In June 1981, the CDC published the first case report describing what is now known as an AIDS related illness. It described five gay men with a type of pneumonia only seen when someone’s immune system is not working. The disease was later called GRID (gay related immune deficiency). GRID was renamed to HIV and was mostly diagnosed in men who have sex with men, confirming some people’s bias against gay men. HIV was called the “gay plague” and was seen as punishment for a “promiscuous lifestyle.” For years, people diagnosed with AIDS did not have treatment options and died in hospitals often without comfort from friends, families, doctors or nurses because of the fear associated with AIDS. In 1985 Rock Hudson, a famous actor confirmed that he had AIDS a few weeks before his death. Before he died, he donated $250,000 to help establish the American Foundation for AIDS research (amfAR).
Gay grass roots organizations were instrumental in responding to the HIV epidemic. AIDS Coalition to Unleash Power, (ACT UP) was founded by Larry Kramer in 1987. ACT UP pushed for streamlined approval of AZT, the first antiretroviral drug approved to treat HIV. The drug was expensive, had significant side effects and was hard to get. ACT UP advocated for and was successful in getting the price lowered and the drug distributed to more people. Cities were disproportionally affected and responded with HIV clinics such as the Gay Men’s Health Crisis in New York, Whitman-Walker Clinic in Washington DC and the Ward 86 Clinic in San Francisco, these clinics provided medications, anonymous testing and promoted safer sex.
The first display of the AIDS Memorial Quilt on the National Mall in DC was in 1987, it contained 1,920 panels. When it returned a year later, it contained 8,288 panels. For some people, this was the only way to eulogize loved ones who died from AIDS. Some funeral homes were not burying people who died or were suspected of dying from an AIDS related illness, so the Quilt was a way to publically grieve the loss of a loved one.
Men who have sex with men still make up the majority of new HIV cases, followed by heterosexual sex and then injecting drug use. There are over a million people in the United States living with HIV. Although HIV is no longer a death sentence and can be treated with a daily pill, there are still remnants of fear and stigma. Two recent advances in HIV are very exciting. The first is the use of Truvada as pre-exposure prophylaxis (PREP) to prevent HIV transmission. There are financial assistance programs and many insurance companies are covering the cost of PREP. The other exciting finding comes from multiple large prospective studies showing that someone with an undetectable viral load is unable to pass the virus through sex. Undetectable is untransmissible (U=U) is the key to stopping the HIV pandemic.
There are many lessons we should learn from the HIV pandemic. A disease is not punishment; thoughts along those lines only delay diagnosis and treatment, which increases the spread of disease. HIV also showed the strength of the gay community. Most of the civic leaders, fundraisers, scientists, caregivers and educators fighting HIV were LGBTQ. The LGBTQ community continues to demonstrate the true meaning of resiliency as the fight to end HIV/AIDS continues. In a society where vulnerabilities are perceived as weaknesses, the LGBTQ community knows that they are truly our greatest strengths. There is so much beauty and dignity in the pride of the community.
We are proud to have resources here in Gallatin County. The Health Department offers HIV Case Management to help clients access appropriate medical services and community support resources. For more information about the HIV/AIDS Case Management Program in Gallatin County, call 406-582-3100.
Infectious Disease Specialist: