Tuesday, June 06, 2006

AIDS Turns 25

[Note: This post has been updated below].

AIDS and malaria and TB are national security issues. A worldwide program to get a start on dealing with these issues would cost about $25 billion... It's, what, a few months in Iraq. --Jared Diamond

As Bush pandered to his base by endorsing a federal gay marriage amendment, yesterday was significant for something more devastating: on June 5, 1981, the Center for Disease Control (CDC) reported a cluster of five homosexual men in Los Angeles with an immunodeficiency syndrome, later known to the world as AIDS.

To date, AIDS has become one of the deadliest epidemics in human history: 25 million have died worldwide, including 500,000 from the U.S. There is still no cure or vaccine, and although medical strides in the last decade have reduced HIV/AIDS to a manageable chronic illness in developed countries, the rest of the world aren't so lucky. In the next 25 years, U.N. researchers predict that AIDS could kill 18 million people in China, 31 million in India and 100 million in Africa.

There are currently 40 million infected with HIV/AIDS worldwide, including 1 million from the U.S. Its spread and treatment continue to be problematic because of ignorance, prejudice, denial and fear. In China, 77% of the population are unaware that condom use can prevent the spread of the disease. In India, police have beaten HIV/AIDS outreach workers, charging them with promoting prostitution. In Africa, men believe that raping virgins, even infants, can cure them of the virus.

Here in the U.S., ignorant and hateful screeds like this from extreme right winger Debbie Schlussel continue to sustain the stigma and disinformation (emphasis mine):

They called it GRID--Gay-Related Immuno-Deficiency.

But amid political pressure from the PC and Gay lobbies, the name was changed to AIDS (Acquired Immune Deficiency Syndrome). We were told, "This is not a gay disease. This is everyone's disease."

[...]

And yet, it never happened. Other than disease-infested athletes who slept around with disease-infested groupies like, say, a guy named "Magic," there really weren't too many straight people struck by the disease, unless they were prostitutes, complete sluts, intravenous drug users who shared needles.

[...]

Yes, that is happening in Africa. And maybe that says something about behavior there. But it just simply isn't happening here. So when are non-breast cancers, heart disease, and other less hip afflications going to get their fair share of research dollars. We're certainly not advocating expanding the research dollars and making government even more bankrupt and large. And we're not saying that AIDS shouldn't be researched and treated. We're saying there are other diseases. The world's cosmos is not San Francisco . . . or even DuPont Circle (memo to Barney Frank).
I don't know what rock Ms. Schlussel crawled out from, but if she bothered to look at the numerous educational resources about the disease, she would discover that the name of the virus was changed from GRID to AIDS because researchers quickly discovered that it was not limited to just homosexual men. And although gays still make up the largest proportion of current and new AIDS infections, women and minorities are becoming more at risk. According to the CDC:

Racial and ethnic minority communities also are disproportionately affected by HIV/AIDS. During 2001--2004, in 35 areas with HIV reporting, 51% of all new HIV/AIDS diagnoses were among blacks, who account for approximately 13% of the U.S. population. Of these, 11% (12,650) of HIV/AIDS diagnoses in men were in black men who were infected through heterosexual contact, and 54% (23,820) of HIV/AIDS diagnoses in women were in black women infected through heterosexual contact. Today, women account for approximately one quarter of all new HIV/AIDS diagnoses and, in 2002, HIV infection was the leading cause of death for black women aged 25-34 years.
As for HIV/AIDS receiving more research dollars, the reason for that is obvious, except apparently to Ms. Schlussel: unlike cancer and heart disease, HIV/AIDS is an aggressive communicable virus, with the ability to rapidly replicate itself and mutate in unpredictable ways.

Why else does she think predictions of widespread infection didn't happen, if not for those research dollars and an intense educational campaign spearheaded by the gay community she despises? If not for them, we would have remained ignorant about the disease, groundbreaking antiretroviral drugs wouldn't have been discovered and HIV/AIDS would still mean certain death for those infected and the millions more who would have been infected.

Perhaps that is what she wants, for the disease to remain a death sentence for gays and what she calls "disease-infested athletes, groupies, prostitutes, complete sluts, and intravenous drug users". In spite of Ms. Schlussel's obscene rhetoric and callous indifference to the rest of humanity, I hope that she or anyone she cares about doesn't acquire the disease. No human being, no matter how flawed or imperfect deserves to die of AIDS, not even Ms. Schlussel herself.

Dr. Michael Gottlieb was the physician who initially treated "Patient Zero" and was one of the authors of that landmark 1981 CDC report identifying AIDS. In a recent LATimes op-ed he wrote:

As a doctor working on the epidemic's front lines since its inception, I find this anniversary one of intense emotions: despair about the lives lost to the disease; frustration with the Bush administration's promotion of abstinence over condoms for HIV prevention; anger at the denial, stigma and prejudice that still fuel the spread of HIV around the globe. But mixed in with those feelings is also pride in the remarkable medical progress we've made in HIV treatment. Twenty-five years ago, AIDS meant certain death. Even when my patient Rock Hudson was diagnosed with AIDS in 1985, the best I could do was recommend an experimental — and ultimately ineffective — treatment.

It wasn't until the advent of the AIDS "cocktail" 15 years into the epidemic that we began to turn this disease around. Those new treatments were truly revolutionary: Almost overnight, people with HIV left hospital beds and were back at work and living their lives. In one year, the number of Americans who died from AIDS dropped by 43%, and over the last decade, the death rate fell more than 70%.
In the 1980s, Republican President Ronald Reagan didn't even bother to acknowledge the AIDS epidemic until years later. A play called Angels in America gave voice to those infected during the early years through its main character Prior Walter, who said:

But still. Still bless me anyway. I want more life. I can't help myself. I do. I've lived through such terrible times and there are people who live through much worse. But you see them living anyway. When they're more spirit than body, more sores than skin, when they're burned and in agony, when flies lay eggs in the corners of the eyes of their children - they live. Death usually has to take life away. I don't know if that's just the animal. I don't know if it's not braver to die, but I recognize the habit; the addiction to being alive. So we live past hope. If I can find hope anywhere, that's it, that's the best I can do. It's so much not enough. It's so inadequate. But still bless me anyway. I want more life.

As Dr. Gottlieb pointed out, we have come a long way from those desperate early years when the world had nothing but empty hope. We are fortunate to have dodged the pandemic bullet so far, but let's not forget that we and the rest of the world still have not dodged it completely.

There is still work to be done. As long as ignorance, prejudice, denial and fear of the disease exist, it is not done. As long as people do not receive the knowledge and resources they need to protect themselves and survive, it is not done. As long as a cure remains elusive, it is not done. It will only be done when we wake up to that day, that one glorious day when the world is finally free of AIDS.

AIDS Resources:

PBS's Frontline: The Age of Aids

AIDS Educational Global Information System (AEGIS)

The American Foundation for AIDS Research

Centers for Disease Control and Prevention: HIV/AIDS

Global AIDS Alliance

UNAIDS: The Joint United Nations Programme on HIV/AIDS

U.S. Department of Health & Human Services: AIDS Info

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