In Part 2 of Series, Kaiser Daily HIV/AIDS Report Looks At How Early Confusion Over AIDS Created Stigmas
On June 5, 1981, the CDC introduced the world to the disease that eventually became known as AIDS. Although the disease had been present in the United States and elsewhere before this time, it was the first known mention of AIDS in a media report. Over the years, media coverage of AIDS has evolved from having an air of mystery to reports of panic, stigma and homophobia; from domestic epidemiology and policies to international crises and drug access. This week, the Kaiser Daily HIV/AIDS Report will feature stories on different aspects of the media's coverage of the disease over the past 20 years, including treatment advances, federal legislation, public fear and stigma and AIDS in the arts. The following report, the second in our series, examines how confusion about the transmission of HIV created public stigma surrounding certain groups and contributed to the public's fear of the disease.
'Sudden Arrival' of Disease Leads to Fear
While the discovery of HIV in 1984 meant that scientists knew how AIDS was transmitted, public fear of the disease remained and grew. One factor that contributed to shaping public perception was the CDC's use of the term "risk group" to define those populations most affected by the virus, including homosexuals, intravenous drug users, Haitian immigrants and hemophiliacs. Although the identification of high-risk groups helped the CDC target its prevention efforts, it also linked public perception of the disease to certain populations, creating stigmas. The Public Media Center, a not-for-profit organization that works to effect social change, defines AIDS-related stigma in three ways: fear of the disease itself, fear and hostility directed toward those perceived as being most affected by and responsible for the disease, and fear and hostility related to specific behaviors that transmit HIV. The center notes that such stigma "can be traced to the fact that AIDS [was] a strange and apparently deadly new communicable disease, whose sudden arrival naturally provoked feelings of fear, confusion and self-protectiveness in our first encounters with the epidemic" (Public Media Center, "The Impact of Homophobia and Other Social Biases on AIDS," 6/4).
Gay men were one of the first groups to experience AIDS-related stigma from being labeled at high risk for contracting HIV. Because the initial AIDS cases were identified primarily among gay men, a population already experiencing stigmatization because of sexual orientation, the media in the early 1980s described the disease as the "gay plague," and the CDC for a time used the term "gay-related immune deficiency," or GRID. Shortly after the term "gay plague" first appeared, the New York Times reported that a "double epidemic" was spreading: AIDS and a growing fear and intolerance of homosexuals (Beauchamp, New York Times, 8/7/83). Afraid that the disease could spread through casual contact, the San Francisco Police Department in 1983 equipped patrol officers with special masks and gloves to use when dealing with a "suspected AIDS patient." At the time, San Francisco Deputy Police Chief James Shannon said, "We have a large homosexual population. The officers were concerned that they could bring the bug home and their whole family could get AIDS" (Boffey, New York Times, 9/20/85). Some called AIDS "God's well-merited punishment for 'perverts,'" with Pat Buchanan writing in the New York Post in 1983, "The poor homosexuals -- they have declared war on nature and now nature is exacting an awful retribution" (Lavigne, Toronto Globe and Mail, 7/7/83). Meanwhile, gay men said that they feared not only contracting the disease, but also losing their civil rights "under the guise of preventing a spread of the epidemic" (Boffey, New York Times, 5/22/83). This fear played out in the workplace, as the Lambda Legal Defense and Education Fund said that gay men who "sho[w] up for work with a cold or a fever may be fired by a boss who thinks it is a symptom of AIDS." Fear of homosexuality and AIDS was also apparent in other fields, with the National Law Journal reporting that in Texas and Georgia, lawyers were using "the threat of AIDS to argue that anti-sodomy laws are constitutional and necessary" (AP/Toronto Globe and Mail, 7/18/83). Even in 1991 -- years after researchers had recognized that AIDS could spread through heterosexual contact -- professional basketball star Magic Johnson, in announcing his HIV-positive status, proclaimed, "First of all, I'm far from being a homosexual," noting that he had believed that only gay people contracted the disease (San Francisco Chronicle, 11/9/91).
Although gay men faced stigma in the early years of the disease, senior CNN political analyst Bill Schneider last night said on "Inside Politics" that the expected "backlash" against gays never materialized, adding that instead of increased "hatred and repression," the "dominant response" to the gay community has been one of "sympathy and tolerance." According to Schneider, many homosexuals came out in the early 1980s because they "had nothing to lose. It was a matter of life and death." There was some backlash, he said, but "by and large, the backlash backfired." Members of the "religious right" who anointed AIDS a "punishment from God" were "tainted by intolerance." Americans were "shocked by [the] bigotry and discrimination" faced by people they had known for a long time who were now revealing their homosexuality. "Why did tolerance triumph?" Schneider asked. "Because AIDS affected the middle class. It frightened middle-class Americans. They were outraged to see suffering and discrimination among their own friends and relatives. Moreover, the gay community had the skills and the resources to organize for themselves, which brought them respect, not resentment," he concluded (Schneider, "Inside Politics" CNN, 6/4).
Intravenous Drug Users
Shortly after the disease was identified among gay men, HIV also appeared among intravenous drug users, who resided predominantly in urban areas ("The Impact of Homophobia and Other Social Biases on AIDS," 1996). The disease proliferated among this population primarily through needle sharing. To curb the epidemic among intravenous drug users, some New York City officials in the 1980s proposed needle-exchange programs, a strategy that remains controversial today (Whitaker, Newsday, 12/28/86). Meanwhile, in San Francisco in the mid-1980s, community groups like the Mid-City Consortium to Combat AIDS began providing bleach to sterilize needles at locations such as the city's "shooting galleries," where drug users took intravenous drugs. But critics of the strategy said that addicts were not effectively cleaning needles and that city officials were endorsing needle-sharing by funding the bleach distribution program. Though some officials advocated needle-exchange programs instead of bleach-distribution programs, which would have eliminated any concerns about the effectiveness of bleach, San Francisco did not move ahead with such a program (Lempinen, Newsday, 12/29/86).
A higher-than-expected incidence of the virus among Haitians also brought media scrutiny to that population. In December 1982, almost a year and a half after the first cases of AIDS had been reported among gay men, a physician affiliated with the National Cancer Institute was widely quoted in the press as saying, "We suspect that this may be an epidemic Haitian virus that was brought back to the homosexual population in the United States." Although eventually proven to be incorrect, the statement had a negative effect on the perception and treatment of Haitian immigrants in the United States (Farmer, "Social Inequalities and Infectious Diseases," Emerging Infectious Diseases, October/December 1996). According to CDC statistics, as of November 1983, 4.8% of all AIDS cases in the United States occurred among Haitians, compared to 72% among gay men and 17% among intravenous drug users. At that time, Dr. James Curran, director of the AIDS task force at the CDC, said that Haitians were considered a high-risk group because "the figures sort of speak for themselves in the sense that they pointed out that 5% (of all AIDS cases) have been of people born in Haiti." He added that fewer than 20% of Haitians with AIDS fit into the two other risk groups, homosexuals or intravenous drug users. Haitian community leaders said that the fear that Haitians were spreading the disease was leading to job discrimination (AP/San Diego Union-Tribune, 12/8/83).
In 1983, another group joined the list of those at "high risk" for HIV infection: blood transfusion recipients, particularly hemophiliacs. By January 1983, the CDC had identified eight cases of AIDS among hemophiliacs (Wall Street Journal, 1/14/83). While hemophiliacs were often viewed as "innocent victims" of the epidemic, having contracted the virus through necessary blood transfusions, many still had to face discrimination associated with being HIV-positive. Perhaps the most well-known HIV-positive hemophiliac is Ryan White, who in 1985 was banned from attending school after he was diagnosed with HIV. White successfully sued in court, but after returning to school he was subjected to taunting and insults from his classmates. In 1987, his family moved to another school district, where White was "generally accepted." After his death in 1990, many AIDS advocates said White "served as a deterrent to bigotry throughout the nation." Thomas Brandt, spokesperson for the National Commission on AIDS, said, "After seeing a person like Ryan White -- such a fine and loving and gentle person -- it was hard for people to justify discrimination against people who suffer from this terrible disease" (Johnson, New York Times, 4/9/90).
Fear and Confusion About Transmission
Public confusion and doubt about HIV transmission continued even as more was learned about the disease. In New York during the mid-1980s, for example, nursing homes refused to accept AIDS patients and funeral homes demanded "as much as an extra $1,000 to handle the bodies of AIDS victims" -- despite an effort to educate city residents that "AIDS is not highly contagious and it is not spread through everyday casual or nonsexual household contact" (New York Times, 8/30/85). Amid the confusion surrounding HIV/AIDS and the resulting stigmas, media reports from that time documented -- and sometimes contributed to -- misperceptions about the disease, especially in the areas listed below.
- Heterosexual sex: With the focus on homosexuals as a high-risk group, it took several years for the media to widely acknowledge that HIV could be spread heterosexually. The New York Times in January 1984 profiled a study published in the Annals of Internal Medicine involving a hemophiliac who was believed to have passed the disease on to his wife. This case was portrayed as unique, as the Times reported that "[p]revious cases of AIDS being transmitted heterosexually involved female sexual partners of male intravenous drug abusers and bisexuals" (Altman, New York Times, 1/5/84). In 1986, the Times noted that AIDS "is still extremely rare among heterosexuals who are not drug abusers, and scientists disagree on how widespread a threat it poses to the heterosexual population" (Nordheim, New York Times, 3/22/86). In March 1987, the San Francisco Chronicle noted that "AIDS has not spread among heterosexuals as rapidly as researchers had feared" just a few years before, adding that "many experts believe recent publicity may have exaggerated the prospect of the epidemic's spread in the straight community" (Shilts, San Francisco Chronicle, 3/24/1987). However, in the summer of 1987, federal health officials "made the fateful decision to bombard the public with a terrifying message: Anyone could get AIDS" (Bennett/Sharpe, Wall Street Journal, 5/1/96).
- Blood transfusions: Amid reports that the U.S. blood supply could be tainted with HIV, fear of transmitting HIV through blood exchange mounted in the 1980s. For example, the Department of Defense in August 1985 announced that it would screen all prospective military recruits for possible exposure to AIDS. Anyone who tested positive in two separate tests was to be "barred from the military." Dr. William Mayer, then assistant secretary of defense for health affairs, said he was concerned in part that AIDS could be spread through transfusions between soldiers on the battlefield (Engel, Washington Post, 8/31/85). Fears heightened in 1987, when the CDC recommended physicians offer an AIDS test to "some patients who received blood transfusions between 1978 and 1985" (Cimons, Los Angeles Times, 3/20/87). Clinics conducting HIV tests were subsequently flooded with calls from residents "alarmed" by the CDC's warning (Weaver, New York Times, 3/29/1987).
- Saliva and casual contact: A study published in the New England Journal of Medicine in 1985 reported that researchers had found the AIDS virus in the saliva of only one of 71 gay men known to be infected with the disease (AP/Washington Post, 12/19/85). But media reports indicate that people took precautions to avoid close interaction with HIV-positive individuals. For example, William Swing, Episcopal bishop of California in 1985, spoke of the "cautious person" who "chooses to receive only the communion bread during a worship service," adding, "We've seen people avoiding the altar rail altogether" (Berger, New York Times, 9/13/1985).
The other parts of the Kaiser Daily HIV/AIDS Report 20th anniversary series are available online:
- The June 4 article examines early media coverage of HIV/AIDS.
- The June 6 article examines HIV/AIDS in the arts.
- The June 7 article looks at 20 years of legislation and policies on the disease.
- The June 8 article recaps advances in treatment.