Thirty years ago yesterday, "the CDC's Morbidity and Mortality Weekly Report (MMR) published a report of five young men with Pneumocystis carinii pneumonia who were treated at three different hospitals in Los Angeles, California." (see This Blog Post for details). Morbidity and Mortality Weekly is a really fun journal to read. It contains the latest reports of, well, death and serious illness as a means of disseminating information in a way that will allow quick response. So, if there are suddenly a bunch of cases of some disease scattered across the country, this kind of reporting may allow the connection to be made to an event ... quite literally, like the Superbowl or a Marching Band Competition or whatever ... at which the disease spread, or perhaps a region of the country where vaccinations are being skipped, or where swine-based flu has jumped the fence into a human population, etc.

In the case of this report, the disease being reported was to eventually be named AIDS and the infection that caused it HIV.

So, happy anniversary AIDS epidemic!

I just have two comments on this: First, how I found out about a certain aspect of HIV infection (which turned out to be unimportant) and second, how everybody else found out about AIDS

It will have turned out that HIV comes from the Congo (then Zaire) and it escaped from a remote area of the rain forest where it had probably jumped from primate to human (I'm simplifying here) and never reached any level beyond very local epidemic. HIV got out of this region of low population density and relatively little outside contact via truckers stopping at "truck stops" which are essentially houses of prostitution set up like a network across Central Africa.

I had heard about HIV but was not paying too much attention to it when I started working in Zaire. Also, there was no postal service there to speak of. You could go to a post office and buy stamps and give the postal guy a letter. They would not accept stamps affixed to a letter; The stamps had to be handed over separately. The claim would be made that a postal clerk would put the stamps on later. Of course, what really happened was the letter was searched for money or other valuables then discarded, and the stamp sold to another gullible customer.

So instead, our mail was handled through the Kenyan post, and from there, via Missionaries or others, brought by civilians to Zaire. Letters were sent to a post office box two countries to the east were they languished until someone picked them up and brought them to a private mail drop 300 or so kilometers away, where they languished until they were brought to a place where we might actually go now and then for supplies. Trouble was, there were two places we would go for supplies, one a day or two drive to the northwest, the other two solid days (maybe three) to the southeast. Researchers in this field site prior to my arrival were very fixated on getting their mail, and they had determined that the farther away supply city was also the more reliable mail city, so they had the mail dropped there. But I cared very little about getting mail, and I needed very few supplies, so we switched our supply route to the northwest unaware that everyone who had anything to do with anything regarding any of the mail had been strongly urged to only send every bit of the mail every time no matter what, hell or high water and all, to the southeastern site. Because those researchers really, really wanted to know where the mail was even if it was going to be harder to get to.

So for months, there was no mail at all because I had been told that the mail randomly moved back and forth between these two depots, and if we simply asked about the mail now and then sometimes someone would give us some.

That's how my advisor, Gynn Isaac, managed to be dead for several months before I got the note telling me that he had passed away on the tarmac of a Chinese airport while being transported, unconscious, to a US military hospital aircraft, having just been declared a citizen of the United States by George Schultz who, apparently, was a friend of a friend of a friend of my other advisor. By the time I returned to the States, the memorial was long over and a lot of adjustment had been made, and now I had to arrive and re-meet everyone, his wife and family, my fellow students, his friends on the faculty, as the person who had not been previously part of the grieving process. Well, to be honest, I never was part of the grieving process because most of it was over before I got the telegram (and yes, it was indeed a telegram, the only one I've ever gotten in my life). Uncanny feelings all around.

Anyway, the other letter of interest in that batch of mail was from the faculty in my department who were assuring us that the precautions regarding HIV and mosquitoes were probably not necessary. Later, we found a letter from months earlier telling us to take serious precautions to not be bitten by a mosquito because they may well carry HIV. Fortunately, we never got that first letter and thus did not spend months worrying about mosquitoes because they might transmit HIV. Instead, we spent months ... well, worrying about mosquitoes because of malaria, and getting malaria now and then to boot.

The other thing I wanted to mention was this: A few years ago, on some anniversary of HIV or another, there was extended coverage on NPR of the history of the disease and the epidemic. At that time the following was made clear: It was NPR, and certain specific reporters and producers working for NPR, that almost single handedly made everyone aware of, and motivated to address, the AIDS epidemic. You see, in those days, all media outlets were banned (by self-censorship mostly) to NOT report ANY story that had anything to do with homosexuals or homosexuality unless it was a story about them being bad or getting arrested or something. NPR broke rules when they used the term "sex among gay men" or even, for that matter, the word gay. I'll bet you didn't know that. This is one of those things that sounds so unbelievable that I know there will be people who read this who demand that I prove to them that what I'm saying is accurate.

It is, indeed, really strange to think that NPR reporters were going out on a limb to use these terms and discuss these topics. But the truth is that the inability of society to openly, in our public media, discuss HIV, AIDS and things like "sex among gay men" and so on probably delayed the onset of serious commitment and funding for HIV research. NPR broke that barrier and caused the public discussion to happen. The development of HIV related research programs and AIDS treatment and prevention was still too slow, still too delayed because it was a "gay problem" and so on, but it would have been much worse had NPR not pushed, forcibly, the conversation into our cars and living rooms. Thank you NPR for doing that.

And it is still the case that a double-digit percentage of the US citizenry can't handle this topic, thinks HIV is a gay disease brought on sinners, or some other such nonsense. WTF? But I suppose it could be worse.


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I didn't know that about NPR. But to be fair, the self-censorship wasn't *only* media. The CDC edited the proposed title of the original MMWR bulletin to take out the word "homosexual."

(You can see that story here if you care to; on SUPERBUG last week, I ran a book excerpt that tells the story of the finding of the original cases and writing of the bulletin: )

I didn't know that about NPR, either! I was a little young at the time to be critiquing media coverage. I will say, though, that my public schools did a good job giving us the facts about how HIV is transmitted and how to avoid becoming infected, once researchers had figured that out and communicated it. I'm sure my memory isn't complete, but I think my teachers avoided condemning anyone for their sexual practices.

I learned about AIDS in a paragraph-sized article in Scientific American that reported the change of the name from Gay-Related Immune Deficiency to Acquired Immune Deficiency Syndrome. I parsed those words: it's infectious; it wipes out your ability to fight off infections; you get lots of diseases. I realized that it was going to kill a lot of people.

I was coming to terms with being gay at the time. I decided to play carefully ⦠that worked for me. Several friends and acquaintances died.

By Timberwoof (not verified) on 06 Jun 2011 #permalink

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