(Editor’s note: The world marks the first official recognition of HIV/AIDS on June 5, 1981, the date the Centers for Disease Control published an article titled “Pneumocystis Pneumonia” in the CDC’s Morbidity and Mortality Weekly Report, written by Los Angeles-based Dr. Michael Gottlieb. At the time Gottlieb was an ambitious 33-year-old assistant professor at the University of California Los Angeles Medical Center specializing in immunology and looking for “teaching cases.” In April 1981, Gottlieb discovered “four cases that were carbon copies” of an “apparently new” disease in “desperately ill” young gay men, two of whom were patients of the late gay Dr. Joel Weisman. Gottlieb found Weisman to be “an astute doctor” who “knew something was afoot among his patients,” and the two started “a very good collaboration” during the beginning of the AIDS epidemic.
By August 1981, the CDC reported 108 cases of the new disease in America. By February 1982, the CDC reported that 251 Americans had the new disease; 99 people had died. Since Gottlieb’s first report, more than 25 million people have died from AIDS worldwide; an estimated 1.8 million people died as a result of AIDS in 2009 alone. Additionally, United Nations AIDS reports, by the end of 2009, estimated 33.3 million adults worldwide were living with HIV/AIDS and 2.6 million were newly infected in 2009 alone. A CDC report in 2008 found that one in five (19 percent of) men who have sex with men in 21 major cities were infected with HIV, and nearly half (44 percent) were unaware of their infection. This article by Dr. Gottlieb kicks off a series on AIDS at 30 that will appear in Frontiers IN LA magazine, on FrontiersWeb.com, and cross-posted here at LGBT POV - Karen Ocamb)
Dr. Michael Gottlieb on Rock Hudson, Elizabeth Taylor and AIDS at 30
It is not easy for young people to imagine what HIV/AIDS was like in the ‘80s and ‘90s. Thirty years ago, my colleagues and I were the doctors who identified AIDS as a new disease. Two years later, French researchers found HIV, the virus that caused the immune deficiency. Fear turned to terror and to sadness, and hundreds of thousands died in the United States alone. In Los Angeles, special immune-suppressed wards in hospitals were filled to capacity, with young men dying miserably with horrible and disfiguring opportunistic diseases.
At first, when case numbers were small, America ignored AIDS. Next, it was pigeonholed as a “gay disease,” important only to “those” people. There was no sign of a compassionate response. Institutions struggled with how—or even whether—to respond. In the prologue to his book And the Band Played On, the late author Randy Shilts wrote, “In those early years, the federal government viewed AIDS as a budget problem, health officials saw it as a political problem, gay leaders considered AIDS a public relations problem and the news media regarded it as a homosexual problem that wouldn’t interest anybody else.”
AIDS flew below the radar until a movie star, my patient Rock Hudson, came down with it in 1985—by which time 12,000 cases had been diagnosed. Until then, most Americans were only vaguely aware that an epidemic was underway and that it was serious.
Before Rock Hudson, the media did not consider AIDS to be a legitimate news story deserving coverage. The disclosure of his AIDS diagnosis changed all that. Randy Shilts wrote, “Rock Hudson riveted America’s attention upon this deadly new threat for the first time, and his diagnosis became a demarcation that would separate the history of America before AIDS from the history that came after.” The disease that had been subject to widespread indifference finally had a face, and it was that of a Hollywood movie idol. Americans saw someone with AIDS on the covers of Newsweek and People.
In 2006, I chuckled when I heard Elizabeth Taylor respond to Larry King’s question on CNN about how she got involved with AIDS. Her answer: “I called a doctor friend of mine, Michael Gottlieb, and said ‘what can I do?’”
As much as I would like to take the credit, the reality was more complicated. Rock and Elizabeth had been friends since the days when they starred in the film Giant, and she had many other gay friends who were already affected by or living in fear of HIV. She had seen firsthand the devastation of the disease when she visited Rock at the UCLA Medical Center.
Elizabeth was very aware of the injustice of homophobia, and instinctively knew that prejudice explained why AIDS was being ignored. Rock’s diagnosis was a pivotal moment in the epidemic; an opportunity to start up a national foundation to raise awareness and press the government for action. Elizabeth took up the cause and stayed with it for 25 years with characteristic tenacity.
It should be noted that she had the courage to take up the cause at a time when AIDS was very unpopular. Young people may not be aware that as late as 1987 there was a California ballot proposition that, among other things, would have prohibited HIV-positive patients from working in restaurants. It was endorsed by then-Gov. George Deukmejian and nearly passed. Elizabeth was the first celebrity AIDS activist to become a public spokesperson when we founded the American Foundation for AIDS Research (AmFAR). Her involvement was a revolutionary event, a game-changer on par with Rock’s disclosure.
And she was perfect in the role. She was beautiful, eloquent and compassionate in making the case for more federal and private funding for research and care. The adoring public that had followed her career and the ups and downs of her personal life saw how deeply committed she was to justice and compassion for people with HIV/AIDS and started listening. Prejudice toward people with AIDS slowly began to soften and was replaced with at least some degree of empathy. It was Elizabeth who finally coaxed President Ronald Reagan into finally saying the word “AIDS,” seven years into his presidency.
I traveled with her to Washington to lobby Sens. Orrin Hatch and Fritz Hollings for federal funding. Although I was the AIDS discoverer and expert, I received absolutely no attention or respect whatsoever from the senators. Elizabeth wowed them with her glamour, good humor and charm. Her star power focused their attention on what needed to be done.
The advances in treatment that we have today are due in no small part to her efforts in promoting research. Other celebrities have generously lent their names to the AIDS cause, but no one will ever come close to her prominence. When the final chapter in the history of the epidemic is written, Elizabeth Taylor will stand as a heroine above all others.
The HIV epidemic is not over. Despite the improved prognosis, younger generations of gay men should not take contracting HIV lightly. Among other obvious disadvantages, a lifelong requirement for medication has a downside in terms of side effects. In 2009 alone there were 2.4 million new infections in the world, 1 million of them in the 15-24-age range.
We are actually losing ground; in 2009, two people were newly infected for every one person who started antiviral therapy. Preventive medication, a vaccine and even a cure are the new frontiers of research.
Elizabeth Taylor made HIV/AIDS her cause, and there is a void in our world left by her passing. Inspired by her example and that of many AIDS activists still among us, a younger generation should get involved, focus on prevention and support ongoing efforts to find a vaccine and cure.
Dr. Michael Gottlieb is still actively practicing medicine—see his website at michaelgottliebmd.com—on staff at Olympia Medical Center and as an Associate Clinical Professor of Medicine at the UCLA Geffen School of Medicine.