AIDS Emerges: Medical Community Warned

Five young men in Los Angeles, all previously healthy, all gay, were dying of a pneumonia that had no business killing them. On June 5, 1981, the Centers for Disease Control published a brief report in its Morbidity and Mortality Weekly Report describing cases of Pneumocystis carinii pneumonia among five homosexual men treated at three Los Angeles hospitals between October 1980 and May 1981. Two were already dead by the time the report appeared. The article, dry and clinical at just two pages, was the first official recognition of the epidemic that became known as AIDS. Dr. Michael Gottlieb, an immunologist at UCLA, had noticed the pattern: young men with devastated immune systems, riddled with infections that normally appeared only in transplant patients on immunosuppressive drugs. All five had cytomegalovirus and candidal mucosal infections. Their T-cell counts were virtually zero. Gottlieb alerted the CDC, which published the report as a routine epidemiological notice. An editorial note at the bottom suggested the cases might indicate "a cellular-immune dysfunction related to a common exposure." Within weeks, similar clusters appeared in New York and San Francisco. By the end of 1981, 270 cases of severe immune deficiency had been reported among gay men, and 121 of those patients were dead. The disease had no name, no known cause, and no treatment. Researchers initially called it GRID (Gay-Related Immune Deficiency) before the term Acquired Immune Deficiency Syndrome replaced it in 1982 as cases appeared in hemophiliacs, intravenous drug users, and Haitian immigrants. The virus responsible, HIV, was identified independently by French and American researchers in 1983 and 1984. Effective antiretroviral treatment did not arrive until 1996. In the fifteen years between that first CDC report and the drugs that transformed AIDS from a death sentence into a manageable condition, the disease killed over 300,000 Americans and approximately 10 million people worldwide. The delay in political response, shaped by stigma and indifference toward the communities hardest hit, remains one of the great failures of modern public health.