from the Centers for Disease Control and Prevention (CDC), as reported in its Morbidity and Mortality Weekly Report.
For the years 1987-2019, data is based on estimates from the National Center for Health Statistics (NCHS). Number of U.S. deaths attributed to HIV infection is in death certificate data (per the NCHS’s Tenth Revision of the ICD [ICD-10] for selecting underlying cause of death).
The first cases of what would become known as AIDS were discovered in Los Angeles in 1981. AIDS would soon become a global epidemic. Since 1981, over 700,000 lives have been lost in the US, and approximately 40 million globally. The World Health Organization recently estimated approximately 38 million people are living with HIV across the world.
Figures represent estimated new diagnoses for the year.
The Morbidity and Mortality Weekly Report (MMWR) series is prepared by the Centers for Disease Control and Prevention (CDC). For the period 1981-2007, the data for HIV diagnoses is based CDC estimates as reported in the MMWR.
For the period 2008-2019, the data for HIV diagnoses is from National HIV Surveillance System (NHSS).
HIV cases include persons with Stage 3 (AIDS) classification.