Where Does Hiv Come From
HIV is thought to have occurred after people ate chimps that were carrying theSimian Immunodeficiency Virus .
HIV is a type of lentivirus, which means it attacks the immune system. SIV attacks the immune systems of monkeys and apes in a very similar way. This suggests HIV and SIV are closely related, and that SIV in monkeys and apes crossed over to humans to become HIV.
Public Health And Health Care
The concentration of the epidemic, both socially and geographically, has differentially affected the component agencies and services of the health care and social welfare systems of New York City. For example, municipal hospitals serving areas with large numbers of people with HIV/AIDS who do not have health care insurance usually have a very large number of patients in various stages of HIV disease. These municipal hospitals are already underfunded, understaffed, and threatened with further budgetary cuts, all of which affect their ability to provide care .
The lack of private care physicians in the inner-city communities enhances the importance of municipal hospitals. For instance, in the Mott Haven/Hunts Point section of the Bronx there are only 34 office-based primary care physicians for every 100,000 people, in contrast to 1,451 per 100,000 in the Upper East Side of Manhattan . Moreover, the few community-based physicians who are available have limited practices. In a recent study of 701 primary care providers in nine low-income communities, only 28 were able to provide “accessible, comprehensive and coordinated primary care,” and only a quarter had admitting privileges to hospitals to which the poor have access. Those without such privileges must refer patients to the closest emergency room for hospital-level care . In such areas of the city, the emergency rooms of the municipal hospitals often serve as the health care providers of the first resort.
Public Health Effects Of Hiv/aids Concentration
The concentration of HIV/AIDS in particular neighborhoods of New York City reveals a chilling epidemiological fact: HIV/AIDS is but one in an overlapping cluster of epidemics. The affected neighborhoods, marked by poverty, poor access to health care, drug addiction, and social disintegration are beset with co-epidemics of disease. The most striking lesson to be learned from the concentration of AIDS in particular neighborhoods is that AIDS cannot be viewed in isolation. The map of HIV disease in New York City is also a map of the epidemic spread of other diseases, including sexually transmitted viral and bacterial diseases, as well as some nonsexually transmitted diseases, particularly tuberculosis. AIDS cases are also concentrated in zones of urban poverty, poor health care, drug addiction, and social disintegration.
Gonorrhea, syphilis, and chancroidâthe three classic venereal diseases that had nearly disappeared except for momentary and treatable recurrencesâare increasing at epidemic rates among urban minority populations in the United States . Syphilis and herpes have been associated with HIV infection in heterosexual men and women and homosexual men in the United States. HIV infection leads to altered manifestations of sexually transmitted diseases and is thought to promote their spread. Thus, it has been suggested that HIV and other STDs interact to facilitate the sexual transmission of HIV .
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The Cultural Response To Hiv
Public response was negative in the early years of the epidemic.
In 1983, Dr. Joseph Sonnabend in New York was threatened with eviction for treating people with HIV, leading to the first AIDS discrimination lawsuit.
Bathhouses across the country closed due to sexual activity and the associated risk. Some schools also barred children with HIV from attending.
U.S. blood banks started screening for HIV in 1985, and men who had sex with men were banned from donating blood . first lifted some of its restrictions in December 2015. The FDA loosened its restrictions again in 2020, motivated by the blood shortage caused by COVID-19.)
In 1987, the United States placed a travel ban on visitors and immigrants with HIV.
The United States government resisted funding needle exchange programs due to the War on Drugs. NEPs were shown to be effective at reducing HIV transmission.
In 1997, researchers calculated that this resistance accounted for .
The number of avoidable transmissions may be even higher.
A 2005 study looked at people in New York City who used injectable drugs and had been admitted to a drug detoxification program. The researchers concluded that the legalization of syringe exchange programs helped reduce HIV prevalence among this group from 50 percent in 1990 to 17 percent in 2002.
It Was A Time Of Confusion And Then A Time Of Considerable Fear
Lisa Power, sexual health and LGBT rights campaigner
I was working on the Gay Switchboard during the Aids outbreak. We were basically a helpline to give out information on what gay bars there were in Burnley or to support someone who was feeling lonely and wanted to come out. Then a pandemic hit us and we really didnt know what was coming. People ran in all sorts of directions. Some thought we should all give up sex. Some said it was just gay men only. There were so many theories going around. Some said it was a plot by the CIA. Some people just didnt believe in it and said that it was all the pharmaceutical industry trying to sell drugs, just as theyre saying now about Covid.
It was a time of deep confusion, and then as people got to know about it, a time of considerable fear. We were completely unaware that this was a virus you got, and it then lay dormant for a quite a while, transmissible but not causing any obvious damage.
A lot of young gay men had moved to London so that they could be gay in their social life but didnt have to tell their parents back home. We were in a situation where some people found out that their son was gay when they saw him in a hospital bed, wasting away. And that provoked all kinds of reactions. Some parents were brilliant and incredibly supportive, and actually started to volunteer with the organisations that were trying to help people with Aids. And then you got others who didnt want to tell anyone what their son had died of.
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‘a Pretty Bleak Time’
Craig Stephenson lived in Barry in the 80s and struggled to come to terms with being gay. But when an opportunity to work in London for a year in 1986 came up, it allowed him the space to come to terms with his sexuality.
“It was a difficult time, under Margaret Thatcher’s government and Clause 28 was happening, they were trying to stop local authorities promoting homosexuality as a way of life.
“There was so much negativity around being gay and, at the same time, there was this kind of double whammy, this new disease that was ripping through the gay community,” he said.
The 57-year-old said it was not a pleasant time to be even thinking about coming out because of the negativity.
“You just had this feeling you were going to be ostracised and it basically took me a lot longer to come out than it probably should have. So I was in my mid-20s when I moved back to Barry and I still hadn’t come out properly.”
In 1989, he moved to Cardiff and felt he could be more open about his sexuality, but he felt you still had to be careful about who you told as there was a lot of homophobia.
On top of this, Craig said the HIV epidemic cast a shadow over the gay community.
“You knew people who were HIV positive or who had Aids and then you gradually no longer saw them, I had two friends who died of Aids.
Craig said it was more prominent in other areas like London, but it did have an impact in smaller cities and towns.
Where And When Did Hiv Start
Studies of some of the earliest known samples of HIV provide clues about when it first appeared in humans and how it evolved. The first verified case of HIV is from a blood sample taken in 1959 from a man who was living in what is now Kinshasa in the Democratic Republic of Congo.
Scientists used this sample to create a ‘family-tree’ of HIV transmission. By doing this, they were able to trace the first transmission of SIV to HIV in humans, which they concluded took place around 1920, also in Kinshasa. This area is known for having the most genetic diversity in HIV strains in the world, reflecting the number of different times SIV was passed to humans. Many of the first cases of AIDS were recorded there too.
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Snapshots Of An Epidemic: An Hiv/aids Timeline
Were it not for the profound sadness I feel for being so close to immense tragedy, I would consider my work for amfARan organization poised on the frontiers of medical researchthe most exciting, enviable, and rewarding of all.Mathilde Krim, Ph.D., Founding Chairman, amfAR
Unexplained cases of enlarged lymph nodes among gay men are observed and studied by physicians and researchers in New York City, including Dr. Mathilde Krim.
Drs. Michael S. Gottlieb, Joel D. Weisman, et al., report five cases of homosexual men with Pneumocystis carinii pneumonia, a rare form of pneumonia usually found only in severely immunosuppressed patients. The report is published in the June 5, 1981, issue of the U.S. Centers for Disease Control and Preventions Morbidity and Mortality Weekly Report . Drs. Gottlieb and Weisman later are among amfARs founding directors. The July 3, 1981, MMWR reports 26 cases of Kaposis sarcoma , a rare cancer, in homosexual men in both New York and California. The New York Times publishes the first news article about the mysterious new disease. Initial use of the term gay-related immune deficiency or gay cancer by the media and others mistakenly suggests an inherent link between homosexuality and the new disease. The first AIDS service organization, Gay Mens Health Crisis , is founded in New York City. U.S.
YEAR-END STATISTICS A total of 159 cases of the new disease are recorded in the U.S.
People Were Being Chucked Out On The Street By Landlords And Room
Rupert Whitaker, co-founder of the Terrence Higgins Trust
There was no idea that Terrys illness was connected to this American disease, as it was called then, when he first went to hospital. They just thought it might be contagious so they put him in isolation. I was not allowed to go in to see him. I had to look through a porthole into an isolation room. Anyone who went in was in full PPE. I wasnt told anything.Our relationship was not recognised until he had, literally, just died. I went to see him and they were trying to resuscitate him as I was waiting at the entrance of the ward. Id brought some lollies and things hed wanted. A nurse came out and put me in a side room and said, Im very sorry, hes just died. She asked me who I was and I said, Im his boyfriend.
Afterwards, when we were setting up the trust, I wrote to his consultant asking for confirmation of the cause of death. And he said, Well, since youre not family, I cant tell you anything. But once youve set up the charity I can probably tell you something. It was Catch 22. We couldnt set it up until we got the information from him. I paid for the funeral out of my student grant. I was 19. So it was like, you can do that, but were not going to tell you how he died.
You had the most vile things done to people who were incredibly vulnerable. But I think we wouldnt have gay marriage now if it hadnt been for Aids, because it showed first of all that we were real people and suffering.
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The Aids Hysteria Of The 1980s
“Rare cancer seen in 41 homosexuals, screamed the New York Times headline.
In retrospect, this July 1981 headline was the first public mention of AIDS, with that name yet to come into use. The reported outbreak was of Kaposi’s Sarcoma, a rare cancer developing in men younger than the norm, with some showing unusually weakened immune systems.
As is often the case during many developing outbreaks, researchers made the wrong call from incomplete knowledge. “The medical investigators say some indirect evidence actually points away from contagion as a cause,” reported the paper, quoting a doctor as saying there was no apparent danger to non-homosexuals.
Within a few years, it became clear that AIDS was much more than a cluster outbreak.
A New Pattern Emerges
On June 5, 1981, CDC published a report in the MMWR describing requests for the drug pentamidine to treat a deadly disease called Pneumocystis carinii pneumonia in five previously healthy young men in Los Angeles. After the reports publication, health officials also noticed a spike in cases of Kaposis sarcoma external icon among gay men in New York. Health officials were alarmed that outbreaks of both PCP and KS, which were rare, deadly diseases associated with immune suppression, appeared in the same part of the population.
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Nhs Workers Watching It’s A Sin Recall Horrifying Ignorance Faced By Dying Aids Patients In The 80s
- Nurses, counsellors and chaplains have shared their stories of what it was like to care for patients dying with AIDS after watching new Channel 4 drama It’s a Sin
- Drama, written by Russell T Davies, follows a group of friends living a hedonistic life in London throughout the eighties as the AIDS crisis began to take hold
- One Twitter user recounted the ‘toast diet’ many patients received – because hospital staff could push the meal under a door and not risk infection
- A hospital worker said every patient he dealt with died, while another said possessions from victims would sometimes not be collected due to stigma
- Writer used only gay actors to play the roles of gay men in the drama
Localization Of The Epidemic
One of the most striking features of the HIV/AIDS epidemic is its concentration in and within large urban centers. This is manifested across the United States, and New York is no exception. As noted above, 87 percent of all cases in New York State are concentrated in the five boroughs of the city. But that is only the first level of concentration of the epidemic. Within the city itself, AIDS cases are concentrated both in individual boroughs and in neighborhoods within the boroughs. Data on various characteristics of AIDS cases by 41 neighborhoods in the five boroughs have been published by the New York City Department of Health . Although there are other ways to define neighborhoods, these 41 areasâ10 each in Manhattan, Queens, and Brooklyn, 7 in the Bronx, and 4 in Staten Islandâhave the virtue of being used for a wide variety of other epidemiologic, health care, and planning purposes.
AIDS case rates in New York City, by zip code, as of April 1989. SOURCE: Data from New York City Department of Health .
Seroprevalence Among Mothers of Newborns in New York City, November 1987-September 1990, by Borough and Neighborhood.
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Impact On Communities Of Color
- Racial and ethnic minorities have been disproportionately affected by HIV/AIDS since the beginning of the epidemic, and represent the majority of new HIV diagnoses, people living with HIV disease, and deaths among people with HIV.37,38
- Black and Latino people account for a disproportionate share of new HIV diagnoses, relative to their size in the U.S. population .39,40 Black people also account for more people living with HIV than any other racial group â an estimated 479,300 of the 1.2 million people living with HIV in the U.S. are black.41
- Black people also have the highest rate of new HIV diagnoses, followed by Latino people â in 2019, the rate of new HIV diagnoses per 100,000 for Black people was about 8 times that of white people Latino people had a rate 4 times that of white people.42
- Black people accounted for close to half of deaths among people with an HIV diagnosis in 2019.43,44
- Survival after an AIDS diagnosis is lower for Black people than for most other racial/ethnic groups, and Black people have had the highest age-adjusted death rate due to HIV disease throughout most of the epidemic.45 HIV ranks higher as a cause of death for Black and Latino people, compared with White people.46 Further, HIV was the 6th leading cause of death for Black people ages 25-34 in 2019.47
The First World Aids Day
At the beginning of the 1980s, before HIV had been identified as the cause of AIDS, the infection was thought to only affect specific groups, such as gay men in developed countries and people who inject drugs. The HIV virus was first isolated by Dr Françoise Barré-Sinoussi and Dr Luc Montagnier in 1983 at the Institut Pasteur. In November that year, WHO held the first meeting to assess the global AIDS situation and initiated international surveillance. It was then that the global health community understood that HIV could also spread between heterosexual people, through blood transfusions, and that infected mothers could transmit HIV to their babies.
United Nations commemorative stamp to raise awareness of HIV and the AIDS epidemic
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Perspectives: Parallels Of Aids And Covid
Four decades after San Francisco became the epicenter of HIV, the early days of the AIDS epidemic are still vivid memories for many in the UCSF community. With the collaboration of clinicians, scientists, civic leaders, community partners and activists, the citys public health response eventually became known worldwide as the San Francisco model of care. Lessons learned in the AIDS epidemic significantly informed San Franciscos early response to the novel coronavirus. The following are perspectives from those who are working on the frontlines to better understand, treat and prevent transmission of both viruses.