A thoughtful, poignant look at the AIDS crisis in the United States that includes primary source interviews, history, medical research, and cultural touchpoints.
The AIDS crisis in America is complex and composed of countless individual stories of grief, love, and advocacy. Its history shows the power of youth activism, how creativity and community can be vehicles for social change, and how bigotry and misinformation led to inequality in care.
The early days of the AIDS crisis saw LGBTQ+ and other marginalized communities making strides in the fight for equality. As many people in positions of power were slow to act or actively didn’t pay attention until their own communities were affected, the fight for equality turned into a fight for their lives. Grassroots efforts filled in gaps where mainstream medicine and politics failed, and over time, a cultural shift of awareness emerged, which led to more research and more treatments. And while the disease has transitioned from a death sentence to one that people can live full lives with, there are still people dying of HIV/AIDS today because they can’t access the care they need. The fight may have begun decades ago, but is not yet over.
Award-winning author David Levithan and University of Cambridge PhD Gabriel Duckels detail a brief history of the epidemic, touching on key moments and figures, such as Ryan White, ACT UP, Larry Kramer and Anthony Fauci, Pedro Zamora from MTV’s The Real World, and the Names Quilt. Threaded throughout are poems, essays, and other creative works, in addition to first-person interviews and narratives. The most important takeaway is that we must remember. We need to know what happened and why. Our voices are powerful, and they can make a difference.
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David Levithan is the author of several books for young adults, including Lambda Literary Award winner Two Boys Kissing; Every Day; Nick & Norah’s Infinite Playlist and Dash & Lily’s Book of Dares (co-authored with Rachel Cohn); Will Grayson, Will Grayson (co-authored with John Green); and Boy Meets Boy. In 2016, David received the Margaret A. Edwards Award for his significant and lasting contribution to young adult literature.
Gabriel Duckels holds a PhD in Education at the University of Cambridge as a Harding Distinguished Postgraduate Scholar. He is an interdisciplinary researcher working at the intersection of children’s literature and childhood studies; queer youth studies in popular culture and education; HIV/AIDS sociology; and the study of aesthetics, culture, and pedagogy.
A Brief Overview of the AIDS Epidemic, in Facts and Figures
When we talk about the AIDS crisis, we are most often describing a distinct period between the early 1980s and the mid-1990s when there was no treatment and AIDS spread unchecked around the world. First, there are the staggering numbers, the census of the sick and the dead. The figures below are from the Centers for Disease Control’s HIV/AIDS Surveillance Report from 1980 through December 2001, the most accurate figures for the United States. Please keep in mind that because of the stigma involved, many AIDS cases went unreported and many AIDS deaths were said to have other causes—so these numbers are likely far lower than the real numbers. But even if they underrepresent, they still give a clear, painful view of the virus’s deadly trajectory.
(Sources for all facts and figures in this book can be found in the Notes section at the end.)
Before 1981: 100 new cases, 31 deaths
There is no single date when we can say the AIDS epidemic began. Because the virus can be present in the body for up to a decade before symptoms occur, it is impossible to pinpoint its emergence. As you will see in the case of Robert Rayford, there may have been isolated cases that went unnoticed by doctors before the 1980s. It is only when a few cases happen in a localized area that doctors begin to see a pattern.
1981: 339 new cases, 130 deaths
The first reports of a “gay pneumonia” or “gay cancer” appear in medical journals and local newspapers as clusters of young gay men in urban areas come down with unusual infections and/or a rare cancer called Kaposi’s sarcoma. Similar conditions are also found in infants in New York City who contracted it from their mothers, pointing to the fact that the disease is not, in fact, unique to gay men.
1982: 1,201 new cases, 466 deaths
The Centers for Disease Control (CDC) uses the term AIDS (acquired immune deficiency syndrome) for the first time, replacing GRID (gay-related immune Deficiency). The source of the disease and how it spreads are still unknown, nor is there any way to test for it. Cases are discovered in hemophiliacs, who have become infected through blood transfusions.
1983: 3,153 new cases, 1,511 deaths
AIDS wards begin to appear in hospitals in major cities. The CDC adds female partners of men with AIDS as an “at-risk” group, and also warns blood banks of a possible problem with the US blood supply. Activists raise the alarm about a lack of funding to fight the disease while also cautioning the gay population in particular to be aware. French scientists discover the retrovirus—HIV (human immunodeficiency virus)—that causes AIDS.
1984: 6,368 new cases, 3,526 deaths
American scientists confirm the connection between HIV and AIDS.
1985: 12,044 new cases, 6,996 deaths
The first blood test is released to diagnose HIV/AIDS. And when famous actor Rock Hudson reveals he has AIDS, the world takes notice in a way it hasn’t before. President Reagan mentions AIDS for the first time in a speech. Meanwhile, a Los Angeles Times poll finds that a majority of Americans favor quarantining people with AIDS. Patients are often subject to isolation, stigma, and ridicule—as shown in the treatment of hemophiliac teenager Ryan White, who is HIV+ and prevented from going to his school.
There are 89 percent more new cases in 1985 than in 1984. Of those who have been diagnosed with AIDS, 51 percent of all adults and 59 percent of all children have died.
1986: 19,404 new cases, 12,183 deaths
Defying conservatives, the surgeon general issues a report encouraging the use of condoms, sex education, and voluntary testing to prevent the spread of AIDS. Meanwhile, the CDC reports that Black and Latine people are disproportionately affected by AIDS.
1987: 29,105 new cases, 16,488 deaths
ACT UP (AIDS Coalition to Unleash Power) is formed to protest governmental and corporate malfeasance in helping people with AIDS. AZT is the first drug approved by the FDA (Food and Drug Administration) to fight AIDS; it is highly (and often prohibitively) expensive and has many potentially toxic side effects.
1988: 36,126 new cases, 21,244 deaths
Grassroots needle-exchange programs begin to help prevent intravenous drug users from infecting themselves through dirty needles.
1989: 43,499 new cases, 28,054 deaths
The National Commission on AIDS, formed by Congress, first meets. The number of new cases continues to grow, as AZT does not prove to be the cure that many hoped it would be.
1990: 49,546 new cases, 31,836 deaths
ACT UP protestors at the NIH (National Institutes of Health) demand more treatments, fast-track approvals of AIDS drugs, and a clinical trial system that is more inclusive, particularly of women and people of color.
1991: 60,573 new cases, 37,106 deaths
The red ribbon becomes the symbol of AIDS awareness. But even if people are talking about it, there is still no cure, and the infection rate is only rising.
1992: 79,657 new cases, 41,849 deaths
AIDS becomes the leading cause of death for US men ages twenty-five to forty-four.
1993: 79,879 new cases, 45,733 deaths
The CDC expands its list of clinical indicators of AIDS to include pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer, which leads to more accurate diagnoses in women and drug users.
1994: 73,086 new cases, 50,657 deaths
AIDS is now the leading cause of death for all Americans ages twenty-five to forty-four.
1995: 69,984 new cases, 51,414 deaths
The number of cases of AIDS in the US passes five hundred thousand. The first protease inhibitor is approved for use in fighting AIDS. HAART (highly active antiretroviral therapy) becomes the newest treatment for people with AIDS.
1996: 61,124 new cases, 38,074 deaths
The HAART combination therapy proves to be effective, and the numbers of new cases and deaths decline for the first time in the epidemic. While AIDS is no longer the leading cause of death for all Americans ages twenty-five to forty-four, it is still the leading cause of death for Black Americans in that age range, highlighting the disparity of care.
1997: 49,379 new cases, 21,846 deaths
UNAIDS (the Joint United Nations Programme on HIV/AIDS) estimates 30 million people worldwide have HIV. Meanwhile, the use of HAART in America leads to a 48 percent decline in deaths from AIDS.
1998: 41,829 new cases, 18,148 deaths
The CDC reports that Black Americans account for 49 percent of AIDS-related deaths in America. The AIDS-related mortality rate for Black people is ten times higher than the rate for white people and three times higher than the rate for Latine people.
1999: 38,811 new cases, 16,762 deaths
According to the World Health Organization (WHO), AIDS has become the fourth biggest cause of death in the world and the biggest cause of death in Africa. It is estimated that 33 million people are living with AIDS and 14 million have died worldwide.
2000: 36,087 new cases, 14,499 deaths
President Clinton announces the Millennium Initiative to find vaccines for HIV/AIDS and other diseases. (Twenty-five years after the millennium, there is still no HIV vaccine.)
2001: 24,855 new cases, 8,998 deaths
In the twenty years between 1981 and 2001, including cases where the year of death couldn’t be determined, there are 816,149 new cases and 467,910...
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