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In the early 1980s, the Dean of UNLV's Department of Public Health, Dr. Mary Guinan, was part of a task force at the Center for Disease Control investigating a strange and deadly illness appearing in gay men. She and her group eventually identified and began studying the AIDS virus. More than 30 years later, she talks about that discovery and how far we’ve come in understanding and treating HIV and AIDS.
The investigation into the disease that would eventually be identified as AIDS began when Guinan and her team at the CDC were concerned by the occurrence of PCP pneumonia in younger adults who otherwise did not have compromised immune systems.
“Finally there was a cluster of these in San Francisco that was reported to CDC. And it was five gay men and they all had died of this pneumocystis pneumonia. And their only commonality was that they were all gay, so the idea was perhaps this was a sexually transmitted infection, and the idea that there was a sexually transmitted disease that could kill you was certainly one that shocked the nation and shocked the medical community especially. In those days, most doctors knew nothing about sexually transmitted disease - we didn’t learn about them. The idea was it happened in other people not in our patients.”
When the CDC was ready to publish its findings, there was concern about even using the word ‘homosexual’ in the report.
“People didn’t talk about gays and homosexuality, they didn’t talk about sexually transmitted infections, those things were terribly sensitive, and when that was published in 1981, all the nation knew something was going on, and more and more things happened. We learned about the tumors but it was marginalized into those groups – gay people, then intravenous drug users, but within 18 months we knew all the ways it was transmitted. It could be transmitted through transfusions, blood products, hemophilia, from mother to child during child delivery, and the nation was at risk – it wasn’t just gays and drug users."
The media was afraid to report on AIDS, and no one wanted to be tested for the disease, both because at that time there was no treatment, and because of the ostracism that went with being labeled an AIDS victim.
“What I saw was totally fear – everybody was afraid and I can tell you that the medical community didn’t want to talk about it. Nobody wanted to be associated with it. The media didn’t want to know about it, they didn’t want to talk about it. So it was very difficult to try and get information – people were pariahs if they had it or were even near people who had it. Nobody wanted to be diagnosed with this disease, nobody wanted anyone to know they were diagnosed with the disease. Families abandoned their family members who had the disease. It was an unbelievably difficult time.”
The CDC faced opposition from politicians and the media in their efforts to educate the public.
“It was a great battle, but I can tell you that we wouldn’t have been able to do it without the gay activists. No politician would take up this role. Many of the media and the columnists – when we tried to say you must have safe sex and use condoms to have sex to prevent disease, columnists wrote that the CDC was trying to teach gay people how to have sex and we were using government funding to teach people how to have gay sex. There was a whole Congressional group who were opposed to even mentioning the word condom. It took awhile because the community was so devastated, but I can tell you that in 1984, the virus was isolated and then in 1985, there was a test but nobody wanted to be tested. Because there was no treatment for it and if found positive, everyone would disown you – you would have lost your community and your support.”
Guinan calls the AIDS cocktail ‘a miracle.’
“In the 80s, I took care of patients from 1981 until 1995 longer than that but every one of the patients died ... We had no resources, and finally in 1995, that cocktail, that treatment became available. It was like a miracle, it changed everything. It was the most incredible change the treatment people used, they were leading normal lives. So that it was extremely important to identify everybody who was infected and to get them on treatment. The treatment is twofold it treats the patent so they can live with a long time disease, but it also prevents transmission of disease, and this is the only prevention we have is to find everyone that’s positive and treat them so that the disease will no longer be communicated.”