AIDS at 25

On June 5, 1981, The Federal Centers for Disease Control and Prevention (CDC) first reported an outbreak of a rare form of pneumonia among gay men. Shortly thereafter, headlines appeared in The New York Times and the San Francisco Chronicle regarding a rare cancer striking gay men.

We didn't know it at the time, but these were the first documented cases of what soon became known as AIDS. We hoped that a cure or vaccine would be developed rapidly, but a quarter century has passed and we as a community have lived through years of death and despair, stigma and discrimination, and hope and progress in the fight against this disease.

Since the earliest years, San Francisco has been at the epicenter of the epidemic. Our community responded heroically, pioneering many of the prevention and treatment strategies that are now the cornerstone of the world's response to the pandemic. Our community simultaneously created a strong philanthropic response which allowed us to create blunt and targeted prevention campaigns to communities at greatest risk; the legalization of needle exchange and other efforts to expand access to sterile syringes; and the development of community- based services and worldrenowned care for those who are infected.

In order to be successful, we have struggled to overcome political and societal indifference to the disease. Activists demanded that our government respond appropriately and we have created an advocacy model that other communities and coalitions now emulate.

Ten years ago, the landscape changed significantly when highly active antiretroviral therapy (HAART) was found to be effective in battling the disease for many patients. Death rates plummeted and advocates clamored for access to these life-saving treatments both in the United States and throughout the world. While access has grown over time, far too many people continue to die because these drugs are not accessible or affordable.

Unfortunately, 25 years into the epidemic, the rate of new HIV infections remains unacceptably high in the United States and throughout the world. While there are indications that the number of new infections may be decreasing slightly in San Francisco, the U.S. has been stuck at a rate of 40,000 new infections annually for over a decade. And, too often, our political leaders have based prevention efforts and policies on politics and ideology, not on sound science and public health research.

To read more about this significant milestone in our history, please read the stories about how HIV has affected the lives of six people here in SF in this issue of OUTReach. You can also download a timeline (420kb PDF) of key events over the last 25 years as well as the reflections of several members of our community about the impact that AIDS has had on their lives over the last two and a half decades. Additionally, you can download the entire June 2006 edition of OUTReach as a PDF (666kb).