A Plague Allowed: The Slow Response to the AIDS Crisis

 “Please know that this is a plague that need not have happened. Please know that this is a plague that has been allowed to happen.” —from Larry Kramer’s letter “Please Know,” distributed after the 2011 Broadway premiere of The Normal Heart.

In 1981, rare illnesses suddenly began appearing in young and apparently healthy gay men. Doctors in New York, Los Angeles, and San Francisco were mystified as they watched their patients die rapidly of infections they shouldn’t have contracted at all. A medical response would take time they didn’t have—time to identify the virus, to develop a drug, and to push the drug through the FDA’s clinical trial process, which took at least four years. The disease was already known on both coasts, suggesting that it had a long incubation period. In short, the known cases were just the tip of the iceberg, and many more people were about to get sick.

Underfunded and understaffed, the Center for Disease Control (CDC) struggled to identify the killer. The FDA was unwilling to fund research on a group of apparently unrelated diseases appearing only in gay men, and suspected the CDC was orchestrating a publicity stunt. Unable to afford a case-control study, the CDC could not test their theory that the disease was sexually transmitted, and could offer no advice to doctors or patients. Men knew neither how the disease was being spread, nor how to protect themselves against it. They only knew that being a gay man seemed to carry a death-sentence.

In the summer of 1981, cases began appearing in heterosexual intravenous drug users, suggesting the disease spread through blood contact. In January 1982, the first case appeared in a hemophiliac. Infected women and babies were discovered soon thereafter, and the disease was rechristened Acquired Immune Deficiency Syndrome (AIDS). The CDC was now able to report that AIDS was spread by “intimate sexual contact or by percutaneous inoculation of blood or blood products.” Though their report insisted airborne transmission was impossible, fear led to widespread discrimination against patients, who were removed from workplaces, schools, and even medical facilities.

Media attention picked up somewhat, but AIDS remained a gay disease in the public mind, newsworthy only when heterosexuals were infected. In April of 1983, when Newsweek ran a cover article titled “EPIDEMIC: The Mysterious and Deadly Disease Called AIDS May Be the Public-Health Threat of the Century. How Did It Start? Can It Be Stopped?” The statistics cited were grim: a death toll of 489 and a zero percent recovery rate. Fewer than 14 percent of patients lived more than three years after their diagnoses. While gay males made of up 72 percent of cases, the article stated that “AIDS will begin appearing with greater frequency among heterosexuals as the epidemic grows.” This article brought widespread public attention to the AIDS epidemic for the first time, and prophesied an impending international crisis.

Want to learn more? This article is excerpted from the latest edition of Words on Plays, which provides fascinating background information, interviews, and behind-the-scenes information about The Normal Heart, now playing at A.C.T. through October 7, 2012. Go online to order your copy today! Both print and electronic editions are available.

You can also join the conversation this Sunday, September 30, following the 2 p.m. matinee of The Normal Heart, as local experts lead “AIDS Now,” a discussion and Q&A that will focus on progress in HIV/AIDS treatment and what must be done medically, politically, and economically if we ever hope to control the disease. This event is free for all ticketholders. 

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