Speaker 1: Hi, I'm erin Welsh and I'm erin Allman Updike.
Speaker 2: And this is this podcast will kill you.
Speaker 1: Before we start off, we first want to ask you
Speaker 1: to make sure that if you're not subscribed, that you
Speaker 1: do so now, because this is our last episode of
Speaker 1: the season and we don't want you to miss next
Speaker 1: season's premiere or all the super fun bonus episodes that
Speaker 1: we're going to have in the interim.
Speaker 2: The subject of this week's episode is HIV and AIDS,
Speaker 2: and we were fortunate enough to interview three individuals who
Speaker 2: shared their experiences with us.
Speaker 3: Well, my name is Frank and my last name is
Speaker 3: I am Ellie. I'm sixty five, gay man. I live
Speaker 3: outside of Boston. I was about twenty seven, I guess
Speaker 3: or twenty eight when we first started to hear about it.
Speaker 3: I remember distinctly walking into work one morning and this
Speaker 3: woman I work with, she hadn't read the news, and
Speaker 3: she said something about, hey, have you heard about this
Speaker 3: gay plague that's going on, this gay cancer, and I
Speaker 3: was I had never heard of it before. You know,
Speaker 3: you started hearing that, well, this one's not well, and
Speaker 3: then this one's not well, and it just sort of
Speaker 3: mushroomed from there, so within I would say about a
Speaker 3: year and a half to two years of reading about
Speaker 3: it in the paper, it had hit Boston like crazy.
Speaker 3: So I think in times of crisis, your true self
Speaker 3: really comes into being. And I've always thought of myself
Speaker 3: as kind of a really nurturing kind of a guy.
Speaker 3: And it was just my first instinct was when people
Speaker 3: around me that I loved and cared for were getting sick,
Speaker 3: that you know, there was nothing that was going to
Speaker 3: keep me away from helping them. And you also have
Speaker 3: to keep in mind for a fair number of people,
Speaker 3: I won't say all of them whose families had abandoned them.
Speaker 3: You know, we were their only family, and so we
Speaker 3: took care of them. We clean them, we fed them,
Speaker 3: you know, we socialized with them, We tried to keep
Speaker 3: them in good spirits and all of that and basically
Speaker 3: just be with them, you know, through the end. I mean,
Speaker 3: I can't tell you how many people have sat and
Speaker 3: held their hands until they died. It wasn't easy for me,
Speaker 3: but I knew I was doing the right thing for them.
Speaker 3: But the bigger thing is in retrospect, when I was
Speaker 3: sort of when I was growing up, I always once
Speaker 3: I started making friends. I mean, we had a really
Speaker 3: large circle of friends in a very very strong gay
Speaker 3: community at the time, and I remember thinking in the
Speaker 3: late seventies early eighties, I had such a wonderful group
Speaker 3: of friends that I thought, this is going to be wonderful.
Speaker 3: You know, we're all going to grow all together, we'll
Speaker 3: all take care of each other as we get older.
Speaker 3: And they're all gone. The whole family that you created,
Speaker 3: it's just gone. I've got, like, maybe I don't know,
Speaker 3: four or five friends left from that time period, and
Speaker 3: you know, I cherished them, but the larger community, it's
Speaker 3: just weird to realize that everybody that you loved is gone.
Speaker 3: I even lost my partner to age two, and honestly,
Speaker 3: that's one of the reasons that I'm doing this today is,
Speaker 3: you know, if we don't tell our stories about what happened,
Speaker 3: who will.
Speaker 4: My name is Hillel Wasserman. I live in Los Angeles, California,
Speaker 4: and at present time, I work in the emotion picture business.
Speaker 4: At the time that I first learned about HIV, I
Speaker 4: was about I guess I was in my late twenties.
Speaker 4: We started to hear these whispers about this weird gay
Speaker 4: cancer that was going around, which you know a lot
Speaker 4: of us discounted because come on, cancer.
Speaker 3: Isn't a communtal disease.
Speaker 4: How can you, you know, transfer cancer from one person
Speaker 4: to another. It must just be a way for the
Speaker 4: repressive society that we were living in to kind of
Speaker 4: cuash the gay you know, liberation revolution, whatever we were doing,
Speaker 4: and so, you know, it was easily discounted. But it
Speaker 4: was getting harder and harder to overlook. Guys were getting
Speaker 4: together for funerals more often than we were getting together
Speaker 4: for brunch, and people were showing up at the gym
Speaker 4: that looked like walking skeletons. It very much became a
Speaker 4: reality for me when I woke up one morning and
Speaker 4: I saw four purple spots on my legs. I jumped
Speaker 4: in my car and I ran to my doctor and
Speaker 4: I marched into his office and I pulled down my
Speaker 4: pants with my legs and I pointed it at them
Speaker 4: and I said, look, I said, I've got the spots.
Speaker 4: They're ks. I'm going to die. Right. He took a
Speaker 4: long breath and he said to me, finally, hello, He said,
Speaker 4: what you have on your legs are bruises. It was
Speaker 4: kind of, but it had really kind of gotten to
Speaker 4: be enough for me because every time I had a
Speaker 4: cold and last the extra week, I'm running to the doctor.
Speaker 4: Every time I got out of shower and get a
Speaker 4: check on me and saw something new grown on me,
Speaker 4: I'm running to the doctor. And every time we had
Speaker 4: the exact same conversation. And so he said to me,
Speaker 4: He'll alway says, I'm happy to give it the eighth sests,
Speaker 4: but you have to be prepared for a results you
Speaker 4: may not like. And I said, you know what, I said,
Speaker 4: I'm a UCLA graduate, I am good at taking tests.
Speaker 4: Give me the age sest. And so there I was
Speaker 4: sitting in my beautiful office when I get a phone
Speaker 4: call from the doctor after those seven days to tell
Speaker 4: me that the test results came back and they were positive.
Speaker 4: And he started to talk to me about statistics, about
Speaker 4: the odds right, about getting my affairs in order, which
Speaker 4: is doctor code for get ready to die. And as
Speaker 4: I sat there and listened to all of that, all
Speaker 4: I could think of was, oh my god, how am
Speaker 4: I ever going to tell my parents?
Speaker 5: And that was it.
Speaker 4: I mean, I controlled that information very very tightly until
Speaker 4: I couldn't anymore. In nineteen ninety five, eight years after
Speaker 4: taking that test, finally, finally, the rain started to fall.
Speaker 4: I developed HIV related non Hodgston's lymphoma, which is luphatic cancer.
Speaker 4: And there I was. I wasn't quite forty years old.
Speaker 4: I was thirty nine. I've never been in love, I'd
Speaker 4: never been to Israel, I'd never been, never done so
Speaker 4: many of the things that I hoped and wish that
Speaker 4: I would do. And yet well your March, you know,
Speaker 4: and that was twenty three almost years ago, and still here.
Speaker 4: How how does he do it?
Speaker 5: You know?
Speaker 4: What is the magic formula of the secret weapon that
Speaker 4: I possess? Well, it's drugs. Not the kind that we
Speaker 4: took back in the day. Oh dude, So these are
Speaker 4: HIV drugs. So when I ask myself for people ask
Speaker 4: me how HIV has affected my everyday life, I mean, seriously.
Speaker 5: How can it not.
Speaker 4: At one point I was taking medicine six times in
Speaker 4: a day. Seriously, who takes that much medicine? Normally no
Speaker 4: one does six people take medicine. But as I've grown
Speaker 4: fond of saying, I may have HIV, but it doesn't
Speaker 4: have me.
Speaker 5: My name is Brian Jackson. And I'm from Saint Louis, Missouri.
Speaker 5: I am a motive based on speaker and life coach.
Speaker 5: What else is there to say about me? I'm cool
Speaker 5: and I think one of the most important things, because
Speaker 5: we're talking about this on the podcast, is I'm HIV positive.
Speaker 5: My story is a little bit different about how people
Speaker 5: contract HIV. When I was eleven months old with my father,
Speaker 5: who was a forbotomist at a hospital, decided to steal
Speaker 5: HIV painted blood and come over to a hospital that.
Speaker 3: I was staying at.
Speaker 5: I was admitted for my asthma attack, and he got
Speaker 5: my mother out of the room and then sinsoring injected
Speaker 5: me with the HIV bias, hoping I would die off
Speaker 5: and he wouldn't have to pay shot support. Not only
Speaker 5: where at HIV, it was also uncompatible blood, and so
Speaker 5: my BiDi signs started going out of whack. I was
Speaker 5: screaming and crying. No one could figure out what was
Speaker 5: going on with me. They transferred me to another hospital.
Speaker 5: Twenty four hours later, I was stabilized and everything was okay.
Speaker 5: In nineteen ninety six, one for being this playful hockey
Speaker 5: and the jet of five year.
Speaker 3: Old to dispload the beavers sick kid.
Speaker 5: In the matter of months, my body began to break
Speaker 5: down and doctor started testing me for numerous diseases even
Speaker 5: forever and sent another country. In conclusion, they came to say,
Speaker 5: you know, I know he's not at risk for HIV,
Speaker 5: but let's text him for HIV. The results came back
Speaker 5: and I was diagnosed with full blown AIDS. Given five
Speaker 5: months to this, my tea cell account was at zero.
Speaker 5: They put me on twenty three or medications through IVY
Speaker 5: in a Vatican team Jess's daily The majority of those
Speaker 5: were not available for SHIVEN at the time. But three
Speaker 5: months past, five months past, and as I stand before
Speaker 5: you today, wasn't supposed to see my sixth birthday, but
Speaker 5: come next month we celebrated my twenty seventh birthday. Well,
Speaker 5: how people and my family were very receptive towards it.
Speaker 5: They wanted to get educated and they wanted to, you know,
Speaker 5: be a part of my life. But on this social atmosphere,
Speaker 5: I wasn't always I was left at a birthday party,
Speaker 5: social event. My oldest sister, who has a different father,
Speaker 5: Her father decided to take out of her life because
Speaker 5: he didn't want to be associated with the HIV family
Speaker 5: who is even left out of birthday parties and social events.
Speaker 5: I lost a lot of friends. I couldn't play sports
Speaker 5: and staff growing up, even though I'm a very athletic person.
Speaker 5: I did find my calling and cheerleading though, and I
Speaker 5: am a state champion. Even after I came clean with
Speaker 5: my story and said, hey, I don't care about what
Speaker 5: you guys think, like this is who I am. HIV
Speaker 5: doesn't defy me, and I started showing people that I
Speaker 5: was lobbying in Washington, DC. You know, some of the
Speaker 5: ignorance went away, but still the ignorance is still consistent.
Speaker 5: But in twenty eighteen, there's you know, we have great
Speaker 5: medications that can help people live long and healthy life
Speaker 5: and be undetectable. Most people can have a zero physic
Speaker 5: chance of passing under by it, but a lot of
Speaker 5: people the stigma is still live and real, so where
Speaker 5: people don't want to go get tested, or when people
Speaker 5: contracted by it, they automatically think I'm I'm going to that,
Speaker 5: and that's not the true. It's like people who are
Speaker 5: living with can be successful lives, and people who are
Speaker 5: not with HIV positive people who are probably gonna always
Speaker 5: remain HIV negative.
Speaker 4: Yeah.
Speaker 2: Wow, wow, those I mean, those stories were so incredibly touching. Yeah,
Speaker 2: thank you again to Frank, to Hillel, and to Brian
Speaker 2: for for sitting.
Speaker 1: Down with us to tell us those stories and for
Speaker 1: being willing to share your stories with our listeners.
Speaker 2: And next week, listeners, we are going to be releasing
Speaker 2: a bonus episode in which Frank, Heillel, and Brian will
Speaker 2: be telling their more of their stories in detail, and
Speaker 2: we want you guys to tune into that because it's
Speaker 2: going to be absolutely incredible, So please keep an ear
Speaker 2: out for that.
Speaker 1: Yeah, all right, this week.
Speaker 2: We are we don't have a quarantine for you, no, nope.
Speaker 2: But what we will advise you to do, which is
Speaker 2: what we're doing, is just make yourself a drink whatever
Speaker 2: you have, yep, and sit back and get ready to learn.
Speaker 5: Yeah.
Speaker 1: I was thinking about it before we started recording this.
Speaker 1: And you know how if you listen to this American Life,
Speaker 1: sometimes it's like you're laughing and it's a funny one.
Speaker 1: And sometimes you're like, wow, gosh, that was really interesting.
Speaker 1: I learned a lot. And then sometimes you just cry. Yeah,
Speaker 1: like the whole episode you're just bawling. Ours is that
Speaker 1: one welcome to this podcast. Will tell you this American
Speaker 1: Life edition the Crying the Crying episode, not really but
Speaker 1: kind of. Well, it's a very serious topic. Not that,
Speaker 1: not that all the ones we've discussed have been serious topics,
Speaker 1: but because this is so recent, it really does hit
Speaker 1: a nerve and there are a lot of very serious
Speaker 1: issues that we're going to discuss in it. So all right,
Speaker 1: business is out of the way.
Speaker 2: All right, Biology time.
Speaker 1: All right, So it's nineteen eighty October, Los Angeles. Okay,
Speaker 1: you're a physician. Okay, a thirty three year old man
Speaker 1: comes to your hospital complaining of a fever for about
Speaker 1: two months. His liver enzymes are elevated, which is not good,
Speaker 1: and his white blood cell count is pretty low, and
Speaker 1: a fever for two months. Two months, it's a pretty
Speaker 1: long time. He's also infected, as it turns out, with cidamegalovirus,
Speaker 1: which is a pretty common virus that generally doesn't cause
Speaker 1: any problems unless a person is immunocompromised. You run a
Speaker 1: whole bunch of tests and you diagnose him with pneumonia
Speaker 1: caused by a fungus called Pneumaicistus corinnei. Weird it's really
Speaker 1: not common, especially not in otherwise healthy young people. You
Speaker 1: also diagnose him with oral candidiasis, which is another fungal infection,
Speaker 1: this time of the mouth instead of the lungs. Unfortunately,
Speaker 1: his condition deteriorates despite attempts to treat with antifungals, and
Speaker 1: the patient dies. In May of nineteen eighty one. Cut
Speaker 1: back to April nineteen eighty one, another patient presents to
Speaker 1: your hospital in LA with strikingly similar symptoms. Then you
Speaker 1: find out that in January and February of nineteen eighty
Speaker 1: one at another hospital, two other men presented with the
Speaker 1: same cluster of symptoms, and in April at yet another hospital,
Speaker 1: the same. So that's a total of five otherwise healthy
Speaker 1: young men aged twenty nine to thirty six who were
Speaker 1: diagnosed with fungal pneumonia and fungal infections of the mouth
Speaker 1: as well a cluster A cluster. This is not normal.
Speaker 3: No.
Speaker 1: By nineteen eighty two, the CDC had received reports of
Speaker 1: a cluster of nineteen cases of PCP. That's numrosistous carinia pneumonia,
Speaker 1: not the drug not the drugs, and something else called
Speaker 1: Caposi's sarcoma, which is a viral induced cancer cooposi. Sarcoma
Speaker 1: leaves these characteristic purple lesions on your skin, and before
Speaker 1: this time pretty much only ever affected much older men
Speaker 1: or severely immunal compromised people, and generally was a very
Speaker 1: slow progressive disease.
Speaker 2: And it wasn't even known at that time that it
Speaker 2: was caused by a virus.
Speaker 3: Right.
Speaker 4: Yeah.
Speaker 1: Of these nineteen patients, eleven of them died. WHOA. At first,
Speaker 1: these case reports were almost exclusively popping up in gay men. However,
Speaker 1: they quickly started seeing cases similar case in patients with hemophilia,
Speaker 1: in intravenous drug users, in infants, and so something was
Speaker 1: clearly happening, and at the time physicians and public health
Speaker 1: professionals had no idea what it was, but we do now.
Speaker 1: What was happening was that each of these men and
Speaker 1: women and children were suffering from what we now know
Speaker 1: of as AIDES acquired immune deficiency syndrome, which we now
Speaker 1: know means they were infected with HIV human immuno deficiency
Speaker 1: virus YEP.
Speaker 2: So that's how it begins.
Speaker 1: This is how it begins. So what is HIV. HIV
Speaker 1: is a retrovirus. Okay, the first actual retrovirus that we're
Speaker 1: going to talk about on this show. So we're going
Speaker 1: to do a quick virology one on one course.
Speaker 2: All right, hey, but come on, it's been several years.
Speaker 1: Let's do it. All right, it's time. Then you need
Speaker 1: a refresher for sure. All right. So, the other RNA
Speaker 1: viruses that we've talked about on this show, like influenza
Speaker 1: and yellow fever, when they get into your cells, they
Speaker 1: basically hijack your cells machinery and force your cells to
Speaker 1: start making protein. Normally, RNA codes for protein.
Speaker 2: Okay, So these.
Speaker 1: RNA viruses basically tell your cells get busy, mech and
Speaker 1: more of me, and your cells are like, okay, whatever,
Speaker 1: your cells mid and scary, okay. But retroviruses do something
Speaker 1: a little bit different. Retroviruses, which are also RNA viruses,
Speaker 1: get into your cells and they bring along an enzyme
Speaker 1: of their own called reverse transcriptase, and that enzyme makes
Speaker 1: copies of their RNA, but not just regular copies. It
Speaker 1: actually makes DNA copies. And so now this viral DNA
Speaker 1: is in your cells, I can just swoop its way
Speaker 1: straight into your DNA.
Speaker 2: So it's a lot of a it's a sneakier tactic.
Speaker 1: Exactly, And so it literally fits this viral DNA into
Speaker 1: your genome and that makes it a lot harder for
Speaker 1: your cells to target. And it basically means that whenever
Speaker 1: your cells replicate, they'll replicate not only your DNA, but
Speaker 1: this viral DNA as.
Speaker 2: Well, which is like a background replication exactly.
Speaker 1: Yes, and then eventually those copies of viral DNA will
Speaker 1: do what DNA normally does, and that is make an
Speaker 1: RNA copy, make some protein, and then get to work
Speaker 1: making more viruses. And HIV is really good once more
Speaker 1: viruses are made at spreading from cell to cell. It
Speaker 1: has a bunch of crazy mechanisms that are too complicated
Speaker 1: for our virology one on one course, okay, So we're
Speaker 1: just saying that it basically has several different ways that
Speaker 1: it can perpetuate itself and selectively spread to more and
Speaker 1: more cells. So that's HIV one oh one all right, Okay,
Speaker 1: So there are two main subtypes of HIV, HIV one
Speaker 1: and HIV two.
Speaker 6: All right.
Speaker 1: HIV one is what the overwhelming majority of people are
Speaker 1: infected with, and it's the more virulent strain.
Speaker 2: Okay, that's the pandemic strain.
Speaker 1: Exactly right, HIV T is pretty much confined to West Africa.
Speaker 2: Okay, but within these.
Speaker 1: Two strains there's considerable genetic variability. And if you remember
Speaker 1: all the way back to leprosy.
Speaker 2: I think I can remember that far back, which.
Speaker 1: Was our slowest reproducing pathogen exactly. Well, HIV makes one
Speaker 1: hundred billion copies of itself every.
Speaker 2: Day, what I know.
Speaker 1: Hold on, I feel like I should have double checked
Speaker 1: that number, because it's really over one hundred billion, yeah,
Speaker 1: with a B every day, every day, every day day.
Speaker 1: And because it's an RNA virus and a retrovirus at that,
Speaker 1: it has a super high mutation rate, so it's constantly
Speaker 1: replicating and it's constantly changing, and so it's really hard
Speaker 1: for our immune system to target, and it mutates a
Speaker 1: lot faster than our drug development can keep up with. Yeah, okay,
Speaker 1: So okay, how does this actually end up causing what
Speaker 1: we know of as eights? That's the real question.
Speaker 2: Yeah, tell me about it.
Speaker 1: So HIV is spread via extremely close contact with a
Speaker 1: few bodily fluids, blood, semen, vaginal secretions, that sort of thing.
Speaker 1: So I'll just say it in case anyone listening doesn't
Speaker 1: know which I assume all of our listeners do know
Speaker 1: m You can't get it by kissing, touching, high fiving,
Speaker 1: hiking hands, hugging, none of that. It's really extremely intimate contact, sex,
Speaker 1: sharing of needles, blood products, things like that. So when
Speaker 1: HIV enters your body, it's not just infecting any random cells.
Speaker 1: It infects several different immune cells. You've probably heard of
Speaker 1: CD four counts in relation to HIV, yes, well, CD
Speaker 1: four cells are a type of T cell, which is
Speaker 1: a lymphocyte or a white blood cell. CD four T
Speaker 1: cells are also called helper T cells, so their job
Speaker 1: in your body normally is to help activate other white
Speaker 1: blood cells to promote an immune response. They also make
Speaker 1: something called cytokines, which we've talked a bit before about
Speaker 1: on this show, right, But basically those are proteins that
Speaker 1: help in your immune response. So CD four T cells
Speaker 1: are basically helper cells that are activating your immune response.
Speaker 1: And one thing that they do that's really important is
Speaker 1: activate another type of cell called your B cells, which
Speaker 1: are the cells that make antibodies.
Speaker 2: So it seems like a lot hinges on CD four
Speaker 2: numbers exactly.
Speaker 1: So when people talk about their CD four cell counts
Speaker 1: they're literally talking about how many CD four T cells
Speaker 1: they have left in their body that haven't been destroyed.
Speaker 1: But the mechanism of CD four T cell destruction in
Speaker 1: HIV is actually unclear at this point, even to this day. Yeah,
Speaker 1: I think that's so fascinating. So I would have assumed that,
Speaker 1: like malaria, for example, when malaria parasites replicate in your
Speaker 1: red blood cells, they burst out and destroy your red
Speaker 1: blood cells in the process. Well, that's not what happens
Speaker 1: in HIV. When HIV re implicates in your CD four
Speaker 1: T cells, it actually buds out.
Speaker 5: Huh.
Speaker 1: I tried really hard to think of an analogy for that,
Speaker 1: but I couldn't come up with one.
Speaker 2: Wait, let me think of one for a second, because
Speaker 2: I know that there's one.
Speaker 1: The best I came up with was it's like if
Speaker 1: a bowl of you're making meatballs, and the whole bowl
Speaker 1: of meat is your CD four cell and you take
Speaker 1: one meatball out at a time, Like that's okay, Okay,
Speaker 1: it's not great. I feel like we could do better.
Speaker 2: No, I definitely, I feel like maybe it's just that
Speaker 2: I have seen a YouTube video with.
Speaker 1: This with this butting off right, Yeah, little viral particles
Speaker 1: butting off, they take a piece of that plasma membrane
Speaker 1: with them, so that's again making them harder to see
Speaker 1: in your body because they're covered in your own lymphocyte tissue, right,
Speaker 1: so they hide out exactly. Yeah, but at the end
Speaker 1: of the day, what happens is you have depletion of
Speaker 1: these T cells. Your body's no longer making citokines or
Speaker 1: other proteins. You can't make antibodies as effectively because you're
Speaker 1: not activating B cells. So usually what happens when you
Speaker 1: get infected with HIV is this replication happens really quickly,
Speaker 1: within ten days. The patient usually has really high viremia,
Speaker 1: so tons of viruses in their bloodstream, and at first
Speaker 1: this is going to activate a massive immune response.
Speaker 2: And just to clarify this is a person who has
Speaker 2: been infected with HIV exactly that we're not talking about
Speaker 2: AIDS quite yet, right, we'll get.
Speaker 1: To exactly what happens with AIDS exactly. So when you
Speaker 1: get infected with HIV, at first HIV is going to
Speaker 1: replicate in your body. You'll have a massive immune response
Speaker 1: and a large proportion of those virally infected cells will
Speaker 1: be actually destroyed, which is great. So during this time
Speaker 1: you'll have a primary HIV infection. You might have a fever,
Speaker 1: you might feel like you have the flu, but mostly
Speaker 1: this is a transient illness. You might not even have
Speaker 1: any symptoms at all. Your body is doing what your
Speaker 1: body is supposed to do when you get an infection,
Speaker 1: and it fights it off. So usually by about twenty
Speaker 1: eight days after exposure to HIV, your body has controlled
Speaker 1: or suppressed the initial infection and viriemia is reduced drastically.
Speaker 1: The problem is it doesn't eliminate it. This virus, like
Speaker 1: we've said, is really hard for your body to detect,
Speaker 1: and so you end up with the latent stage of HIV.
Speaker 2: Okay, so it's.
Speaker 1: Hanging out, it's quietly, slowly replicating, and eventually, albeit slowly,
Speaker 1: it will deplete your city for T cells, making it
Speaker 1: impossible for your immune system to fight off opportunistic infection.
Speaker 1: This can take anywhere from three to twenty years. Wow,
Speaker 1: but on average about fifty percent of people who are
Speaker 1: infected with HIV and are untreated will progress to AIDS
Speaker 1: within ten years.
Speaker 2: Ten years.
Speaker 1: Yeah, so the incubation period for HIV itself, the virus
Speaker 1: is only about seven to ten days, but the incubation
Speaker 1: period for AIDS is about ten years. And one thing
Speaker 1: that's really important is that the infectivity of HIV really
Speaker 1: depends on your viremia. So you're far far more infectious
Speaker 1: at that early stage, say within the first month of infection,
Speaker 1: because your viral load is insanely high, whereas after that,
Speaker 1: for a number of years, you're actually not very infectious.
Speaker 1: And then again when you reach the aid stage, your
Speaker 1: viremia increases again and you become extremely infectious. Okay, So
Speaker 1: there are four recognized stages of an HIV infection, all
Speaker 1: of which are classified by measuring your CD four T
Speaker 1: cell count and then also looking for specific symptoms or
Speaker 1: opportunistic infections associated with AIDS, and that is the ultimate
Speaker 1: stage of HIV infection. So that's what those doctors were
Speaker 1: seeing all the way back in the eighties, and at
Speaker 1: the time, they had no idea about everything that had
Speaker 1: been happening in that patient's body for years prior to
Speaker 1: their presentation with AIDS. So tell me how all of
Speaker 1: this happened, Darren, Oh, okay, yeah, So how did we
Speaker 1: end up with this global pandemic.
Speaker 2: I'm going to try to answer that. The history of
Speaker 2: HIV and AIDS is a big one. And I'm dividing
Speaker 2: the history of this modern plague into four acts. This
Speaker 2: American life, right, I said so, from its earliest beginnings
Speaker 2: in Central Africa, to its eruption in the US in
Speaker 2: the eighties and nineties, then to the failures of the government,
Speaker 2: and then the heroic actions of advocacy groups, and finally
Speaker 2: to the development of effective treatments and the emotional fallout
Speaker 2: of the pandemic. Let's start Act one, origin nineteen o
Speaker 2: eight to nineteen eighty two. Let's take a trip in
Speaker 2: space and time back to Central Africa in the early
Speaker 2: nineteen hundreds, to a lush rainforest filled with the sounds
Speaker 2: of exotic birds and a chorus of insects. In this
Speaker 2: rainforest stood a hunter. He was there to check on
Speaker 2: the snares he had so carefully laid a few days earlier,
Speaker 2: and luck in, one of the snares was a chimpanzee.
Speaker 2: The hunter quickly and efficiently killed the chimp, But in
Speaker 2: the process of butchering the chimp, the hunter sliced his
Speaker 2: own hand, and some of the chimp's blood flowed into
Speaker 2: the fresh wound. Unbeknownst to the hunter the blood from
Speaker 2: the chimp. The blood that had just entered the cut
Speaker 2: on his hand contained the virus that would later become
Speaker 2: the human immuno deficiency virus HIV. The hunter hauled his
Speaker 2: killed back home and continued his day to day life.
Speaker 2: Over the next few years, the virus continued to integrate
Speaker 2: itself into the hunter's DNA and more viral particles were produced,
Speaker 2: but it wasn't for years that he felt any effects
Speaker 2: of the virus, and by the time he did, he
Speaker 2: had transmitted the virus to at least one other person.
Speaker 2: This bloody encounter between the hunter and the chimpanzee killed
Speaker 2: is the true ground zero of the AIDS pandemic. We
Speaker 2: have no way of knowing exactly who this hunter was
Speaker 2: or exactly when or where it happened, but we have
Speaker 2: a pretty good guess, which is around nineteen oh eight
Speaker 2: in Central Africa.
Speaker 1: I think that that's a lot earlier than most people think. Definitely,
Speaker 1: so I think that's an important thing. Like nineteen oh eight,
Speaker 1: that's a really long time ago. Highlight that double underline,
Speaker 1: double underline, and it was from most likely a hunter
Speaker 1: hunting bush meat who caught a chimpanzee yes, not anything
Speaker 1: else you might have in mind, right, not you, but
Speaker 1: like the royal you. Yeah.
Speaker 2: The virus moved beyond this hunter, eventually making its way
Speaker 2: to a city where it continued to be transmitted through
Speaker 2: sexual contact, through reuse of dirty needles or some other root.
Speaker 2: And that's when it became HIV type one, the pandemic
Speaker 2: strain of the virus. And slowly, with one one person
Speaker 2: infecting one or two others, and those people infecting one
Speaker 2: or two more. In turn, the virus' distribution grew until
Speaker 2: it had spread across the globe. Later testing of stored
Speaker 2: blood samples helped to flesh out a timeline for the
Speaker 2: spread of HIV. Ooh, I'm going to give you a
Speaker 2: brief rundown of this timeline to bring us up to
Speaker 2: speed to the early days of the AIDS pandemic in
Speaker 2: the US. Great Okay scientists guessed that HIV was circulating
Speaker 2: in Conshasa, which is the capital of the DRC Democratic
Speaker 2: Republic of the Congo by the early nineteen twenties. Wow,
Speaker 2: circulating circulating in that baking population. Yes, And the first
Speaker 2: molecular evidence of HIV infection comes from nineteen fifty nine
Speaker 2: in a man from the DRC. The virus then probably
Speaker 2: arives in Haiti, which became later a big hot spot,
Speaker 2: in nineteen sixty six, and it probably arrived first in
Speaker 2: the US in nineteen sixty eight, though it could have
Speaker 2: been almost ten years earlier.
Speaker 1: Wow.
Speaker 2: So the first AIDS related death in the US was
Speaker 2: in nineteen sixty nine, and that was confirmed by later
Speaker 2: blood testing. And for that to be the case, that
Speaker 2: person had to have been infected, who was a young man,
Speaker 2: had to be infected much earlier, years earlier. So it's
Speaker 2: kind of it's a shaky ground there, but I would
Speaker 2: say nineteen sixty eight is at the latest estimate of
Speaker 2: when the virus arrived.
Speaker 1: In the US the US populations.
Speaker 2: Later testing of blood samples shows HIV infection in a
Speaker 2: Norwegian sailor and his family and a Danish physician in
Speaker 2: the mid to late nineteen seventies. Wow, all of whom
Speaker 2: died of AIDS related illnesses.
Speaker 1: Wow.
Speaker 2: By this time, the virus had firmly established itself in
Speaker 2: major cities in the US, in particular those that would
Speaker 2: later be identified as the epicenters of the AIDS crisis,
Speaker 2: New York City, San Francisco, LA In April nineteen eighty,
Speaker 2: San Francisco resident Ken Horn goes to his doctor complaining
Speaker 2: of dark purple spots on his skin, which his doctor
Speaker 2: diagnoses as Kaposi's sarcoma and as we learned earlier, super
Speaker 2: rare cancer, which is he's not of the right demographic
Speaker 2: or the typical demographic.
Speaker 1: No, not at all. It's like men over the age
Speaker 1: of sixty six.
Speaker 2: Yeah, and of mediterrane or Ashkenazi background.
Speaker 1: Oh, I didn't know that part. That's interesting.
Speaker 2: And his doctor doesn't know what to make of the
Speaker 2: diagnosis or of the unusual blood test results which show
Speaker 2: almost no functional immune system. Something was making ken Horn
Speaker 2: very sick, but he didn't know what.
Speaker 4: So.
Speaker 2: Yeah, as we heard earlier, there were a bunch of
Speaker 2: these other cases, and doctors were baffled. Why were these
Speaker 2: men in otherwise good health struggling to beat these normally
Speaker 2: harmless infections and losing. It would be many years and
Speaker 2: thousands more cases before there would be an answer. By
Speaker 2: the end of nineteen eighty, fifty five men had been
Speaker 2: diagnosed with some infection later recognized as characteristic of AIDS.
Speaker 3: WOW.
Speaker 2: Doctors were beginning to notice a pattern was destroying gay
Speaker 2: men's immune systems, leaving them open to opportunistic infection. Early
Speaker 2: nineteen eighty one, the CDC is alerted to the pandemic
Speaker 2: for the first time by Sandra Ford, a lab tech
Speaker 2: at the CDC who works to fill prescriptions and notices
Speaker 2: an unusual increase in requests for a drug used to
Speaker 2: treat a rare pneumonia.
Speaker 1: I found our firms of stem crossover.
Speaker 2: Here we go, Sandy Ford.
Speaker 1: Andy Ford.
Speaker 2: By May, rumors of a mysterious disease attacking and killing
Speaker 2: gay men are rampant throughout parts of the country. The
Speaker 2: first article in the world in the world about the
Speaker 2: disease is published on May eighteenth in The New York Native,
Speaker 2: which is a gay newspaper, titled Disease Rumors Largely Unfounded.
Speaker 2: Turns out they were founded. Yeah but yeah, so anyway.
Speaker 2: Shortly after that, the Morbidity Immortality Weekly report describing those
Speaker 2: five the cluster of five cases that Aaron talked about
Speaker 2: in the biology section, appears and a task force is
Speaker 2: formed at the CDC. Their immediate goal is to identify
Speaker 2: what is causing this epidemic. So far, this disease has
Speaker 2: seemed to primarily hit gay males, in cities with large
Speaker 2: gay communities, the scientists think, okay, we're dealing with a
Speaker 2: common exposure or an infectious agent. Poppers or nitrial inhalance
Speaker 2: was a contender in the non infectious origin camp, while
Speaker 2: a sexually transmitted virus new to humans was proposed by
Speaker 2: epidemiologist and task Force member Don Francis as the cause.
Speaker 2: Criminally understaffed and suffering from sweeping budget cuts, the CDC
Speaker 2: Task Force set about trying to isolate a common thread
Speaker 2: that would reveal the origin of this epidemic. For those
Speaker 2: physicians an epidemiologist who were seeing the suffering and devastation
Speaker 2: caused by aid's first hand. There was no time for
Speaker 2: a leisurely comprehensive case control study. The house was already
Speaker 2: on fire. To any others, AIDS was an opportunity to
Speaker 2: get an article published in science, to patent a test
Speaker 2: for the disease, or a shot at a Nobel prize.
Speaker 2: The CDC task for set out to conduct some shoe
Speaker 2: leather epidemiology, which, if you remember from the Collar episode,
Speaker 2: includes interviews with people suffering from the disease and physicians
Speaker 2: who had treated.
Speaker 1: Them and all of their friends and family and contact
Speaker 1: contacts exactly, especially if you think that it might be
Speaker 1: something that's transmitted sexually, right, then that's really important to
Speaker 1: trace contacts exactly.
Speaker 2: And two things emerged from these early interviews. One is
Speaker 2: that heterosexual intravenous drug users were also becoming sick with
Speaker 2: the disease. The other is that several of the gay
Speaker 2: men who were among the earliest recognized cases seemed to
Speaker 2: be linked to one another by their sexual history. Both
Speaker 2: of these things pointed to an infectious disease transmitted by
Speaker 2: blood or bodily fluids, not an environmental exposure. I wasn't
Speaker 2: going to talk much about the infamous Patient zero, but
Speaker 2: I feel like I need to just to clear up
Speaker 2: a few things. Okay, First of all, did you know
Speaker 2: that the term patient zero comes from the AIDS crisis
Speaker 2: in the US?
Speaker 4: No?
Speaker 1: I didn't know that at all.
Speaker 2: Yeah, if you've read anything about the early days of
Speaker 2: the AIDS epidemic, it's likely that you've stumbled upon the
Speaker 2: name Gaton Duga, or at least his description a handsome,
Speaker 2: charming gay flat attendant from Montreal, a frequenter of gay
Speaker 2: bath houses in the cities he visited, and in popular history,
Speaker 2: responsible for the AIDS epidemic in the US. In the
Speaker 2: early days of the CDC Task Force, the epidemiologist took
Speaker 2: note of interviewees, social network friends, sexual contacts, etc. Gaton
Speaker 2: had registered on the CDC's radar because he popped up
Speaker 2: in a few of the networks they had mapped, and
Speaker 2: because he had been interviewed and provided a sizable list
Speaker 2: of past contacts himself. His circle on the network map
Speaker 2: of sexual contacts was labeled patient oh, as in the
Speaker 2: letter oh for outside of California, as someone who did
Speaker 2: not live in the study site.
Speaker 6: Huh.
Speaker 2: This was later misread and the term patient zero became
Speaker 2: popularized in And the Band Played On, which was the
Speaker 2: incredible journalistic work by Randy Schiltz published in nineteen eighty seven.
Speaker 1: Dude, yep, that is so interesting. Yeah, so they just
Speaker 1: meant this is a patient that is outside of California
Speaker 1: that is interacting with these patient circles, and now we
Speaker 1: use the term patient zero all the time.
Speaker 2: He was absolutely well yes, so not only that, like
Speaker 2: in terms of the origin of the phrase patient zero,
Speaker 2: but he was demonized in this Oh yeah, I mean
Speaker 2: he was basically portrayed as a sociopath, like he.
Speaker 1: Was like doing it on purpose or something.
Speaker 2: Oh god, absolutely, I don't know anything about the validity
Speaker 2: of any of the claims that he went against public
Speaker 2: health advice or whatever. But regardless of that, later genetic
Speaker 2: analyzes would exonerate him as the US patient zero. The
Speaker 2: virus had been in the US, as we as we've learned,
Speaker 2: in New York and California, long before Katan was sexually active. Unfortunately,
Speaker 2: he would never know that the blame heaped on him
Speaker 2: was unfairly done. He died of AIDS in nineteen eighty four.
Speaker 1: Oh, poor baby.
Speaker 2: I just wanted to clear that up. Yeah, okay.
Speaker 1: That's also a really interesting way that we have a
Speaker 1: term now, right, patient zero on a misreading, on a misreading,
Speaker 1: and then a further victimization. Wow, that is so interesting.
Speaker 2: Yeah, I really wanted to include that. Yeah, okay, moving
Speaker 2: back to the timeline here. Yeah, let's it was clear
Speaker 2: to many of those studying it that this was an
Speaker 2: infectious agent transmitted by the exchange of bodily fluids. But
Speaker 2: where were the front page headlines? Where was the funding
Speaker 2: requested by the CDC task for worse months earlier?
Speaker 1: Who was the president at this time?
Speaker 2: Reagan?
Speaker 1: Okay, we'll get that. Yeah, we'll get that. I just
Speaker 1: want to remind myself. Yeah yeah.
Speaker 2: By the end of nineteen eighty one, one hundred and
Speaker 2: twenty one people in the US had died from the disease,
Speaker 2: with hundreds more infected, likely thousands. And yet among public
Speaker 2: health officials, among politicians, among those whose very job it
Speaker 2: is to protect the health and well being of the
Speaker 2: people they served, all there was was deadly silence. Compare
Speaker 2: this silence and lack of funding to the outbreak of
Speaker 2: Legionnaire's disease in nineteen seventy six, which killed twenty nine
Speaker 2: and infected one hundred and eighty two people, mostly straight
Speaker 2: male veterans.
Speaker 1: I was just gonna say, you have to say who
Speaker 1: it killed? Old white men. Yep, straight white old yeah men.
Speaker 2: The funding records show that the life of a gay
Speaker 2: man with AIDS was worth one tenth of the life
Speaker 2: of a straight legionnaire to those making funding decisions.
Speaker 1: Oh my god.
Speaker 2: Because legionnaires was not a marginalized group, not a group
Speaker 2: that was repeatedly told they were sick, homosexuality as a diagnosis,
Speaker 2: as a pathological diagnosis was not removed from the diagnostic
Speaker 2: and statistical manual used by the American Psychological Association until
Speaker 2: nineteen seventy three, at which point it was replaced by
Speaker 2: quote sexual orientation disturbance.
Speaker 1: Well, they just removed transgender very recently, right from the
Speaker 1: dism five or four or something. Yeah, yeah, it's disgusting.
Speaker 2: Yeah, I mean so this means that if you were
Speaker 2: not heterosexual, you could be diagnosed by a medical professional
Speaker 2: as being sick.
Speaker 3: Right.
Speaker 2: This and the general discrimination by so many others led
Speaker 2: to the complete failure to provide adequate funding and resources
Speaker 2: quickly enough to slow down this building epidemic. In the
Speaker 2: early years of the AIDS crisis, the disease was referred
Speaker 2: to as alternatively gay cancer, gay pneumonia, or GRID for
Speaker 2: Gay related immune deficiency. This labeling of AIDS as unique
Speaker 2: to gay men had profound consequences. First, as Susan Sontag
Speaker 2: points out in her essay AIDS and its metaphors, people
Speaker 2: seek meaning in disease and want to find out why me,
Speaker 2: Oh my god, I know. This labeling allowed people to
Speaker 2: answer because you're gay or because I'm gay, which perpetuated
Speaker 2: feelings of shame and.
Speaker 1: Guilt, and also is just factually untrue, completely untrue. So
Speaker 1: that sucks for people who are infected who are not
Speaker 1: gay or you know.
Speaker 2: I mean in this this is a form of victim
Speaker 2: blaming that were still not passed today. It also allowed
Speaker 2: home I'm aphobic, bigoted people to look at this as
Speaker 2: justified as divine punishment for what they viewed as immoral behavior.
Speaker 2: Many of these bigots, by the way, were politicians who
Speaker 2: would later actively lobby against funding for AIDS research. Jesse Helms,
Speaker 2: I'm looking at you, you piece of human garbage.
Speaker 1: You your rage chilling, your rage inhaling right now.
Speaker 2: Yeah, welcome to the past three weeks life. Finally, these
Speaker 2: labels made silence acceptable. After all, this was a disease
Speaker 2: hitting only a small group of people. It would probably
Speaker 2: burn itself out quickly. What's the point of throwing money away?
Speaker 2: That's not what I believe. That's what the politicians believe.
Speaker 1: Yeah, learn to clear that up.
Speaker 5: Yeah.
Speaker 2: Yeah, Some, however, refuse to be silent. In January of
Speaker 2: nineteen eighty two, Larry Kramer, who was the author of
Speaker 2: the play The Normal Heart, which was just a few
Speaker 2: years ago, turned into an.
Speaker 1: HBO movie Without really beautiful, fantastic.
Speaker 2: You need to see it. It's oh my God, I
Speaker 2: cried a lot. So Larry Kramer, along with Paul Popham,
Speaker 2: formed the Gay Men's Health Crisis in New York City
Speaker 2: GMHC to raise money for AIDS awareness and research. The
Speaker 2: GMHC stepped in where no other public health organization had
Speaker 2: even attempted. This group of men, mostly gay, set up
Speaker 2: a crisis counseling hotline, raised awareness, recruited social workers, and
Speaker 2: provided legal aid and other forms of assistance to gay
Speaker 2: men and their friends and family. Remind me what year
Speaker 2: this is, nineteen eighty.
Speaker 1: Two, Okay, because we're in early years, early years. Yeah,
Speaker 1: No one knows what's causing AIDS, not at all. Yeah, okay.
Speaker 2: Later their mission would extend to anyone affected by AIDS.
Speaker 2: The GMHC would continue to play a big role on
Speaker 2: HIV and AIDS advocacy throughout present day, and their early
Speaker 2: organized approach to raising awareness and providing support set an
Speaker 2: example that many other organizations would later follow. In its
Speaker 2: first year, several internal debates raged at GMHC, one of
Speaker 2: them over whether or not to tell gay men to
Speaker 2: change their sexual behavior, which mirrored a debate among public
Speaker 2: health officials over the closing of gay bathhouses it was
Speaker 2: becoming clear that this disease, whatever it was, was sexually transmitted.
Speaker 2: Telling gay men to stop having sex, or at least
Speaker 2: stop having unprotected sex, even if that message was delivered
Speaker 2: by another gay man, harkened back to a pre stonewall
Speaker 2: time when gay people were even more shunned than they
Speaker 2: were in the eighties. It was viewed by many as
Speaker 2: finger wagging, moralistic bs that served to only shame people
Speaker 2: and stall gay liberation, which had gained so much momentum
Speaker 2: since the sixties. Larry Kramer was on the losing side
Speaker 2: of this argument. He wanted to tell people to stop
Speaker 2: having sex, and this disagreement, along with others, would lead
Speaker 2: to his departure from the group. The discussion at the
Speaker 2: public health level was the forced closure of bathhouses, which
Speaker 2: was supported by some epidemiologists on the CDC Task Force,
Speaker 2: but was obviously illegal, Plus the owners of the bathhouses
Speaker 2: didn't want to lose profit and have their institutions labeled
Speaker 2: as centers of disease. Whether or not bathhouse closure or
Speaker 2: telling gay men to stop having unprotected sex was well intentioned,
Speaker 2: these suggestions replacing the burden of disease prevention not on
Speaker 2: the medical research community, but on the people who may
Speaker 2: become infected or already are infected. And that's just not
Speaker 2: the way to do things.
Speaker 1: That's not the way we do public health, or not
Speaker 1: the way we should do public health right.
Speaker 2: Shortly after the creation of the GMHC, AIDS gets its
Speaker 2: first mention in the Wall Street Journal February nineteen eighty two.
Speaker 2: Buried deep beyond the first page was the headline quote
Speaker 2: new often fatal illness and homosexuals turns up in women
Speaker 2: heterosexual males. If you read between the lines, that headline reads,
Speaker 2: you know, we've known about this disease killing gay people
Speaker 2: for a while, but now that it's also killing straight people,
Speaker 2: we care enough to tell you about it. Yeah, And
Speaker 2: this exemplifies how mainstream news outlets framed HIV and AIDS
Speaker 2: well into the nineties and two thousands. Nineteen eighty two
Speaker 2: saw no slowing of AIDS diagnoses. Instead, epidemiologists and doctors
Speaker 2: were using the word exponential to describe its growth.
Speaker 5: Yeah.
Speaker 1: I was looking at a lot of numbers, and well
Speaker 1: through the nineties it was terrifying just how much not
Speaker 1: only diagnoses but deaths were increasing.
Speaker 7: Oh.
Speaker 2: Absolutely, Yeah, whatever was causing this disease. It had been
Speaker 2: spreading silently for years, and the worst was clearly yet
Speaker 2: to come.
Speaker 5: Yep.
Speaker 2: By the end of nineteen eighty two, the disease's name
Speaker 2: had been officially changed from GRID to AIDS, though GRID
Speaker 2: would continue to be used well into the nineties.
Speaker 1: Wow.
Speaker 2: Yeah, and the estimated number of people with AIDS in
Speaker 2: the US was around nine hundred. The last year that
Speaker 2: number would be in the triple digits.
Speaker 1: In nineteen eighty two.
Speaker 2: Nineteen eighty two.
Speaker 1: Wow, and already in nineteen eighty two, nine hundred.
Speaker 2: I know we're I know we're at the beginning of
Speaker 2: our history here so much. It's a long one in it.
Speaker 1: Buckle up for three more hours.
Speaker 2: I it is so important. I wanted to tell it.
Speaker 2: I wanted to tell all parts of it.
Speaker 1: Good.
Speaker 2: Act two Explosion nineteen eighty three to nineteen eighty seven.
Speaker 2: Nineteen eighty three would later be viewed as a turning
Speaker 2: point for AIDS research and AIDS awareness. But don't expect
Speaker 2: any great advancements or justice yet. The before is just
Speaker 2: that AIDS wasn't recognized as a problem by the general public,
Speaker 2: while the after was that it was suddenly making the
Speaker 2: news and popping up on scientist radar as the hottest
Speaker 2: new thing to research.
Speaker 1: Oh god, don't we all know about that. You get
Speaker 1: funding for like a day, and then your funding is
Speaker 1: taken away. Uh huh, that's what the next new thing is.
Speaker 4: Yeah.
Speaker 2: By the time that the National Cancer Institute announced in
Speaker 2: April of nineteen eighty three that it was committed to
Speaker 2: finding the cause of the disease, one thousand, two hundred
Speaker 2: and ninety five Americans had contracted AIDS and four hundred
Speaker 2: and ninety two had died.
Speaker 1: Wow.
Speaker 2: Add in the extremely long latent period of the virus,
Speaker 2: which was still undiscovered at this point, and the estimates
Speaker 2: of current and future infections ran into the tens and
Speaker 2: hundreds of thousands. Contributing to the recognition of AIDS as
Speaker 2: a public health problem were reports of people with AIDS
Speaker 2: who seemed to have gotten it from a blood transfusion,
Speaker 2: people who tended to not belong to marginalized groups. Suddenly,
Speaker 2: to many Americans, this became a it could happen to
Speaker 2: you disease and a reason to care.
Speaker 1: God, yeah, it's really humans man, horrible.
Speaker 6: Uh huh.
Speaker 2: The CDC had been wary of blood transfusion cases for
Speaker 2: several years and their fears were confirmed. Bringing their reports
Speaker 2: to the heads of the blood banks, the CDC was
Speaker 2: met with scorn and resistance. The chances of developing AIDS
Speaker 2: from infective blood banks was, according to one official, less
Speaker 2: than one in a million.
Speaker 1: Oh my gosh, it's over ninety percent.
Speaker 7: Yeah.
Speaker 1: So, the infectivity of HIV from what we'll call maybe
Speaker 1: standard roots of transmission, sexual contact, intravenous drug use, or
Speaker 1: needlesticks is extremely low, like, well under one percent. Usually
Speaker 1: per contact it's only abou zero point three percent, but
Speaker 1: with blood transfusions it's over ninety percent. Like, I can't
Speaker 1: believe that people would be like, don't worry about it,
Speaker 1: it's fine.
Speaker 2: Uh huh uh huh.
Speaker 1: Oh my god.
Speaker 2: Well, I think that that one in a million was
Speaker 2: referring to the number of bags of blood that were
Speaker 2: infected with HIV or whatever they Yeah, but that's crazy.
Speaker 2: I mean, it was an incredible, incredible underestimate.
Speaker 1: They had no idea what they were dealing with at
Speaker 1: that time, so to just throw a number out there
Speaker 1: is so incredibly.
Speaker 2: Well, let's let's find the motivation. Screening was too expensive?
Speaker 1: Well, and what were they going to screen for? Well, actually, there.
Speaker 2: Wasn't a test for the disease itself, but there still
Speaker 2: was a test for hepatitis B for screens of hepatitis,
Speaker 2: and it was found I think that those who weren't
Speaker 2: had AIDS or were diagnosed with AIDS, eighty eight percent
Speaker 2: of them also had that makes sense be so it
Speaker 2: was like one way to do it. Yeah, it was
Speaker 2: a proxy.
Speaker 1: Yeah, interesting, Okay, And so.
Speaker 2: A very small minority did screen, okay, but so many didn't. Yeah,
Speaker 2: And so many just waited until the cost of being
Speaker 2: sued by infected transfusion recipients outweighed the cost of testing.
Speaker 2: Oh my god, money, money money, Wow. And about that
Speaker 2: cause of agent thing, Yeah, let's get to that.
Speaker 1: Let's talk about it.
Speaker 2: It's nineteen eighty three. Where do we stand? Where do
Speaker 2: we Well, let me fill you in. Are you ready
Speaker 2: for your daily dose of toxic masculinity?
Speaker 1: Oh my god, we need it every episode? Can we
Speaker 1: have a toxic masculinity jingle? Toxic masculinity time?
Speaker 7: Love it?
Speaker 2: I hate it? Actually? Yeah? Love your jingle? Hate toxic masculinity? Yeah?
Speaker 5: Okay.
Speaker 2: Well, here it comes in the form of old Bob Gallo,
Speaker 2: former researcher for the National Cancer institute still alive.
Speaker 1: By the way, Wow Gallo.
Speaker 2: When Gallo first heard about AIDS, and in particular the
Speaker 2: high rate of Caposi's sarcoma, immediately thought retrovirus. He happened
Speaker 2: to be right, and he would go to great length
Speaker 2: to show this. Although the vast majority of what I've
Speaker 2: talked about so far has taken place in the US,
Speaker 2: that does not mean that AIDS wasn't being diagnosed or
Speaker 2: researched across the world, because it was. And one of
Speaker 2: those places is France, where a team of researchers had
Speaker 2: in May nineteen eighty three, published their discovery of a
Speaker 2: virus they called lav Bob Gallo had read the article heck.
Speaker 2: Bob Gallo had reviewed the article.
Speaker 1: Heck.
Speaker 2: And now Gallo was paralyzed with fear that he would
Speaker 2: get no credit for the discovery. He made angry, threatening
Speaker 2: calls to Don Francis at the CDC, pledging to withhold
Speaker 2: funds and refusing to send any specimens or antibodies because
Speaker 2: he feared that the CDC was collaborating with this French
Speaker 2: team behind his back. Oh my god, All this while
Speaker 2: people were dying, and this narcissism slowed research considerably. Oh
Speaker 2: my god, rumors began circulating, probably started by Gallo himself,
Speaker 2: that the French specimens were contaminated and that the true
Speaker 2: virus could only come from Gallo's lab.
Speaker 1: Oh my god, I hate this person.
Speaker 5: Oh yeah.
Speaker 2: So, even though there was a likely candidate for the
Speaker 2: virus that caused AIDS, testing or development of anti virals
Speaker 2: wouldn't start for another year, when Gallo would announce that
Speaker 2: he had discovered the cause of AIDS, a virus he
Speaker 2: called HTLV three.
Speaker 1: Oh my god, I hate people who just care about
Speaker 1: themselves and their own How are you going to research
Speaker 1: cancer and diseases and this and not care about human
Speaker 1: being like lives.
Speaker 2: Well, he's doing research for himself. Yeah, he's doing research
Speaker 2: for the people that the research should be done for.
Speaker 1: No, not at all.
Speaker 2: Yeah, it's a messed up system and messed up people.
Speaker 5: Yea.
Speaker 2: So, when Gallo finally got his discovery papers safely published,
Speaker 2: he included images of his virus, which looked, oddly enough,
Speaker 2: exactly like the French lav But the real revelation and
Speaker 2: scandal wouldn't come until nineteen eighty five. What at a
Speaker 2: press conference came the announcement that tests had revealed that
Speaker 2: when comparing Gallow's HTLV three and the French la v
Speaker 2: they were shown to be less than one percent different.
Speaker 1: He stole their samples.
Speaker 2: Yeah, oh my god, yeah he basically Gallo had simply
Speaker 2: re isolated the lav that the French virus that the
Speaker 2: French team had sent him on previous samples are a
Speaker 2: year before.
Speaker 1: Okay, So not only is he a horrible person who
Speaker 1: cares only about himself, but he's not even fast and
Speaker 1: good at science because it takes him forever. Are you serious?
Speaker 2: I'm one hundred percent serious.
Speaker 1: That's infuriating.
Speaker 2: Whether this was an intentional theft by Gallo or just
Speaker 2: an accidental bs BRO contamination remains unclear. No, I know,
Speaker 2: Oh I know, I know, I know deep in my
Speaker 2: heart of heart.
Speaker 1: Yep.
Speaker 2: A nineteen ninety one federal inquiry did find Gallo guilty
Speaker 2: of misconduct during this research.
Speaker 1: Misconduct was I get you absolutely nothing.
Speaker 2: I'll tell you.
Speaker 1: Except a lot of hate on this podcast and kill you.
Speaker 2: There is a little bit of justice, wait for it.
Speaker 2: The relationship between the French and US research teams had soured,
Speaker 2: and tensions continued to build, with a legal dispute over
Speaker 2: a patent for an antibody test.
Speaker 1: I hate these people.
Speaker 2: I know. It got so bad that in nineteen eighty
Speaker 2: five the US President Reagan and the French President Jacques
Speaker 2: Schiac had to settle this Oh my person. The result,
Speaker 2: Gallo and the French researchers would share co discoverer credit
Speaker 2: and the virus would be called HIV, which is how
Speaker 2: it got its name.
Speaker 3: Wow.
Speaker 2: This ugly chapter in AIDS research would cost Gallo the
Speaker 2: Nobel Prize in two thousand and eight, which was granted
Speaker 2: not to him but to the French discoverers of the
Speaker 2: viral cause of AIDS.
Speaker 1: I don't want either of them to get it, to
Speaker 1: be honest, they both annoyed me.
Speaker 3: Yeah.
Speaker 2: Well, and while all this posturing and shameless self promotion
Speaker 2: was going on, people were dying by the thousands. Although
Speaker 2: the mid nineteen eighties saw increased awareness of AIDS and
Speaker 2: news reports, this wasn't accompanied by increased compassion or treatment.
Speaker 2: Quite the opposite. Violence toward gay men increased enormously and
Speaker 2: fear took hold. Hospitals refused to treat AIDS patients. Morge
Speaker 2: refused to handle the bodies of those who had succumb
Speaker 2: to AIDS. Schools refused to admit children who were HIV positive,
Speaker 2: and the availability of an antibody test, while hugely valuable
Speaker 2: for an individual who could now keep an eye out
Speaker 2: for their own well being and for also for public
Speaker 2: health officials to try to get an idea of the
Speaker 2: number of people that were HIV positive, but on the
Speaker 2: other side of things, this test brought with it the
Speaker 2: fear that huge screening campaigns would be forced upon the
Speaker 2: populations that had been hardest hit by AIDS.
Speaker 1: Right, and it's not like they're offering anything like, Okay,
Speaker 1: you know you're positive.
Speaker 2: Now what now we can give you drugs for free
Speaker 2: to treat it. No, no, there was nothing. Yeah, countries
Speaker 2: were closing their borders to those who tested HIV positive,
Speaker 2: including the US.
Speaker 1: Really, Oh yeah, I didn't know that. Oh my god.
Speaker 2: So yeah, so there was a test, there was no treatment.
Speaker 2: Right when in nineteen eighty five, Rock Hudson announced to
Speaker 2: the world that he was suffering from AIDS, finally, in fury, aidingly,
Speaker 2: finally the world paid attention.
Speaker 1: Who's Rock Hudson.
Speaker 2: Who's a movie star? Yeah, So, all of a sudden,
Speaker 2: there were articles in the New York Times in Newsweek,
Speaker 2: all of a sudden people cared. Rock Hudson was handsome
Speaker 2: and all American movie star, good friends with Ronald and
Speaker 2: Nancy Reagan. Oh my god, yeah, iye roll and I
Speaker 2: do like I feel, I feel really bad of course
Speaker 2: that he controlled that he died of AIDS. He eventually
Speaker 2: did diet of AIDES in nineteen eighty five. It just
Speaker 2: is such a shame that it took that famous person
Speaker 2: for people to care about it.
Speaker 1: It so often does, I mean still to this day?
Speaker 7: I know?
Speaker 2: And where was the president in all of this? What
Speaker 2: was he doing about the disease that was killing thousands
Speaker 2: of US citizens? Reagan would first publicly say the word
Speaker 2: AIDS in nineteen eighty five, Wow, And that was only
Speaker 2: in response to a reporter's question. It would be another
Speaker 2: two years before Reagan would deliver his first speech on
Speaker 2: the AIDS epidemic.
Speaker 1: Are you serious?
Speaker 2: Nineteen eighty seven, eighty seven. He had been president for
Speaker 2: seven years at this point.
Speaker 1: That's disgusting. The entirety of the AIDS epidemic to that
Speaker 1: point was during his presidency.
Speaker 2: Yes, at the time of his speech, which did not
Speaker 2: mention gay men as one of the hardest hit groups.
Speaker 2: Thirty six thousand and fifty eight Americans had been diagnosed
Speaker 2: with AIDS and twenty thousand, eight hundred and forty nine
Speaker 2: had died. Oh, those numbers don't include the global figures,
Speaker 2: which by now are climbing into the hundreds of thousands.
Speaker 4: Yeah.
Speaker 2: Act three outrage.
Speaker 1: I'm already feeling that. So, my god.
Speaker 2: Nineteen eighty seven to nonineteen ninety six. The year was
Speaker 2: nineteen eighty seven. The AIDS crisis in the US was
Speaker 2: in its seventh year. Scientists had identified the virus that
Speaker 2: caused the disease and even developed a test to determine
Speaker 2: the infection status, but with five hundred thousand cases of
Speaker 2: AIDS worldwide and still no reliable, effective treatment, the diagnosis
Speaker 2: of AIDS was basically a death sentence.
Speaker 4: Yeah.
Speaker 2: Years of delays in starting research on the disease and
Speaker 2: providing adequate funding in isolating its cause had a cascading
Speaker 2: effect on the development, testing, and approval of treatment to
Speaker 2: manage or cure the disease. The timeline for a pharmaceutical
Speaker 2: drug to be approved by the FDA is on average
Speaker 2: ten years.
Speaker 1: Yeah that's still true. Yeah, still true today?
Speaker 4: Yeah?
Speaker 2: Oh was that's current numbers? Yeah, Yeah, that's an incredibly
Speaker 2: long time for people who are dying within a year
Speaker 2: of diagnosis. The later this process started, the more people
Speaker 2: died without ever receiving treatment. It's not exaggerating to say
Speaker 2: that tens or hundreds of thousands of lives were lost
Speaker 2: due to the apathy which with the US government responded
Speaker 2: to the AIDS crisis in its early years, and people
Speaker 2: saw this and they would not stand for it. In
Speaker 2: March nineteen eighty seven, Larry Kramer, remember him from GMHC
Speaker 2: Ideal Gay Mens Health Crisis, helped to found act UP,
Speaker 2: an advocacy group focused on improving the lives of people
Speaker 2: with AIDS by direct actions aimed at changing policy, affecting
Speaker 2: the medical research pipeline, and helping to get treatment to
Speaker 2: those in needs. Act UP, by the way, stands for
Speaker 2: Aid's Coalition to Unleash Power. The actions of act UP
Speaker 2: are the subject of the twenty twelve documentary How to
Speaker 2: Survive a Plague in the twenty sixteen book of the
Speaker 2: same name. If you haven't seen or read it, go
Speaker 2: do that immediately. If you have seen or read it,
Speaker 2: go do it again. We'll wait, Yeah, you really should.
Speaker 2: By nineteen eighty seven, one drug had been approved to
Speaker 2: treat AIDS. AZT in the US.
Speaker 5: Yep.
Speaker 2: Developed initially as an anti cancer drug.
Speaker 1: I didn't know that. So that explains how they were
Speaker 1: able to get it on the market faster than they
Speaker 1: would have if it had already been developed. Yep.
Speaker 2: Yeah, and so yeah. It had gone through clinical trials
Speaker 2: in nineteen eighty five to treat AIDS and shown some promise,
Speaker 2: although many patients experienced strong negative reactions like anemia, it
Speaker 2: was uncontrollable. Yeah.
Speaker 7: Yeah.
Speaker 2: When FDA approval went through in March of nineteen eighty seven,
Speaker 2: the pharmaceutical company that held the single patent on the drug,
Speaker 2: Burrows Welcome, announced that it would charge ten thousand dollars
Speaker 2: a year for the treatment, a price well out of
Speaker 2: reach of many.
Speaker 1: People with AIDS, not just many, like literally everyone. Uh huh,
Speaker 1: that's absurd.
Speaker 5: Yeah.
Speaker 1: I hate money.
Speaker 2: I hate I hate people.
Speaker 1: Yeah, I hate people and money, people and money together.
Speaker 1: Like if you took the money away from the people
Speaker 1: then and then would be too much? Okay continue.
Speaker 2: This announcement inspired one of the earliest actions of Act UP,
Speaker 2: a demonstration on Wall Street to protest this criminally high
Speaker 2: cost of AZT. Though it would take a couple of
Speaker 2: years and many more demonstrations, act UP would finally get
Speaker 2: Burrows Welcome to reduce that price to eight thousand dollars.
Speaker 1: Oh my god.
Speaker 2: Yeah, but still it was, I mean it was. That's
Speaker 2: amazing to me that this advocacy group actually made like
Speaker 2: made a change, made an impact on a pharmaceutical company.
Speaker 7: I know.
Speaker 1: But that's still just like so infuriating that they can
Speaker 1: just charge whatever the hell they want. I know.
Speaker 7: Well, it's we've got glass half full, glass half there
Speaker 7: we go. We need both say, that's why we do
Speaker 7: this together. It is when one of us is up
Speaker 7: to the other, one is the way in the whole.
Speaker 5: Oh.
Speaker 6: True.
Speaker 2: But even when AZT was more easily accessible, many people
Speaker 2: with aids couldn't take it. As I mentioned, So what
Speaker 2: other drugs were being researched? What else was out there?
Speaker 3: Yeah?
Speaker 2: Not very much, it turns out no. No, So a
Speaker 2: lot of the US research efforts seemed to be focused
Speaker 2: on honing AZT without developing new drugs. It was well,
Speaker 2: it was money making, right, and that's where the incentives were. Yeah,
Speaker 2: but there were some drugs. In their early infancy, act
Speaker 2: UP members read the latest medical journals to do their
Speaker 2: own research on the status of new drugs to treat
Speaker 2: HIV or AIDS, educating themselves reading textbooks about pharmacology, immunology, virology.
Speaker 2: In the words of Derek Hotle, who's one of the
Speaker 2: act UP members, quote, in the absence of adequate healthcare,
Speaker 2: we have learned to become our own clinicians, researchers, lobbyists,
Speaker 2: drug smugglers, pharmacists. We have our own libraries, newspapers, drug stores,
Speaker 2: and laboratories. And that's exactly what they did.
Speaker 5: Dude.
Speaker 1: This is why I'm sorry to get off topic for
Speaker 1: a second, but I'm feeling the outrage, so I just need.
Speaker 2: Too that we're in Act three outrage.
Speaker 1: Yeah, I feel like this is such a beautiful example
Speaker 1: of why it is so important that we have diverse
Speaker 1: people in diverse roles, because then you wouldn't end up
Speaker 1: in this situation in the first place. If it wasn't
Speaker 1: all old white men in politics, research, medicine, everything at
Speaker 1: this point in time, I don't think you would have
Speaker 1: seen the same situation, you know what I mean. Like,
Speaker 1: that's so, it's just because if everyone in your office
Speaker 1: in your lab is the same, then you all have
Speaker 1: the same viewpoint then no one is going, hey, but
Speaker 1: what about this thing, what about this new drug, or
Speaker 1: what about looking at it from this perspective?
Speaker 2: And yes, multidisciplinary is such a word that's thrown around,
Speaker 2: you know, but it actually is can really make a
Speaker 2: big impact in terms of thinking reframing things in a
Speaker 2: way that you wouldn't have thought of earlier.
Speaker 1: Well, and just having like like intersectional workplaces where you
Speaker 1: have multiple literal people of different colors and different creeds
Speaker 1: and different genders and everything, you know, And that's that's
Speaker 1: very true.
Speaker 2: The problem though, that is that still remains is the
Speaker 2: fact that the money is all held primarily and the
Speaker 2: policies are all held primarily by old rich exactly men. Yeah,
Speaker 2: an agenda that is only self serving.
Speaker 1: Yep, exactly totally And so yeah, one hundred percent on
Speaker 1: board with hating that.
Speaker 2: Yeah, I mean we could go on forever talking about
Speaker 2: the injustice. Yeah and yeah, yep, okay, So so yeah,
Speaker 2: the members of act UP affected real measurable change in
Speaker 2: the turnaround time for experimental HIV or AIDS drugs.
Speaker 1: That's awesome.
Speaker 2: They made it like, let's get it to the market faster,
Speaker 2: yet's get these these experiments done faster. They also brought
Speaker 2: about the early the long long overdue approval of drugs
Speaker 2: used to treat AIDS related opportunistic infections in terms of preventatives,
Speaker 2: the development of educational materials about AIDS for people with
Speaker 2: AIDS and their advocates. So a lot of distribution of
Speaker 2: materials and compiling it into packets that were accessible, that
Speaker 2: that could be read by people without a PhD In
Speaker 2: biophysics and molecular genetics.
Speaker 1: So that the research is actually reaching the people they need.
Speaker 2: Yea, what They're bridged the gap from primary research to
Speaker 2: communication so amazingly. It was really it's so.
Speaker 1: Inspiring sycom at its finest.
Speaker 4: Yeah.
Speaker 2: Their demonstrations were unignorable, shutting down the FDA for a
Speaker 2: day during one awesome protest. In another, some members chained
Speaker 2: themselves to a balcony at the New York Stock Exchange.
Speaker 1: Wow.
Speaker 2: My personal favorite is when thag Tag Treatment Action Group,
Speaker 2: which had split off from act UP, put a giant
Speaker 2: inflatable condom over North Carolina Republican Senator Jesse Helms House
Speaker 2: what Yeah, Oh my god. Helms was one of the
Speaker 2: politicians actively campaigning on the Senate floor against federal funding
Speaker 2: for AIDS related research or treatment on the basis of
Speaker 2: moral outrage.
Speaker 1: Oh my god, I hate him. How did they get
Speaker 1: an inflatable condom that big?
Speaker 2: There's an entire story that actually, like Peter Staley tells
Speaker 2: the story in a blog. I can't remember the exact website,
Speaker 2: but he tells the story. It's in the documentary.
Speaker 1: We'll link to it. We'll find that it's so great
Speaker 1: because that sounds amazing.
Speaker 2: Yeah, yeah, so, Jesse Helms was an enormous piece of garbage.
Speaker 2: On the condom was written quote, a condom to stop
Speaker 2: unsafe politics. Helms is deadlier than a virus.
Speaker 5: Oh my god. I love that.
Speaker 2: And I don't think they got in trouble for it,
Speaker 2: which is the best part. I think they got like
Speaker 2: a parking ticket or something.
Speaker 1: Oh that's so funny, so happy.
Speaker 2: Perhaps the most recognizable demonstration, or the most the one
Speaker 2: that you may have heard of from the late eighties
Speaker 2: was the second National March on Washington for Lesbian and
Speaker 2: Gay Rights, an event which marked the first national media
Speaker 2: coverage of act UP and which revealed the AIDS quilt
Speaker 2: three and a half tons one nine hundred squares.
Speaker 5: Oh my god.
Speaker 2: At the time, it's since grown. Yeah, with each square
Speaker 2: representing someone who had died of AIDS. This march was
Speaker 2: attended by an estimated seven hundred and fifty thousand people. Wow,
Speaker 2: way more, way more than attended Trump's inauguration.
Speaker 6: By the way, there's like seven people there, so oh
Speaker 6: so probably it could be as many as three times
Speaker 6: more than attended Trump's inauguration. Throughout the late eighties and
Speaker 6: early nineties, Act UP chapters started in cities across the
Speaker 6: US and continued to educate, demonstrate, and advocate. Meanwhile, the
Speaker 6: number of people with AIDS around the world was steeply climbing.
Speaker 6: By nineteen ninety one, it was at an estimated ten million, wow,
Speaker 6: ten million, ten.
Speaker 1: Million people with AIDS, not just with HIV mm hmm wow, and.
Speaker 2: An estimated one hundred thousand people in the US had
Speaker 2: died from AIDS since the start of the epidemic by
Speaker 2: nineteen ninety one, eleven years.
Speaker 3: Oh my god.
Speaker 2: It is during these years that we see the highest
Speaker 2: death tolls in the US. Yeah, with fifteen thousand, twenty
Speaker 2: twenty five thousand dead each year in.
Speaker 1: The early nineties, Yeah, I saw some numbers es made
Speaker 1: it even higher than that, Like in the thirties and
Speaker 1: forty five.
Speaker 2: Yeah, thirties and forties were around ninety four to ninety five.
Speaker 2: Ninety six, Yeah, Jesus. New experimental antivirals came onto the scene,
Speaker 2: sometimes cooked up at home, sometimes brought into the country.
Speaker 2: Buyers clubs are all over, providing people with experimental drugs, which,
Speaker 2: if they didn't offer a cure, may be offered hope.
Speaker 2: Real measurable qualified hope didn't come until nineteen ninety five,
Speaker 2: the year the first proteas inhibitors were approved. People with
Speaker 2: AIDS who seemed to be nearing the end of their
Speaker 2: days rebounded after taking these drugs.
Speaker 5: Wow.
Speaker 2: Doctors called it the Lazarus effect. It was very dramatic.
Speaker 2: Within two years, death rates in the US and in
Speaker 2: much of Europe plummeted. But this miracle cure would come
Speaker 2: too late for so so many people, For over three
Speaker 2: hundred thousand dead in the US, for the millions dead worldwide.
Speaker 2: The members of act UP number in the thousands. But
Speaker 2: I want to mention the names of just some of
Speaker 2: those who were instrumental in the fight to improve the
Speaker 2: lives of people with AIDS through act UP. David Barr,
Speaker 2: Spencer Cox, David France, jim Igo Grants, Frank Ruda, Larry Kramer,
Speaker 2: Iris Long, Mark Harrington, Bob Rafsky, Peter Staley. These people
Speaker 2: are heroes. Act for Persistence nineteen ninety seven to two thousand.
Speaker 2: The first few years in gay communities after the release
Speaker 2: of proteas inhibitors have been compared to coming up from
Speaker 2: the trenches only to realize that the world had no
Speaker 2: idea you were even fighting a war. Entire neighborhoods in
Speaker 2: San Francisco and New York City were empty. People had
Speaker 2: watched as hundreds of their friends died. It wasn't uncommon
Speaker 2: to attend one or more funerals a week. These were
Speaker 2: young men, and so many of them died. PTSD and
Speaker 2: survivor's guilt were prevalent among those who had escaped the epidemic,
Speaker 2: But escape isn't really an appropriate word. There was no
Speaker 2: escape from the experience and it would stay with them forever.
Speaker 2: As we heard in our first hand account, there was
Speaker 2: no parade, no march, no rally to signify the end
Speaker 2: of the AIDS crisis. In the US. Slowly, AIDS treatment
Speaker 2: centers closed their doors, demonstrations became more infrequent, although an
Speaker 2: HIV positive result no longer carried the death sentence it
Speaker 2: had before proteas inhibitors, AIDS diagnoses continued to c i'm
Speaker 2: worldwide and in regions where treatment is completely unaffordable. In
Speaker 2: nineteen ninety seven, the worldwide death count is six point
Speaker 2: four million and current cases twenty million.
Speaker 1: Wow.
Speaker 2: Before getting in to current status of HIV and AIDS today,
Speaker 2: I want to say one more thing. At the end
Speaker 2: of each episode, we usually ask the question how scared
Speaker 2: to you need to be of X disease? But researching
Speaker 2: the history of HIV and AIDS made me realize that
Speaker 2: that's not the question we should have been asking all along.
Speaker 4: Yeah.
Speaker 2: Instead we should be asking what should scare you about
Speaker 2: this disease? For smallpox, I would have said that it
Speaker 2: was historical accounts of intentional infection or the future threat
Speaker 2: of bio warfare. For leprosy, it's the mistreatment of people
Speaker 2: with leprosy. In every case, the answer has something to
Speaker 2: do with the failings of humanity, and the story of
Speaker 2: AIDS is no different. There are towering villains in this story,
Speaker 2: the people that you would have thought you could have
Speaker 2: trusted to do something about the disease. The thing that
Speaker 2: we should be most scared about in terms of HIV
Speaker 2: and AIDS is not the disease itself, but the response
Speaker 2: or lack of response of the government and public health
Speaker 2: agencies to this crisis, the discrimination and disregard for this
Speaker 2: disease because in the US it happened to pop up
Speaker 2: in a marginalized and long ostracized group of people. For
Speaker 2: every villain in this story, though, there is a hero
Speaker 2: or several heroes, those brave men and women who took
Speaker 2: it upon themselves to organize, mobilize, and effect change. And
Speaker 2: while the history of AIDS is full of heartbreak and injustice,
Speaker 2: these heroes should give you hope and a belief that
Speaker 2: some people will have the courage to fight and prevail.
Speaker 2: And with that handing off to you, how.
Speaker 1: On earth am I supposed to follow that? Oh God,
Speaker 1: that was beautifully written there.
Speaker 2: Thanks, that was That was the first thing I wrote. Actually,
Speaker 2: it was really the end.
Speaker 1: You have little cries in your eyes.
Speaker 2: I do little cries of my ass.
Speaker 5: Oh my god, I just like.
Speaker 1: Mm okay, So, so what's happening today?
Speaker 2: What's happening? I want to know about it?
Speaker 1: Well, I could sit here and hit you with number
Speaker 1: after number, which is what I did to myself while
Speaker 1: I was researching this. Yeah, it was like table table infections, deaths, deaths.
Speaker 2: Death It's it kind of detaches you real it does.
Speaker 1: So I really appreciate what you said because that's it's
Speaker 1: very true, and it's yeah, sometimes it's there's two too
Speaker 1: many numbers when I'm just staring at them to deal with.
Speaker 1: So here's what I want to say. HIV AIDS is
Speaker 1: still a huge problem today. It's not a problem of
Speaker 1: the past. Like tens of thousands of people in the
Speaker 1: US are diagnosed with HIV and with AIDS every year,
Speaker 1: and thousands are still dying from it in the US
Speaker 1: my gosh. But what I think is the most important
Speaker 1: thing to realize is that this risk still to this day,
Speaker 1: is not homogeneous. And if you thought that we learned
Speaker 1: from how marginalized groups were treated at the start of
Speaker 1: the HIV AIDS eponemic, you're very much mistaken. Because while
Speaker 1: advocacy groups did a lot to raise awareness, and it's
Speaker 1: true that HIV AIDS research is very well funded in
Speaker 1: comparison to many other very inadequately funded diseases, and while
Speaker 1: CDC and who say things on their website, like rates
Speaker 1: of HIV infections are decreasing and aid's debts are decreasing,
Speaker 1: it's not happening across the board. By far, the largest
Speaker 1: population at risk and getting diagnosed with HIV every year
Speaker 1: in the US are gay African American men, followed by
Speaker 1: gay Hispanic and Latino men. And for years, while the
Speaker 1: number of new diagnoses in other groups, especially in white
Speaker 1: gay men, were declining, they've been increasing in African American
Speaker 1: men and Latino men. And just finally, over the last
Speaker 1: year or two have these numbers seem to have stabilized.
Speaker 1: Stabilized exactly. They're not decreasing by any rate. African Americans
Speaker 1: men and women represent only twelve percent of the US population,
Speaker 1: but accounted for forty four percent of HIV diagnoses last year.
Speaker 2: Oh my god.
Speaker 1: And to make it even worse, because why not, the
Speaker 1: most neglected group that has the worst out comes are
Speaker 1: transgender women. In the US, transgender women are diagnosed with
Speaker 1: HIV at rates three times higher than the general population.
Speaker 4: Wow.
Speaker 1: And a meta analysis in twenty thirteen that will link
Speaker 1: to estimated that infection prevalence and transgender women worldwide was
Speaker 1: seventeen percent and in high income countries, including the United
Speaker 1: States twenty two percent.
Speaker 5: What.
Speaker 1: Yeah, that's ridiculous. Two, it's ridiculous. It's unacceptable. And there
Speaker 1: is essentially no research being done on how to stop
Speaker 1: this from happening in these communities.
Speaker 2: We haven't I mean, we haven't learned anything.
Speaker 5: Yeah.
Speaker 1: Yeah, And now we've talked a lot today about HIV
Speaker 1: AIDS in the US, but this is by no means
Speaker 1: a disease of the US. This is a global pandemic.
Speaker 1: The WHO currently estimates that there are over thirty six
Speaker 1: million people globally living with HIV wow, including two million children.
Speaker 1: And there were almost two million cases new cases diagnosed.
Speaker 2: Last year, two million new cases.
Speaker 1: And remember that these new cases don't necessarily represent new infections.
Speaker 1: They just mean that people are finally coming and seeking
Speaker 1: treatment or getting.
Speaker 2: Tested, and so those are HIV.
Speaker 1: Those are HIV cases, right. The saddest statistic is that
Speaker 1: only around fifty percent of adults and forty three percent
Speaker 1: of children that currently live with HIV are actually receiving
Speaker 1: any sort of antiretroviral therapy.
Speaker 2: Why, like, why is that number fifty percent? Why is
Speaker 2: that number not one hundred percent? Oh right, Yeah, So
Speaker 2: I think accessibility.
Speaker 1: Yeah, I think it's lack of access.
Speaker 2: And this lack of access means oftentimes not just logistics
Speaker 2: but actual financial.
Speaker 1: Yes, definitely, definitely financials. And the WHL also estimates that
Speaker 1: only about seventy percent of people living with HIV or
Speaker 1: seventy percent of people who are HIV positive actually know
Speaker 1: their status. And even today in twenty it's twenty eighteen. Now, Yeah,
Speaker 1: one in three people that present with HIV for the
Speaker 1: first time are presenting with advanced disease, which means they're
Speaker 1: not getting tested early. They're waiting, you know, they don't
Speaker 1: know that they're infected until the disease has already progressed
Speaker 1: to either AIDS or you know, stage two or something
Speaker 1: like that. So wow.
Speaker 2: And the thing about getting tested, which I didn't I
Speaker 2: didn't talk much about, but the term disease is so
Speaker 2: or diseased is so interesting. And if part of the
Speaker 2: fear of getting tested, and it's a completely legitimate fear,
Speaker 2: is that if, even if, if you get an HIV
Speaker 2: positive result, even though that's no longer the death sentence
Speaker 2: that it used to be, you are automatically lumped into
Speaker 2: this diseased category. Yeah, and if you and if you
Speaker 2: have no symptoms or seem perfect health, and.
Speaker 1: If you are part of an already marginalized group, you
Speaker 1: just then further marginalize and potentially ostracize ourself are ostracized
Speaker 1: by that. Yeah, and yeah, it's it's horrible. And even
Speaker 1: though I mean, with treatment you can effectively reduce the
Speaker 1: risk of transmission to other people to very small and
Speaker 1: treatment is not perfect by any means. Drug resistance is
Speaker 1: very real, and treatment has serious side effects and complications,
Speaker 1: but it does greatly prolong your life expectancy and decreases
Speaker 1: the risk of progressing to AIDS if you are HIV positive. So,
Speaker 1: I mean, yeah, it sucks that there's such such a
Speaker 1: huge stigma associated with it, where there might be many
Speaker 1: people out there who don't get tested because they don't
Speaker 1: want to know.
Speaker 2: What's so frustrated is that, you know, public health officials
Speaker 2: or government officials complain about this lack of people testing themselves,
Speaker 2: but they're the ones who created the stigma. They're the
Speaker 2: ones who created these conditions which being tested is not
Speaker 2: a desirable thing to do, right, It's so frustrating. Yep,
Speaker 2: So is there anything? Is there any not silver lighting,
Speaker 2: but is there any sort of like, what about PREP.
Speaker 1: Yeah, so let's talk about PREP. So PREP is pre
Speaker 1: exposure prophylaxis, which is it's when zero negative people, so
Speaker 1: HIV negative people are taking retrovirals to prevent infection with HIV.
Speaker 1: The good news is it's very effective.
Speaker 2: Awesome.
Speaker 1: This has actually been around for at least ten years.
Speaker 1: Trials started in two thousand and five, was the earliest
Speaker 1: that I saw. It wasn't licensed. Oral use of PREP,
Speaker 1: the trade name I think is Truevada or something wasn't
Speaker 1: licensed in the US until twenty twelve. But it's been
Speaker 1: around since long before that, and it's really effective. Dozens
Speaker 1: and dozens of clinical trials and cohort studies have shown
Speaker 1: that the use of these oral antiretrovirals can reduce risk
Speaker 1: of infection by around ninety percent. That's more effective than
Speaker 1: condom use. Condoms are about eighty five percent effective when
Speaker 1: used correctly.
Speaker 2: Wow.
Speaker 1: Yeah, so that's great. There is also a gel that
Speaker 1: is an antiretroviral gel that is used. I don't think
Speaker 1: that it's licensed that I know of. Someone can correct
Speaker 1: me if I'm wrong in the US, but it is
Speaker 1: used in a lot of other countries that you can
Speaker 1: use either before or sometime during I think I would
Speaker 1: assume before sexual intercourse. And that is an anti retroviral gel,
Speaker 1: not a spermicidal gel. And that's also very effective, so
Speaker 1: it's not something that you have to take all the time.
Speaker 2: Very cool.
Speaker 1: Yeah, And so I want to point out that there
Speaker 1: have been a lot of criticisms of this drug PREP
Speaker 1: because people claim that since it can prevent HIV infection,
Speaker 1: it will then lead to an increase in the rates
Speaker 1: of other STDs because people are no longer using condoms essentially,
Speaker 1: And to that, I just want to say, yeah, like,
Speaker 1: that's the same that's the same BS argument that people
Speaker 1: try to use to say that women shouldn't have access
Speaker 1: to birth control options.
Speaker 2: Uh huh.
Speaker 1: Any option that is available that can prevent the spread
Speaker 1: of a disease as gnarly and devastating as HIV should
Speaker 1: be available to people who could benefit from it.
Speaker 6: Yep.
Speaker 1: Should people practice safe sex in general, da da da da.
Speaker 1: Of course, yeah, that would be great, but also they
Speaker 1: should use PREP if they can benefit from it. Yeah,
Speaker 1: I mean I was reading that. I was just it's
Speaker 1: so demeaning. It's insulting to assume that humans aren't capable
Speaker 1: of making our own decisions about our own healthcare and
Speaker 1: what is best for us. Uh uh, it's just plain wrong.
Speaker 2: We're looking at you, conservatives, yet out of our bedrooms.
Speaker 1: I also want to point out that this is a
Speaker 1: very expensive drug. I was looking for coupons for it.
Speaker 1: It's like sixteen hundred dollars for thirty tablets, So that's
Speaker 1: for a one month's supply. What it is covered by
Speaker 1: most health insurance.
Speaker 2: That's awesome.
Speaker 1: Yes, I didn't know that, and it seems like it is.
Speaker 1: It's not covered under Medicaid or Medicare or any other
Speaker 1: government insurance policy.
Speaker 2: Government insurance, oh my mm hmm.
Speaker 1: Which means guess what the most vulnerable sections of our
Speaker 1: populations aren't don't have access?
Speaker 2: Exactly cool yet again, thumbs up, thumbs up government.
Speaker 1: We give you something good and then we take it back.
Speaker 1: So it's not surprising to know that these are the
Speaker 1: same populations that we see having the highest rates of
Speaker 1: HIV and AIDS.
Speaker 5: Right.
Speaker 1: So, honestly, because of all this, I feel like we
Speaker 1: don't even have time to talk about the research that
Speaker 1: is being done on HIV. Sorry, there is a ton
Speaker 1: everything from better rapid diagnostic tools more effective anti retroviral therapies,
Speaker 1: and of course a vaccine.
Speaker 2: That'd be awesome.
Speaker 1: It would be great. There are tons of different strategies
Speaker 1: that people are exploring, and I'm sure there's a podcast
Speaker 1: episode out there somewhere about all of these different options,
Speaker 1: and maybe we can find it and link to it.
Speaker 1: But just to end it off with some numbers, yeah,
Speaker 1: because I didn't do a lot of numbers. In total,
Speaker 1: from the beginning of the epidemic in nineteen eighty one
Speaker 1: or nineteen eighty until twenty sixteen, there have been an
Speaker 1: estimated one million, two hundred and thirty two thousand, three
Speaker 1: hundred and forty six people diagnosed with AIDS in the US.
Speaker 4: Wow.
Speaker 1: Cumulatively, six hundred and ninety two thousand and seven hundred
Speaker 1: and eighty nine people have died since the beginning of
Speaker 1: the epidemic in the US. In the US, yes, oh
Speaker 1: my god, millions and millions more worldwide. And that is
Speaker 1: the state of HIV today.
Speaker 2: Well, i'd say that's a pretty sorry state.
Speaker 1: Yep, I'd agree.
Speaker 2: Okay, Well, there you have it, the biology, history, and
Speaker 2: current status of HIV and AIDS in the world.
Speaker 1: Thanks for sticking with us.
Speaker 2: Thank you. So much for listening.
Speaker 1: We really really appreciate it.
Speaker 3: Yeah.
Speaker 1: I hope that you guys feel that you learned something new.
Speaker 1: I know I definitely did. I didn't know a lot
Speaker 1: about this history.
Speaker 2: So yeah, and again, thank you so so much to
Speaker 2: the providers of our first hand accounts.
Speaker 1: Brian, hellel and Frank. We really really appreciate it. It
Speaker 1: was wonderful talking to you and listeners. Hold your breath
Speaker 1: for next week because you're going to get to hear
Speaker 1: more of these stories. So should we talk about what
Speaker 1: our sources were?
Speaker 2: Let's do it. I have a few books here. The
Speaker 2: first is The Chimp and the River by David Kwaman
Speaker 2: and the Band Played On by Randy Schiltz, How to
Speaker 2: Survive a Plague by David France I mentioned, And the
Speaker 2: final book I'll mention is called Aids and it's metaphors
Speaker 2: and it's really more of an essay by Susan Sontag.
Speaker 5: Cool.
Speaker 1: I've got honestly too many things to cite here, so
Speaker 1: we will post just because they're too long to read. Yeah.
Speaker 2: You can find all of these books and articles on
Speaker 2: a Google doc list that we have a link to
Speaker 2: on our podbeam website.
Speaker 1: Yeah, and We'll also make sure that that's posted on Facebook,
Speaker 1: so if you're interested in getting a list of everything
Speaker 1: that we've ever cited from all of our episodes, that'll be.
Speaker 2: There as always. Thanks for listening, Yeah, thank you so much,
Speaker 2: we really like it. And thanks to Bloodmobile for providing
Speaker 2: the music in this episode. And finally, wash your hands.
Speaker 1: Yeah, filthy animals and be kind of relationsh