WEBVTT - 197. The AIDS Crisis 0:00:10.600 --> 0:00:14.480 Hello, delicious friends, and welcome to Who Did What Now? 0:00:14.640 --> 0:00:18.319 The history podcast that is not your history class with me, 0:00:18.480 --> 0:00:23.200 your host Katie Charlwood, History harlot and reader of books. 0:00:24.040 --> 0:00:29.240 If I sound sick, it's because I am. So. I 0:00:29.360 --> 0:00:32.560 was in London at the weekend because the Donegal International 0:00:32.640 --> 0:00:36.200 Rally was in Donegal and typically every year I leave, 0:00:36.720 --> 0:00:37.400 and so that's. 0:00:37.200 --> 0:00:37.680 What I did. 0:00:38.600 --> 0:00:41.879 So I left doney Goal and I went to London, 0:00:42.520 --> 0:00:44.920 and I brought the children because they also do not 0:00:45.159 --> 0:00:48.520 like all the rally stuff because it's loud and all. 0:00:48.360 --> 0:00:52.639 This type of stuff. So we get to London and. 0:00:54.040 --> 0:00:59.160 It's our second day in London at our first sort 0:00:59.160 --> 0:01:03.360 of notes like or first like fill day, and by 0:01:03.480 --> 0:01:07.800 the evening time, I have a searing headache that is 0:01:07.880 --> 0:01:12.080 penetrating from my eyeballs to deep into my skull. Like 0:01:12.160 --> 0:01:14.280 it felt like it was trying to push my eyeballs 0:01:14.319 --> 0:01:16.560 out of my head but also crush my nose at 0:01:16.560 --> 0:01:19.199 the same time. So I was like saying, his headache, 0:01:19.240 --> 0:01:22.440 I'll get some pain colors after the show. It'll be fine. 0:01:24.120 --> 0:01:27.920 It was not fine. In the interval, I was holding 0:01:28.040 --> 0:01:32.679 like a glass coke bottle against my eye because it 0:01:32.720 --> 0:01:35.319 was the only thing cooling it down. We ended up 0:01:35.319 --> 0:01:38.480 getting ice cream, so I thought this could work, right, 0:01:39.200 --> 0:01:42.920 and it temporarily did. Apparently the ice coldness just helped. 0:01:43.080 --> 0:01:45.000 I don't know, because it pulls the blood from your 0:01:45.400 --> 0:01:49.040 head down to your stomach. But yeah, I ended up 0:01:49.400 --> 0:01:53.720 like at the end of the musical, I was gone, 0:01:54.280 --> 0:01:58.040 Like the kids had to tuck me in, Like I'm 0:01:58.080 --> 0:02:02.680 talking like that evening I had feet, sweats, confusion, like 0:02:02.920 --> 0:02:05.559 they made up this little bomb bunk for me and 0:02:06.360 --> 0:02:08.880 like it's so cute. So like my daughter she puts 0:02:08.919 --> 0:02:11.160 some water bottle there and they put the bin next 0:02:11.160 --> 0:02:14.480 to me, and I'm I'm like shaking on this blanket. 0:02:14.880 --> 0:02:16.520 They have their doneer a, they getting their jommius, they 0:02:16.520 --> 0:02:19.040 go to bed. They're done right, They're they're ten and eleven. 0:02:19.880 --> 0:02:25.680 And I yeah, that being said, I saw a Hercules 0:02:25.880 --> 0:02:31.360 the musical. Why Hercules, you say, Well, my daughter is 0:02:31.400 --> 0:02:34.880 like looking at the big sort of Gresshian urn on 0:02:34.919 --> 0:02:40.960 the on the stage and she's like, what's Hercules? And 0:02:41.000 --> 0:02:44.880 I was like, Oh, it's Hercules. The character's name is Hercules. 0:02:45.000 --> 0:02:46.880 Like I was like, I try to get you to 0:02:46.919 --> 0:02:48.880 watch this movie with me one hundred times. You guys 0:02:48.919 --> 0:02:50.320 didn't want to do it, and she goes, I don't 0:02:50.320 --> 0:02:56.359 remember that. So yeah, So Hercules was being played by 0:02:56.720 --> 0:03:01.400 Philippe Verano, whose name I have probably dred, and oh 0:03:01.480 --> 0:03:04.239 my god, he was amazing, like absolutely amazing. Didn't even 0:03:04.240 --> 0:03:07.800 occur to me that he was the swing. And here's 0:03:07.840 --> 0:03:10.680 the thing. It was the kid's first musical and I am. 0:03:10.840 --> 0:03:12.040 So glad it was. 0:03:12.320 --> 0:03:15.359 They caught confetti, they laughed at the side jokes and 0:03:15.400 --> 0:03:18.359 my boy, oh, well, like he had his ear defenders 0:03:18.360 --> 0:03:21.440 on and so he was like, we were prepared like 0:03:21.560 --> 0:03:24.120 for this, We had snacks the whole shebang, like we 0:03:24.160 --> 0:03:29.160 were good. You know. Well he had this like panda 0:03:29.200 --> 0:03:33.080 with him as well, for like tactile comfort, and so 0:03:33.240 --> 0:03:37.800 like he's got this stuffy, plushy motherfucker and he's waving 0:03:37.840 --> 0:03:41.600 it like at the cast at the at the curtain call. 0:03:41.920 --> 0:03:43.640 It's a curtain call, I know. 0:03:43.600 --> 0:03:45.080 The bit where they all bow at the end, right, 0:03:45.680 --> 0:03:49.840 I don't know everything. And so he says that, you know, 0:03:49.960 --> 0:03:53.120 they were like waving back or looking at him and stuff, 0:03:53.120 --> 0:03:56.280 and I was like, I was too busy trying not 0:03:56.440 --> 0:03:57.280 to die from pain. 0:03:57.440 --> 0:03:58.760 But it was a really good Joe. 0:04:00.120 --> 0:04:01.640 I didn't know if I was gonna make it through 0:04:01.640 --> 0:04:05.840 the second half. I did and it was really really good. 0:04:06.160 --> 0:04:09.600 And also I should know the name of the actress 0:04:09.600 --> 0:04:12.600 who played Magara, but she may be the most beautiful 0:04:12.600 --> 0:04:17.360 woman I've ever seen in my life anyway, so oh yeah, 0:04:17.480 --> 0:04:22.320 So like, my boy was also convinced that like Givender 0:04:22.320 --> 0:04:25.839 going hm Hercules now that herk Dailey's and Meg like 0:04:25.920 --> 0:04:28.279 the actors were a real life boyfriend and girlfriend. But 0:04:28.320 --> 0:04:31.280 I'm like, that's acting, okay. 0:04:31.839 --> 0:04:32.240 But yeah. 0:04:33.000 --> 0:04:36.440 Also, his favorite character was Hades, because of course it 0:04:36.720 --> 0:04:41.920 was the boy watched Star Wars. I'm dressed as Kylo 0:04:42.000 --> 0:04:44.880 Wren for two halloweens in a row. Like for someone 0:04:44.960 --> 0:04:47.560 so full of empathy, he really does like a villain. 0:04:48.360 --> 0:04:52.760 And in fairness, his sister when she saw Capop Demon Hunters, 0:04:53.160 --> 0:04:55.680 she didn't want to be a demon hunter. She wanted 0:04:55.680 --> 0:05:00.520 to be a demon specifically, the demon version of baby Saja, 0:05:00.960 --> 0:05:04.400 not the K pop boy band Saja boy right no 0:05:04.400 --> 0:05:06.560 no no, no, no no. She wanted to be the 0:05:06.680 --> 0:05:10.880 demon version specifically. So I'm not entirely sure what that 0:05:10.920 --> 0:05:18.520 says about me as a parent. Finally, I got blocked 0:05:18.720 --> 0:05:23.039 news about me. This is what happened last night. I 0:05:23.240 --> 0:05:27.320 got blocked by Bernard the Elf on threads because I 0:05:27.440 --> 0:05:29.479 told him to be a big boy and deal with 0:05:29.480 --> 0:05:33.680 the consequences of his actions. But I know what you're thinking. 0:05:33.720 --> 0:05:38.320 You're thinking, Katie, please quidor jibber jabber in fact me, 0:05:39.560 --> 0:05:40.560 in fact you, I will. 0:05:40.600 --> 0:05:43.200 But first we've got to get. 0:05:43.040 --> 0:05:49.920 Our source on. Our sources are and the band played 0:05:49.960 --> 0:05:55.120 on on Politics. People and the AIDS Epidemic by Randy Schultz. 0:05:57.480 --> 0:05:59.080 Let the record show. 0:06:00.320 --> 0:06:03.440 History of Act Up New York nineteen eighty seven to 0:06:03.520 --> 0:06:08.640 nineteen ninety three by Sarah Schulman, The Life and Death 0:06:08.720 --> 0:06:15.120 of Ryan White by Paul m Renfro, Play Years, A 0:06:15.240 --> 0:06:19.000 Doctor's Journey through the AIDS Crisis by ross A Slottin. 0:06:20.720 --> 0:06:26.920 And of course we have articles from The New Yorker, 0:06:27.279 --> 0:06:30.839 the New York Times, we have the La Times. We 0:06:31.040 --> 0:06:38.880 have our old favorites, biography dot com and history dot com. 0:06:39.240 --> 0:06:39.520 Io. 0:06:39.680 --> 0:06:48.360 Sitting comfortably good, then let's begin. Those of us who 0:06:48.400 --> 0:06:51.719 are a little bit older will have at least some knowledge, 0:06:51.839 --> 0:06:56.799 if not a full recollection of the AIDS crisis. However, 0:06:57.000 --> 0:07:01.960 the way that we discuss history now this often gets 0:07:02.160 --> 0:07:04.960 I'm gonna say, side stepped, and so a lot of 0:07:05.000 --> 0:07:08.560 younger people tend to not know that much about the subject. 0:07:09.680 --> 0:07:13.000 And by that I mean when I mentioned the AIDS crisis, 0:07:13.080 --> 0:07:14.880 they look at me like a cow looks at an 0:07:14.920 --> 0:07:21.880 oncoming train. No, l like this is a part of 0:07:22.040 --> 0:07:27.920 history that changed the entire world. And that's not hyperbole. Now, 0:07:28.920 --> 0:07:32.160 just for clarification, I'm not gonna be able to cover 0:07:32.400 --> 0:07:34.880 every single thing here, So before anyone starts bumping their 0:07:34.920 --> 0:07:39.200 gums about well you forgot about no, I fucking didn't. 0:07:40.080 --> 0:07:42.160 I have a lot of information to provide and a 0:07:42.320 --> 0:07:45.960 finite time to say it. Okay, I am going to start, however, 0:07:46.720 --> 0:07:52.400 talking about EastEnders. Do Do Do Do Do, Do Do Doo. 0:07:54.200 --> 0:07:55.680 I was going to go into the theme song there, but 0:07:55.720 --> 0:07:57.440 I chose not to. You're welcome. I don't know if 0:07:57.480 --> 0:08:03.920 my throat could take it. So my first memory of 0:08:04.360 --> 0:08:08.360 any sort of understanding of AIDS was in the London 0:08:08.440 --> 0:08:13.320 based soap opera EastEnders on the BBC. This is where 0:08:13.320 --> 0:08:16.960 everyone founds out that longtime resident Mark Fowler was HIV 0:08:17.200 --> 0:08:23.600 positive and Peggy Mitchell, played by the legend Barbara Windsor, 0:08:24.480 --> 0:08:28.640 shouts like in the pub she's the landlady of the 0:08:28.640 --> 0:08:33.280 pub of the Queen Vic right, and there's this whole 0:08:33.320 --> 0:08:36.880 scene and I might not be getting this verbatim, by 0:08:36.920 --> 0:08:39.319 the way, but she just goes, why you don't get 0:08:39.360 --> 0:08:42.319 it at home with your family? Yes, I know that 0:08:42.520 --> 0:08:46.679 is a terrible impression of Barbara Windsor, but so she 0:08:47.520 --> 0:08:51.200 yells it all across the Queen vic Everyone goes silent, 0:08:51.280 --> 0:08:55.840 the glasses do that clinky chinky thing, and the camera 0:08:55.920 --> 0:08:59.040 pans on all these different faces who are just sort 0:08:59.080 --> 0:09:07.479 of judging and looking, and Mark proclaims that he contracted 0:09:07.480 --> 0:09:12.920 the infection from his wife, who dies or has died. 0:09:12.960 --> 0:09:17.480 At this point, I'm not entirely sure because this is 0:09:17.520 --> 0:09:22.840 all from memory. That being said, the character was a 0:09:22.880 --> 0:09:25.320 habitual drug user in his teens, and I think the 0:09:25.320 --> 0:09:28.040 whole point was that he didn't have an exact point 0:09:28.040 --> 0:09:30.880 of origin, which a lot of people don't, you know, 0:09:31.400 --> 0:09:35.520 And it was to show that so many different people 0:09:35.559 --> 0:09:42.400 from different walks of life contract HIV. So the Terence 0:09:42.480 --> 0:09:45.920 Higgins Trust, which is like the UK's leading HIV and 0:09:46.040 --> 0:09:49.960 AIDS charity, worked with the production team for the duration 0:09:50.120 --> 0:09:56.120 of Mark Fowler's story, which was thirteen years and the 0:09:56.160 --> 0:10:00.640 biggest peak in requests for HIV testing in Britain was 0:10:00.679 --> 0:10:04.960 seen in January nineteen ninety one when Mark Fowler was 0:10:05.040 --> 0:10:06.840 diagnosed HIV positive. 0:10:07.280 --> 0:10:11.640 Right, it was like a massive. 0:10:11.440 --> 0:10:16.760 Deal, right, So that's how I learned about it, And 0:10:16.840 --> 0:10:19.920 it was like a big talking point of sort of. 0:10:19.880 --> 0:10:21.480 TV history for years. 0:10:23.559 --> 0:10:30.440 So that being said, I'm gonna focus across the pond, 0:10:31.320 --> 0:10:33.960 and I'm going to talk about the AIDE crisis in 0:10:34.000 --> 0:10:39.719 the US, because the age crisis didn't just happen in America, right. 0:10:41.080 --> 0:10:45.400 The epidemic was enabled by a series of institutional failures 0:10:45.600 --> 0:10:51.440 gel surprise, numerous and I do mean numerous organizations. They 0:10:51.480 --> 0:10:55.319 were responsible for protecting public health and failed to carry 0:10:55.360 --> 0:11:00.000 out their duties effectively. Like they failed to do their job. 0:11:01.440 --> 0:11:07.320 As a result, countless people suffered unnecessarily, leaving a legacy 0:11:07.400 --> 0:11:12.880 of pain and loss that it continues to affect societies 0:11:12.920 --> 0:11:17.400 across the Western world decades later. And although I'm going 0:11:17.440 --> 0:11:21.280 to be focusing primarily on the AIDS crisis in the 0:11:21.400 --> 0:11:27.439 nineteen eighties in the US, well the story starts much earlier, 0:11:28.840 --> 0:11:33.720 thousands and thousands of miles away and earlier in time 0:11:34.640 --> 0:11:40.319 in Central Africa. See to understand the whole. Like where 0:11:40.320 --> 0:11:44.840 the disease started, it is necessary to understand and examine 0:11:45.040 --> 0:11:52.160 epidomology behind it. Now, scientists cannot be completely, one hundred 0:11:52.200 --> 0:11:57.400 absolutely certain about every single detail of HIV's emergence. The 0:11:57.440 --> 0:12:00.520 widely accepted consensus is that the virus cre lost from 0:12:00.600 --> 0:12:05.880 chimpanzees to humans during the period between the eighteen nineties 0:12:06.360 --> 0:12:11.360 and the nineteen twenties in what is now known as 0:12:11.440 --> 0:12:17.040 the Democratic Republic of Congo, which, yes, if you know 0:12:17.080 --> 0:12:22.640 your history, that timeframe is round about when King Leopold 0:12:22.720 --> 0:12:26.040 the Second of Belgium tyrannically ruled the Congo under the 0:12:26.080 --> 0:12:30.040 guise of aid and diplomacy that was in reality a 0:12:30.080 --> 0:12:36.240 reign of torture and terror. So back to chimpanzees, right, 0:12:36.960 --> 0:12:46.000 They carried a related virus known as SIV simean immunodeficiency virus, 0:12:46.600 --> 0:12:53.079 so contact between humans and infected animals happened, probably during 0:12:53.240 --> 0:12:58.440 hunting and the preparation of bush meat. After a while, 0:12:58.440 --> 0:13:02.480 the virus adapted to humans, eventually evolving into HIV, which 0:13:02.520 --> 0:13:10.120 is the virus responsible for it kills the praise men 0:13:10.200 --> 0:13:12.120 say an animal and does are gone to say whether 0:13:12.160 --> 0:13:15.120 they want to eat it or fuck it, and sometimes 0:13:15.120 --> 0:13:22.320 the choice isn't mutually exclusive. I swear like it's I 0:13:22.360 --> 0:13:25.960 feel like I should be surprised, or but I'm not 0:13:26.360 --> 0:13:31.120 because hunters are like, I'm gonna eat a monkey now, 0:13:31.200 --> 0:13:34.480 because bush meat is a weird term, it relates to 0:13:34.520 --> 0:13:38.040 a few animals, but especially to non human primates, which 0:13:38.080 --> 0:13:40.520 does feel like it is the closest thing one can 0:13:40.520 --> 0:13:46.120 get to cannibalism from a legal perspective, so they do believe. 0:13:46.160 --> 0:13:49.280 Typically it probably transferred to humans as a result or 0:13:49.440 --> 0:13:53.480 undercooked meat, or through like chimp blood getting into human 0:13:53.520 --> 0:13:59.400 cuts and winds, etc. Now, again, normally a hunter will 0:13:59.400 --> 0:14:04.560 be able to fight SIV. But virus is adapt That 0:14:04.720 --> 0:14:07.880 is why you have to get a different flu vaccine 0:14:07.920 --> 0:14:13.400 because there are different strains of viruses because they change. Okay, 0:14:14.320 --> 0:14:20.960 so yeah, viruses adapt, and this one adapted itself to 0:14:21.000 --> 0:14:25.320 the new host and became known as HIV so HIV 0:14:25.480 --> 0:14:32.280 one human immunodivision say virus. See there is another strain 0:14:32.360 --> 0:14:36.760 of that virus, HIV two. Now this is significantly less 0:14:36.760 --> 0:14:41.560 infectious and far less widespread than HIV one, which is 0:14:41.600 --> 0:14:43.920 why most people haven't heard of it or know that 0:14:43.960 --> 0:14:48.120 there are different strains see HIV two originated from a 0:14:48.320 --> 0:14:54.760 different primate species, the city Mangabey monkey rather than chimpanzees, 0:14:55.800 --> 0:14:59.240 and the jump to humans probably happened through much the 0:14:59.240 --> 0:15:04.240 same process HIV one, close contact with infected blood during 0:15:04.360 --> 0:15:12.000 hunting or butchering. Now, unlike HIV one, which would go 0:15:12.040 --> 0:15:14.680 on to conquer the globe with I'm going to say 0:15:14.760 --> 0:15:22.000 alarming efficiency, HIV two remained quite confined to several countries 0:15:22.040 --> 0:15:29.360 in West Africa. Like HIV one became a pandemic, and 0:15:29.680 --> 0:15:34.880 HIV two never really made out of the regional part. 0:15:36.600 --> 0:15:41.560 So the earliest confirmed case of HIV comes from a 0:15:41.560 --> 0:15:45.280 blood sample collected in nineteen fifty nine from a man 0:15:45.320 --> 0:15:48.520 living in what is now the Democratic Republic of Congo. 0:15:49.720 --> 0:15:53.280 At the time, nobody knew what they were looking for, 0:15:54.000 --> 0:15:57.400 and it was only decades later when scientists analyzed the 0:15:57.440 --> 0:16:01.800 preserved sample that the idea to find the HIV within it, 0:16:02.720 --> 0:16:08.240 making it the first very viable case on record. Now, 0:16:08.360 --> 0:16:12.480 I know that you know that this does not mean 0:16:12.520 --> 0:16:18.240 that HIV suddenly appeared in nineteen fifty nine, that no. 0:16:18.960 --> 0:16:24.320 See genetic analysis, yeah, we're doing science suggests that it 0:16:24.360 --> 0:16:29.440 had already been circulating amongst humans for decades by then, right, 0:16:30.400 --> 0:16:34.400 probably since the early twentieth century, like that turn of 0:16:34.400 --> 0:16:39.320 the century time. Now, the nineteen fifty nine sample is 0:16:39.520 --> 0:16:42.840 just the earliest surviving piece of evidence that we have 0:16:43.040 --> 0:16:47.960 managed to find. Like it's the confirmed case. It's not 0:16:48.160 --> 0:16:51.280 the patient zero, and we will be getting into patient 0:16:51.360 --> 0:16:59.360 zero later kind of. Soe now this is important, right, see, 0:16:59.360 --> 0:17:06.080 because this demolishes one of the most persistent misconceptions about 0:17:06.119 --> 0:17:10.960 AIDS that it somehow like popped up out of nowhere 0:17:11.040 --> 0:17:16.200 in nineteen eighties America. But by the time doctors in 0:17:16.280 --> 0:17:20.200 Los Angeles and New York began noticing clusters of unusual illnesses, 0:17:21.359 --> 0:17:27.320 HIV had already been silently spreading through human populations for generations. 0:17:27.800 --> 0:17:29.159 The virus was. 0:17:30.640 --> 0:17:34.320 Around for a while, it was all news, but humanity 0:17:35.400 --> 0:17:41.119 effectively was just late to the party. By nineteen eighty 0:17:41.320 --> 0:17:47.199 and nineteen eighty one, doctors in places like Los Angeles, 0:17:47.240 --> 0:17:52.640 San Francisco, and New York, et cetera, began noticing something. 0:17:53.840 --> 0:17:55.560 Very odd. 0:17:56.080 --> 0:18:00.800 Right, gay men who had previously been very very healthy, 0:18:00.920 --> 0:18:04.399 like they're young, they're healthy, they're strong, you know, suddenly 0:18:05.320 --> 0:18:10.280 they're developing diseases that most doctors really saw outside of 0:18:10.359 --> 0:18:17.440 patients with severely weakened immune systems, cases of Caposi circoma, 0:18:17.960 --> 0:18:22.399 a rare cancer that typically affected elderly men from the Mediterranean, 0:18:22.840 --> 0:18:27.320 old men in the Mediterranean and young men in San Francisco. 0:18:27.880 --> 0:18:33.239 Feels like a different demographic, but here we are. There 0:18:33.240 --> 0:18:39.920 were also things like pneumocyitis korenan pneumonia, which started appearing 0:18:40.040 --> 0:18:45.600 with I'm gonna say alarming frequency because these were illnesses 0:18:45.600 --> 0:18:49.119 that normally showed up in clusters amongst healthy people in 0:18:49.160 --> 0:18:55.720 their twenties and their thirties. They would leave purple spots 0:18:56.080 --> 0:18:59.439 on the skins of sufferers and it was one of 0:18:59.480 --> 0:19:03.880 the many illnesses that would become the mark of HIV. 0:19:06.600 --> 0:19:11.000 At first, nobody knew what was causing it. Doctors were 0:19:11.080 --> 0:19:17.480 seeing the symptoms, but the underlying diseases remained invisible. By 0:19:17.520 --> 0:19:20.600 the end of nineteen eighty one, roughly two hundred and 0:19:20.600 --> 0:19:23.800 seventy cases of these unusual illnesses had been reported to 0:19:23.840 --> 0:19:28.840 the United States, and the majority were amongst gay men. 0:19:29.440 --> 0:19:34.160 And what made the situation so scary was that these 0:19:34.200 --> 0:19:38.360 diseases were usually associated with people whose immune systems had 0:19:38.359 --> 0:19:44.359 already been compromised by conditions such as cancer, organ transplants 0:19:44.400 --> 0:19:50.359 severe infections. Even seeing them suddenly appear in otherwise healthy 0:19:50.400 --> 0:19:52.840 adults was like finding a smoke alarm going off in 0:19:52.960 --> 0:19:58.040 every room of the entire house and nobody could see 0:19:58.320 --> 0:20:02.840 the fire. Now today we know that that fire was HIV. 0:20:03.960 --> 0:20:08.399 At the time, however, researchers had no fucking clue what 0:20:08.440 --> 0:20:11.800 they were dealing with. They knew that something was destroying 0:20:11.800 --> 0:20:14.520 the immune systems of their patients, they just didn't know 0:20:14.560 --> 0:20:22.880 what the culprit was. Now this raises another question, how 0:20:22.920 --> 0:20:26.280 did HIV arrive in the United States in the first place. 0:20:28.640 --> 0:20:33.840 For many, many years, the blame was unfairly concentrated on 0:20:34.240 --> 0:20:38.920 a single man, creating one of the most enduring myths 0:20:39.280 --> 0:20:45.119 of the AIDS epidemic. This man was Getting Duga, a 0:20:45.119 --> 0:20:50.240 flight attendant from Quebec, Canada see now. Because his job 0:20:50.440 --> 0:20:55.159 involved constant international travel, and because he appeared in early 0:20:55.640 --> 0:21:01.240 epidemiological investigations, he was labeled by many people as patient zero, 0:21:01.960 --> 0:21:06.960 the supposed individual who brought HIV to America. It was 0:21:07.000 --> 0:21:10.399 a dramatic story, which is usually a warning sign that 0:21:10.440 --> 0:21:11.320 the story is. 0:21:11.320 --> 0:21:12.560 About to be wrong. 0:21:14.440 --> 0:21:20.080 Duga was openly gay, attractive, sociable. In part of the 0:21:20.119 --> 0:21:23.840 post sexul revolution culture that emerged in many North American 0:21:23.880 --> 0:21:28.840 cities during the seventies. He traveled frequently between metor urban centers, 0:21:28.880 --> 0:21:32.720 and naturally, because he was so charming and amazing, had 0:21:32.760 --> 0:21:37.959 a large social network. When investigators later mapped connections between 0:21:38.040 --> 0:21:43.879 early age cases, his name appeared repeatedly. Unfortunately, a misunderstanding 0:21:43.960 --> 0:21:47.680 turned him from a participant in a scientific study into 0:21:47.720 --> 0:21:51.679 a public villain. In the research notes, he had been 0:21:51.720 --> 0:21:58.560 identified as patient O, the O standing for outside California. 0:21:59.040 --> 0:22:01.520 Somewhere along the line, people read the letter OH as 0:22:01.520 --> 0:22:03.920 the number zero, and the myth was. 0:22:03.840 --> 0:22:08.200 Born like it is. 0:22:09.800 --> 0:22:18.159 Impressive and terrifying that humanity's ability to turn paperwork into conspiracy, 0:22:18.240 --> 0:22:22.480 Like it's his skill, and it really should never be underestimated, 0:22:22.600 --> 0:22:31.840 because people can craft bullshit from anything in reality. Later 0:22:31.920 --> 0:22:35.280 genetic studies showed that HIV was already circulating in the 0:22:35.400 --> 0:22:40.359 US before Douga even became ill. The virus had likely 0:22:40.520 --> 0:22:44.240 entered North America years earlier and was spreading through multiple 0:22:44.320 --> 0:22:49.280 networks long before anyone had heard the term AIDS. Douga 0:22:49.400 --> 0:22:53.120 was not the source of the epidemic. He was one 0:22:53.160 --> 0:22:58.440 of its victims. He was diagnosed with a Caposi circoma 0:22:58.560 --> 0:23:02.879 around nineteen eighty and eventually died from complications related to 0:23:02.960 --> 0:23:04.480 AIDS in nineteen eighty four. 0:23:07.520 --> 0:23:11.359 For decades, however, he. 0:23:11.280 --> 0:23:14.080 Carried the reputation of being the man who started the 0:23:14.119 --> 0:23:21.200 epidemic in America, a reputation that modern research has thoroughly discredited. 0:23:22.520 --> 0:23:27.639 Like he died of kidney failure as a result of 0:23:27.880 --> 0:23:34.040 AIDS related complications, he was a victim to a disease, 0:23:35.320 --> 0:23:39.600 and people pinned. They pinned the blame on him because 0:23:39.640 --> 0:23:42.960 they want to have someone to blame, and they want 0:23:43.000 --> 0:23:49.080 to have someone to attack. And the thing is, the 0:23:49.119 --> 0:23:52.800 real story is much less dramatic and far more troubling. 0:23:54.280 --> 0:23:58.560 HIV did not arrive because of one reckless individual. It 0:23:58.600 --> 0:24:03.440 spread quietly through human plant populations. For years, well medicine, 0:24:03.720 --> 0:24:07.640 public health systems, and government struggled to recognize what was happening. 0:24:08.800 --> 0:24:11.800 The epidemic was not the work of a single patient zero. 0:24:12.960 --> 0:24:14.920 It was the result of a virus that had been 0:24:14.960 --> 0:24:22.720 moving through communities long before anyone knew it existed. See 0:24:22.840 --> 0:24:27.399 In nineteen eighty two, Gaetan Duga was undergoing chemotherapy for 0:24:27.480 --> 0:24:30.480 cancer when he was interviewed by the CDC, which is 0:24:30.520 --> 0:24:34.480 the US Center for Disease Control and Prevention. They asked 0:24:34.560 --> 0:24:38.199 him questions about his sexual activity, and the CDC at 0:24:38.200 --> 0:24:42.159 this point started making the connection between HIV AIDS and 0:24:42.440 --> 0:24:49.240 sexual activity, like they realized it was a sexually transmitted infection. 0:24:50.320 --> 0:24:53.880 And Douga, he is doing his best to provide all 0:24:53.920 --> 0:24:57.760 of the information in this study. He wants to help, 0:24:58.200 --> 0:25:01.399 and he is being honest, and he he estimates that 0:25:01.440 --> 0:25:04.800 he'd had some seven hundred and fifty partners in the 0:25:04.840 --> 0:25:09.040 previous few years. And so the CDC gets a list 0:25:09.080 --> 0:25:12.280 of contacts from his address book because that's a thing 0:25:12.359 --> 0:25:17.720 people had, and he ends up becoming patient fifty seven. 0:25:18.560 --> 0:25:25.879 The CDC right, fifty seven, not zero, And on the 0:25:25.920 --> 0:25:30.479 thirtieth of March nineteen eighty four he died of kidney failure. 0:25:33.600 --> 0:25:36.119 And of course there was no singular moment when the 0:25:36.119 --> 0:25:40.760 truth suddenly became clear. The CDC initially tried to correct 0:25:40.760 --> 0:25:44.359 the emerging narrative, emphasizing that Gates and Duga was not 0:25:44.560 --> 0:25:47.840 the origin of the outbreak, but by then the media 0:25:47.920 --> 0:25:52.320 had already found its villain and dug its claws in 0:25:53.480 --> 0:25:58.520 and public perception is rarely corrected after it has been created, 0:25:58.600 --> 0:26:03.640 especially not as quickly the idea of patient zero had 0:26:03.680 --> 0:26:09.119 taken hold and du Gad had it. 0:26:09.359 --> 0:26:11.560 He was the blame game. That was that. 0:26:12.920 --> 0:26:18.640 It would take decades before this false narrative was properly dismantled. 0:26:20.480 --> 0:26:26.119 Like by twenty sixteen, genetic and epidemiological research had confirmed 0:26:26.160 --> 0:26:30.600 beyond reasonable doubt that Gates and Duga had not introduced 0:26:30.760 --> 0:26:35.320 HIV AIDS to North America, and that it had been 0:26:35.359 --> 0:26:41.480 present in the US long before he was ever diagnosed. Basically, 0:26:41.600 --> 0:26:46.160 patient zero was never a starting point, but just an 0:26:46.200 --> 0:26:53.760 early case that was misread, misleveled, and mythologized. And yet 0:26:53.800 --> 0:26:58.600 the myth stuck because it was simpler and more convenient 0:26:59.119 --> 0:27:05.520 than reality. By the early nineteen eighties, scientists were beginning 0:27:05.560 --> 0:27:11.000 to connect a series of otherwise unrelated clinical reports clusters 0:27:11.040 --> 0:27:15.720 of rare illnesses appearing in young, otherwise healthy men, primarily 0:27:15.960 --> 0:27:21.200 in these big cities. Okay, they fairly noticed, Oh it's 0:27:21.240 --> 0:27:24.119 happening over there and over there and over there. And 0:27:24.280 --> 0:27:26.840 at that time the condition did not have a name. 0:27:26.880 --> 0:27:30.200 There was no HIV and no AIDS in public language, 0:27:31.119 --> 0:27:38.600 only this growing awareness that something unusual was happening. Now, 0:27:39.760 --> 0:27:43.920 the thing about HIV is like people might know the name, 0:27:44.040 --> 0:27:49.840 but they don't really know anything about it. In most cases, 0:27:50.119 --> 0:27:55.479 infection begins with a short fluw like illness, occurring two 0:27:55.520 --> 0:28:01.240 to six weeks after exposure. Symptoms can include fittigue, favor, 0:28:01.560 --> 0:28:06.679 sore throat, and sometimes a rash. After this brief initial phase, 0:28:06.680 --> 0:28:14.160 symptoms typically disappear. They go dormant, sometimes for years. This 0:28:14.480 --> 0:28:18.720 is the clinical latency stage, during which a person may 0:28:18.720 --> 0:28:22.879 feel entirely healthy while the virus continues to replicate and 0:28:22.960 --> 0:28:28.840 remain transmissible. The reason the HIV is so effective as 0:28:28.880 --> 0:28:35.920 a pathogen is precisely this and is this long dormant period. 0:28:37.040 --> 0:28:41.760 During latency, the virus targets CD four T cells, which 0:28:41.800 --> 0:28:45.440 are key components of the immune system responsible for coordinating 0:28:45.480 --> 0:28:51.400 the body's respond to infection. As CD four counts gradually decline, 0:28:51.760 --> 0:28:56.320 the immune system becomes weaker, leaving the body vulnerable to 0:28:56.360 --> 0:29:02.440 infections it would normally suppress without any difficulty. AIDS or 0:29:02.640 --> 0:29:08.280 Acquired immune deficiency syndrome refers to the most advanced stage 0:29:08.480 --> 0:29:13.480 of the HIV infection. It is diagnosed when CD four 0:29:13.640 --> 0:29:16.840 T cell levels fall below two hundred cells per of 0:29:16.920 --> 0:29:22.960 cubic millimeter of blood or when specific opportunistic infections appear, 0:29:23.040 --> 0:29:31.720 regardless of count. These infections can include neumocitis, pneumonia, toxoplasmosis, 0:29:33.160 --> 0:29:41.480 candidy isis right, candidy isis thrush okay, and certain cancers 0:29:41.760 --> 0:29:46.920 such as caposis or coma, which we mentioned earlier. Basically, 0:29:47.120 --> 0:29:51.360 the immune system becomes so depleted that even minor pathogens 0:29:51.400 --> 0:29:57.720 can become life threatening. One commonly repeated line puts it bluntly. 0:29:59.040 --> 0:30:01.959 You do not die from A itself, but from the 0:30:02.000 --> 0:30:06.479 infections your immune system can no longer control. It is 0:30:06.520 --> 0:30:12.480 an accurate simplification, it is not a comforting one. Today 0:30:13.840 --> 0:30:20.480 HIV is a manageable chronic condition thanks to anti retroviral therapy, 0:30:21.520 --> 0:30:23.760 But in the early eighties there was no treatment, no 0:30:23.920 --> 0:30:26.760 established name for the syndrome, and no clear understanding of 0:30:26.840 --> 0:30:32.680 what was causing it. For those first recognized patients, infection 0:30:33.080 --> 0:30:40.480 was effectively a death sentence. When I was in Toronto, 0:30:40.960 --> 0:30:45.960 we ended up over in I don't know the probably 0:30:46.120 --> 0:30:50.880 Toronto's version of the West Village, and we were in 0:30:50.920 --> 0:30:55.080 this park and they had this monument with all of 0:30:55.080 --> 0:30:57.040 these names on it. It was these sort of pillars 0:30:57.040 --> 0:31:02.040 like one after the other, and it was all members 0:31:02.600 --> 0:31:09.640 of the gay community who had succumbed to HIV and AIDS, 0:31:10.080 --> 0:31:14.040 and some of the pillars at the end were blank 0:31:14.080 --> 0:31:14.920 because they knew there. 0:31:14.840 --> 0:31:21.080 Was more to come. And I stopped. I read all 0:31:21.120 --> 0:31:26.000 the names because history doesn't mean anything without people. 0:31:28.280 --> 0:31:29.120 This is a sidebar. 0:31:29.280 --> 0:31:30.520 Sorry, and. 0:31:31.840 --> 0:31:33.640 I have to I don't know. It's a thing. 0:31:34.640 --> 0:31:42.560 We have an interesting relationship with death in Ireland. We 0:31:42.640 --> 0:31:44.600 respect the dead, we revere the dead, but we were 0:31:44.600 --> 0:31:52.560 also honest about the dead, and so honestly, so many 0:31:52.600 --> 0:32:00.240 people and the first three four rows of those pillars, 0:32:01.040 --> 0:32:08.040 they were let down by society. They were accused and 0:32:08.240 --> 0:32:12.600 blamed as if there was something wrong with them for 0:32:12.720 --> 0:32:19.440 them getting ill. They were the less dead, and it 0:32:19.480 --> 0:32:21.960 was their community that continued to support them through this. 0:32:24.560 --> 0:32:30.240 And they deserve to be remembered. They deserve to be considered, 0:32:33.040 --> 0:32:37.640 and they deserve for you to stop and give them 0:32:37.680 --> 0:32:45.840 a moment of your time when you see their names. 0:32:46.160 --> 0:32:49.520 The first widely cited report appeared in June nineteen eighty 0:32:49.520 --> 0:32:55.920 one in the CDC's Morbidity and Mortality Weekly Report. It 0:32:56.040 --> 0:33:00.640 described five young men in Los Angeles diagnosed with neuroscida pneumonia. 0:33:01.720 --> 0:33:05.600 Two of hume who had already died, all were men 0:33:05.720 --> 0:33:09.880 who had sex with men, and all showed severely depleted 0:33:09.880 --> 0:33:14.240 immune function. It was the first official signal that something 0:33:14.320 --> 0:33:18.600 new and series was emerging, even if no one yet 0:33:18.680 --> 0:33:20.000 had the language. 0:33:19.560 --> 0:33:20.520 To describe it. 0:33:21.440 --> 0:33:27.160 A second report published in July nineteen ninety one, documented 0:33:27.280 --> 0:33:32.320 twenty six additional cases, again predominantly amongst gay men, with 0:33:32.440 --> 0:33:37.320 patients presenting with neumrocidas, pneumonia, and composi sir coma. Over 0:33:37.360 --> 0:33:39.800 the following years, it became increasingly clear that these were 0:33:39.880 --> 0:33:44.560 not isolated anomalies, but part of a growing epidemic. Hospitals 0:33:44.560 --> 0:33:49.720 across the United States began reporting similar cases with disturbing consistency, 0:33:49.880 --> 0:33:52.720 even though the condition itself still had no official name. 0:33:54.800 --> 0:33:57.360 In the early stages, the syndrome was referred to in 0:33:57.360 --> 0:34:02.240 some media and informal discussions as grid grid gay related 0:34:02.240 --> 0:34:07.000 immune deficiency. The term very briefly appeared in public discourse, 0:34:07.000 --> 0:34:10.560 including a nineteen eighty two New York Times article. However, 0:34:10.640 --> 0:34:15.400 it was never adopted into scientific literature. It quickly became 0:34:15.440 --> 0:34:18.880 clear that the name was both misleading and scientifically unsound. 0:34:20.239 --> 0:34:24.600 More importantly, it reinforced the dangerous assumption that the disease 0:34:24.719 --> 0:34:29.840 was confined to gay men. At the time, there was 0:34:29.920 --> 0:34:34.719 a widespread and deeply damaging misconception that this was a 0:34:34.960 --> 0:34:39.600 gay disease or even moral judgment expressed in biological form. 0:34:40.000 --> 0:34:45.120 Now I say misconception, its actual downright bullshit. 0:34:47.200 --> 0:34:48.560 See. 0:34:48.760 --> 0:34:53.839 Some narratives went even further, framing the illness is some 0:34:54.000 --> 0:34:58.560 kind of punishment. Now, I know you're surprised, but none 0:34:58.600 --> 0:35:02.440 of this had any scientific basis, but it reflected the 0:35:02.480 --> 0:35:06.520 social climate of the early nineteen eighties, when stigma, shock, 0:35:06.600 --> 0:35:11.960 and lay traveled faster than evidence. As surveillance expanded, it 0:35:12.000 --> 0:35:15.279 became obvious that the pattern did not fit those assumptions. 0:35:16.800 --> 0:35:21.160 Cases began to appear in other populations, including hemophiliacs who 0:35:21.160 --> 0:35:25.640 were infected through contaminated blood products, and hyacian patients who 0:35:25.680 --> 0:35:30.640 were unfairly and baselessly stigmatized in early reporting. In nineteen 0:35:30.680 --> 0:35:33.680 eighty three, the CDC outlined what became as the four 0:35:34.040 --> 0:35:43.239 H risk groups homosexuals, heroin users, hemophiliacs, and hyacians. While 0:35:43.320 --> 0:35:51.080 intended as early epidemological shorthand, the classification had serious unintended consequences. 0:35:52.680 --> 0:35:56.320 It reinforced the false impression that the HIV was confined 0:35:56.360 --> 0:36:02.080 to specific marginalized groups. In reality, these categories reflected patterns 0:36:02.080 --> 0:36:07.640 of early detection and transmission routes, not exclusivity. The virus 0:36:07.680 --> 0:36:13.319 itself did not respect identity labels or social boundaries. The 0:36:13.400 --> 0:36:19.440 consequences were severe. Heighten communities faced discrimination and job loss. 0:36:20.040 --> 0:36:22.760 Gay men were further stigmatized at a time when stigma 0:36:22.800 --> 0:36:26.560 had already shaped nearly every aspect of public and private life, 0:36:27.640 --> 0:36:32.320 and perhaps most critically, many outside these labeled groups concluded 0:36:32.360 --> 0:36:40.840 incorrectly that they were not at risk. That misunderstanding allowed 0:36:40.840 --> 0:36:45.520 the virus to spread more widely because public awareness did 0:36:45.560 --> 0:36:51.960 not catch up with reality as quickly as it should. HIV, 0:36:52.080 --> 0:36:54.840 as it turned out, did not belong to any group. 0:36:55.480 --> 0:37:00.400 I belonged to biology. The term AIDS came in wider 0:37:00.480 --> 0:37:05.319 use around late eighty two, when the CDC adopted it 0:37:05.360 --> 0:37:08.360 to describe the growing syndrome, a severe immunal deficiency that 0:37:08.480 --> 0:37:15.120 was being observed across multiple patient groups. Described the outcome 0:37:15.280 --> 0:37:22.960 rather than the cause, but this stage the cause was 0:37:23.040 --> 0:37:27.600 still unknown. The breakthrough began to emerge in eighty three, 0:37:27.640 --> 0:37:32.160 when research teams in Europe and the US identified independently 0:37:32.800 --> 0:37:37.759 a retrovirus associated with the condition. In Paris, doctor Luke 0:37:37.840 --> 0:37:41.240 Montaigne and his team at the Pastio Institute investigated samples 0:37:41.280 --> 0:37:45.080 from patients in early stages of EIDs, which was then 0:37:45.120 --> 0:37:52.160 sometimes referred to as pre AIDS or arc AIDS related complex. 0:37:53.440 --> 0:37:56.440 From these samples, they isolated a retrovirus which showed a 0:37:56.480 --> 0:38:01.399 clear preference for infecting T cells, but particularly the CED 0:38:01.520 --> 0:38:10.440 four limphocytes. The virus was initially named LAV limphandenopathy associated virus. 0:38:10.560 --> 0:38:14.200 Although will its role in causing AIDS is not fully established, 0:38:14.200 --> 0:38:17.280 it was still a strong candidate for the underlying agent. 0:38:18.640 --> 0:38:21.759 Their findings were published in Science in May eighty three, 0:38:21.840 --> 0:38:25.279 although at the time the significance of this discovery was 0:38:25.320 --> 0:38:30.440 not universally recognized and like around the same period, the 0:38:30.480 --> 0:38:34.719 American researcher doctor Robert Gio and his team were conducting 0:38:34.760 --> 0:38:40.040 similar investigations, so he identified Gio did what he called 0:38:40.520 --> 0:38:47.360 HTLV three Human talum potropic virus type three, a retrovirus 0:38:47.400 --> 0:38:50.480 found in a significant proportion of patients with AIDS or 0:38:51.000 --> 0:38:55.600 early immune dificiency symptoms. His work, also published in Science 0:38:55.600 --> 0:38:59.759 in eighty four, strengthened the growing consensus that a retroviral 0:38:59.800 --> 0:39:06.320 AID was responsible for a time, the scientific community faced 0:39:06.320 --> 0:39:10.640 an uncomfortable overlap, two different names, two research groups, and 0:39:10.760 --> 0:39:14.279 what appeared to be the same virus. It would later 0:39:14.320 --> 0:39:17.760 be confirmed that LAV and HDLV three were in fact 0:39:18.719 --> 0:39:25.080 the same virus, now known universally as HIV human immuno 0:39:25.120 --> 0:39:32.239 deficiency virus. In hindsight, this moment marked the transition from 0:39:32.280 --> 0:39:37.400 speculation to identification. Now the disease still had no cure 0:39:37.480 --> 0:39:42.680 and treatment options were practically non existent, but the scientific 0:39:42.719 --> 0:39:47.239 world had finally isolated the agent responsible. What remained was 0:39:47.280 --> 0:39:50.880 the far harder task catching up with a virus that 0:39:50.880 --> 0:39:58.520 had already been circulating silently four years. Basically, the French 0:39:58.560 --> 0:40:01.040 and American teams had isolated the same virus, and they 0:40:01.040 --> 0:40:03.879 both wanted credit for discovering the virus that they both had. 0:40:05.880 --> 0:40:09.640 Now this leads to a scientific dispute that was as 0:40:09.719 --> 0:40:12.279 much about priority as it was discovery. 0:40:13.400 --> 0:40:16.040 Right So, America. 0:40:15.600 --> 0:40:18.240 Argued that their team had demonstrated not only the presence 0:40:18.320 --> 0:40:21.560 of the virus but its causal role in aids. The 0:40:21.640 --> 0:40:25.800 Montaigne group, however, pointed out a more cautious phrasing in 0:40:25.840 --> 0:40:30.359 their original paper the role of the virus and causing aids. 0:40:30.360 --> 0:40:36.200 They noted remained to be fully established. Basically, one side 0:40:36.320 --> 0:40:38.759 framed the virus as the confirmed cause and the other 0:40:38.960 --> 0:40:44.320 explicitly left the question open. This dispute did not entirely 0:40:44.320 --> 0:40:50.000 fade away. Questions of attribution, research ethics, and priority continued 0:40:50.080 --> 0:40:53.840 four years, reflecting how high the stakes had become in 0:40:53.880 --> 0:40:58.560 the race to understand the epidemic. Like Eventually, they're both 0:40:58.600 --> 0:41:02.600 recognized for their contributions, though in different ways, with the 0:41:02.640 --> 0:41:06.319 scientific consensus acknowledging that each had played a significant role 0:41:06.480 --> 0:41:12.919 in identifying and characterizing the virus. In two thousand and eight, 0:41:13.880 --> 0:41:18.840 Luke Montaigne, alongside Francois Bersinouci, was awarded the Nobel Prize 0:41:18.840 --> 0:41:23.600 in Physiology or Medicine for the discovery of HIV. Doctor 0:41:23.680 --> 0:41:27.160 Gaio notably was not included in the prize, a decision 0:41:27.200 --> 0:41:30.960 that reignited discussion about how scientific credit is assigned in 0:41:31.040 --> 0:41:33.719 collaborative and competitive research environments. 0:41:34.719 --> 0:41:36.200 But that's another story for another day. 0:41:38.360 --> 0:41:45.840 Basically, discovery wasn't like one single moment, but a contested 0:41:45.960 --> 0:41:52.200 process unfolding under immense pressure. While scientists debated naming rights 0:41:52.239 --> 0:41:58.960 and priority, the virus itself continued its work uninterrupted, spreading 0:41:58.960 --> 0:42:03.480 through populations far faster than the politics of recognition could 0:42:03.520 --> 0:42:07.680 keep up. How had HIV spread so quickly and why 0:42:07.800 --> 0:42:12.239 was it so focused within gay communities. Well, part of 0:42:12.280 --> 0:42:16.239 the problem was the sexual revolution of the nineteen seventies. 0:42:17.400 --> 0:42:22.200 So behavior and sexuality and relationships had been changing right. 0:42:22.800 --> 0:42:27.120 Casual sex outside traditional monogamous relationships was becoming more accepted, 0:42:27.200 --> 0:42:29.120 and sex was spoken about in a way that it 0:42:29.200 --> 0:42:34.480 had never been before. In terms of both hetero and homosexuality. 0:42:35.520 --> 0:42:39.280 It became normal ish to have more than one sexual partner. 0:42:40.560 --> 0:42:44.000 And the eighties came a decade after the Stonewall Riots, 0:42:44.040 --> 0:42:50.480 which changed the attitudes of LGBTQ plus people nationwide. Pre Stonewall, 0:42:51.160 --> 0:42:53.560 much of the gay life in the United States operated 0:42:53.640 --> 0:42:56.800 under enforced and visibility. Part of this as a result 0:42:56.800 --> 0:42:59.520 of mcartheism, I say, part of quite a lot of 0:42:59.560 --> 0:43:03.680 this because of McCarthyism, Like probably most of that is 0:43:03.680 --> 0:43:09.040 because of McCarthyism. So for many people, homosexuality was something 0:43:09.080 --> 0:43:14.560 to conceal rather than express openly. Marriage to opposite sex partners, 0:43:15.520 --> 0:43:18.880 long term secrecy and what was politely called double lives 0:43:19.320 --> 0:43:22.279 were of common survival strategies in a society that was 0:43:22.320 --> 0:43:27.840 to put it mildly, not particularly welcomed. After a stonewall 0:43:27.880 --> 0:43:33.400 in nineteen sixty nine, the dynamics shifted dramatically. Queer communities 0:43:33.440 --> 0:43:38.520 became more visible, politically active, and socially organized. Pride marches 0:43:38.600 --> 0:43:41.359 replaced silence with public pressure, and in cities like San 0:43:41.400 --> 0:43:46.440 Francisco and New York, gay culture developed visible neighborhoods, social venues, 0:43:46.440 --> 0:43:50.879 and community institutions. People were no longer just surviving. They 0:43:50.920 --> 0:43:57.839 were increasingly living openly, and this visibility marroed socially and politically, 0:43:58.280 --> 0:44:05.640 and it also meant like something less poetic. Epidemiologically, sexual 0:44:05.680 --> 0:44:09.480 networks became easier to form, more interconnected, and more visible 0:44:09.520 --> 0:44:13.239 to both community researchers and later public health officials. Not 0:44:13.360 --> 0:44:18.160 uniquely so, heterosexual populations also experienced changing norms in the 0:44:18.200 --> 0:44:23.000 same era, but in certain urban gay mail networks, partner 0:44:23.080 --> 0:44:26.840 change rates were higher on average, particularly in specific social 0:44:26.880 --> 0:44:31.719 settings like bars and bathhouses. Right. This is again just 0:44:31.719 --> 0:44:36.360 a structural observation, although people try to turn this into 0:44:36.400 --> 0:44:42.200 a moral judgment, and this is where the bollocks comes in. Right. So, 0:44:43.640 --> 0:44:48.520 there was this massive wave of disinformation basically trying to 0:44:48.600 --> 0:44:55.080 state that HIV could be transmitted casually through shared food, 0:44:55.320 --> 0:45:02.760 through kissing, by using the same toilet, or sweating coughing. 0:45:02.800 --> 0:45:09.319 Even I need this to be clear, it cannot. Transmission 0:45:09.360 --> 0:45:17.640 requires specific bodily fluids, blood, semen, vaginal fluids, rectal fluids, 0:45:17.640 --> 0:45:21.680 and breast milk. In other words, it is not a 0:45:21.880 --> 0:45:27.480 socially contagious virus. It is a biologically specific one. You 0:45:27.560 --> 0:45:32.760 don't need to be bleaching all your doorknobs. The actual 0:45:32.800 --> 0:45:36.160 roots of transmission matter because HIVA is not equally efficient 0:45:36.239 --> 0:45:40.040 in all contexts. One of the highest risk forms of 0:45:40.080 --> 0:45:44.759 sexual transmission is receptive anal intercourse, and this is due 0:45:44.800 --> 0:45:48.720 to anatomy. The rectal lining is thinner and more prone 0:45:48.760 --> 0:45:54.080 to microtears than vaginal tissue, providing easier access to the bloodstream. 0:45:54.480 --> 0:45:58.240 Estimates vary by studying conditions, but the risk per single 0:45:58.320 --> 0:46:03.080 act of unprotected receptor of anal sex is significantly higher. 0:46:03.920 --> 0:46:07.120 Oftenside is roughly an order of magnitude greater than unprotected 0:46:07.160 --> 0:46:14.920 receptive vaginal intercourse. Now basically, bum tissue tears easier. Like, 0:46:15.000 --> 0:46:22.759 that's it, there's an easier access rooted now. Condoms did 0:46:22.760 --> 0:46:26.040 exist by the late seventies and early eighties, but widespread 0:46:26.160 --> 0:46:30.719 explicit saper sex education tailored to HIV did not yet 0:46:30.920 --> 0:46:35.279 exist because the virus itself had not been identified. In 0:46:35.320 --> 0:46:38.760 the earliest years of the epidemic, people were effectively trying 0:46:38.760 --> 0:46:41.240 to avoid a pathogen that they did not know existed, 0:46:41.920 --> 0:46:45.680 using tools designed for pregnancy prevention and other known sexually 0:46:45.680 --> 0:46:51.480 transmitted infections. Now there's a mismatch right there. As for 0:46:51.560 --> 0:46:54.359 the spread in places like New York and San Francisco, 0:46:54.880 --> 0:46:59.200 it reflected a combination of dense social networks, high mobility, 0:46:59.640 --> 0:47:02.920 delay to medical recognition, and a virus that can remain 0:47:03.280 --> 0:47:09.600 asymptomatic four years as well still being transmissible like that. 0:47:09.600 --> 0:47:13.560 That's the important part. HIV does not announce itself immediately, 0:47:13.600 --> 0:47:17.160 which meant and had already spread wildly before anyone realized 0:47:17.200 --> 0:47:20.360 there was a pattern at all. By the time the 0:47:20.360 --> 0:47:23.400 pattern became visible, the virus had a head start measured 0:47:23.480 --> 0:47:28.279 in years, not months, and at that point public health 0:47:28.320 --> 0:47:31.319 was not dealing with the beginning of an outbreak. It 0:47:31.360 --> 0:47:33.719 was dealing with the middle of one that it had discovered. 0:47:35.560 --> 0:47:39.120 There were more bathhouses, gay bars, clubs, and in certain cities, 0:47:39.160 --> 0:47:42.800 a growing sense that being openly gay was at least possible, 0:47:42.880 --> 0:47:49.240 if not universally safe. That visibility translated into denser sexual 0:47:49.239 --> 0:47:54.880 networks and more opportunities for transmission. At the same time, 0:47:55.000 --> 0:47:57.040 the United States was also in the middle of a 0:47:57.239 --> 0:48:02.000 major intravenous drug crisis, which provided another efficient route for 0:48:02.200 --> 0:48:03.720 HIV spread through needles. 0:48:04.080 --> 0:48:05.720 They shared needles. 0:48:06.480 --> 0:48:10.120 By nineteen eighty five, the contrast and outcomes was already stark. 0:48:11.239 --> 0:48:14.360 Germany had recorded roughly one hundred and seventy AGS related 0:48:14.360 --> 0:48:17.640 to deaths at this point, and the United States was 0:48:17.680 --> 0:48:22.839 already approaching seven thousand. And that's the ones that were 0:48:22.880 --> 0:48:28.480 registered now. Population size explains like part of the gap, 0:48:28.680 --> 0:48:33.279 but not all of it, and certainly not neatly, And 0:48:33.360 --> 0:48:44.080 what filled the remaining space was stigma, confusion, and delay. 0:48:45.239 --> 0:48:49.800 In the early years, HIV AIDS was wildly and incorrectly 0:48:50.120 --> 0:48:54.760 labeled the gay plague, a term enthusiastically amplified by parts 0:48:54.760 --> 0:48:57.720 of the media and eagerly adopted by those already inclined 0:48:57.719 --> 0:49:02.360 to see homosexuality as DV. For some religious groups, the 0:49:02.360 --> 0:49:05.960 epidemic was framed less as a public health crisis and 0:49:06.120 --> 0:49:10.480 more as moral accounting punishment delivered by biology. 0:49:10.040 --> 0:49:11.320 On behalf of God. 0:49:12.480 --> 0:49:15.279 The arrival of intravenous drug users, and other groups. As 0:49:15.360 --> 0:49:19.640 recognized risk categories did little to soften this narrative. It 0:49:19.880 --> 0:49:22.680 just expanded the list of people. Some were comfortable blaming 0:49:25.719 --> 0:49:34.880 reality as usual refused to cooperate with moral storytelling. Invints 0:49:34.880 --> 0:49:37.799 acquired it from mother to child, transmission during pregnancy, birth, 0:49:37.880 --> 0:49:42.360 or breastfeeding. Heterosexual men and women were infected through sexual contact. 0:49:43.320 --> 0:49:49.160 Hemophilac contracted HIV through contaminated blood products. HIV did not 0:49:49.239 --> 0:49:56.600 require identity. It required exposure rich or poor, men or women, 0:49:56.960 --> 0:50:00.759 straight or gay, young or old, black or white. The 0:50:00.920 --> 0:50:07.040 virus did not read the cultural commentary. But fear doesn't 0:50:07.080 --> 0:50:10.720 behave rationally, as we've seen with every other fucking moral 0:50:10.760 --> 0:50:16.000 panic in existence. When people do not understand a disease, 0:50:16.360 --> 0:50:20.520 they tend to overgeneralize it, and when they overgeneralize it, 0:50:20.719 --> 0:50:24.520 they tend to locate it in other people. The social 0:50:24.560 --> 0:50:28.280 reflex built a wall between effected communities and the wider public. 0:50:28.880 --> 0:50:34.480 Part protection, part panic, part avoidance, and the consequences they 0:50:34.520 --> 0:50:39.040 will not abstract. In the eighties, and a's diagnosis often 0:50:39.080 --> 0:50:44.120 meant immediate social exile alongside medical crisis. Many people lost 0:50:44.160 --> 0:50:46.960 their jobs once their status became known, which meant a 0:50:46.960 --> 0:50:50.759 loss of income, insurance, and access to a care in 0:50:50.840 --> 0:50:56.000 a system already struggling to respond. Public fear translated into 0:50:56.040 --> 0:51:00.120 real world avoidance. People were austracized not because of what 0:51:00.239 --> 0:51:04.919 HIV could casually do, but because of what people incorrectly 0:51:04.960 --> 0:51:08.880 believed it could do casually, And that belief that it 0:51:08.920 --> 0:51:14.360 could be transmitted to everyday contact persisted four years despite 0:51:14.400 --> 0:51:18.680 no scientific evidence supporting it. And this is like a 0:51:18.719 --> 0:51:24.520 feedback loop. Fear produced misinformation. Misinformation reinforced stigma and stigma 0:51:24.600 --> 0:51:28.600 discourage testing and treatment, and even today, echoes of that 0:51:28.640 --> 0:51:34.839 period remain. Studies have shown that men who have sex 0:51:34.840 --> 0:51:37.759 with men can experience higher levels of depression, anxiety, and 0:51:37.800 --> 0:51:43.120 substance use in context where stigma is severe, along with 0:51:43.239 --> 0:51:49.160 reduced engagement in healthcare services. Right, it is the stigma. 0:51:49.360 --> 0:51:54.040 The stigma is an underlying factor in all this. It 0:51:54.239 --> 0:52:07.120 breeds and compresses the broader lesson is uncomfortable but consistent. 0:52:08.520 --> 0:52:11.000 HIV spread faster, and not because of who people were, 0:52:12.080 --> 0:52:15.280 but because of what they did not know and society 0:52:15.360 --> 0:52:19.720 refused to understand in time because fear filled the information gap. 0:52:21.960 --> 0:52:26.120 Oh and doesn't sound familiar at all and where fair leads, 0:52:26.400 --> 0:52:31.239 clarity tends to arrive late, if at all. And I'm 0:52:31.280 --> 0:52:33.799 gonna talk about Princess Diana for a second. Even though 0:52:33.880 --> 0:52:37.120 you all know my feeling's honor right, brown clock can 0:52:37.200 --> 0:52:41.319 still be right twice a day. In nineteen ninety one, 0:52:41.719 --> 0:52:46.160 Princess Diana made one of the most iconic public gestures 0:52:46.239 --> 0:52:49.360 of the early AIDS era when she visited the newly 0:52:49.400 --> 0:52:53.640 opened HIV AIDS ward at London's Middlesex Hospital and shook 0:52:53.680 --> 0:52:57.960 hands with a patient without wearing gloves. Now, remember, people 0:52:57.960 --> 0:53:04.200 still thought this could be spread casually. It can't, and 0:53:04.600 --> 0:53:09.040 Diana was already like properly briefed on transmission routes. So 0:53:09.080 --> 0:53:12.439 this was an ignorance. This was deliberate right. She knew 0:53:12.440 --> 0:53:14.720 that she was safe, she knew she had notting to lose. 0:53:15.400 --> 0:53:18.000 The only thing she could do is be seen as 0:53:18.040 --> 0:53:22.680 a good person for doing this. So a very simple act, 0:53:23.200 --> 0:53:25.560 but a very public correction of a persistent myth in 0:53:25.600 --> 0:53:28.480 an era where people with AIDS were still often avoided. 0:53:29.200 --> 0:53:31.680 It did real cultural works, and. 0:53:31.680 --> 0:53:35.359 She had her continued advocacy through HIV charities, helping sheft 0:53:35.360 --> 0:53:38.080 public attitudes in the UK. Even if her role like 0:53:38.120 --> 0:53:41.680 most public figures, was a mix of genuine engagement and 0:53:41.880 --> 0:53:48.200 careful visibility. Now, the reality for people with AIDS in 0:53:48.239 --> 0:53:51.520 the nineteen eighties and early nineties was not just medical, 0:53:51.600 --> 0:53:54.840 it was social exile. Stigma framed the illness as a 0:53:54.880 --> 0:53:58.160 moral failure rather than a viral infection, and that narrative 0:53:58.239 --> 0:54:02.879 did damage. So who did the actual day to day 0:54:02.920 --> 0:54:09.640 support work. A large share came within the LGBTQ communities themselves, 0:54:09.680 --> 0:54:15.320 particularly from lesbian activists, whose contribution is often underplayed now. 0:54:15.680 --> 0:54:19.440 The community wasn't perfectly unified by the seventies. There was 0:54:19.480 --> 0:54:23.160 a real cultural divide between gay men and lesbians around politics, 0:54:23.200 --> 0:54:28.919 gender roles, priorities. But AIDS changed the equation fast. Gay 0:54:28.960 --> 0:54:32.680 men were hit earliest and hardest, and formal institutions were 0:54:33.040 --> 0:54:39.120 slow to respond. In that gap, community networks became survival infrastructure, 0:54:39.960 --> 0:54:45.080 and lesbians in particular stepped into caregiving, fundraising, and hospital 0:54:45.120 --> 0:54:50.440 support roles at scale. The crisis didn't erase differences, it 0:54:50.640 --> 0:54:56.720 just made survival more important. Most of the population became 0:54:56.800 --> 0:55:00.400 terrified of catching this disease. In shock horror, we realized 0:55:00.440 --> 0:55:02.400 they weren't willing to care for the gay men to 0:55:02.480 --> 0:55:07.440 come into the disease en mass. Meanwhile, the hospitals were 0:55:07.440 --> 0:55:10.799 full of lesbians volunteering their time going to the rooms 0:55:10.800 --> 0:55:13.680 of AIDS patients to talk to them, feed them, hold them. 0:55:14.880 --> 0:55:16.880 There were some of the only people willing to treat 0:55:16.920 --> 0:55:20.959 them as human beings. Many of these men's had been 0:55:21.440 --> 0:55:24.319 rejected by their families, so many members of the gay 0:55:24.360 --> 0:55:28.840 community were wasting away in their hospital beds. AIDS was 0:55:28.880 --> 0:55:33.480 a lonely, isolating illness, and lesbian women provided the kindness 0:55:33.520 --> 0:55:43.120 and compassion that nobody else would or could. Lesbians were 0:55:43.160 --> 0:55:45.760 actually one of the lowest risk groups for catching HIV, 0:55:46.200 --> 0:55:52.919 and it's through their empathy and care that a lot 0:55:52.960 --> 0:55:57.960 of these people are even remembered. I being told a 0:55:58.000 --> 0:56:02.279 story about the leathers, so like, there's a big leather 0:56:02.320 --> 0:56:07.560 community in the gay scene. And the reason like people 0:56:07.560 --> 0:56:10.000 talk about oh kink of pride when they see leathers 0:56:10.000 --> 0:56:13.120 and leathers isn't the kink leathers is not that. And 0:56:13.160 --> 0:56:16.520 the reason the leathers are worn it pride is because 0:56:16.560 --> 0:56:23.839 the lesbians carried them on a lot of the time 0:56:24.040 --> 0:56:27.520 when someone was diagnosed in there put into hospital a 0:56:27.560 --> 0:56:31.640 lot of their items, their lives, everything they'd collected was 0:56:31.920 --> 0:56:36.239 fucking incinerated. People destroyed it, they burned it. They were 0:56:36.280 --> 0:56:38.560 again they're afraid of touching it and catching the aids, 0:56:38.640 --> 0:56:39.719 you know what I mean. And so. 0:56:42.239 --> 0:56:46.920 They seeople loved their leathers and the lesbians are the 0:56:47.000 --> 0:56:51.040 reason that they managed to care for them and have 0:56:51.120 --> 0:56:51.759 this pass on. 0:56:52.239 --> 0:56:55.959 So you don't get to have that opinion. You don't 0:56:55.960 --> 0:56:59.319 get to say that that's not allowed a pride when 0:56:59.400 --> 0:57:06.520 this is one of the few physical remaining items of 0:57:06.600 --> 0:57:13.840 an entire generation, generations, even several generations of men whose 0:57:13.920 --> 0:57:26.160 lives were just wiped out. In ninetee eighty three, sexually 0:57:26.200 --> 0:57:29.320 active homosexual men were banned from giving blood across America 0:57:29.480 --> 0:57:32.120 in an effort to prevent HIV from being spread to 0:57:32.200 --> 0:57:37.200 blood transfusions. This band led to blood reserves across the 0:57:37.240 --> 0:57:41.240 country severely depleting, and HIV sufferers needed blood to fight 0:57:41.280 --> 0:57:45.160 the disease, and so Lesbian Blood Drive started popping up. 0:57:45.720 --> 0:57:49.840 Bands of lesbian women came together to donate blood specifically 0:57:50.160 --> 0:57:55.960 to men with AIDS. On the sixteenth of July eighty three, 0:57:56.560 --> 0:57:59.080 the first drive happened and two hundred women showed up. 0:58:00.320 --> 0:58:02.800 Similar tribes were wearing up all over the country and 0:58:02.800 --> 0:58:05.560 continued all the way through the eighties and nineties and more. 0:58:05.600 --> 0:58:08.240 Gay men who survived the epidemics say they were saved 0:58:08.240 --> 0:58:15.120 physically and mentally by the lesbian community, the scientific and 0:58:15.200 --> 0:58:18.080 medical communities working overtime to try and fight this disease. 0:58:18.280 --> 0:58:22.920 But what about everyone else? Now this may shock you, 0:58:22.960 --> 0:58:24.640 but they were kind of hoping it would just go away. 0:58:26.680 --> 0:58:29.240 Being queer was such a taboo that people didn't even 0:58:29.280 --> 0:58:33.480 want to think about queer people existing, let alone help them. 0:58:34.320 --> 0:58:36.800 And what about the media, Well, it doesn't exactly help 0:58:36.840 --> 0:58:39.320 by calling AIDS the gay disease. For the first couple 0:58:39.320 --> 0:58:45.160 of years, disinformation or you know, just shitty journalism led 0:58:45.360 --> 0:58:48.400 many people to think that it could only affect gay men. 0:58:49.960 --> 0:58:51.800 And then, of course it was the drug users, which 0:58:51.840 --> 0:58:55.000 is another group of the less dead. The next finger 0:58:55.120 --> 0:58:57.440 the Haysi men. So now straight white people. 0:58:57.240 --> 0:58:58.320 Were totally in the clear. 0:58:59.040 --> 0:59:02.560 But no so while talking heads and newspapers turning out 0:59:02.600 --> 0:59:06.680 bullshit bases dehumanizing victims of the disease as degenerates, it 0:59:06.760 --> 0:59:10.800 didn't actually inform anyone of any preventative measures that they 0:59:10.840 --> 0:59:20.560 could take. The stories were mostly sensationalized bullshit. There was 0:59:20.560 --> 0:59:22.520 no push to tell men to work on laws to 0:59:22.520 --> 0:59:25.920 help prevent spreading of the disease. They didn't say that 0:59:26.040 --> 0:59:31.480 anyone was at risk, right, just the promiscuous and the homosexuals, 0:59:32.240 --> 0:59:35.480 two things that the conservative media definitely did not want 0:59:35.520 --> 0:59:39.360 to be seen as promoting. And like it wasn't until 0:59:39.800 --> 0:59:44.400 Rock Hudson, like famous Golden Age of Hollywood star, announced 0:59:44.440 --> 0:59:47.800 that he was HIV positive, did the media suddenly proclaim, 0:59:47.880 --> 0:59:50.920 Oh no, no one is free from AIDS. 0:59:52.240 --> 0:59:54.000 Suddenly they cared. 0:59:54.640 --> 0:59:58.960 Right at this time, Rock Hudson was firmly in the closet, 0:59:59.000 --> 1:00:01.840 so they were like, wh oh, anyone can catch it? 1:00:02.080 --> 1:00:06.840 Oh no, Like it's it's such a whole thing. 1:00:07.080 --> 1:00:12.840 But there was a sharp rise an organized anti gay 1:00:12.880 --> 1:00:16.200 activism across the United States. Even after a stonewall legal 1:00:16.240 --> 1:00:19.840 and social progress was uneven by an engine eighty only 1:00:19.840 --> 1:00:25.760 about two dozen states still criminalized sort of me reflecting 1:00:25.760 --> 1:00:30.280 how recently these laws had begun to shift rather than disappear. Now, 1:00:30.320 --> 1:00:33.440 the postal Meal period had seen real momentum in LGBTQ 1:00:33.600 --> 1:00:38.920 plus rights and visibility. You know, communities were more politically organized, 1:00:38.960 --> 1:00:44.160 public presence increased, and activists were already openly discussing possibilities 1:00:44.240 --> 1:00:47.800 like same sex marriage. Ideas at that time still sounded 1:00:48.480 --> 1:00:52.480 speculative instead of imminent, and then AIDS arrived and the 1:00:52.520 --> 1:00:57.200 trajectory changed abruptly. It triggered a major backlash. In many 1:00:57.200 --> 1:01:01.240 parts of the country, existing prejudice was amplified rather than challenged, 1:01:01.880 --> 1:01:06.560 and a public health panic often merged seamlessly with moral judgment. 1:01:08.000 --> 1:01:12.320 Political resistance to LGBTQ plus rights intensified, and earlier gains 1:01:12.320 --> 1:01:15.720 in visibility and acceptance stalled or reversed. 1:01:15.240 --> 1:01:16.440 In some areas. 1:01:17.120 --> 1:01:19.400 It's what had been for a brief period a forward 1:01:19.440 --> 1:01:23.160 moving rights movement became entangled in a public health crisis 1:01:23.840 --> 1:01:27.000 that many were quick to interpret through a moral lens 1:01:27.000 --> 1:01:30.400 and not a medical ones. A virus had arrived in 1:01:30.400 --> 1:01:33.120 the middle of a culture war, and neither side it 1:01:33.200 --> 1:01:39.760 in more encouragement to make it worse. Conservative American political 1:01:39.920 --> 1:01:45.200 organizations sought to mobilize conservative Americans to become politically active, 1:01:45.600 --> 1:01:47.760 and issues that they thought were important were of course, 1:01:48.160 --> 1:01:52.720 the issues were the fact against homosexuality. They had to 1:01:52.760 --> 1:01:55.680 save their children from the immoral gaze, and the AIDS 1:01:55.720 --> 1:02:00.280 crisis grew, so the moral majority feeling that God was 1:02:00.320 --> 1:02:04.840 backing them up. Hann Ronald Reagan, the fortieth President of 1:02:04.880 --> 1:02:08.160 the United States president between eighty one and eighty nine, 1:02:10.480 --> 1:02:14.880 basically oversaw the whole crisis. The Reagan administration has quite 1:02:14.880 --> 1:02:17.640 a bit to answer for here, and not just in hindsight. 1:02:18.200 --> 1:02:22.760 With the benefit of anatly organized timeline. Eighty one, AIDS 1:02:22.800 --> 1:02:25.400 had been identified as a new and groding medical crisis, 1:02:25.480 --> 1:02:29.120 eighty two, the CDC was actively investigating it. Eighty three 1:02:29.240 --> 1:02:33.160 eighty four, the virus responsible had been identified, and yet 1:02:33.640 --> 1:02:36.919 within roughly three years of the epidemic entering public view, 1:02:37.440 --> 1:02:40.240 there were already thousands of confirmed cases in the US 1:02:40.520 --> 1:02:45.600 and thousands of deaths, with many more infections undiagnosed. And 1:02:45.640 --> 1:02:49.880 the response from the White House, however, was selective silence. 1:02:52.720 --> 1:02:56.760 Reagan did not publicly address AIDS until eighty five, and 1:02:56.800 --> 1:02:59.840 at that point, over five thousand the Americans had already died. 1:03:01.680 --> 1:03:04.320 And this wasn't a situation where the administration was unaware. 1:03:04.920 --> 1:03:06.960 They just chose not to make it a public priority. 1:03:07.720 --> 1:03:11.640 Whether it was political caution, cultural discomfort with homosexuality, or 1:03:11.720 --> 1:03:16.280 fear of alienating conservative voters, the outcome was the same. 1:03:16.840 --> 1:03:25.960 Federal leadership arrived late to a rapidly escalating crisis. Like 1:03:27.000 --> 1:03:29.920 one journalist and like in the early eighties, asked questions 1:03:29.920 --> 1:03:33.320 about AIDS, And it was eighty two, and he asked 1:03:33.320 --> 1:03:36.960 the Press secretary about the CDC's report, And the response 1:03:37.040 --> 1:03:43.640 was essentially non response, deflection, minimization, and at times openly dismissal. 1:03:44.520 --> 1:03:48.280 Like this gay plague. 1:03:48.560 --> 1:03:51.280 This framing of it was still common enough in public 1:03:51.320 --> 1:03:54.520 discourse that it shaped how seriously the questions were taken. 1:03:56.120 --> 1:04:00.800 By eighty four, it was asked for the president would 1:04:00.800 --> 1:04:04.000 take steps to restrict access to food service or military 1:04:04.040 --> 1:04:07.400 rules for people with AIDS, referencing public health presidents like 1:04:07.440 --> 1:04:12.440 typhoid controls. The question itself reflected the confusion of the era, 1:04:12.600 --> 1:04:17.320 mixing legitimate containment concerns with misunderstanding about transmission, but at 1:04:17.400 --> 1:04:21.280 least it acknowledged, like the scale you know. The Press 1:04:21.320 --> 1:04:27.919 secretary's reply, again was evasive, including a drinking suggestion that 1:04:28.000 --> 1:04:35.040 the journalist asking the questions might want to get himself tested. Now, 1:04:35.080 --> 1:04:39.560 this is revealing, not just the fact that this is 1:04:40.000 --> 1:04:44.320 humor in tone. A serious public health crisis was being 1:04:44.360 --> 1:04:47.320 discussed in a room where laughter was still an acceptable 1:04:47.320 --> 1:04:55.640 reaction like the journalist, which is interesting was actually I 1:04:55.640 --> 1:04:57.000 think it was consolving. 1:04:57.840 --> 1:04:58.680 He was. 1:05:00.280 --> 1:05:03.600 Opposed to gay rights, which is like why he's like 1:05:03.720 --> 1:05:06.840 asking all these questions about it and why he wants 1:05:06.840 --> 1:05:09.960 the government to comment on it. But they were just 1:05:10.040 --> 1:05:14.960 like oh ho ho ho, watch out get tested, Like 1:05:15.040 --> 1:05:20.240 it's not just a political delay, Like it's an institutional 1:05:20.640 --> 1:05:29.440 delay at scale any fast moving epidemic, and that gap mattered. Now. Allegedly, 1:05:29.960 --> 1:05:33.080 Ronald Reagan and his personal life was not homophobic, and 1:05:33.160 --> 1:05:37.200 because he was like big, super cool friend of Rock Hudson, 1:05:39.120 --> 1:05:44.520 like he didn't want to like publicly condone, you know, 1:05:44.600 --> 1:05:49.080 civil rights for the LGBTQ community, but like privately he's 1:05:49.120 --> 1:05:51.320 like whatever you do in your bedroom is what you do. 1:05:51.400 --> 1:05:55.400 And it's like it's not just about sex, man, but 1:05:55.440 --> 1:06:02.640 nothing there, you know there, But listen, listen, Ronald Reagan 1:06:02.840 --> 1:06:08.440 had gay friends and he was the first president. And 1:06:08.560 --> 1:06:15.600 like he's promoting like abstinence only education, which is again bullshit, 1:06:16.360 --> 1:06:20.160 Like he doesn't even mention AIDS until eighty five and 1:06:20.240 --> 1:06:22.800 it's in a passing response to a question at a 1:06:22.800 --> 1:06:27.760 press conference, and he's just like family values. The next 1:06:27.840 --> 1:06:32.720 year in abstinence is right, like that's it right. By 1:06:32.760 --> 1:06:36.240 the late eighties, eight had moved from an ignored crisis 1:06:36.280 --> 1:06:40.960 to an unavoidable one. In ninety, the former President Reagan 1:06:41.440 --> 1:06:48.080 probably reflected on the epidemic following the death of Ryan White, 1:06:48.160 --> 1:06:50.960 a teenage hemophiliac from Indiana who had become one of 1:06:51.040 --> 1:06:55.440 the most visible faces of HIV AIDS in the United States. 1:06:56.200 --> 1:07:00.640 Ryan White contracted HIV from a contaminated blood transfusion and 1:07:00.760 --> 1:07:03.280 was barred from attending school in his community due to 1:07:03.440 --> 1:07:09.560 fear and misinformation about transmission. After his death in April 1:07:09.600 --> 1:07:14.240 nineteen ninety, Reagan stated that society owed it to Ryan 1:07:14.400 --> 1:07:16.439 to make sure that the fear and ignorance that chased 1:07:16.520 --> 1:07:19.280 him from his home in school will be eliminated, like 1:07:19.320 --> 1:07:25.320 this kid got HIV from a blood transfusion, and teachers 1:07:25.440 --> 1:07:34.600 and parents protested about having this child. 1:07:31.240 --> 1:07:33.400 In their class. 1:07:33.480 --> 1:07:36.160 Now. Ryan White never wanted to be a poster boy. 1:07:36.600 --> 1:07:38.880 He hated the effect that he. 1:07:39.000 --> 1:07:44.000 Was labeled the innocent victim because it implied that others 1:07:44.040 --> 1:07:48.520 were somehow guilty. He says that he was just like 1:07:48.560 --> 1:07:50.960 everyone else with AIDS, no matter how he got it. 1:07:53.000 --> 1:07:56.520 In his case, helped chief public perception and even prompted 1:07:56.560 --> 1:07:59.800 support from communities that had themselves been heavily affected by 1:07:59.840 --> 1:08:06.760 the epidemic, but it also highlighted the uncomfortable truth public 1:08:06.800 --> 1:08:13.720 empathy was often shaped less by medical facts than perceived similarity. 1:08:14.960 --> 1:08:21.320 The disease wasn't understood by the general public, like imagine 1:08:21.640 --> 1:08:25.960 your kid has a disease and it's not contagious, right, 1:08:26.120 --> 1:08:30.759 not in that environment, and the teachers are worried about. 1:08:30.600 --> 1:08:33.599 Catching it, Like what the fuck? 1:08:39.080 --> 1:08:46.760 So after he passed away In April nineteen ninety, Congress 1:08:46.800 --> 1:08:50.680 passed the Ryan White Care Act, which I think to 1:08:50.720 --> 1:08:53.920 this day is still the largest fairly funded HIV AIDS 1:08:53.920 --> 1:08:58.360 assistance program in the United States. It continues to provide 1:08:58.360 --> 1:09:01.479 treatment support for low income and insured people living with HIV. 1:09:04.680 --> 1:09:09.559 At the same time, grassroots activism remained essential. From the 1:09:09.560 --> 1:09:13.320 early eighties onwards, Queer organizations and allied groups had already 1:09:13.320 --> 1:09:16.680 begun building networks for education, save for sex outreach and 1:09:16.880 --> 1:09:20.680 mutual aid, because waiting for official responses was simply not 1:09:20.720 --> 1:09:24.320 an option. If anything, the epidemic made it brutally clear 1:09:24.720 --> 1:09:27.360 the communities often had to be their own first responders. 1:09:29.000 --> 1:09:31.320 In the mid eighties, it was clear the HIV AIDS 1:09:31.400 --> 1:09:33.760 was not just a medical crisis, it was a social one. 1:09:33.800 --> 1:09:38.760 With paperwork, landlords refused to rent people with HIV, employers 1:09:38.840 --> 1:09:43.080 quietly and sometimes not so quietly, pushed them out. Insurance 1:09:43.120 --> 1:09:45.599 didn't always cover care, and in the absence of strong 1:09:45.640 --> 1:09:49.840 institutional support, activists end up doing everything the system was 1:09:49.880 --> 1:09:50.639 supposed to do. 1:09:52.479 --> 1:09:52.599 So. 1:09:52.680 --> 1:09:55.280 One of the most powerful examples, I think is the 1:09:55.360 --> 1:09:59.640 Aid's Memorial Quilt. It was conceived in eighty five but 1:09:59.680 --> 1:10:02.040 active Cleve Jones as a way to remember friends who 1:10:02.040 --> 1:10:06.240 had died from AIDS. The idea was simple and devastating. 1:10:06.880 --> 1:10:11.160 One panel, one life name, stitched into fabric, because official 1:10:11.200 --> 1:10:13.960 records and polite society were not doing enough remembering on 1:10:14.000 --> 1:10:17.880 their own. It began with a list of forty names, 1:10:17.880 --> 1:10:21.519 and even that number sounds small until you remember it 1:10:21.600 --> 1:10:27.920 was just personal loss, not national statistics. Forty people gone 1:10:28.240 --> 1:10:33.080 from one activist's immediate world alone. The quilt began growing 1:10:33.160 --> 1:10:37.160 in parallel with public demonstrations, including the nineteen eighty seven 1:10:37.160 --> 1:10:41.080 March on Washington for Lesbian gay rights. Early panels were 1:10:41.080 --> 1:10:44.120 displayed in San Francisco, including a public hanging on City 1:10:44.120 --> 1:10:49.160 Hall's balcony during Gay Freedom day, roughly two hundred thousand 1:10:49.200 --> 1:10:54.920 people gathered an information both nearby offered instructions so other 1:10:55.000 --> 1:10:59.240 could make their own panels. Grief, as it turns out, 1:11:00.120 --> 1:11:03.919 is scalable. By the time it was displayed in Washington, 1:11:05.160 --> 1:11:10.000 it contained around one thousand, nine hundred and twenty panels. 1:11:10.680 --> 1:11:14.439 Every name was read aloud while crowd stood listening and crying. 1:11:15.960 --> 1:11:21.120 It was part memorial, part protest, part attempt to make 1:11:21.200 --> 1:11:26.040 the numbers feel like people again. The project kept expanding. 1:11:26.080 --> 1:11:29.040 By nineteen eighty eight, it toured twenty US cities in 1:11:29.120 --> 1:11:35.680 just four months. Families, especially mothers, would arrive with new 1:11:35.720 --> 1:11:37.080 panels sown for sons and. 1:11:37.120 --> 1:11:38.000 Daughters they had lost. 1:11:39.680 --> 1:11:42.560 Within a year, it had grown to eight thousand panels. 1:11:43.160 --> 1:11:47.800 Today it includes more than forty eight thousand names and 1:11:47.840 --> 1:11:53.120 ways and estimated fifty four tons. It remains one of 1:11:53.160 --> 1:11:58.960 the largest community memorials ever created a physical record of 1:11:58.960 --> 1:12:02.840 an epidemic that haffished show systems were slow to fully acknowledge, 1:12:04.920 --> 1:12:11.519 and it's still growing. In the late nineteen eighties, Truman 1:12:11.560 --> 1:12:16.840 options were still extremely limited. Doctors could manage opportunistic infections 1:12:16.840 --> 1:12:20.759 and ease symptoms, but there was no cure. HIV infection 1:12:21.040 --> 1:12:24.280 was for most patients at the time still effectively terminal. 1:12:26.560 --> 1:12:33.320 Then came azt zadoviurine zeroviurine one of those. It was 1:12:33.360 --> 1:12:36.439 first developed in the sixties as a cancer drug, later 1:12:36.479 --> 1:12:39.679 repurposed in the eighties when researchers realized it could inhibit 1:12:39.880 --> 1:12:45.960 HIV replication. On paper, it was a breakthrough. In practice, 1:12:46.000 --> 1:12:51.599 it was complicated. Azat was rushed through clinical trials under 1:12:51.640 --> 1:12:55.920 intense pressure. The standard long term testing process was shortened 1:12:55.920 --> 1:13:01.439 significantly due to the urgency of the epidemic. Earlier results suggested, 1:13:01.439 --> 1:13:07.080 which is mortality entreated patients compared to placebo groups, leading 1:13:07.120 --> 1:13:10.720 to ethical concerns about continuing to withhold the drug. The 1:13:10.760 --> 1:13:14.080 trail was halted early and as t was made widely available. 1:13:16.160 --> 1:13:21.519 Side effects, however, were severe nausea, headaches, gastro intestinal distress, 1:13:22.120 --> 1:13:26.760 and in some cases bone marrow suppression requiring blood transfusions. 1:13:28.120 --> 1:13:32.160 It was not subtle medicine. It was closer to control 1:13:32.280 --> 1:13:36.639 toxicity with a hoped for benefit, and even the data 1:13:36.720 --> 1:13:41.240 was messy. Patients were often receiving multiple treatments from different providers, 1:13:41.240 --> 1:13:46.400 making outcomes harder to attribute cleanly. Some even shared or 1:13:46.439 --> 1:13:51.000 pulled medication to ensure everyone had access, which, while understandable, 1:13:51.000 --> 1:13:55.400 didn't exactly improve the integrity of the study. Design still 1:13:55.560 --> 1:13:59.439 eased marked the beginning of anti retrovile therapy, not a 1:13:59.520 --> 1:14:02.200 victory line, but at least the first moment with the 1:14:02.240 --> 1:14:07.040 medical response shipped from purely reactive care to something resembling intervention. 1:14:08.520 --> 1:14:12.719 On March nineteenth, nineteen eighty seven, AZT went on sale 1:14:13.840 --> 1:14:17.960 and immediately introduced itself as the most expensive prescription drug 1:14:18.080 --> 1:14:20.960 in history at the time, around eight thousand dollars a 1:14:21.040 --> 1:14:24.280 year per patient, which today would sit well over what 1:14:24.439 --> 1:14:29.880 seventeen thousand dollars for a life saving medication. It also 1:14:29.920 --> 1:14:33.080 doubled as a masterclass and how quickly urgent medical breakthrough 1:14:33.120 --> 1:14:37.040 can become. Who exactly can afford to stay alive? 1:14:37.400 --> 1:14:39.240 Which is fucking bullshit. 1:14:39.360 --> 1:14:42.280 No, I can't afford to lose my voice. In the US, 1:14:43.040 --> 1:14:46.479 many people with HIV AIDS were already marginalized, gay men, 1:14:46.640 --> 1:14:49.640 intravenous drug users, sex workers, and others already sitting on 1:14:49.680 --> 1:14:52.439 the edges of healthcare access, so it was not exactly 1:14:52.439 --> 1:14:55.200 a fair playing field, and even calling it a market 1:14:55.400 --> 1:15:00.920 feels generous when the entry fee is survival like whatas suggested, 1:15:01.280 --> 1:15:05.200 drug companies stood to make hundreds of millions in profit 1:15:05.240 --> 1:15:10.040 from AZT within a year. Now, depending on your temperament, 1:15:10.520 --> 1:15:15.800 that's either innovation funding itself or healthcare discovering capitalism in 1:15:15.840 --> 1:15:16.880 real time. 1:15:18.760 --> 1:15:20.040 Get fucked. 1:15:21.840 --> 1:15:27.040 Access problems predictably followed. A black market emerged almost immediately, 1:15:27.080 --> 1:15:32.800 because desperation tends to ignore law. Everyone wanted the miracle drug, 1:15:32.840 --> 1:15:36.759 and the only issue is it wasn't really miraculous. Early 1:15:36.760 --> 1:15:41.519 optimism faded fast. ACT initially showed improvements in T cell counts. 1:15:42.800 --> 1:15:46.280 Later evidence suggests that at high early dosing schedules famously 1:15:46.320 --> 1:15:51.360 four hundred mg every four hours, toxicity became a serious problem, 1:15:52.200 --> 1:15:55.080 bone marrow suppression, severe side effects, and in some cases 1:15:55.200 --> 1:15:58.759 overall worsening health meant the drug's promise did not neatly 1:15:58.800 --> 1:16:04.000 match its early hype. Eventual dosages were revised, and EASYT 1:16:04.280 --> 1:16:07.439 was later used in combination therapies, but not before a 1:16:07.479 --> 1:16:13.240 lot of damage and disillusionment had already accumulated. By the nineties, 1:16:13.320 --> 1:16:18.479 things began to shift slowly. Public awareness increased, stigma stated 1:16:18.520 --> 1:16:25.280 to listen, not disappear, listen, and governments began investing more 1:16:25.320 --> 1:16:31.519 seriously in research and prevention. Condomnious entered public health messaging openly, 1:16:31.560 --> 1:16:36.960 which seems obvious now but was once treated like controversial content. 1:16:38.400 --> 1:16:43.360 Abstinence only approaches were still floated despite consistently underwhelming results in. 1:16:43.320 --> 1:16:44.120 The real world. 1:16:45.000 --> 1:16:51.719 It doesn't fucking work. It doesn't work like the studies. 1:16:51.880 --> 1:16:52.760 The evidence is. 1:16:52.760 --> 1:17:00.840 There, it doesn't fucking work like I don't know how 1:17:00.840 --> 1:17:05.080 many ways I can say this before people understand abstinence 1:17:05.200 --> 1:17:12.799 only education, abstinence only values doesn't fucking work. High profile 1:17:12.880 --> 1:17:17.560 deaths also garnered attention. So you have got like Freddie Mercury, 1:17:17.760 --> 1:17:24.519 Anthony Perkins, liberace like public figures whose illnesses made denial 1:17:24.600 --> 1:17:28.920 harder to maintain, and infection rates eventually began to stabilize 1:17:28.960 --> 1:17:31.840 in some regions, though globally the crisis it's far from over. 1:17:33.360 --> 1:17:37.760 Policy responses were mixed. In many places, HIV positive individuals 1:17:37.760 --> 1:17:42.080 faced legal restrictions around employment and healthcare, blood donation, immigration, 1:17:42.200 --> 1:17:46.400 and travel. Some measures were grounded in legitimate safety concerns 1:17:46.439 --> 1:17:50.360 like blood donation. Others reflected stigma addressed up as regulation, 1:17:51.080 --> 1:17:56.599 and the distinction was not awfully maintained, and. 1:17:56.600 --> 1:17:58.040 The skill of laws. 1:17:59.479 --> 1:18:05.679 Like we always want to compress it intonate figures, and 1:18:05.720 --> 1:18:08.920 there was always a way of trying to make it analytical, 1:18:10.000 --> 1:18:14.559 but that's not how the world works entire Friendship groups 1:18:14.560 --> 1:18:17.680 were white out communities describe years where funerals were not 1:18:17.760 --> 1:18:23.839 occasional events, but there was like several per calendar months, 1:18:25.280 --> 1:18:30.040 one after another, week after a week. It wasn't just mortality, 1:18:30.080 --> 1:18:36.280 it was repetition. Hint. Today HIV is no longer the 1:18:36.320 --> 1:18:40.280 automatic death sentence it was in the eighties. In the US, 1:18:40.439 --> 1:18:44.000 over a million people were living undiagnosed with HIV by 1:18:44.000 --> 1:18:47.839 the late twenty tens, with a significant portion of infections 1:18:47.880 --> 1:18:53.360 still undiagnosed. Globally, worldwide, tens of millions still live with HIV, 1:18:54.720 --> 1:18:57.440 with around one point seven million new infections. 1:18:57.840 --> 1:18:58.519 What was it. 1:19:00.080 --> 1:19:00.839 In twenty eighteen? 1:19:01.000 --> 1:19:05.880 I think awareness has improved. Roughly four fifths people living 1:19:05.880 --> 1:19:10.920 with HIV globally know their status, but gaps remain. Sub 1:19:10.960 --> 1:19:14.640 Saharan Africa has carried a disproportionate burden of the epidemic, 1:19:15.520 --> 1:19:17.880 especially in the early two thousands, shooed by a mix 1:19:18.000 --> 1:19:23.120 of healthcare and equality, delayed policy responses, and stigma. Some 1:19:23.320 --> 1:19:29.000 of it aerially familiar to early Western responses, but the 1:19:29.080 --> 1:19:33.760 key shift in modern treatment is anti retroviral therapy. HIV 1:19:33.880 --> 1:19:36.720 is still not cured, but it is now medically manageable. 1:19:37.360 --> 1:19:41.599 With consistent treatment, many people achieve and undetectable viral lot, 1:19:42.240 --> 1:19:45.920 and that word matters. Undetectable means the virus is so 1:19:45.960 --> 1:19:53.519 suppressed it cannot be transmitted sexually. The idea undetectable equals 1:19:53.640 --> 1:19:59.799 untransmirable has fundamentally changed both prognosis and public perception. Treatment 1:20:00.000 --> 1:20:02.400 isn't a RaSE HIV, but it can reduce it to 1:20:02.479 --> 1:20:05.360 a level which no longer defines a person's health or their. 1:20:05.280 --> 1:20:10.559 Risk to others. It's not a finish line medication. 1:20:10.600 --> 1:20:14.960 Adhering still matters, Monitoring still matters, and access still matters. 1:20:14.960 --> 1:20:18.120 But compared to the nineteen eighties, when diagnosis was effectively 1:20:18.160 --> 1:20:23.280 a countdown to your death, the difference is night and day, 1:20:23.439 --> 1:20:28.280 or science eventually caught up. It just took longer than 1:20:28.280 --> 1:20:34.120 the virus did. Today, HIV usually involves a combination of drugs, 1:20:34.160 --> 1:20:39.679 often called a cocktail. The formal name is highly active 1:20:40.360 --> 1:20:46.679 anti retroviral therapy. Today, HIV treatment usually involves a combination 1:20:46.720 --> 1:20:50.519 of drugs a cocktail. The target of virus in different 1:20:50.560 --> 1:20:53.320 stages of its life cycle. The formal name for this 1:20:53.479 --> 1:20:59.519 is highly active antiretroviral therapy or HEART, which, despite sounding 1:20:59.600 --> 1:21:02.479 like something order any very intense pharmacy, has one of 1:21:02.520 --> 1:21:07.360 the biggest medical turning points over the modern era. It's 1:21:07.360 --> 1:21:10.400 not a one size fits all system. People respond differently 1:21:10.439 --> 1:21:14.559 and finding the right combination can take time. But you 1:21:14.600 --> 1:21:17.120 don't need to eliminate the virus to live a normal 1:21:17.120 --> 1:21:23.040 life with it. Many people on treatment maintain an undetectable 1:21:23.120 --> 1:21:32.320 viral load. It's controlled, not gone, and that's not optimism, 1:21:32.560 --> 1:21:38.639 it's evidence based public health. If you're undetectable and stale treatment, 1:21:38.880 --> 1:21:44.479 you cannot sexually transmit HIV, and life expectancy for someone 1:21:44.560 --> 1:21:48.679 diagnosed today with access to treatment and consistent care can 1:21:48.720 --> 1:21:54.439 be close to that of general population. Like HIV no 1:21:54.479 --> 1:21:57.360 longer progresses to AIDS. In most cases, where treatment is 1:21:57.400 --> 1:22:01.439 started and maintained properly, it is shifted from a fatal 1:22:01.479 --> 1:22:05.320 diagnosis to a chronic, manageable condition. It is still serious, 1:22:05.400 --> 1:22:09.240 it is still real, but is no longer the automatic 1:22:09.360 --> 1:22:15.640 endpoint it once was. Now there are also rare documented 1:22:15.640 --> 1:22:19.480 cases of apparent cures or long term emission following specialized 1:22:19.479 --> 1:22:24.920 procedures like stem cell transplants, but these are exceptional, medically complex, 1:22:25.040 --> 1:22:28.759 and not widely applicable. In other words, science has opened 1:22:28.760 --> 1:22:32.840 the door, it's not kicked it down, and even so 1:22:33.040 --> 1:22:38.799 precautions still matter. Undetectable status only applies when treatment is consistent, 1:22:38.800 --> 1:22:42.200 and it does not predict against other sectry transmitted infections. 1:22:43.280 --> 1:22:46.759 Condoms remain important, and so does regular testing for anyone 1:22:46.880 --> 1:22:53.519 sexually active, especially with multiple partners. Contraception prevents pregnancy, it 1:22:53.560 --> 1:22:57.479 does not prevent infections, a distinction that for some reason 1:22:57.520 --> 1:23:02.920 still needs a reading. Testing access varies by countries. In 1:23:02.960 --> 1:23:05.639 the UK, sexual health clinics offer free testing and at 1:23:05.640 --> 1:23:09.320 home kits that are available through improved services, allowing people 1:23:09.360 --> 1:23:13.880 to test privately and receive results remotely. In Ireland you 1:23:13.920 --> 1:23:17.800 can actually send away for a test. You can send 1:23:17.800 --> 1:23:20.800 away for a private test and you do all the 1:23:21.120 --> 1:23:23.560 bits at home, you seal it up, you post it 1:23:23.600 --> 1:23:29.040 away and they give your results completely free sexual health testing. 1:23:31.560 --> 1:23:35.080 The point is simple, testing exists and avoiding it doesn't 1:23:35.080 --> 1:23:41.839 make risk disappear. So pre exposure profile ACCESS or PREP 1:23:42.439 --> 1:23:46.280 is another major prevention tool. It is a medication taken 1:23:46.320 --> 1:23:50.880 by HIV negative individuals. Before exposure to significantly reduce the 1:23:51.040 --> 1:23:55.479 risk of infection. When it is taken correctly, it produces 1:23:55.560 --> 1:23:59.800 the risk of sexual transmission by over ninety percent, even 1:23:59.800 --> 1:24:04.160 more when combined with condom use. It is highly effective, 1:24:04.160 --> 1:24:09.840 but again only protects against HIV, not other infections. Now, 1:24:11.320 --> 1:24:13.840 modern HIV treatment is one of those rare cases where 1:24:13.840 --> 1:24:17.000 medicine actually did the thing it keeps promising and the 1:24:17.000 --> 1:24:21.400 press releases. It turned a once fatal diagnosis into something 1:24:21.439 --> 1:24:22.040 people live. 1:24:22.000 --> 1:24:22.839 With long term. 1:24:23.120 --> 1:24:27.000 It's not cured in the Hollywood sense, but controlled enough 1:24:27.040 --> 1:24:29.280 that the virus mostly minds its own business. 1:24:29.280 --> 1:24:30.120 A few mind dules. 1:24:32.320 --> 1:24:36.200 At the extreme end of treatment, let's talk about stem 1:24:36.240 --> 1:24:40.800 cell transplantation, the closest thing. HIV medicine has two boss 1:24:40.880 --> 1:24:45.759 level intervention, which not subtle. First, the patient's immune system 1:24:45.800 --> 1:24:49.599 is wiped out using chemotherapy, which is already a cheerful start, 1:24:50.320 --> 1:24:53.080 then replaced with donor stem cells that then rebuild a 1:24:53.120 --> 1:24:56.719 new immune system from scratch. In a handful of cases, 1:24:57.200 --> 1:25:03.360 this has led to long term HIV remission. The trick 1:25:03.800 --> 1:25:07.920 originally was that some donors carried a rare mutation called 1:25:08.000 --> 1:25:12.519 c c R five Delta three two. It's kind of 1:25:12.600 --> 1:25:16.160 like removing the virus's favorite entry door into cells and 1:25:16.200 --> 1:25:20.799 sort of welding it shut. No entry point, no infection pathway, 1:25:21.200 --> 1:25:25.839 no problem, least in theory, and this is what happened 1:25:25.880 --> 1:25:29.479 in landmark cases like the Berlin patient where a stem 1:25:29.520 --> 1:25:32.760 cell transplant performed for cancer just happened to also not 1:25:32.960 --> 1:25:37.680 KHIV into remission. Later cases sometimes referred to as in 1:25:37.760 --> 1:25:41.160 like the circles as Geneva patient and second Berlin patient 1:25:42.040 --> 1:25:46.919 suggested something even more interesting. Remission might still be possible 1:25:47.040 --> 1:25:51.000 even when the genetic setup isn't perfectly textbook. In other words, 1:25:51.120 --> 1:25:58.960 nature occasionally improves that. Being said, this is not like 1:25:59.000 --> 1:26:02.880 a treatment plan is the last resort medical gamble with 1:26:02.960 --> 1:26:08.439 a very expensive ticket and serious risks chemotherapy toxicity, immune collapse, 1:26:08.600 --> 1:26:12.639 graft versus host disease, and all the other charming features 1:26:12.640 --> 1:26:16.160 of rebooting a human immune system from scratch. It is 1:26:16.200 --> 1:26:19.120 only done when someone already needs a stem cell transplant 1:26:19.120 --> 1:26:23.519 for something like cancer. HIV remission, when it happens is 1:26:23.600 --> 1:26:25.000 essentially the universe. 1:26:24.680 --> 1:26:26.040 Thrown in a bonus round for you. 1:26:26.880 --> 1:26:29.840 For everyone else, the actual workers of HIV is far 1:26:29.920 --> 1:26:33.840 less dramatic and far more effective, and that is your 1:26:34.080 --> 1:26:41.559 anti retroviral therapy. People live normal lifespans, go to work, 1:26:42.120 --> 1:26:45.719 argue IT bills, and generally do everything except die from HIV, 1:26:45.800 --> 1:26:49.320 And like it's still nineteen eighty five, scientists are still 1:26:49.400 --> 1:26:52.240 chasing a functional cure, basically trying to get to a 1:26:52.280 --> 1:26:56.200 point where the virus is controlled without lifelong medication. Now 1:26:56.280 --> 1:26:59.879 the ideas on the table are very very twenty first century. 1:27:00.600 --> 1:27:04.639 Gene editing, which is like crisp perstel attempts to disable 1:27:04.800 --> 1:27:08.320 HIV's ability to integrate into cells, and you've got engineer 1:27:08.360 --> 1:27:16.000 immune cells, like CRT therapies, bored from CANC treatment, neutralizing 1:27:16.040 --> 1:27:19.400 antibodies that tried to cover every viral infection HIV can 1:27:19.439 --> 1:27:23.080 throw out, and vaccine research that has been like five 1:27:23.240 --> 1:27:24.760 to ten years away for about the. 1:27:24.800 --> 1:27:26.639 Last twenty years now. 1:27:26.680 --> 1:27:29.240 None of these are routine treatments yet most are still 1:27:29.280 --> 1:27:33.120 in trials, in early studies, or like the scientific equivalent 1:27:33.160 --> 1:27:36.680 of don't try this at home. So the situation is 1:27:36.720 --> 1:27:40.719 now oddly split. On one side, we already have treatments 1:27:40.720 --> 1:27:43.840 so effective the HIV can be medically invisible and non 1:27:43.960 --> 1:27:49.439 transmissible with adherents. On the other, researchers are still trying 1:27:49.479 --> 1:27:51.400 to see if they can go one step further and 1:27:51.520 --> 1:27:55.680 actually remove it entirely. We're not cre achieved yet, but 1:27:56.280 --> 1:27:59.640 we're also very far from the era where diagnosis was 1:27:59.680 --> 1:28:01.160 just a down with paperwork. 1:28:03.479 --> 1:28:06.240 And that is. 1:28:06.200 --> 1:28:10.479 Where I will leave you today. That is the nineteen 1:28:10.520 --> 1:28:13.160 eighties Eights Crisis. 1:28:15.520 --> 1:28:19.160 It's one of those things I wanted to share. 1:28:19.200 --> 1:28:23.360 I know it's a very dense, information dense episode, and 1:28:23.439 --> 1:28:27.559 I understand that it's not the most joyful thing, but 1:28:28.960 --> 1:28:32.960 I think the fact that we're here and people are 1:28:33.000 --> 1:28:37.479 still trying, we're still trying to improve the lives of 1:28:38.680 --> 1:28:42.120 people with HIV, We're trying to reduce the transmission of it. 1:28:42.560 --> 1:28:46.519 Like there were so many positive aspects that are coming 1:28:46.560 --> 1:28:49.760 out now, and I know it doesn't help everyone who 1:28:49.880 --> 1:28:54.439 suffered before, but the fact that we are moving forward, 1:28:55.600 --> 1:29:00.479 the fact that it's no longer a death sentence, it's 1:29:01.280 --> 1:29:04.040 it's something, and I know I've been trying to do 1:29:04.080 --> 1:29:10.160 it like relatively jolly stuff for pride because the world 1:29:10.240 --> 1:29:13.439 is on fire and everything's terrible, but here. 1:29:13.240 --> 1:29:17.360 We are the AIDS crisis, and with that. 1:29:17.439 --> 1:29:22.919 It is recommendation time for reading Disaster Gate Detective Agency 1:29:23.240 --> 1:29:29.280 by lev A C. Rosen for listening Kelly Minogue spinning 1:29:29.320 --> 1:29:31.360 around as a banger and I'll hear nothing against it. 1:29:32.360 --> 1:29:36.040 And for watching You Know What The Fall. I've recommended 1:29:36.080 --> 1:29:40.479 it before, I'll recommend it again Late Pace. It's so 1:29:40.560 --> 1:29:43.919 beautiful and it is probably one of the most visually 1:29:44.000 --> 1:29:45.200 beautiful movies. 1:29:44.880 --> 1:29:46.280 I have ever seen in my life. 1:29:46.360 --> 1:29:49.439 So go watch that and I will chat to you 1:29:49.439 --> 1:29:53.519 next time. Adios. Au revoir of Way to Say My 1:29:53.560 --> 1:29:55.040 Friends Bye Bye,