The AIDS Epidemic
As of 2015, 33.3 million people were living with the Human Immunodeficiency Virus (HIV) across the globe (World Health Organization 13). This is the virus responsible for causing AIDs. The world is currently grappling with the coronavirus pandemic. There is much the world can learn from how the AIDs epidemic was handled in order to know which steps to follow to ensure that the current COVID-19 pandemic is resolved as soon as possible. When the world was first introduced to HIV, there were massive stigma and misinformation regarding this condition. The condition was associated with certain groups of people, and this impaired the implementation of effective response measures that could have tamed the disease before it kills many people. This paper argues that misinformation, bias, stigma and stereotype are to blame for the AIDs epidemic.
Origin of HIV
It is believed that HIV dates back in the 1920s when the virus was transferred from chimpanzees to human beings (Avert). As such, the virus crossed from one species to another about a century ago. The first incident of humans who had HIV was reported in the Democratic Republic of Congo (Avert). It is believed that this is the country in which the virus crossed species from chimpanzees to people. For many years, the spread and mortality rates of HIV/AIDs remained unknown. As a result, the available data indicated that the Aids epidemic could be traced back to the mid-1970s (Avert). At this point, HIV had already spread across the globe. By the 1980s, five continents, which included South America, Australia, Africa, North America and Australia, had reported at least one case of the HIV virus (Avert). The condition continued to spread far and wide within countries and across the world.
The First Incidents of HIV in the U.S.
In 1981, five young gay men from Los Angeles were diagnosed with a rare lung condition identified as pneumocystis carinii pneumonia (PCP) (U.S Department of Health and Human Services). The five gay men were healthy prior to their diagnosis with PCP. Besides, there were men in California and New York that had a rare, aggressive cancer identified as Kaposi’s sarcoma (KS) (U.S Department of Health and Human Services). Bobbi Campbell was the first patient with KS to go public regarding his diagnosis. Mr. Campbell identified himself as “KS poster Boy” when he wrote a newspaper column titled “Gay Cancer Journal” about his experience living with HIV (U.S Department of Health and Human Services). The story of Campbell demonstrates the degree of stigma associated with HIV. In the early days, people with HIV had come to accept the label given to them as a result of their conditions, as evidenced in the case of Campbell. At the same time, Ryan White is an Indiana teenager who had acquired AIDs from contaminated blood that he was receiving for his hemophilia (Avert). When it was discovered that Ryan White had AIDs, he was suspended from school. Evidently, people with HIV were dehumanized and discriminated against, which further worsened their situations. It is possible that some of them avoided getting tested or disclosing their positive status to their partners for fear of facing further stigma and discrimination.
In the beginning, HIV was associated with homosexuality. As 1981 came to an end, 270 gay men had been diagnosed with severe immune deficiency, and 121 of them had already succumbed to their illness (Avert). As a result of the high number of gay men affected by HIV, this virus was believed to only affect homosexuals. In the beginning, AIDs was known as gay-related immune deficiency denoted as GRID (Avert). After being detected in young gay men, the other group that was affected by HIV comprised of intravenous drug users (Avert). Later on, the disease was reported in Haitians and hemophiliacs (Avert). As a result, many individuals started believing that HIV could be traced to Haitians, intravenous drug users, and homosexuals. The first incident of HIV being transferred to heterosexual women was reported in January of 1983 (Avert). However, it was believed that heterosexual women were contracting HIV from bisexual men. All the stigma and misinformation regarding HIV could have resulted in authorities wasting meaningful time since they were engaged in blaming patients with this condition as opposed to finding its solution.
At the same time, the first incidents of children having AIDs were identified in June of 1983 (Avert). Initially, the children were believed to have acquired the disease from casual contact. However, it was later ruled out that the children had acquired the disease directly from their mothers prior to or after birth (Avert). Instead of engaging in objective research of the rare cases of children who had AIDs, government authorities and scientists found a scapegoat in sex workers, homosexuals, and bisexuals. However, not all physicians agreed with the conclusion that children were getting HIV from casual contact. In December of 1981, a pediatric immunologist from Albert Einstein Medical College in New York, identified as Dr. Arye Rubinstein, treated five black infants who exhibited symptoms associated with immune deficiency (U.S Department of Health and Human Services). Apart from the infants being blacks, some of them came from parents who were not only engaged in the sex trade but also used drugs. Dr. Rubinstein raised the alarm about the children showing signs that were synonymous with those exhibited by gay men who were diagnosed with HIV but his colleagues dismissed him (U.S Department of Health and Human Services). The failure by other healthcare specialists to take Dr. Arye’s concerns seriously could be attributed to the former being convinced that AIDs was a disease for homosexuals, blacks, and sex workers.
The Initial Response to AIDs Epidemic
In the beginning, the government was not very actively involved in finding solutions to the AIDs epidemic. For example, the Reagan administration neglected lesbians, gay, bisexual and transgender (LGBT) when AIDs started killing a significant proportion of members of these groups (“Its Morning in American (Except for Homosexuals, Blacks, Chicanas”). At the same time, members of the LGBT were blamed for the HIV epidemic. This may explain the slow response by Reagan’s administration regarding the epidemic. Besides, members of the LGBTs were not as vigorous and vocal when AIDs epidemic hit the country as they are now. As a result, the entertainment community decided to act as voices for LGBT and other members of the American public whose lives were greatly threatened by the AIDs epidemic (“Its Morning in American (Except for Homosexuals, Blacks, Chicanas”). The stigma directed at homosexuals in the country could explain the failure of these individuals to fight against their discrimination by the federal government.
At the same time, the initial responses were based on the misconception that AIDs could only affect homosexuals and intravenous drug users. For instance, the Center for Disease Prevention and Control stated in July 1984 that sharing needles and avoiding injecting drugs was effective in preventing HIV transmission (Avert). This meant that other groups were given the green light to continue engaging in indiscriminate sex without knowing that they too could contact and spread the virus. Later in the same year, areas frequented by homosexuals were closed in a bid to curb the spread of the virus. For instance, San Francisco closed private sex clubs and bath houses in October 1984, and Los Angeles and New York followed suit (Avert). The misconception that AIDs was a condition associated with homosexuality prevented the government from mounting a multi-faceted response to the epidemic.
At the same time, the federal government was slow to act in responding to the AIDs epidemic. Representatives Ted Weiss and Philip Burton introduced a bill aimed at allocating funds for AIDs-related research in 1982 (U.S Department of Health and Human Services). However, the proposal did not go past the committee speech. Besides, Congress chose to overwhelmingly support the policy the banned HIV positive people from entering the country in March 1993 (Avert). This means that even Congress was perpetrating discrimination against HIV positive individuals.
Later Responses to AIDs Epidemic
The World Health Organization launched The Global Program on AIDs in February 1987 with the goal of raising awareness, providing financial and technical support to nations, generating evidence-based policies, conducting research, and promoting the rights of individuals already infected with HIV (Avert). This marked a crucial step toward fighting discrimination, stigma, and misinformation associated with HIV/AIDs. In March of 1987, the Federal Drug Administration approved zidovudine (AZT), the first antiretroviral drug for treating HIV (Avert). Antiretroviral therapy has played a pivotal role in reducing the rate of mortality and morbidity associated with AIDs. For example, the U.S. Center for Disease Control and Prevention argues that antiretroviral therapy can help a person attain an undetectable level of HIV levels (Kaiser Family Foundation). A person whose HIV viral load level is not detectable has a significantly lower chance of transmitting the virus to other people. Besides, the United States passed into law the Americans with Disabilities Act (ADA) in July 1990 (Avert). This piece of legislation prohibited discrimination based on a person’s disability status. At this juncture, people who had been diagnosed with HIV received protection from discrimination under ADA.
In the 1990s, the fight against stigma directed at HIV positive people received massive boast. For instance, the Red Ribbon Project was launched by the Visual Aids Artists Caucus in 1991 (Avert). The project was aimed at turning hatred and stigma against HIV positive patients into compassion for these individuals. At the same time, the era saw some celebrities disclose their HIV positive status to the public. For instance, professional basketball player magic Johnson announced that he was HIV positive on November 7th 1991 (Avert). The announcement by celebrities such as Magic Johnson regarding their HIV positive status served to dispel the stereotype that HIV was a disease for homosexuals.
At the moment, numerous local and federal government agencies and departments are involved in the domestic HIV/AIDs response, and they include Housing Opportunities with HIV/AIDs Program (HOPWA), Medicare, Medicaid, and the Ryan White HIV/AIDS program (Kaiser Family Foundation). These agencies focus on arranging for disease surveillance, care, prevention, support services and health insurance pertaining to AIDs. Besides, community-based organizations and the private sector are involved in the provision of services to HIV positive patients, including those who face an increased risk of contracting this virus. In the 2019 financial year, the United States allocated $ 34.8 billion to efforts aimed at combating HIV (Kaiser Family Foundation). The measures aimed at handling the AIDs epidemic head-on without blaming or discriminating against certain groups of people for the condition yielded positive results, as demonstrated in the following paragraph.
The Rise and Fall in the Rates of HIV Infection across the Country
As 1985 came to an end, every part of the globe had reported one or more cases of AIDs. Around the world, there were at least 20,303 (Avert). The following years saw more people get infected with the disease. By the end of 1999, AIDs was identified as the fourth major cause of death across the globe (Avert). Things would have been much different if the stigma and misinformation against HIV had never been allowed to continue at the same level as was the case when the virus was first discovered. However, the trend started to change in the last few decades. There has been a 43% decrease in HIV-related deaths between 2003 and 2016 (World Health Organization. 11). Besides, mortality rates associated with HIV have been decreasing significantly over the last few years. In 2016, 6,000 individuals succumbed to AIDs-related complications in the U.S. in 2016 (Kaiser Family Foundation). At the same time, recent years have experienced changes in transmission patterns. For example, only 6% of the new HIV diagnoses in 2017 could be attributed to injection drug use (Kaiser Family Foundation). The change in transmission challenges the notion held by many scientists and government officials regarding AIDs being an illness for the gays when the condition was first discovered.
What Is the Way Forward?
The World Health Organization is on a mission to eradicate HIV across the world. However, major inequalities exist in the fight against the eradication of HIV. Since AIDs was first identified, it has disproportionately affected ethnic and racial minorities. Currently, 468, 800 people out of the more than 1.1 million individuals who have HIV in the U.S. are African Americans (Kaiser Family Foundation). Minorities are also more likely to succumb to complications associated with this virus in comparison to other racial groups. According to the Kaiser Family Foundation, African Americans were responsible for 43% of HIV-related deaths in 2016. Blacks account for only a small proportion of the general American population.
Besides, successes in the global HIV responses are distributed unevenly and inequitably. The World Health Organization argues that “While HIV incidence is declining overall, it is increasing in some countries and regions” (11). In the United States and other developed countries, incidents of people being diagnosed with HIV are decreasing. However, Approximately 70% of HIV positive individuals across the world are found in middle-income countries (World Health Organization 11). Global success in the fight against HIV requires a coordinated strategy. Rich countries must help poor ones in the fight against HIV if this epidemic is to be eradicated from the face of the world any time soon.
At the same time, there is a need for accelerated testing. It is important that all people who are HIV positive know their status. For example, the World Health Organization has a goal of reducing new HIV infections among adults from 2.1 million to 500,000 in 2010 and 2020, respectively (15). This is only possible if massive testing is done. Also, universal health coverage is pertinent in reducing deaths and other negative outcomes associated with AIDs. The World Health Organization states that “150 million people experience financial catastrophes and 100 million people suffer impoverishment every year as a result of out-of-pockets health expenses” (19). Universal coverage will help HIV positive people easily access the drugs they need to lower their viral loads and decrease their chances of infecting other individuals with this virus. President Obama spearheaded the enactment of a piece of legislation that would enhance increased access to health services for HIV positive Americans when he signed into law the Affordable Care Act (ACA) (Kaiser Family Foundation). This piece of legislation prohibited discrimination in access to healthcare services against people with pre-existing conditions, including those with HIV. Such laws are needed across the world to ensure increased access for healthcare services by HIV positive patients.
In conclusion, the AIDs epidemic has been plaguing the world for a few decades now, and it has claimed the lives of thousands of people across the world. The way the virus was handled when it was first identified accounts for its high prevalence and mortality rates. In the beginning, the condition was associated with gays and drug abusers. As a result of this misinformation, governments did not take the necessary measures to prevent further spread of the disease. The stigma against gay men and drug users prevented these people from seeking the help they need and which could have increased their likelihood of passing the virus to their wives and other individuals. At the same time, the governments did not allocate adequate finances for research, testing and helping HIV positive patients. At the moment, world governments are making huge investments toward ensuring that HIV positive patients get access to testing services and antiretroviral therapy at lower prices or for free. The world can learn numerous reasons from the way the AIDs epidemic was managed. These lessons can inform measures aimed at managing the current and future pandemics.
Works Cited
Avert. “History of HIV and AIDS overview.” Avert, 12 Jan. 2017. Web. https://www.avert.org/professionals/history-hiv-aids/overview. Accessed on April 28, 2020.
Kaiser Family Foundation. “The HIV/AIDs epidemic in the United States: The basis.” Kaiser Family Foundation, 25 March. 2019, https://www.kff.org/hivaids/fact-sheet/the-hivaids-epidemic-in-the-united-states-the-basics/. Accessed on April 28, 2020.
Its Morning in American (Except for Homosexuals, Blacks, Chicanas). PowerPoint File.
U.S Department of Health and Human Services. “A Timeline of HIV and AIDs.” U.S Department of Health and Human Services, n. d., https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline. Accessed on https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline
World Health Organization. Global health sector strategy on HIV 2016-2021. Towards ending AIDS. No. WHO/HIV/2016.05. World Health Organization, 2016.