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WHO: The coronavirus is officially a pandemic (UPDATES)

HRC/LA Gala still on, GLAAD Awards/NYC cancelled

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The United States is imposing new travel restrictions to prevent spread of the virus, banning all travel from the EU (not the UK).

(PLEASE NOTE: This is a fast moving story. Please check the CDC and the LA County Dept. of Public Health and trusted news sites for accurate updated information).

The World Health Organization (WHO)  officially declared the coronavirus a pandemic on March 11, meaning it’s a new super bug with no immunity, no vaccine, no cure and a threat to the public health system.

But while  Director-General Tedros Adhanom Ghebreyesus “rung the alarm bell loud and clear,” he also tried to forestall widespread panic.

“All countries can still change the course of this pandemic,” he said, “if countries detect, test, treat, isolate, trace and mobilize their people in the response.”

President Donald Trump’s self-obsessed magical thinking, however, continues to throw up inaccurate and contradictory barriers to the dissemination of important information, even that espoused by his own administration’s trusted health experts.

(UPDATE) On March 10, shaken after yet another precipitous sharp Wall Street stock decline, Trump went to Capitol Hill to discuss measures to stem feared financial fallout resulting from the increasing spread of the virus. He met with congressional Republicans who did not automatically fall in line this time – some were even supportive of an economic relief package Speaker Nancy Pelosi has prepared. (UPDATE: On March 12, The Dow had its worst day since the Crash of 1987, per CNBC.)

Trump stopped to talk with reporters on his way out.  “We’re doing a great job with it,” he said, despite news reports of just how badly the administration failed to act to contain the virus early on.

“It will go away. Just stay calm,” Trump said. “It’s really working out. And a lot of good things are going to happen.”

Meanwhile, on another part of Capitol Hill, Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, told the House Oversight Committee the very opposite.

“We have got to assume it is going to get worse and worse and worse,” Fauci said, noting that the new virus will not just die off with warmer weather, as Trump insists.

“We must be much more serious as a country about what we might expect,” Fauci added. “We cannot look at it and say, ‘Well, there are only a couple of cases here, that’s good.’ Because a couple of cases today are going to many, many cases tomorrow.”

Fauci also rebutted Trump repeatedly saying that the coronavirus is no worse than the flu. “People always say, ‘Well, the flu does this, the flu does that.’ The flu has a mortality of 0.1 percent. This has a mortality of 10 times that,” Fauci said.

AIDS activists and LGBTQ people who lived through the HIV/AIDS crisis recognize Fauci as someone who started out as a slow-moving bureaucrat but eventually became an AIDS ally. He is now a trust-worthy voice and — perhaps a trait learned from AIDS activists — he speaks truth to power, though the “power” might not listen.

“I have never ever held back telling exactly what is going on from a public health standpoint,” Fauci told Rep. Stephen F. Lynch (D-MA) who suggested the expert be more forthright instead of just standing behind Trump at news conferences and rolling his eyes.

Part of the problem is that even the experts don’t know the precise nature of the highly contagious novel coronavirus, nor its status in the US because there hasn’t been enough testing. There are also questions about how many testing kits have actually been distributed, to whom, and when will more be available. NBC News reported March 11 that a company in Germany sent machines to the US capable of producing hundreds of test kits – but they are sitting idle awaiting FDA approval.

Meanwhile, considering that the virus can live in the air and on a surface for several hours and infectious incubation can be up to nine days without symptoms, officials extrapolate that every single person diagnosed with coronavirus probably had contact with up to three other people.

(UPDATE) John Hopkins Coronavirus Resource Center reports 4,718 deaths globally (as of March 12). The US reported 1,323 coronavirus cases and 38 deaths.

California Gov. Gavin Newsom declared a state of emergency and the state now has 157 cases, with thousands more people assumed to have been exposed.

“We’re a nation-state,” Newsom said March 10. “This is not a small, isolated state. The state of California is 40 million strong, 58 counties. So, what we’re doing is a bottom-up process, not a top-down process. We’re providing guidance in concert, in collaboration with the federal government and we are sending that down … but each and every county is experiencing a different set of circumstances on the ground.”

The Los Angeles County Public Health Department reported 24 cases in LA County, with one confirmed coronavirus-related death – a woman over 60 with underlying health issues, Public Health Department Director Dr. Barbara Ferrer said, according to the LA Times.

UPDATE: So far, Newsom has not call out the National Guard for containment but he has instead strongly encouraged organizations to consider canceling or postponing events with more than 100-250 people, admittedly an arbitrary number. (Late Wednesday night, Newsom called for a ban on all large gatherings over 250 people.).

California counties, businesses and non-profits have reacted differently, some ordering bans and other forms of mitigation, others preferring alerts suggesting health protocols such as vigorously washing your hands for 20 seconds,  using alcohol-based hand sanitizer; covering your mouth with a disposable tissue or your sleeve when coughing or sneezing; not touching your face; wiping down publicly used surfaces; and self-quarantining when not feeling well.

Keep your hands clean.

In particular, officials advise practicing “social-distancing” by avoiding being within three to six feet of people you don’t know (they could be asymptomatic) or who display signs of illness. Do not kiss or hug to either inadvertently spread or breath in those harmful droplets — instead bump elbows or feet. Or do an old spiritual acknowledgement: briefly join your hands in prayer and bow or clutch your heart like a 1930s motion picture singer.

Health officials also recommend staying and working from home with a fever or cough and calling a doctor or clinic if the symptoms worsen or do not get better after several days. The elderly and those with underlying health conditions such as diabetes, high blood pressure, chronic heart disease, respiratory conditions, cancer and compromised immune systems are particularly at risk.

LA County health officials have issued new guidance to mitigate the spread of the virus.

“It’s time to start thinking about limiting activities anywhere you have a lot of exposure to the general public,” Ferrer said March 10. She also said that health teams will start visiting all nursing homes and long-term-care facilities in Los Angeles County — roughly 300 — to enforce infectious disease protocols and prevention measures. The teams will also assess the 330 homeless shelters and numerous encampments throughout L.A. County to quarantine the sick from the healthy, she said.

On March 11, the National LGBT Cancer Network and GLMA: Health Professionals Advancing LGBTQ Equality (formerly known as the Gay & Lesbian Medical Association) issued an open letter signed by more than 100 LGBT-affiliated organizations that offered culturally competent information to supplement recommendations put out by the CDC and local public health agencies.

“As the spread of the novel coronavirus a.k.a. COVID-19 increases, many LGBTQ+ people are understandably concerned about how this virus may affect us and our communities,” they write.

“Our increased vulnerability is a direct result of three factors:

The LGBTQ+ population uses tobacco at rates that are 50% higher than the general population. COVID-19 is a respiratory illness that has proven particularly harmful to smokers.

The LGBTQ+ population has higher rates of HIV and cancer, which means a greater number of us may have compromised immune systems, leaving us more vulnerable to COVID-19 infections.

LGBTQ+ people continue to experience discrimination, unwelcoming attitudes, and lack of understanding from providers and staff in many health care settings, and as a result, many are reluctant to seek medical care except in situations that feel urgent – and perhaps not even then.”

Additionally, they write, “there are more than 3 million LGBTQ+ older people living in the United States. LGBTQ+ elders are already less likely than their heterosexual and cisgender peers to reach out to health and aging providers, like senior centers, meal programs, and other programs designed to ensure their health and wellness, because they fear discrimination and harassment. The devastating impact of COVID-19 on older people – the current mortality rate is at 15% for this population – makes this a huge issue for the LGBTQ+ communities as well.”

Darrel Cummings, Chief of Staff at the Los Angeles LGBT Center, says he did not get an invitation to sign onto the letter. However, the Center has initiated its own precautions at its senior housing facility Triangle Square in Hollywood in reaction to the outbreak.

“For us, the primary client concerns are 1) those who are healthcare patients and who come to our McDonald/Wright building for a variety of healthcare services, 2) our senior services which include residents of Triangle Square but also the many others who come to the Campus for programs, meals, etc. and 3) our programs for youth that includes our drop in center services and housing through our emergency overnight beds and transitional living program,” Cummings tells the Los Angeles Blade.

“The good news is that we now have tests on site and are prepared to administer those both at our clinic site but also off site at our other facilities,” he says. “We have been providing, almost on a daily basis, the most up-to-date information to our staff and clients about the preventative measures they can take to protect themselves and others.

“We have been following the guidelines for congregate care and living issued by the department of public health and the CDC and have plans in place for appropriately reacting to any identified case that we may identify in the clinic or at our other facilities, especially those in our seniors and youth programs,” he says. “We are prepared, as best we can be, to provide testing and any needed isolation.

“Generally, we are encouraging people (staff and clients) who are exhibiting symptoms, not to come to our services and to call us or their medical provider for counsel.  Obviously, we have masks and hand sanitizers throughout. although these things can be in short supply so we have lots on back-order,” Cummings continues.

“We have established a COVID-19 (aka coronavirus) management team that is meeting and talking on a very regular basis so we can act on or react to developments as they happen and are just assuming that the numbers of those identified with the virus will grow dramatically as more and more are tested.”

POZ Magazine has also been reporting on HIV/AIDS and the coronavirus and notes that “the HIV population is aging, and nearly half are over 50. Those with low CD4 T-cell counts, indicating advanced immune suppression, are at greatest risk. People with HIV are more likely to develop cardiovascular disease and may do so at a younger age. Certain HIV medications, especially older drugs, can cause neutropenia, or depletion of immune system white blood cells that fight infection.”

“When you look at who’s been most profoundly ill, it tends to be people who are older, in their 60s, 70s and 80s. As you get older, your immune system doesn’t function as well,” Steve Pergam, MD, MPH, of the Vaccine and Infectious Disease Division at Fred Hutchinson Cancer Research Center, told POZ.

Among people living with HIV, “it’s all based on level of immune suppression.”

“For an HIV patient who is on stable antiretroviral therapy and has a normal CD4 count, their risk may be slightly increased. People often lump HIV patients with other immunosuppressed patients, but HIV is a different disease than it was years ago. For people who have a reconstituted immune system because of treatment, I think the risk is not going to be tremendously different,” Pergam told POZ.

(UPDATE) Individual LGBTQ and HIV/AIDS organizations are handling their responses with health safety protocols and their constituencies in mind. Equality California and the California LGBT Legislative Caucus, for instance, issued an advisory in advance of their March12-13 summit in Sacramento but decided to postpone after Newsom issued new guidance Wednesday night banning all gatherings over 250 people.  The LA County HIV Commission, on the other hand, decided to cancel the March 12 2020 Commission on HIV meeting and special panel presentation commemorating National Women + Girls HIV/AIDS Awareness Day reschedule “at later date/time to be determined.”

(UPDATE) Other major events have canceled or postponed, as well, including the big Dinah bash in Palm Springs, the Los Angeles Times annual Festival of Books and Food Bowl. Goldenvoice announced the Coachella Valley Music and Arts Festival has been postponed until October. Also cancelled – RuPaul’s DragCon LA 2020, NCAA March Madness tournaments.

(UPDATE)  Disneyland in Anaheim is closing through mid-April. Universal Studios said they are monitoring the outbreak but presumably will close for a period of time after Newsom’s announcement.

The LA Times reports that “San Francisco announced it is banning large group events of 1,000 or more people.”

“We know that this order is disruptive, but it is an important step to support public health,” said Mayor London Breed, noting that city officials were following advice from state officials.

LA has not followed suit, so far. “We will get to a point, unfortunately, here in L.A. County, where we will be asking for events to close. But we’re not there yet,” said Public Health Director Ferrer.

(UPDATE) The Human Rights Campaign canceled its gala on March 28.

“We are facing a global health crisis, and the Human Rights Campaign’s number one priority is to look out for the health and safety of our members, supporters, staff, the LGBTQ community and the community at large,'” says HRC President Alphonso David in a March 12 press release. “For that reason, we have decided to cancel or postpone all of our public events through the weekend of April 4, including our large-scale fundraising dinners in Nashville on March 14, Los Angeles on March 28 and Houston on April 4.

 

“Our focus remains on the goal of advancing the rights of LGBTQ people around the world and on the  defeat of Donald Trump and Mike Pence in November,” he says. “We will continue to work toward this goal, and weather this crisis as we have weathered crises before — by uniting as a community.”

GLAAD chose to cancel their 31st Annual GLAAD Media Awards in New York.

“Given GLAAD’s long-standing commitment to the safety of our members, sponsors, and guests, the GLAAD Media Awards will no longer take place on March 19th in New York City,” GLAAD’s Rich Ferraro, Chief Communications Officer and an Executive Producer of the GLAAD Media Awards, said in an emailed advisory.

“The team at GLAAD has been in communication with the City of New York and is following the latest recommendations from Governor Cuomo. We were planning to unveil a historic get-out-the-vote campaign at the event because everything is at stake for LGBTQ Americans this election year,” he says, “and are hopeful that the program and GLAAD’s ongoing work to fight against anti-LGBTQ discrimination will continue to be supported and funded.”

Ferraro notes that the loss of event funding will hurt their advocacy work.

“We are beyond proud to honor Ryan Murphy and Judith Light, two trailblazing beacons of LGBTQ advocacy and inclusion, and we will ensure their game-changing work is rightfully recognized at another time. We are so thankful to our host Lilly Singh, performers Adam Lambert and Ben Platt, and all of the LGBTQ people who were working hard to ensure our stage show would once again send much-needed messages of LGBTQ acceptance around the globe,” he says.

GLAAD will contact the nominees about plans on how the awards will be announced, “acknowledging that a GLAAD Media Award nomination or win can raise the bar for LGBTQ representation and serve as a catalyst for media executives to greenlight additional LGBTQ projects.”

GLAAD is also speaking with public health officials in Los Angeles about next month’s GLAAD Media Awards dinner and stage show.

Stay tuned.

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Oregon House passes over-the-counter HIV prevention drugs bill

HIV-related stigma, homophobia and transphobia, and lack of access create equity gaps in HIV prevention, testing, and treatment

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Oregon State Capitol Building in Salem (Photo Credit: State of Oregon)

SALEM, OR. – The Oregon House of Representatives re-passed House Bill 2958B, a measure that would allow Oregon’s pharmacists to prescribe, dispense, and administer both pre-exposure, (PrEP) and post-exposure prophylaxis, (PEP) the two drugs designed to prevent HIV infection.

The bill also sets the legal authority to conduct HIV tests in the state. The measure had passed in April on a 44-11 vote, was sent to the Senate, and then the measure was sent back after a compromise and conference bill was voted out of the Senate returning it to the House.

The Oregon House on Monday re-passed House Bill 2958 B, which allows pharmacists to prescribe, dispense, and administer both pre-exposure and post-exposure prophylaxis. Known as PrEP and PEP, the two drugs prevent HIV infection. The bill also clarifies that pharmacists have the legal authority to conduct HIV tests. The bill, which previously passed out of the House in April, passed today 44-11.

In an interview with Oregon Public Broadcasting, Rep. Rob Nosse, (D-SE Portland) who is openly gay and a lead sponsor of the bill noted; “Throughout this bill’s journey through the legislative process, we heard repeatedly that pharmacists have the training necessary to administer these life-saving drugs.”

“By making PrEP and PEP more widely available, we can get these medicines into communities that have been disproportionately impacted by HIV,” he added.

Approximately 1.2 million people in the U.S. have HIV. About 13 percent of them don’t know it and need testing. HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay, bisexual, and other men who have sex with men.

CDC estimates of annual HIV infections in the United States show hopeful signs of progress in recent years. CDC estimates show new HIV infections declined 8% from 37,800 in 2015 to 34,800 in 2019, after a period of general stability.

While new HIV diagnoses have declined significantly from their peak, the CDC and other Public Health officials across the U.S. have expressed concern of HIV resurgence due to several factors, including trends in injection and other drug use.

“When this disease first came into national focus, it was often referred to as ‘gay related immune deficiency,’ or GRID. Today, HIV is recognized as a disease that can be contracted by anyone, and those who are diagnosed as HIV positive can be given resources and medical support to live a long and healthy life,” said Nosse. “This bill is potentially a lifesaving solution that will prevent deaths from HIV by making PrEP more accessible to all who need it.”

Lawmakers in support of the bill say HIV-related stigma, homophobia and transphobia, and lack of access create equity gaps in HIV prevention, testing, and treatment, OPB reported.

“This is about reducing barriers to access for life-saving medications,” said Rep. Dacia Grayber, D-Tigard, who also co-sponsored the bill. “PrEP and PEP are both vital parts of the toolkit for ending the HIV epidemic. By empowering pharmacists to test for HIV and prescribe these medications, we make it easier for Oregonians to get the health care services they need.”

“Preventative treatments for HIV have saved countless lives, but not all communities have equal access to these drugs, and we can see the disparities in outcomes for low-income and BIPOC communities,” said co-sponsor Rep. Karin Power, D-Milwaukie. “HB 2958 will help to distribute these life-saving drugs more broadly, so that we can begin to close these gaps in our health care system and ensure that more people are protected.”

HB 2958 B now heads to Governor Kate Brown for her signature.

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AIDS and HIV

AIDS @40: AIDS disaster overwhelms the gays

“This horrible disease afflicts members of one of the nation’s most stigmatized and discriminated-against minorities.”

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Undated photograph of U.S. Rep. Henry Waxman, (D-Beverly Hills) (Photo Credit: Library of Congress via LA Times)

By Karen Ocamb | LOS ANGELES – After the Centers for Disease Control published his June 5, 1981 article on the mysterious new infectious disease sickening and killing gay men, Dr. Michael Gottlieb, an immunologist at UCLA School of Medicine, expected the government to show up and save the day. But it was Ronald Reagan, America’s new and the conservative president who decided to dance with the right-wing anti-LGBTQ evangelicals who brought him to the White House.

“Government is not the solution to our problem, government is the problem,” Reagan said at his Inauguration, before drastically cutting the federal budget, including the CDC and National Institutes of Health budgets and healthcare programs such as Medicare and Medicaid impacting more than a fifth of the US population, according to a Washington Post story at the time.

“I thought there’d be an aggressive response by the federal government, by the National Institutes of Health and CDC with the funding for research, but that never happened,” Gottlieb told the Los Angeles Blade. “We were very frustrated — very frustrated. We piggybacked the research on funding that we already had for other things. But we continued to do the work.” 

In early 1982, the CDC launched a national case–control study that found that more case-patients were sexually active and more likely to have had sexually transmitted infections than their control gay patients. Meanwhile, in Los Angeles, Dr. David Auerbach, who replaced Dr. Wayne Shandera, the CDC Epidemic Intelligence Service (EIS) officer assigned to the Los Angeles County Department of Health Services, was asked by a gay community member if there was a possible sexual link between “the still rare cases” in Southern California. Auerbach collaborated with Dr. William Darrow of the Task Force on Kaposi’s Sarcoma and Opportunistic Infections to investigate 13 of the first 19 cases reported in LA and Orange counties. They found that “nine had reported sexual contact with another person reported with AIDS within 5 years before their onset of symptoms,” the CDC reported. They extended their epidemiologic investigation nationwide and, together with the case–control study, found evidence that “strongly suggested that the new syndrome was caused by a sexually transmissible infectious agent. Nonetheless, whether because of competing hypotheses or merely denial, many scientists and the public were skeptical of the infectious agent causation theory.”

By the end of 1982, new cases of AIDS were reported in hemophiliacs, needle-sharing drug users, infants, women, people who received blood transfusions and heterosexual Haitian migrants. 

The “gay plague” impacted heterosexuals, too. “[I]t was clear that others were at risk for the disease, and what had been complacency turned into serious concern, even panic. Many persons caring for AIDS patients were concerned about their own safety and, in some cases, health-care workers refused to provide needed care. To provide guidance for protection of clinicians and laboratory workers managing patients with AIDS and their biologic specimens, CDC issued guidelines in November 1982 that were based on those previously recommended to protect against hepatitis B virus infection,” wrote James W. Curran, MD, and Harold W. Jaffe, MD in  AIDS: the Early Years and CDC’s Response, a CDC special report in 2011.

Proud and thriving gay liberationists and suave disco and ballroom dancers started wasting away uncontrollably. KS lesions blotched faces and bodies. Muscles atrophied. Beauty was betrayed by shrunken cheeks. Bowels wouldn’t behave. Sweat fell like pouring rain onto bed sheets. Spirituality clashed with the most practical questions about quantity versus the quality of life. Gay men turning 20, rejected by their families after being outed by AIDS, died forlornly in the arms of lesbian friends, knowing they would never fall in love. AIDS was a cruel thief. Support groups started popping up: Gay Men’s Health Crisis in New York; Shanti and The Kaposi’s Sarcoma (KS) Research and Education Foundation and AIDS Project Los Angeles in 1983.  Flirtations singer Michael Callen and Richard Berkowitz, two gay patients of Dr. Joseph Sonnabend, published How to Have Sex in an Epidemic, which essentially created the idea of safe sex with use of a condom. 

On April 13, 1982, Rep. Henry Waxman, then the Chair of the House Energy and Commerce Subcommittee on Health and the Environment convened the first congressional hearing on AIDS (Acquired Immune Deficiency Syndrome). Waxman’s district included the still unincorporated gay haven of West Hollywood and he went to where the gays were — the Los Angeles Gay and Lesbian Community Services Center on Highland Ave. in Hollywood, California. Years later, in presenting Waxman with an award, NIH’s Dr. Anthony Fauci recalled that event

According to an account in the Washington Blade, DC’s gay newspaper of record at that time, Rep. Waxman did not mince words. “‘I want to be especially blunt about the political aspects of Kaposi’s sarcoma,’ Rep. Waxman said.  ‘This horrible disease afflicts members of one of the nation’s most stigmatized and discriminated-against minorities.’  He continued, ‘There is no doubt in my mind that if the same disease had appeared among Americans of Norwegian descent, or among tennis players, rather than among gay males, the responses of the government and the medical community would have been different.’  He noted that the outbreak of Legionnaire’s disease a few years earlier appeared to have received greater attention and funding for research and treatment than did the latest outbreaks of Kaposi’s sarcoma and pneumocystis pneumonia among gay men.”

Five months later, on Sept. 24, 1982, Waxman and Rep. Phillip Burton introduced legislation to allocate funds to the CDC for surveillance and to the NIH for AIDS research.

Dr. James Curran, head of the CDC’s Task Force on Kaposi’s Sarcoma and Opportunistic Infections, estimates that tens of thousands of people may be affected by the disease. Bobbi Campbell, a San Francisco nurse who came out Dec. 10, 1981 in the San Francisco Sentinel as the first KS patient to go public, also testified. The self-proclaimed “KS Poster Boy,“ was asked to translate “cold data into flesh and blood and tears,” and to speak “of the men, my brothers, who have Kaposi’s sarcoma and other illnesses.” 

Gottlieb was there but he doesn’t remember much — just that his friend Steve Schulte was there and he met Tim Westmoreland, the gay man who staffed and organized the hearing for Waxman. And he remembers the Center as a broken-down old motel with the meeting held outside. It didn’t get much press coverage.

 

Dr. Michael Gottlieb with Ivy Bottini: “Young City At War production photo by Andy Sacher, Courtesy of The Lavender Effect®.”

Gottlieb does remember his friendship with Ivy Bottini, an artist turned AIDS activist. Bottini’s old friend from Long Island, Ken Schnorr, had collapsed and died in 1982. “After Ken died, something said to me there is more to this than we see,” Bottini told the LA Blade. “So, for some reason, I just picked up the phone and called the CDC. I had never done that before. ‘Look, this just happened to my friend. Do you have any answers? The hesitancy at the other end of the line, the hemming and the hawing before they would say anything — I just knew it was bad.”  

The CDC official explained that the bruises on Ken’s body were Kaposi sarcoma, usually found in elderly Jewish men. “And that was the explanation,” she said. “I got off and thought, ‘no, this doesn’t make sense because Ken was one of three first guys diagnosed with Kaposi in town, in West Hollywood, in L.A., and that started me on working to find out what the hell was going on. It was just horrible.” 

Waxman’s hearing was held shortly after Schnorr’s death. Bottini was there. “We all met in the lobby and under the stairs on the first floor,” she said. “Waxman’s basic message was spread the word: nobody really knows how it’s passed.”   

“Thousands of deaths and no one cares! No one cares – except us,” an emotional Bottini told Andy Sacher of the Lavender Effect about that time. “That was inhuman what was really happening to gay men. It was inhuman how they were demonized.” 

Karen Ocamb is the Director of Media Relations for Public Justice, a national nonprofit legal organization that advocates and litigates in the public interest.

The former News Editor of the Los Angeles Blade, Ocamb is a longtime chronicler of the lives of the LGBTQ community in Southern California. 

This is Part 3 of a series of 5 articles on AIDS @40.

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AIDS and HIV

AIDS @40: Gay men terrified, stigmatized by mysterious new fatal disease

“If this article doesn’t rouse you to anger, fury, rage, and action, gay men may have no future on this earth…”

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The photo of a dying David Kirby in Ohio in 1990 by photographer Therese Fare (Royalty Free LIFE.com)

By Karen Ocamb | LOS ANGELES – Before the CDC’s first report on AIDS, there was news from the New York Native,  a biweekly gay newspaper published in New York City from December 1980 until January 13, 1997. It was the only gay paper in the City during the early part of the AIDS epidemic and it pioneered reporting on AIDS.

On May 18, 1981, the newspaper’s medical writer Lawrence D. Mass wrote an article entitled “Disease Rumors Largely Unfounded,” based on information from the Centers for Disease Control and Prevention  scotching rumors of a “gay cancer.”

“Last week there were rumors that an exotic new disease had hit the gay community in New York. Here are the facts. From the New York City Department of Health, Dr. Steve Phillips explained that the rumors are for the most part unfounded. Each year, approximately 12 to 24 cases of infection with a protozoa-like organism, Pneumocystis carinii, are reported in New York City area. The organism is not exotic; in fact, it’s ubiquitous. But most of us have a natural or easily acquired immunity,” Mass wrote. He added: “Regarding the inference that a slew of recent victims have been gay men. . . . Of the 11 cases . . . only five or six have been gay.”

Eighteen days later, on June 5, 1981, the world turned when the CDC published an article by Dr. Michael Gottlieb in Morbidity and Mortality Weekly Report (MMWR) on AIDS symptoms, including cytomegalovirus (CMV) infection and candidal mucosal infection, found in five gay men in Los Angeles. By then, 250,000 Americans were already infected, according to later reports.

Gottlieb’s CDC report was picked up that same day by the Los Angeles Times, which published a story entitled ”Outbreaks of Pneumonia Among Gay Males Studied.” A slew of similar reports followed and on June 8 the CDC set up the Task Force on Kaposi’s Sarcoma and Opportunistic Infections to figure out how to identify and define cases for national surveillance. On July 3, the CDC published another MMWR on pneumocystis carinii pneumonia (PCP) and Kaposi’s Sarcoma (KS) among 26 identified gay men in California and New York. The New York Times’ story that day — “Rare Cancer Seen in 41 Homosexuals” – stamped the disease as the “gay cancer.” GRID (Gay-Related Immune Deficiency) came next. In the new Reagan/Bush Administration, dominated by homophobic evangelical advisors such as Gary Bauer, funding to investigate the new disease was scarce. 

Two years later, the New York Times finally put AIDS on the front page, below the fold, with a May 25,1983 headline that read: “HEALTH CHIEF CALLS AIDS BATTLE ‘NO. 1 PRIORITY.’”  By then 1,450 cases of AIDS had been reported, with 558 AIDS deaths in the United States; 71 percent of the cases were among gay and bisexual men; 17 percent were injection drug users; 5 percent were Haitian immigrants; 1 percent accounted for people with hemophilia; and 6 percent were unidentified. 

But Health and Human Services Assistant Secretary Dr. Edward N. Brandt Jr. told reporters that no supplemental budget request had been made to Congress. ”We have seen no evidence that [AIDS] is breaking out from the originally defined high-risk groups. I personally do not think there is any reason for panic among the general population,” he said.

Frontiers Magazine Cover Story by Larry Kramer (Photo Credit: Karen Ocamb)

Gays in denial seemed to accept feigned governmental concern. Others were deathly afraid. The HHS news conference was just 10 weeks – and 338 more cases – after the March 14 publication of playwright Larry Kramer’s infamous screed on the cover of the New York Native: “1,112 and Counting…”

“If this article doesn’t scare the shit out of you, we’re in real trouble. If this article doesn’t rouse you to anger, fury, rage, and action, gay men may have no future on this earth. Our continued existence depends on just how angry you can get,” Kramer wrote. “I repeat: Our continued existence as gay men upon the face of this earth is at stake. Unless we fight for our lives, we shall die. In all the history of homosexuality we have never before been so close to death and extinction. Many of us are dying or already dead.”

Too many gay men were not scared shitless. When LA gay Frontiers News Magazine re-published Kramer’s article as their March 30 cover story, bar owners threw the publication out, lest it unnerve patrons. Meanwhile, gay men wasted away and died, often alone, sometimes stranded on a gurney in a hospital hallway; sometimes – if lucky – with family or friends crying at their bedside as in the intimate photo taken by Therese Frare as her friend AIDS activist David Kirby died.  

None of this was new or startling to Gottlieb or fellow AIDS researcher and co-author, Dr. Joel Weisman.   

Gay San Francisco Chronicle reporter Randy Shilts dubbed Weisman “the dean of Southern California gay doctors” in his AIDS opus, “And the Band Played On.” In 1978, as a general practitioner in a North Hollywood medical group, Weisman treated a number of patients with strange diseases, including a gay man in his 30s who presented with an old Mediterranean man’s cancer, Kaposi’s sarcoma.

In 1980, Weisman opened his own Sherman Oaks practice with Dr. Eugene Rogolsky and identified three seriously ill gay patients with strange fevers, dramatic weight loss from persistent diarrhea, odd rashes, and swollen lymph nodes, all seemingly related to their immune systems. He sent two of those patients to Gottlieb, a young UCLA Medical Center immunologist studying a gay male patient with pneumocystis pneumonia and other similar mysterious symptoms, including fungal infections and low white blood cell counts. 

“On top of these two cases,” Shilts wrote, “’another 20 men had appeared at Weisman’s office that year with strange abnormalities of their lymph nodes,’ the very condition that had triggered the spiral of ailments besetting Weisman and Rogolsky’s other two, very sick patients.”

LGBTQ activist David Mixner, former U.S. Ambassador Jim Hormel, Dr. Joel Weisman at an amfAR event (Photo by Karen Ocamb)

Weisman later recalled to the Washington Post that “what this represented was the tip of the iceberg. My sense was that these people were sick and we had a lot of people that were potentially right behind them.”

There were other missed signs, such as the CDC getting increasing requests for pentamidine, used to treat pneumocystis pneumonia. Gottlieb says that after his first report, the CDC’s Sandra Ford confirmed that she was sending increasing shipments of Pentamidine around the country. “But I’m not sure any infectious disease doctor there knew or investigated why they were seeing a run on pentamidine or asked what that meant,” Gottlieb told the Los Angeles Blade. Later pentamidine became “the second line therapy for pneumocystis,” after Bactrim. 

Pentamidine “caused kidney problems, so we didn’t like it. Eventually, aerosolized Pentamidine became one of the preventatives. We didn’t realize at first that pneumocystis would happen in multiple episodes. Like a patient would have pneumocystis, we treated, it would clear and they’d go home for a month and then they’d get it again. We didn’t learn until later that we had to do something to prevent recurrences. And that’s where aerosolized Pentamidine came in doing a monthly breathing treatment.” 

Though being gay was highlighted as a high-risk factor, race was largely left out of reports until 1983, despite the fact that Gottlieb’s fifth patient in his June 5, 1981 CDC article was Black. Gottlieb remembers him as a previously healthy 36-year-old gay Black balding man named Randy, referred to him in April by a West Side internist. 

But Randy’s race was not included in that first report, nor was the omission caught by the MMWR editors, probably, Gottlieb speculates, because they were focused on collecting disease data while they struggled  to save their dying patients. Gottlieb views the absence of race “as an omission and as an error” because demographic data is “good form as a doctor because it is important.” If race was not included in the MMWR, it was an unconscious omission.”

Karen Ocamb is the Director of Media Relations for Public Justice, a national nonprofit legal organization that advocates and litigates in the public interest.

The former News Editor of the Los Angeles Blade, Ocamb is a longtime chronicler of the lives of the LGBTQ community in Southern California. 

Editor’s note; The photo of a dying David Kirby in Ohio in 1990 by photographer Therese Fare was labeled by LIFE Magazine as the photo that changed the face of AIDS. To read the story and to see a gallery of addition photos visit here; (LINK)

This is Part 2 of a series on AIDS @40. Part 3 looks at Rep. Henry Waxman’s congressional hearing in LA and the creation of AIDS Project Los Angeles.

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