1981-1986: In the Beginning ...

In the period October 1980 - May 1981, five young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at three different hospitals in Los Angeles, California. Two of the patients died. (Morbidity & Mortality Weekly Report, 6/5/1981.)

With that statement, the CDC's MMWR published the first clinical reports of what would become known as Acquired Immune Deficiency Syndrome, or AIDS. The report documented five cases of young homosexual men who had developed Pneumocystis carinii pneumonia, a type of pneumonia that at that time was "almost exclusively limited to severely immunosuppressed patients," such as older patients or those receiving cancer chemotherapy. Although the report noted that the "patients did not know each other and had no known common contacts or knowledge of sexual partners who had had similar illnesses," it stated, "The fact that these patients were all homosexuals suggests an association between some aspect of a homosexual lifestyle or disease acquired through sexual contact and Pneumocystis pneumonia in this population" (MMWR, 6/5/1981).

Because of this early belief that somehow this new disease was connected to homosexual activity, the CDC first named the disease GRID, an acronym for Gay Related Immune Deficiency. Although this name was used only for a short period of time, being replaced by the name AIDS by August of 1982, this early stigma of a new disease fueled by the rampant homophobia of the early 1980s defined the early years of the epidemic. One early quote in The New York Times on July 3, 1981, by then-CDC spokesperson James Curran summed up the public perception at the time. "'The best evidence against contagion,' he said, 'is that no cases have been reported to date outside the homosexual community or in women.'"

Although within five months of the first report by the CDC, cases of AIDS were being reported in other risk groups such as injection drug users and Haitian immigrants, it was the gay and lesbian community that first took action to provide care and treatment to those living with the disease. Among the first to respond was New York playwright Larry Kramer. On the web site of the American Foundation for AIDS Research (AmFAR), he reminisces on the efforts that led to the creation of the first AIDS service organization, GMHC.

"We arranged for [Dr. Alvin Friedman-Kien of New York University] to come and talk -- here in my apartment -- to about 80 people who we were able to round up. If you were willing to listen to him, what he had to say was pretty scary. It seemed that the sensible thing to do was to spread the word that something was afoot, and that it might be wise for us to consider being more careful sexually -- Alvin said at that very first meeting that he thought the disease might very well be spread sexually. Over the next six months we had some totally unsuccessful fund-raisers and we distributed material that Larry Mass wrote, laying out in a very straightforward fashion the little that was known and suggesting that caution was something you might consider. But already there were a lot of people up in arms, accusing us of being alarmists.

"By January of 1982, things were obviously getting much worse, and I decided that we should become a more official organization and escalate our activity. So I called a meeting with six of us: Larry Mass; Paul Popham, who had already lost several close friends; Paul Rapoport, a rich real estate man who had lost his lover; Nathan Fain, who was a journalist and a friend of mine; and Edmund White, the writer, because I thought his name would help us get attention. At some point, Paul Rapoport said something like, 'Gay men certainly have a health crisis,' and I said, 'Let's use that for our name, Gay Men's Health Crisis.' And awkward as it was, that's what it became. It was useful because it announced the problem and it also showed that this was an attempt at community empowerment, that gay men were actually trying to help themselves. Paul Popham was elected the first president, and we chose a board of directors. And so was GMHC born."

By 1983, the response to the growing AIDS epidemic was shifting into high gear. By March of that year, Larry Kramer penned what many consider to be the first public call for increased awareness and activism around AIDS in a piece he wrote for New York Native entitled "1,112 and Counting."

The article begins, "There are now 1,112 cases of serious Acquired Immune Deficiency Syndrome. When we first became worried, there were only 41. (In only twenty-eight days, from January 13th to February 9th [1983], there were 164 new cases -- and 73 more dead. The total death tally is now 418. Twenty percent of all cases were registered this January alone. There have been 195 dead in New York City from among 526 victims. Of all serious AIDS cases, 47.3 percent are in the New York metropolitan area. These are the serious cases of AIDS, which means Kaposi's sarcoma, Pneumocystis carinii pneumonia, and other deadly infections. These numbers do not include the thousands of us walking around with what is also being called AIDS: various forms of swollen lymph glands and fatigues that doctors don't know what to label or what they might portend. The rise in these numbers is terrifying. Whatever is spreading is now spreading faster as more and more people come down with AIDS."

The article ends with these prophetic words, "We shall always have enemies. Nothing we can ever do will remove them. Southern newspapers and Jerry Falwell's publications are already printing editorials proclaiming AIDS as God's deserved punishment on homosexuals. So what? Nasty words make poor little sissy pansy wilt and die? And I am very sick and saddened by every gay man who does not get behind this issue totally and with commitment to fight for his life. I don't want to die. I can only assume you don't want to die. Can we fight together?"

Later that year, the Denver Principles, upon which organizations such as the National Association of People with AIDS and AIDS Survival Project were founded, were unveiled at the Second National AIDS Forum, which was sponsored by the Lesbian and Gay Health Education Foundation. By the end of 1983, with reported cases in Europe and Africa, the World Health Organization began to monitor what was now recognized as a global pandemic.

The next several years saw some important medical and social milestones in the history of the disease. The first needle exchange programs began operating in the Netherlands. It was determined that HIV (also known in the early years as HTLV-III) was the principal cause of AIDS. Young Ryan White, a then-13-year-old boy living with AIDS, became one of the first activists to gain renown by the general public over his fight to attend public school. And President Ronald Reagan made the first public mention of AIDS when he was quoted in September of 1985 with the following response to a question about Ryan White's efforts: "It is true that some medical sources had said that this cannot be communicated in any way other than the ones we already know and which would not involve a child being in the school. And yet medicine has not come forth unequivocally and said, 'This we know for a fact, that it is safe.' And until they do, I think we just have to do the best we can with this problem. I can understand both sides of it."

The year 1985 also marked the development of the first HIV test and a major awareness of the disease in the mainstream community with the death of Rock Hudson in October of that year. AZT had entered clinical trials as the first medication to show efficacy against HIV, and screening of blood supplies both here and abroad were beginning to be routine.

In Georgia, the response mirrored that of the rest of the country. The first of our AIDS service organizations were formed in this time. AID Atlanta was the first, in 1982, with organizations such as Outreach, Jerusalem House and the Grady Infectious Disease Program to follow in later years. It should also be noted that while we continue today to speak of the epidemic among African-Americans, women and heterosexuals as the "changing face of AIDS," in 1986, we heard the first warnings that this disease was not the disease of gay white men as so many believed. Dr. Roger Bakeman of Georgia State University, along with other researchers from Clark Atlanta University, Morehouse School of Medicine and local infectious disease specialists in private practice, wrote a letter to the New England Journal of Medicine showing that their analysis of AIDS statistics from the CDC indicated that AIDS was already having a disproportionate impact on the African-American community.

By the end of 1986, 85 countries had reported 38,401 cases of AIDS to the World Health Organization. By region, these were: 2,323 cases in Africa; 31,741 cases in the Americas, 84 cases in Asia; 3,858 cases in Europe; and 395 cases in Oceania.