The disease, which would change health care provision in the U.S. completely, entered the public conscious quietly, with the publication of the article “Pneumocystis Pneumonia (PCP)—Los Angeles,” in the June 5, 1981 edition of the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR). The brief entry described five previously healthy young gay men who had become inexplicably ill with PCP.9 The Lancet quickly followed with a paper about eight gay men diagnosed with an aggressive form of Kaposi sarcoma (KS), a rare cancer previously observed only in immunosuppressed organ transplant patients and elderly people of Mediterranean, Eastern European, and Middle Eastern descent.10
The New York Times published its first article about AIDS in July 1981, which cemented the new disease’s association with promiscuous “homosexual men who have had multiple and frequent sexual encounters with different partners, as many as 10 sexual encounters each night up to four times a week.”11 The same article quoted James Curran, a medical doctor and spokesperson for the CDC, who reassured the public that “nonhomosexuals” had no reason to worry. ''The best evidence against contagion,'' he said, ''is that no cases have been reported to date outside the homosexual community.''12
Early terms for the disease, including gay cancer, gay-related immunodeficiency or GRID, gay compromise disorder, and community-acquired immune dysfunction, furthered stigmatized AIDS and gay men.13,14,15 These stigmas—and the belief that other people were not at risk—continued long after the disease was officially renamed acquired immunodeficiency syndrome (AIDS) in 1982, and the disease was identified in every other population: women, children, adolescents, injection drug users, and straight men.16,17,18 In recalling the early days of the epidemic, Cliff Morrison, who established Ward 5B/5A at San Francisco General Hospital and created the systematic approach to AIDS care now known as the San Francisco Model of Care, says it felt as if “the door to darkness had been opened, and all the taboos were out there—sex, death, homosexuality, drug use. Things that people had never heard discussed openly before.”
Among nurses and doctors on the frontlines of the burgeoning epidemic, panic set in fast. AIDS patients filled emergency rooms throughout the U.S., first in the epicenters of the epidemic in New York and San Francisco, and then in smaller cities and towns, from Baltimore and Chicago to Mobile and Baton Rouge. Patients brought cultural identities and life experiences that many providers wished had stayed on the margins of society. They were gay stock traders from Wall Street and transwomen engaged in sex work. They were pregnant African-American women who used injection drugs and Black men who had just emigrated from the Caribbean. Doctors treating these patients had to work around their prejudices, as well as their patients’ complicated coinfections, such as herpes and hepatitis B, and histories of drug use.19 Many had been abandoned in these acute care facilities to die, dropped off by families and loved ones fearful of contracting the disease themselves.
Sheila Davis, a nurse who spearheaded early AIDS care programs, recalls how health care workers often refused to enter AIDS patients’ rooms to clean or deliver meals; medical doctors donned HAZMAT “moon suits” before touching or conferring with AIDS patients—when they bothered speaking to them at all. As Davis says, many doctors routinely talked over the patients and their families, particularly if they were part of a same-sex couple. Many medical personnel seemed to resent being ripped from their comfort zones even more than they feared HIV, as evidenced by their criticism of Davis and her colleagues for “wasting their time treating ‘those people.’”20