The Rise of HIV/AIDS in America
Introduction
Official Notice
Origin of HIV
The Numbers
Is HIV the Cause of AIDS?
Is HIV a Myth?
Introduction
HIV disease undoubtedly began in Africa at least ten years and probably fifty or more years before the events
discussed below. There it was, a disease spread by heterosexual transmission.
The following events contributed to the explosion of the disease among one, and only one, susceptible subgroup
of people in this country. For, social and political reasons, this group bore the brunt of the fear, blame, and
stigmatization that this country had to offer.
During the summer of 1969, the New York Police Department embarked on a program closing illegal afterhours clubs throughout the city, although their main emphasis was on black clubs, Hispanic clubs, and gay clubs.
The gay community was losing its party locations as the Checkerboard and the Tele-Star were recently closed and
the Sewer and the Snake Pit were being regularly raided. That made for a large number of irate customers with far
fewer places to congregate on the weekends.
It was midnight, Friday, June 27, 1969 and New York City’s finest were preparing to raid a gay bar at 53
Christopher Street in Greenwich Village. Patrons were being led out into a warm and festive atmosphere (as if in
celebration of the life and death the previous day of Judy Garland, a gay favorite)—until the paddy wagons arrived.
As the police got rough with some of the "queens," one of the bystanders did not take kindly to being struck with a
nightstick and bloodied, so she1 punched the offending cop and knocked him out cold. Then all hell broke loose.
That night and the following four nights saw melees unlike anything before—gay men, lesbians, transvestites,
bisexuals, and transsexuals—all had taken arms against a sea of troubles. These were called the Stonewall Riots by
the popular media and the Stonewall Rebellion by most students of gay history.
A sea change is what it was; from that time forward gay sexuality, which previously flourished in the dark, was
in the open—and it was this sexuality that many gay men used to define themselves. It was considered a badge of
honor.
Whereas gay men had previously assumed fixed classical roles, as in anal intercourse where one partner was
always dominant and the other always submissive, they now freely interchanged roles and relished it. Sex clubs
were open and thriving. A typical visit to such establishments resulted in an average of 2.7 sexual encounters. Many,
if not most, of these encounters, were anonymous. Sex with multiple partners (as in many hundreds and even
thousands) was the norm; abstinence was not considered. Oral-genital, oral-anal, genital-anal, etc.; nothing was
barred. Fisting, rimming, water sports, you name it. What had been closed groups of sexual partners broke down as
they shared experiences with men from far beyond their small circles of friends. Frequent anonymous sex was
everywhere.
As the rate of casual sex skyrocketed, so too did the rates of sexually transmitted diseases (STDs). Gonorrhea
reports tripled and syphilis reports quadrupled between 1965 and 1975. On August 27, 1976, the CDC reported two
cases of penicillin resistant gonorrhea, called PPNG, for penicillinase2 producing Neisseria gonorrhea. By October
there were ten more cases. Even as far away as Liverpool, England, 40 cases were reported. One third of all new
cases were coming from service men returning from the Philippines. By May 1977, PPNG had been detected in
seventeen countries and the US had 150 cases, most in New York City. Not only PPNG, but herpes simplex 2 (HSV2), and even newer strains of gonorrhea and syphilis were running wild.
Randy Shilts, reporter, historian, recorder of the events of the time, and author of And the Band Played On,
suggested that the arrival in New York of the Tall Ships to celebrate the US Bicentennial on July 4, 1976 was a
major contributing factor to what folowed. In particular, the sailors from these sailing ships added to the sexual tenor
of the times, and they brought their globally contracted infections with them.
Gay men seemed to be especially susceptible to these new classes of STDs. Entamoeba histolytica, normally a
third world infection of the malnourished, was being commonly found in the intestines of gay men who lived in the
fast lane. The general name for this was Gay Bowel Syndrome.
In his book, Surviving AIDS (New York: HarperCollins, 1990), pop singer Michael Callen wrote,
1
Several sources say the woman was Stormé DeLarverié, the daughter of a wealthy white man and a black woman. She started as
a jazz singer and worked her way up to performing as a man in the Jewel Box Revue. Stormé now lives in New York and
celebrated her 80th birthday in 2002.
2
Penicillinase is an enzyme that breaks down the penicillin molecule before it causes the microbe to lyse.
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I calculated that since becoming sexually active in 1973, I had racked up more than three
thousand different sexual partners in bathhouses, back rooms, meat racks, and tearooms. As a
consequence I also had the following sexually transmitted diseases, many more than once:
hepatitis A, hepatitis B, non-A/non-B hepatitis; herpes simplex Types I and II; venereal warts;
giardia lamblia and entamoeba histolytica; shigella flexneri and salmonella; syphilis; gonorrhea;
nonspecific urethritis; chlamydia; cytomegalovirus (CMV), and Epstein-Barr virus (EBV)
mononucleosis; and eventually cryptosporidiosis.
Official Notice
Michael Gottlieb was the principal author of the first report of gay men with the respiratory fungal infection
Pneumocystis carinii pneumonia (PCP) [now called Pneumocystis jerovecii pneumonia] that appeared in the
Morbidity and Mortality Weekly Report for June 5, 19813. A report of rare cases of Kaposi’s sarcoma (KS) followed
within a month on July 3. All patients were strangely immunodeficient—their immune systems could not fight off
even the simplest infections. Other rarely seen infections accompanied these diagnoses.
The initial diagnosis was given the pejorative acronym GRID, Gay Related Immunodeficiency Disease. But,
mercifully, that name was later changed. Since male homosexuals and intravenous drug users were frequent blood
donors, for possibly altruistic and certainly financial reasons, the blood supply was quickly tainted. Suddenly
hemophiliacs living outside the usual risk areas and not engaging in any of the usual risk activities, who needed
Factor VIII—which at that time was extracted from the whole blood of thousands of donors—came down with the
same symptoms. Newspapers published during July of 1982 carried the first reports of AIDS among hemophiliacs
and intravenous drug users (IDUs). In January 1983 the CDC reported the first case of heterosexual transmission.
To further complicate the matter and deepen the mystery, Haitian men, as a group, seemed to be susceptible to
this strange malady. Even many non-drug-using Haitian “heterosexuals” got it.
The first studies performed by the CDC in 1981 looked at a large sample of AIDS sufferers and attempted to
find what they had in common. Transmission can occur only if there is some connection among people having the
disease. One of the first suggestions was the use of so-called poppers. These were inhalers originally designed to be
used as deodorizers. They came in two chemical forms: amyl nitrite and/or butyl nitrite. Both forms increased libido
and relaxed the anal sphincter to facilitate anal intercourse. But, some gay men with AIDS never used poppers. Most
other connections did not pan out. The only verifiable commonality among gay men was sexual.
The CDC was able to methodically and meticulously determine many, if not most, of the sexual contacts of a
small, but geographically diverse, group of 40 patients suffering from KS, PCP, and/or other opportunistic
infections. All of these cases could be traced back to the single so-called index case, called Patient Zero, a French
Canadian flight attendant, Gaetan Dugas. Although Dugas was most certainly not the first person to show symptoms
of HIV infection, he was the center of this particular cohort of diseased individuals. In the diagram on the next page,
a line joins men who had sex with each other. Each circle is labeled by the state or city of residence of the infected
patient. The legend explains the infection for each patient.
This cohort study, and many others that have followed, reinforced the contention that this infection among gay
men was sexually transmitted.
The watershed event that brought the disease into full view of the public eye was the announcement that the
(thought to be very macho) film star Rock Hudson had the disease4.
3
See http://www.cdc.gov/hiv/pubs/mmwr/mmwr05jun81.pdf
Even after he had been diagnosed with AIDS, he continued cruising the gay bars and did not notify any of his sexual partners of
his HIV status.
4
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2
Patient Zero is the index case for this cohort or AIDS sufferers. A line between two patients indicates
there had been a sexual contact between them.
The Numbers
Of the between 16,000 and 20,000 hemophiliacs in this country, more than 50% are HIV+ and over 2700 have
already died. 98% of the HIV-positive hemophiliacs were infected by tainted blood products.
The World Health Organization’s best estimates are that there were about 5.0 million new HIV infections in
2003, for a grand total of 40.0 million people who are HIV+. There were 3 million deaths due to AIDS in 2003.
Far and away the largest numbers of cases are in sub-Saharan Africa, where there were 3.4 million new cases in
2003 and 28 million people who are positive. 50% of all HIV infections occur in women and 75% of those are the
result of vaginal intercourse. Currently, Botswana, Namibia, Swaziland, and Zimbabwe have more than 20% (and
maybe as high as 40%) of their adult populations infected with HIV. Although Botswana is a relatively
economically well-off country5, its infection rate went from 36% in 2000 to an estimated 39% in 2002! Even the
relatively advanced country of South Africa is experiencing an acceleration in its infection rate. Recent estimates
are that its prevalence rate is at least 10% and may possibly, because of reporting errors, be higher than 15%.
Currently South Africa has over 5.2 million people infected—more than any other country in the world, even more
than either China or India, although India is rapidly closing the gap.
5
Botswana is the world’s largest exporter of diamonds and has extensive safer sex educational programs.
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Estimated Number of Adults and Children Living with
HIV/AIDS as of 12/2003
North America
Caribbean
Latin America
Western Europe
North Africa & Middle East
Sub-Saharan Africa
Eastern Europe & Central Asia
East Asia & Pacific
South & Southeast Asia
Australia & New Zealand
Total
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790,000-1,200,00
350,000-590,000
1,300,000-1,900,000
520,000-680,000
470,000-730,00
25,000,000-28,200,000
1,200,000-1,800,000
700,000-1,300,000
4,600,000-8,200,000
12,000-18,000
34,000,000-46,000,000
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Estimated Number of Adults and Children Newly
Infected with HIV During 2001
North America
45,000
Caribbean
60,000
Latin America
130,000
Western Europe
30,000
North Africa & Middle East
80,000
Sub-Saharan Africa
3,400,000
Eastern Europe & Central Asia
250,000
East Asia & Pacific
270,000
South & Southeast Asia
800,000
Australia & New Zealand
500
Total
5,000,000
The mortality figures are equally shocking.
Estimated Number of Adult and Child Deaths from
HIV/AIDS During 2001
North America
20,000
Caribbean
30,000
Latin America
80,000
Western Europe
6,800
North Africa & Middle East
30,000
Sub-Saharan Africa
2,300,000
Eastern Europe & Central Asia
23,000
East Asia & Pacific
35,000
South & Southeast Asia
400,000
Australia & New Zealand
120
Total
3,000,000
The situation involving children directly is even bleaker.
Estimated Number of Children (<15 years) Living with
HIV/AIDS as of 12/2001
North America
10,000
Caribbean
20,000
Latin America
40,000
Western Europe
4,000
North Africa & Middle East
20,000
Sub-Saharan Africa
2,400,000
Eastern Europe & Central Asia
15,000
East Asia & Pacific
7,000
South & Southeast Asia
200,000
Australia & New Zealand
< 200
Total
2,700,000
Estimated Number of Children (<15 years) Newly
Infected with HIV During 2001
North America
< 500
Caribbean
6,000
Latin America
10,000
Western Europe
< 500
North Africa & Middle East
12,000
Sub-Saharan Africa
700,000
Eastern Europe & Central Asia
1,000
East Asia & Pacific
3,000
South & Southeast Asia
65,000
Australia & New Zealand
< 100
Total
800,000
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Estimated Number of Deaths of Children (<15 years) Living
with HIV/AIDS as of 12/2003
North America
< 100
Caribbean
5,000
Latin America
8,000
Western Europe
< 100
North Africa & Middle East
6,000
Sub-Saharan Africa
500,000
Eastern Europe & Central Asia
< 100
East Asia & Pacific
1,500
South & Southeast Asia
40,000
Australia & New Zealand
< 100
Total
580,000
A major problem in many of these countries is the care of the millions of children orphaned by the deaths of
their parents due to AIDS. Figures from 2000 are that 13.2 million children were orphaned6 due to HIV, and 12.1
million of those were in sub-Saharan Africa.
Estimates are that there are 15,000 new HIV infections each day; that is one new infection every 5.8 seconds.
More than 95% of those infections occurred in developing countries and 1,700 of those were children under the age
of 15; that’s one every 51 seconds. Of those, 13,000 of those newly infected are aged 15 to 49, 47% are women and
over 50% are between 15 and 24 years of age!
In the United States, there is a great disparity in pediatric (below age 13) AIDS cases by race.
Racial Group
African-American
Hispanic
Caucasian
% Pediatric AIDS Cases
57
23
18
% of General Population
14
12
70
Statistical information is regularly being updated by the CDC and UNAIDS. You should visit their web site at
www.cdc.gov or www.unaids.int
HIV/AIDS has reversed a trend of increasing longevity that continued almost uninterrupted since the Plague
pandemic of the middle ages. The effect has been most pronounced in sub-Saharan Africa. A comparison of
longevity figures from 1970–1975 to those in 2004 is striking: Botswana has fallen from 56.1 to 39.7 years, Kenya
from 50.9 to 44.6, Lesotho from 49.5 to 35.1, South Africa from 53.7 to 47.7, Zambia from 49.5 to 35.1, and
Zimbabwe from 56 to 33.1 years.
Is HIV a Myth?
The most prominent naysayer was Peter Duesberg, a well-known microbiologist from the University of
California at Berkley. In his book Inventing the AIDS Virus, he maintained that HIV and AIDS are unrelated. He
presents many arguments that seem to very selectively look at the evidence. After being confronted by current
research, he has withdrawn those arguments.
Some disbelievers will go to any lengths to prove their points. Dr. Robert Willner, author of Deadly Deception:
The Proof that SEX and HIV Absolutely DO NOT CAUSE AIDS, who had his medical license revoked in Florida for
a series of infractions, held a press conference on October 28, 1993. He stuck himself with a needle he had just
inserted into a man who claimed to be HIV+. His attempt at refutation fell short when on April 15, 1995 he died of a
heart attack.
The vast majority of scientists feel that the arguments of these people have been completely refuted. The less
said, the better.
6
The United Nations defines an orphan as a child that has lost its mother.
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