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AIDS

The New Reality

Identified in 1981, the incurable disease known as AIDS (acquired immunodeficiency syndrome) has had a major impact on American society. As ignorance and misunderstanding of the inevitably fatal disease—most commonly transmitted by intravenous drug use and sexual activity—gradually gave way to fuller knowledge, the number of reported cases in the United States rose from 225 in 1981 to 40,000 in 1987. By the end of the decade hundreds of thousands of Americans were known to be infected; it looked as if the nation were in the midst of an epidemic; and thousands of people began to transform their lifestyles in accordance with the new reality.

Discovering AIDS

In 1980 doctors in cities such as New York, Los Angeles, and San Francisco began noticing patients who were dying because their immune systems had been rendered inoperative, making them susceptible to opportunistic infections. Researchers eventually learned that the human immunodeficiency virus (HIV), which was recognized in 1984 as the cause of AIDS, could infect a person years before that individual developed AIDS. They also learned that carriers of HIV could infect others while the virus was incubating within their own bodies, and they determined that HIV was transmitted through body fluids, in particular blood and semen. This discovery accounted for the fact that most AIDS victims in the early 1980s were homosexuals and intravenous drug users who shared needles. The relatively good news that AIDS was infectious rather than contagious meant that spread of the disease could be controlled more easily than if one could get it from simply being near someone with HIV.

Public Reaction

Americans' responses to this information varied widely, but two reactions dominated. Many were judgmental, with some religious leaders and other spokespersons for mainstream morality believing that AIDS victims deserved their fates. Many other people were merely indifferent, feeling that it was not their problem. The federal government was also slow to respond. Even as awareness of the disease grew, the Reagan administration did not offer much support for AIDS research. Funding for AIDS research did increase substantially during the Bush administration.

The Fundamentalist Response

Religious conservatives tended to be even less caring in their responses. Many Christian fundamentalists, whose political power grew during the 1980s, were quick to label AIDS as God's retribution against those who had defied divine authority. America, they believed, had gone astray during the 1960s and the 1970s, violating moral conduct by condoning widespread drug use and promoting gay and lesbian lifestyles, as well as promiscuity, in the name of the Sexual Revolution. These behaviors, they claimed, were justly punished by AIDS, which Moral Majority leader Jerry Falwell called a "gay plague." Nor were such people swayed from their belief in AIDS as divine punishment as statistics gradually revealed that victims of AIDS were to be found not only among homosexuals and drug users but among heterosexuals as well. If anything, this fact confirmed their opinion that AIDS was an indictment of those who flouted biblical morality.

Growing Awareness

It took much of the decade for health officials to convince the American public that the threat of AIDS was not restricted to homosexuals and intravenous drug users. Eventually, though, the message began to reach most Americans that anyone who was exposed to the bodily fluids of someone already infected with HIV could get AIDS. Despite this improvement in public knowledge about the disease, some continued to fear that AIDS was contagious, not just infectious. Moreover, the common perception about AIDS being transmitted through bodily fluids created its own share of problems. Fears grew among many in the population that the disease could be contracted through the air; through touch, kissing, or being sneezed on; through using a toilet seat previously used by someone with HIV; or even through mosquitoes. Although researchers tried to dismiss such misconceptions about the disease, myths and fears persisted for many. In addition, many Americans considered AIDS an urban problem, with the result that some people in the suburbs or in rural areas felt less risk, and therefore took more risks, in their sexual lives.

Precautions

The fact that AIDS could be transmitted through contaminated blood led to preventive measures that were adopted with astonishing speed. Blood-collection agencies such as the Red Cross began screening blood for HIV in 1985, after a test became available; they also added questions to their interview forms aimed at identifying high-risk donors, with professed homosexuals being denied the chance to donate blood. Doctors and dentists, and eventually police officers, began donning rubber gloves for routine jobs, and schoolteachers added rubber gloves to their supplies—all to avoid the possibility of accidental infection. The case of a Florida dentist who had infected a handful of his patients was a rare instance of AIDS being transmitted by a health-care worker, but public fears about AIDS were such that cautionary measures were deemed essential.

Outcasts

Because of fears and misconceptions about the disease, many AIDS patients found themselves pariahs, the modern equivalent of lepers or plague victims. Even those who acquired the disease through blood transfusions or other medical procedures were frequently shunned. A notable case was that of Ryan White, a young hemophiliac who acquired HIV through a routine blood transfusion. The decision of a school to deny him admission received nationwide attention, and White, whose family won a legal battle to force his admission, was befriended and defended by celebrities such as singer Michael Jackson. As a consequence of such public responses, many AIDS patients decided to hide the fact that they had the disease for fear of discrimination or persecution. Such a situation was dramatized in the movie Philadelphia (1993), for which Tom Hanks received an Academy Award for his sensitive portrayal of a gay man dying of AIDS. Ryan White died on 8 April 1990 at age eighteen.

Safe Sex

AIDS had a significant impact on the sexual practices of thousands of Americans. The phrase "safe sex" was added to Americans' vocabulary as public-health representatives tried to teach people that the best way to avoid catching the disease was either to be in a monogamous relationship with someone who did not have HIV or to abstain from sex altogether. People were told that when they went to bed with someone, they were going to bed with everyone their partner had ever had sex with. If one were unsure of one's partner's sexual history, public-health officials said, one should at least refrain from sexual acts involving the transmission of semen. Sales of condoms, which went from being a drugstore commodity to a product advertised in magazines and on television, soared. Local communities stirred controversy by giving away condoms and hypodermic needles in an effort to cut down on dangerous practices. Some high schools made condoms available to students, and condom vending machines appeared on college campuses. Though not everyone got the message, thousands of Americans changed their sexual practices in response to the threat of AIDS. For those who feared they might have been exposed to the disease, AIDS testing became widely available.

Media Attention

Public-health officials spread the word about AIDS through public-service announcements on television and articles in magazines and newspapers. Once it was clear that the epidemic was not limited to a small segment of the population, media attention grew rapidly. The AIDS-related death of popular actor Rock Hudson in 1985 shocked many people and brought home to them the seriousness of the epidemic. Hudson was only the first of a string of celebrities who would die of AIDS: he was followed by popular pianist Liberace in 1987, photographer Robert Mapplethorpe in 1989, and artist Keith Haring in 1990, to name only a few artists and entertainmers who succumbed to the disease.

Popular Responses

Inevitably American popular culture dealt with such a serious issue through indirection or by making light of it. Jokes about condoms, safe sex, and the possible consequence of having multiple sexual partners proliferated in movies and television shows of the decade. Only a handful confronted the issue directly. Many artists dealt with the disease in their work, as did playwrights such as Harvey Fierstein, Larry Kramer, and Tony Kushner. Celebrities such as Madonna and Elizabeth Taylor performed for AIDS-research benefits, and red ribbons, indicating support for those with AIDS, appeared on lapels, evening gowns, and eventually postage stamps.

Gay Support

In addition, the gay community rallied to the challenge of AIDS. In the face of increased homophobia resulting from the public's association of the disease with the gay lifestyle, homosexuals, their friends, and their families participated in parades and demonstrations calling for increased AIDS research. Besides red ribbons, one especially visible sign of support and sympathy emerged with the NAMES Project, in which victims of AIDS were commemorated by having panels with their names sewn into quilts that were displayed across the country as a striking visual representation of the impact of the disease.

A Continuing Problem

The effects of AIDS continued to be felt worldwide into the 1990s. Many individuals failed to modify their behavior, and a sense of fatalism set in for many people. Nonetheless, scientists continued to struggle to find a cure for the disease and to educate people about how they could avoid it.