I’ve mentioned before that the AIDS crisis began on June 5th 1981, when the CDC published its findings on the mysteriously deteriorating conditions of five gay men. This fact is important because it shaped the rest of the disaster. From this point on the disease was associated with all the sins and taboos attached to homosexuality, despite the capacity for heterosexual and even non-sexual transmission of the infection. As such, AIDS itself became its own cultural taboo: many considered it “God’s punishment for homosexuals” in the early years. There was virtually no system of public or institutional support for people with AIDS. Government response of any kind was delayed and disorganized, even actively obstructive upon occasion. People with AIDS were extremely stigmatized within society, losing their jobs, their homes, even their medical support at the time they needed it the most. Because of the sexual taboos involved, modern crisis management worked counter-productively for almost an entire decade in the face of the AIDS crisis.

When compared to how the last major epidemic in America was managed, this response to AIDS appears troublingly short. As medical historian Michael Oldstone argues in Viruses, Plagues, and History, the polio outbreak of the 1952 was met with a united effort from both the government and the population, from both the private and public spheres: “Not since the Second World War had the fabric of America been woven together more tightly in a single cause.” Voluntarism seemed to be at an all-time high throughout society, with organizations like the National Foundation of Infantile Paralysis providing civilian-lead care for those affected. All institutions across America were invested in finding a functional vaccine or a cure. By 1953 Dr. Salk had developed a successful vaccine and, combined with the later success of Sabine’s vaccine in 1956, polio rates plummeted by 1961 and were nearly non-existent by the seventies. Admittedly, there were some key differences in the two diseases, both physiologically and culturally: while both epidemics were caused by viruses, polio had been recorded since the 1840’s with the first major epidemic occurring in 1916 while AIDS appeared almost out of nowhere in the early eighties. Trying to create a vaccine or even a treatment for HIV infection was a massive struggle against microbiological forces barely understood. It took years after HIV was first isolated for researchers to understand the significance of proteins like reverse transcriptase in the proliferation (and eventually, the treatment) of the disease. Whereas with polio, scientists had been analyzing the virus for almost half a century and in the fifties they finally had the means to create an attenuated vaccine. Its transparency made it easier to inhibit its spread. Additionally, polio mostly impacted small children and infants while AIDS occurred most often in gay men, which created different cultural meanings in the diseases. While these epidemics might have occurred consecutively, it is clear that the model management of polio in the fifties cannot be used to understand the management of AIDS in the eighties. 

In fact, the epidemic that most resembles the AIDS crisis in terms of scale and response is actually the outbreak of syphilis in early modern Europe. Around the fourteenth and fifteenth centuries, people fell ill with syphilis publicly and horrifically with symptoms ranging from full-body rashes to the complete disfiguration of the face. This plague  of syphilis provided early modern medicine with its first real focus of analysis, according to Bruce Boehrer, due to its spread throughout society and its religious significance. Like their 20th-century counterparts, early modern communities believed syphilis to be punishment from God. At first feared and then mocked, medieval European societies were quick to avoid both discussion of the disease as well as those diseased, reasoning that the actions of the victims lead them to these consequences. The paranoid taboos came to dominate the public sphere, leading sufferers to find their own treatments individually. Meanwhile, early modern medicine also contributed to this idea of venereal disease as divine punishment. Struggling between finding treatment and cultural morality, Boehrer discusses in more depth the development of early modern medicine in relation to syphilis and its tensions with religious ideologies. Care for those with syphilis did not emerge until nearly the end of the sixteenth century, with doctors providing perhaps more harm than good with their cures which included hot baths and leeching. The government showed no interest in intervention until the 1800’s, when the blame for the spread was placed on women.

Nearly five centuries later, the AIDS crisis followed a disturbingly similar narrative of distribution. In both epidemics were the same discourses of religion and sexuality, as well as similar absences and delayed developments in scientific understanding. We can see today that some of the first scientific theories about AIDS were clearly influenced by cultural understandings of homosexuality and  heteronormativity: as Paula Treichler discusses in How to Have Theory in an Epidemic, there was such a drive to maintain the identity categories associated with AIDS (4 H’s: homosexual, hemophiliac, heroin addict, and Haitian) in the first few years of the epidemic that researchers pushed all “outlier” cases into the unclassified categories rather than redefining their terms. Cases where women, children, and straight men developed AIDS were present almost from the very beginning but they were not officially recognized until much later. Some of the first scientific theories on AIDS focused on the “promiscuity” of the gay community. One hypothesis even ventured that human semen was poisonous to the immune system, and that women had evolved an immunity over time. The slang term for this idea became “toxic cock syndrome,”a name ridiculous enough to match the theory. While early modern medicine may seem ridiculous to the modern audience, such cultural distortions can be seen just as easily in these scientific discourses of the 1980’s.

Political powers overlooked both crises as they spread and grew worse. It is clear that neither AIDS nor syphilis lent itself to the kind of positive narrative that characterized polio due to their sexual modes of transmission. Being codified within this taboo of sexuality meant that the diseases could quietly spread as society did their best to ignore them. But one of the key differences between the AIDS crisis and the early modern syphilis outbreak is that there was no precedence for government intervention in medieval European countries. In the modern government of America, however, there was an expectation for the structures of authority to overcome these social taboos and provide adequate disaster management as they had for other epidemics, like polio. Instead the federal government patently ignored the growing threat of AIDS which consequently prevented any social action to counter the spread of the disease. As such, the AIDS crisis became shaped by the paranoia and taboos surrounding homosexuality and other stigmatized forms of sexuality. These social expressions of anxiety towards both the disease and the ‘deviant’ sexualities targeted ultimately prevented any actual attempts at disaster management in the early years.

In a later post I will concentrate more on both the governmental and social response to HIV/AIDS. I’ll also consider more in-depth the medical history of HIV/AIDS. 

Featured Image Credit: American Pregnancy, “HIV/AIDS During Pregnancy“