In my class on Health and Disease in Ancient Populations this semester, I talk frequently about the epidemiological transitions - the times when people started coalescing into cities and increasing their risk of disease, then realizing that hygiene was important and began curbing disease, and finally where degenerative diseases and long-term issues are the major killers. We've made it through the third epidemiological transition - most people are felled by heart disease and cancer, not infection. But this epidemiological transition also means that some old diseases are returning and becoming antibiotic resistant (like tuberculosis), and new diseases are arising, like AIDS.
In talking to my class about disease among ancient populations, I also explain that, before germ theory, people didn't understand how disease was spread. Lots of strange explanations arose. The Romans thought that "black bile" caused cancer, for example, and the medieval Italians said that "bad air" (mal aria) could lead to disease. We marvel at how silly these people were and how advanced our understanding of disease is through modern medicine.
Today, I came across this excellent 2006 New York Magazine timeline of the history of AIDS and had to share some of the highlights. My first memory of AIDS was the media coverage of the illness and death of Ryan White in 1990, and then the discovery that Magic Johnson was HIV positive in 1991. I was a teenager and assumed that doctors had it all figured out. The timeline is truly eye-opening (really, you should go read the whole thing right now), particularly in the 1980s. It shows how little we knew about a brand-new disease, how certain populations were blamed for its origin and spread, how medical professionals ignored symptoms because of preconceived notions of how the disease worked. Some of the 80s entries show just how far we've come in understanding HIV and AIDS:
- October 31, 1980. French-Canadian flight attendant Gaetan Dugas pays his first known visit to New York City bathhouses. All of the city’s early infections would be traced to Dugas, since dubbed “Patient Zero.”
- January 1982. “Gay-related immune deficiency” (GRID) gains currency, though the name becomes obsolete when straight Haitians show up with symptoms in Brooklyn hospitals. (Hemophiliacs would soon join them in the public’s mind as the third H group seen to be at any real risk.)
- December 1982. Dr. Arye Rubinstein submits a study to the American Academy of Pediatrics finding evidence of AIDS among five infants in the Bronx. It’s rejected—based on the belief that the disease is confined to gay men.
- September 9, 1985. Queens parents launch a school boycott after the city allows a second-grader with AIDS to attend classes.
- September 29, 1986. Early results show that the drug AZT can slow down progress of HIV. Jubilation breaks out—prematurely. “After six years of having nothing to do for people but hold their hands and watch them die, I got my patients on it ASAP,” recalls Dr. Howard Grossman. “We didn’t know that AZT on its own is only good for six months before resistance sets in.”
- June 2, 1987. Mayor Koch calls for mandatory HIV testing for visitors and immigrants to the U.S. Those with HIV should be denied entry, he says.
- January 1988. Cosmopolitan magazine says women can have unprotected sex with an HIV-positive man without fear. “Most heterosexuals are not at risk,” the magazine says, adding that it’s impossible to transmit HIV in the “missionary position."
AIDS education has a long way to go, but we have already started to look back on our early, flawed understanding of the disease. The 2006 New York Magazine timeline shows that thirty years ago, we were no smarter than people who blamed syphilis on the disenfranchised and foreign or people who thought that malaria was caused by bad air. Fortunately, it has only taken us a couple decades rather than a couple millennia to learn how to manage and cure most modern diseases.
The faster I raise money, the sooner this notice goes away. It's like an NPR or PBS fund drive, but instead of a lame tote bag, you get pictures of real Roman skeletons!