In the late 1970s and early 1980s, a virus that had previously appeared sporadically around the world began to spread throughout the United States. Originally identified as a “gay disease” because gay men were one of the primary groups afflicted, HIV and the syndrome it causes, Acquired Immune Deficiency Syndrome, were unknown in 1981 but had become household terms and the number one threat to public health by the late 1980s.
For several years after the Center for Disease Control first realized that the illnesses cropping up in communities around the country were all the work of the same virus, the American government did little to address the epidemic, a failure to act that many attribute to the fact that HIV/AIDS was primarily affecting gay men, intravenous drug users, immigrants and racial minorities.
HIV/AIDS activists, medical professionals, artists and a number of people with AIDS who went public with their diagnoses despite the stigma surrounding the disease eventually spurred a massive response from the U.S. government and the international health community. By the mid-1990s, HIV/AIDS numbers were on the decline in America, and today there are a variety of effective treatments for HIV/AIDS that have made the diagnosis significantly less dire than it was when the epidemic began—but there is still no cure. Despite significant progress, the global AIDS epidemic is far from over: 1.7 million people around the world were infected with HIV in 2019, bringing the total number of people living with AIDS today to 38 million.
Origins and Silent Spread
Early 20th Century - At some point in the first few decades of the 20th century, Simian Immunodeficiency Virus makes the jump from chimpanzees to humans in Central Africa. Now known as the subtype HIV-1, the virus begins circulating in Léopoldville, now Kinshasa in the Democratic Republic of the Congo—believed to be the first zoonotic transmission of HIV.
1959 - A man dies in the Congo—tests of his blood samples later establish this is the earliest confirmed HIV-related death.
1960s - HIV-2 is believed to have jumped to humans from monkeys in West Africa, likely Guinea-Bisseau, around this time. Studies later reveal that HIV-1 arrived in the Americas during the late 1960s. A significant number of Haitians were working in the Congo at the time, with some likely bringing the virus back to the Caribbean on their return.
December 12, 1977 - Grethe Rask, a Danish physician and surgeon who spent years working in the Congo, dies of pneumonia. Over several years, she suffered from a number of opportunistic infections and severe immunodeficiency. Ten years after her death, a blood test finds she was infected with HIV.
A Gay Men's Crisis
April 24 – The CDC receives a report on Ken Horne, a gay man living in San Francisco who is suffering from Kaposi’s Sarcoma, a rare and unusually aggressive cancer linked with weakened immunity. Horne dies on November 30, 1981. The same year, the CDC retroactively identifies Horne as the first American patient of the AIDS epidemic.
May 18 – Lawrence Mass, a gay doctor in New York City, writes an article for The New York Native, an LGBT newspaper, titled “Disease Rumors Largely Unfounded.” Although the headline would soon be proven false, his report that a number of gay men have been admitted to New York City intensive care unites with severely compromised immune systems is the first article to mention what soon becomes known as AIDS.
June 5, 1981 – The CDC publishes an article describing five cases of a rare lung infection in young, otherwise healthy gay men in Los Angeles, two of whom have died and three of whom die a short time after. The same day, New York City dermatologist Dr. Alvin Friedman-Kien reports a cluster of instances of Kaposi’s Sarcoma in gay men in New York and California. Several major outlets report on the article, and the CDC begins to receive a steady trickle of reports of similar cases. This article is often cited as the official beginning of the AIDS Crisis.
July 1981 – An LGBT newspaper in San Francisco, The Bay Area Reporter, writes about “Gay Men’s Pneumonia” and urges gay men experiencing shortness of breath to see a doctor. The New York Times article “Rare Cancer Seen in 41 Homosexuals” leads to the coining of the term “gay cancer” to describe Kaposi’s Sarcoma.
August 11, 1981 – Writer and film producer Larry Kramer hosts a fundraiser in his New York City apartment, at which Dr. Friedman-Kien addresses a crowd of gay men. He raises $6,635 to fund research into the mysterious new illness, the only money raised for the cause in 1981. Kramer soon co-founds the Gay Men’s Health Crisis (GMHC), a community-based non-profit dedicated to serving the community throughout the emerging crisis.
May 11 – In an article titled “New Homosexual Disorder Worries Health Officials,” the New York Times first publishes the phrase Gay-Related Immune Deficiency, or GRID, contributing to the widespread misconception that AIDS only affects gay men.
September 24 – The CDC uses the term “AIDS” for the first time. It defines Acquired Immune Deficiency Syndrome as “A disease at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease.”
January 1 – Ward 86, the world’s first dedicated outpatient clinic for people with AIDS, opens at San Francisco General Hospital. The clinic develops the San Francisco Model of Care, a holistic approach that focuses not only on medical care but also on making patients comfortable, providing them with resources they need to deal with the many challenges of living with AIDS, and allowing patients facing severe social stigma to live, and in many cases die, with dignity. This compassionate model is adopted by medical professionals around the world and sets the standard for excellence in treating HIV-AIDS patients.
January 7 – The CDC reports the first cases of AIDS in women.
March 4 – The CDC publishes an article saying that AIDS is most prevalent “among gay men with multiple sexual partners, people who inject drugs, Haitians, and people with hemophilia.” It suggests that sexual contact and exposure to blood and blood products are the most likely vectors for the disease.
May 20 – Dr. Françoise Barré-Sinoussi and her colleagues at France’s Pasteur Institute report their discovery of a retrovirus believed to be the cause of AIDS. She and a colleague eventually receive the Nobel Prize for their work.
May 25 – The New York Times publishes its first front-page article on AIDS.
June 12 – At the National AIDS Forum in Denver, 11 gay men with AIDS take over the stage. They issue a statement laying out what becomes known as the Denver Principles, asserting the rights of people with AIDS to be protected from discrimination, to have their voices heard by organizations making decisions about AIDS research and treatment, and to respect and dignity. They also demand that the phrase “AIDS victims” be replaced by “people with AIDS.”
September 9 – The CDC rules out the possibility of transmission by casual contact, air, water, food, or environmental services, but misconceptions about the ways AIDS can be spread lingers for years.
November 22 – The World Health Organization convenes its first meeting on AIDS and begins formal surveillance of the illness.
Awareness Spreads, Misconceptions Linger
March 1 – A study in the American Journal of Medicine examines a cluster of 40 patients with KS and other opportunistic illnesses, tracing their sexual contacts. It describes an unidentified flight attendant, “Patient O” (the O standing for “outside Southern California,” where the study was focused), who was known to have hundreds of sexual partners a year. The report states this man had sexual contact with eight of the men in the study, and was the first patient in the study to show the onset of HIV/AIDS symptoms. Misconceptions around the study (and a misreading of Patient O”) give rise to the myth of Patient Zero, a promiscuous or even malicious gay man who single-handedly and knowingly touched off the AIDS pandemic in the United States.
April 23 – The Department of Health and Human Services announces the discovery of a retrovirus they call HTLV-III, the cause of AIDS. They also announce the development of a blood test and raise hopes that a vaccine could be developed in the next two years.
July 13 – The CDC recommends avoiding injection drug use and reducing needle sharing as ways of preventing transmission.
March 2 – The U.S. Food and Drug Administration licenses the first blood test for HIV, and blood banks begin screening the country’s blood supply.
April 22 – The Normal Heart, an autobiographical play about the early days of the crisis by Larry Kramer, opens off-Broadway.
July 25 – Rock Hudson, a legendary actor from the Golden Age of Hollywood whose homosexuality was an open secret in the industry, announces he has AIDS. Media coverage of AIDS increases dramatically in the following months.
August 27 – Ryan White, a teenager who contracted AIDS through donated blood, is barred from attending his middle school in Russiaville, Indiana due to his condition. The ensuing legal battle makes White a national figure, highlighting the stigma of the disease and the misconceptions surrounding how it is spread and who can contract it.
September 17 – President Ronald Reagan mentions AIDS publicly for the first time. He calls it a “top priority” and rebuffs accusations that his administration has not taken it seriously.
October 2 – Rock Hudson dies of an AIDS-related illness. He bequeaths $250,000 to create the American Foundation for AIDS Research.
A Public Health Crisis
January 16 – The CDC reports that 1985 saw an 89 percent increase in AIDS diagnoses from 1984, and predicts that the number will double in 1986.
May 1 – The International Committee on the Taxonomy of Viruses officially gives the name Human Immunodeficiency Virus, or HIV, to the virus that causes AIDS.
July 18 – A group of minority community leaders meet with Surgeon General C. Everett Koop to voice concerns about HIV/AIDS in communities of color, unofficially founding the National Minority AIDS Council.
November – In the Life: A Black Gay Anthology, the first collection of writings about the AIDS crisis from 29 Black, gay authors, is published. The book receives little mainstream attention at publication, but goes down in history as a watershed moment in gay literature.
February – Cleve Jones creates the first panel of the AIDS Memorial Quilt in honor of his friend Marvin Feldman, who died of an AIDS-related illness the previous October. Jones makes the panel three feet by six feet, the standard size of a grave plot, intending it and subsequent panels to serve as a way of remembering, grieving and celebrating the lives of people who have died from AIDS in a society where many families refused to acknowledge their cause of death and some funeral homes and cemeteries refused to handle their remains. The project becomes the NAMES Project.
February 4 – Legendary pianist Liberace dies of an AIDS-related illness. His doctor claims that Liberace, who had long denied rumors that he was gay, died of a heart attack. A week later, the actual cause of his death is revealed.
March 12 – Kramer helps found the AIDS Coalition to Unleash Power, or ACT UP, a direct-action group that pressures officials, governments, pharmaceutical companies, and other institutions to protect those at risk of HIV and those who have contracted it. The organization’s motto is “Silence = Death.” ACT UP begins agitating for increased access to experimental medications, as well as a coordinated national AIDS response.
March 19 – The FDA approves AZT, the first medication for treat AIDS. The treatment does not cure HIV-AIDS, but can be used to slow its progress and prevent transmission in some instances, such as during birth. The FDA also adjusts regulations to expand access to experimental medications.
March 31 – President Reagan and Prime Minister Jacques Chirac of France agree their countries will share credit for the discovery of HIV.
May 15 – The Public Health Service adds HIV to its immigration exclusion list. For the next 23 years, visa applicants are required to take a blood test and may be denied entry to the U.S. if they test positive.
May 31 – Reagan gives his first speech about AIDS. On June 24, he creates the first Presidential Commission on AIDS.
August 5 – A federal judge rules that a Florida school board cannot ban three HIV-positive brothers, Ricky, Robert, and Randy Ray, from attending school. The community of Arcadia, Florida responds with death threats, bomb threats and a school boycott.
August 18 – The FDA green-lights the first human test of a candidate vaccine against HIV.
August 28 – After weeks of threats following a ruling that they could not be banned from school for being HIV-positive, the home of brothers Ricky, Robert, and Randy Ray is burned to the ground while the family is staying elsewhere. The Rays later announce that they will leave Arcadia.
October 1 – The first national AIDS Awareness Month begins, with the CDC launching a massive public education campaign that warns “everyone is at risk.”
October 11 – The NAMES Project displays its AIDS Memorial Quilt on the National Mall in Washington, D.C. for the first time. The Quilt bears the names of 1,920 people who died of AIDS-related illnesses when it is first displayed—the number eventually grows to over 10,000, making the Quilt the largest piece of community folk art in the world.
November – San Francisco Chronicle journalist Randy Shilts publishes And the Band Played On, a book about the early years of the AIDS crisis. Shilts traces the story of AIDS from the death of Grethe Rask to the death of Rock Hudson, arguing that the epidemic was allowed to happen thanks to incompetence, apathy, and discrimination against the populations it affected the most. His framing also leads to French Canadian flight attendant Gaëtan Dugas being identified as “Patient Zero.”
May 26 – The Surgeon General releases the nation's first coordinated HIV/AIDS education strategy, mailing out 107 million copies of a pamphlet titled Understanding AIDS in an attempt to reach every household in America, the largest public mailing in history.
November 4 – President Reagan signs the first comprehensive federal AIDS bill, the Health Omnibus Programs Extension (HOPE) Act, establishing the Office of AIDS Research and authorizing federal funds for AIDS prevention, research, and testing.
December 1 – The WHO declares the first World AIDS Day.
February 16 – Keith Haring, a pop artist whose graffiti-inspired works often promoted AIDS-related charities and other social causes, dies of an AIDS-related illness.
April 8 – Ryan White dies of an AIDS-related illness.
June 6 – The International AIDS Conference convenes in San Francisco, but a number of organizations boycott in protest of American immigration restrictions.
July 26 – President George H.W. Bush signs the Ryan White Comprehensive AIDS Resources Emergency Act, allocating over $220 million in federal funds for care and treatment of people with AIDS in its first year. The bill is the result of a bargain—in exchange for instituting “payer of last resort” programs to cover treatment for poor and uninsured people with HIV/AIDS, conservatives won the inclusion of clauses stipulating that certain funds will only be available to states that have passed harsh criminal laws against knowingly transmitting HIV.
May – The Visual AIDS’ Artists Caucus launches the Red Ribbon project, creating small red ribbons for people to wear to raise awareness and fight against the stigma of HIV/AIDS. The ribbons receive widespread attention the following month, when they are worn by a number of attendees and presenters at the 45th Tony Awards.
November 7 – Earvin “Magic” Johnson, a future Hall of Fame basketball player and one of the most famous athletes in the country, announces that he has tested positive for HIV and will retire immediately. He does not elaborate on how he contracted the virus, but later acknowledges that he had unprotected sex with many women over the course of his career. The news reverberates around the country, and while rumors spread that Johnson is gay, for many his diagnosis confirms that straight people also face risk of contracting HIV/AIDS.
November 24 – Legendary Queen frontman Freddie Mercury dies of an AIDS-related illness, one day after announcing that he has AIDS. A gay icon and the first rock star known to have died of HIV/AIDS, his death sets of outpourings of grief around the world, as many in the AIDS activist community express their gratitude that he made his diagnosis public.
AIDS becomes the leading cause of death for American men aged 25 to 44.
April 8 – Tennis star Arthur Ashe, the only Black man to win singles titles at Wimbledon, the US Open and the Australian Open, announces that he is HIV-positive. He believes he contracted the virus via a blood transfusion he received during heart surgery.
April 20 – The Freddie Mercury Tribute Concert for AIDS Awareness draws a crowd of 72,000 to London’s Wembley Stadium.
December 13 – Fifteen-year-old Ricky, the oldest of the Ray brothers, dies of an AIDS-related illness.
February 3 – Rudolf Nureyev, a Soviet ballet dancer whose 1961 defection and subsequent performances with London’s Royal Ballet made him an international sensation, dies in Paris of an AIDS-related illness.
February 6 – Arthur Ashe dies of an AIDS-related illness.
June – President Bill Clinton establishes the Office of National AIDS Policy to coordinate federal effort to combat HIV/AIDS.
December 14 – Philadelphia, a major motion picture starring Tom Hanks as a gay man with AIDS and Denzel Washington as his lawyer in an anti-discrimination lawsuit, debuts to rave reviews. One of the first mainstream films to deal with homophobia and HIV/AIDS, it is a box office hit and Hanks wins Best Actor at the 66th Academy Awards.
AIDS becomes the leading cause of death for all Americans aged 25-44.
February 17 – Journalist Randy Shilts dies of an AIDS-related illness.
June – The FDA approves the first protease inhibitor, ushering in the era of highly active antiviral therapy (HAART). Over the next few years, aggressive treatments like this become the new standard in HIV care.
September 22 – The National Academy of Sciences concludes that syringe exchange programs are effective in preventing the spread of HIV/AIDS.
November – The number of total AIDS cases reported in the United States passes 500,000.
November 11 – Pedro Zamora dies of an AIDS-related illness. The 22-year-old broke many barriers as a contestant on MTV’s The Real World, in which he discussed living with AIDS with his housemates, dispelled many misconceptions, and began a relationship with another contestant, with whom he shared the first same-sex commitment ceremony to be aired on American television.
February 23 – Greg Louganis, who swept the diving events at the 1984 and 1988 Olympics and is considered by many the greatest American diver ever, announces that he is HIV-positive. First diagnosed six months before the 1988 games, Louganis had kept his diagnosis and treatment a secret, even after coming out as gay in 1994.
The number of AIDS cases diagnosed annually in the U.S. declines for the first time since the pandemic began. AIDS ceases to be the leading cause of death for all Americans aged 25-44, although it remains the leading case of death among African Americans aged 25-44.
November 21 – The Food and Drug Administration Modernization Act institutes an accelerated drug-approval process, enshrining in law a demand frequently made by activists.
President Clinton declares HIV/AIDS a “severe and ongoing health crisis” in African American and Hispanic communities, after community leaders develop a “Call to Action” to address the dramatically disproportionate amount of cases in their communities. Congress soon allocates $156 million for the Minority AIDS initiative.
Despite declining numbers in the United States, the WHO announces that AIDS has become the fourth-leading cause of death worldwide and the number one killer in Africa.