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AIDS (acquired immunodeficiency syndrome) appears to have originated in Africa at some time in the twentieth century. The human immunodeficiency virus (HIV) is assumed to be a variant of a simian immunodeficiency virus (SIV) that became capable of crossing the species barrier. It is unclear how that crossover first occurred, although scholars have posited contamination in the slaughter of bush meat or contamination of an oral polio vaccine cultured on chimpanzee kidneys that was administered widely in parts of Africa. In either case it appears that HIV and AIDS were present in the human population long before they were recognized.

Scholars have identified isolated deaths in European countries as early as the 1950s that now appear to be the result of AIDS and HIV, and analysis in the 1980s of blood samples originally drawn from African subjects in 1959 turned up one sample contaminated by HIV. It is possible that isolated individuals or communities experienced AIDS outbreaks earlier in the century, but political and social upheaval in Africa after World War II, coupled with widespread vaccination campaigns in regions that often could not afford to use disposable needles, provided an environment in which HIV was readily transmissible.

AIDS first came to public attention in the United States in 1979 and 1980, when doctors in New York and Los Angeles began noticing an increased incidence of fatalities resulting from extremely rare and normally benign diseases. In Los Angeles doctors were seeing multiple cases of a deadly form of pneumonia caused by Pneumocystis carinii, a generally harmless and extremely common protozoan that rarely induces illness and almost never causes death. In New York physicians were also seeing Pneumocystis carinii pneumonia as well as cases of Kaposi's sarcoma, an extremely rare and benign skin cancer that normally afflicted (though seldom killed) elderly men of Jewish and Mediterranean origin. In New York, however, Kaposi's sarcoma suddenly was making fairly young men extremely ill and, often coupled with other opportunistic infections, leading to rapid deterioration and death. All those early cases of AIDS involved homosexual men.

The gay rights movement of the 1970s had been invested in the importance of sexual freedom. If mainstream America deemed gay sexuality distasteful and shameful, there seemed no better way to confront and overturn those prejudices than by celebrating gay sex. In the early 1970s sexual promiscuity not only was accepted but was considered politically and socially desirable, a means of forging a new kind of community that resisted heteronormative ideals of partnership, family, and sexual practice.

By the late 1970s bathhouses designed expressly to facilitate fast, anonymous sex were a common feature of gay life in some urban centers, notably New York and San Francisco. The first victims of AIDS had in common frequent bathhouse attendance and a promiscuous lifestyle that included lifetime sexual contacts that numbered in the thousands and sometimes in the tens of thousands. Because of their numerous sexual partners, those early victims were an ideal vector for the disease, and because of the long incubation period that preceded the symptoms, HIV was well established in urban centers in the United States before anyone knew it existed. By the time people became aware of it, gay men in other areas of the country--men who were not part of the San Francisco or New York gay scenes but who may have slept with someone who was or once had been--had been infected.

In the second half of 1981 reports began to surface of AIDS infections in the heterosexual population. Drug addicts who used intravenous drugs became sick in noticeable numbers, infant children of drug addicts fell ill shortly after birth, and hemophiliacs and those who had received blood transfusions started to develop symptoms. Intense political pressure surrounding the disease, however, stymied the attempts of doctors, health officials, and activists to mobilize a defense. Many doctors and health officials were reluctant to accept evidence that the epidemic was not limited to the homosexual population, and the testing of blood donors for HIV was instituted much too late to stem the progression of the disease.

The gay press often considered claims of the prevalence and severity of the disease to be hysterical, overly alarmist, and indicative of widespread homophobia, whereas the mainstream press largely refused to touch an issue that involved primarily gay sexuality. Only when evidence that AIDS could strike heterosexuals became overwhelming did the major news organs begin to run stories about HIV and AIDS, and even then there were relatively few compared with earlier, much smaller epidemics. The Reagan administration provided little leadership or research funding, and the response of the National Institutes of Health (NIH) was slow and was accompanied by inadequate funding. Ultimately, AIDS research and prevention in the first decade after the emergence of the disease were driven by local groups and individual doctors, activists, health officials, and politicians, usually with insufficient resources and funding. Thus, by the time the U.S. government gave HIV and AIDS substantive attention, the virus was well entrenched and spreading rapidly in U.S. society and throughout the world.

References:

Barnett, Tony, and Alan Whiteside. 2006. AIDS in the Twenty-First Century: Disease and Globalization. 2nd edition. New York: Palgrave Macmillan.

Hooper, Edward. 1999. The River: A Journey to the Source of HIVand AIDS. Boston: Little, Brown.

Shilts, Randy. 1988. And the Band Played On: Politics, People, and the AIDS Epidemic. New York: St. Martin's.

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