America and AIDS

Archive ID: 2007_america_and_aids_edited

This film tells the US story of the AIDS epidemic starting in the early 1980's. Scientists and activists, both pioneers and youths of today, talk about research, prevention, treatment and care. They also discuss stigma, homophobia and poverty as closely related to HIV and AIDS.

Background material

"I was very honored to get the assignment from Dr Anthony Fauci to produce a film for the 25th Anniversary of the federal NIH research on HIV/AIDS. I especially like the segment where Tony and the writer and AIDS activist Larry Kramer talk about the time when the activists tried to occupy Dr Fauci's office at the NIH in 1991. Fauci thought several of their demands were very relevant, and he invited Kramer and the other leaders to his office instead of sending the police to clear the area. This was the beginning of a strong friendship between Fauci and Kramer, which is highlighted in this unique film sequence." - Staffan Hildebrand


Well, I remember very clearly sitting in my office
at the National Institutes of Health
in Bethesda when I first saw the first June 5th Morbidity
and Mortality Weekly Report from the Centers for Disease Control
and Prevention of pneumocystis carinii pneumonia in five
gay men in Los Angeles, getting a degree of intense interest,
but anxiety.
And then four weeks later, a report
on July 4, 1981, that was several more patients that
had not only pneumocystis pneumonia, but also
Kaposi sarcoma in New York, and in Los Angeles,
and San Francisco.
And it was at that time that I got goosebumps of anxiety
that we were dealing with something
that was very ominous that we didn't completely
understand that I wasn't quite sure where it was going.

In the 1970s, sexual promiscuity, sexual freedom,
whatever you want to call it, really reached a peak.
People were free to have sex with each other, any time,
any place, night or day, and they did.

We're standing at 18th and Castro in San Francisco.
If AIDS, back in the early 1980s was a bomb,
this was the ground zero, the place where the bomb exploded.
One week we had two cases.
The next week we had four cases.
By the end of the month, we had 20 cases and two of them
were already dead, or three were dead, and it was devastating.
Literally half of the gay men in San Francisco
were infected with HIV.
And within every little social group or gathering--
for example, if you had a dinner party five or six people come
over for dinner-- three or four of them were visibly sick.
I don't think anyone who was not there then,
in this group of people, can imagine what it was like.
It was like, literally, being in wartime, in a battlefield.
People were dropping like flies.
You could not walk down the street here
in Greenwich Village without learning of somebody else,
somebody died, someone sick.
It was a hideous experience.
I'll never forget it.
Never forget it.
Nor do I want to.
Nor should anyone else.
When a whole community is hit by something like this,
you can only feel sorry for them because they're
caught in something they can't control.
Just stay away from drugs.
Just stay away from promiscuity.
Follow how you feel inside and you'll know when sex is right.
The timing, unfortunately, for the gay community
was, if you were an infection and you wanted
to take hold in a population, it was optimum for that to happen.
Here in the Bronx, New York, one of the places
where HIV first made its appearance
in the United States.
I was working here in 1981 as an infectious disease specialist
when I saw my first patients with, what was then,
an unknown disease.
In the 1960s, there was a epidemic of heroin.
So laws were passed limiting the supply of needles,
forcing drug users to share more,
and then HIV happened just at that point.
How do you see the development of the drugs,
and the violence, and everything now in the Bronx?
Well, a big influx of drugs.
Huge amounts.

Are you afraid of AIDS?
Yes, we are.
Very much so.
A lot has to do with drug use, intravenous use,
and these type of people we come across every day.
So what about the police?
Excuse me.
We have to go.
I'm sorry.

We're only two cops.
What the heck are we going to do?

In the late 1980s, Ryan White, a young boy with hemophilia,
was removed from his school in one state.
He and his mother had to move to another state.
The first school district had been
afraid that he would transmit to others
despite the recommendations from the CDC that there was no risk.
He was befriended by Michael Jackson and Elton John.
His case became a national cause.
He was very courageous in speaking out for AIDS,
until he died in 1991 and the nation then mourned for him.
US Congress passed the Ryan White Care Act
to provide care for people with AIDS
throughout the United States.
We are, as scientists, motivated to take knowledge
from our research and bring it to the patients
that we're caring for.
But there are sometimes impediments that
block our ability to do that.
And from time to time, we need advocates
who can help move that agenda forward.
In the case of HIV disease at its very inception in children,
individuals like Elizabeth Glaser and the Ryan White
family became those advocates.
They stood for these children.
They promoted public awareness.
They committed the federal government,
the pharmaceutical industry, the FDA,
to stand behind them so that progress
could be made on behalf of children and adolescents
with HIV disease.
AIDS really kicked off a kind of activism
we had never seen for a disease, at least in this country.
In many ways, it was similar to the activism
we saw around the Vietnam War in the United States
where people were willing to march in the streets
and fight for their beliefs and for their needs.
So when they were protesting, what
they did was to get the attention of the government
would pick out me and a few others
and say, you know, you've got to do something.
You know you're slowing down drug approval.
You're doing this, you're doing that.
Even to the point of someone like Larry Kramer, who
was very influential, was involved with signs that said,
Fauci, you are killing us.
And then one very, very famous headline in the magazine
section of the San Francisco Examiner where he said,
Dr. Fauci, I call you a murderer.
An open letter to an idiot, something like that.
He got off to a very bad start, Tony.

And you have to realize that government was not
accustomed to having to deal with civilians.
They were used to working and doing exactly what they wanted.
And since, as far as we could see,
they weren't doing anything, we couldn't leave them alone.
Rather than hand over the process to the authorities
and let the police and the local law enforcement authorities
get them off campus, I went down and I asked our police
officials to bring a group of leaders up to my office,
in my conference room, so I could sit down with them
and talk to them and say, you know, I've heard what you say.
It makes some sense to me.
Let's talk about it.
So he opened the door for us at a great personal cost to him.
A lot of criticism from his side.
It very gutsy of him to do it, but it's
been a very moving experience for both
him and me to go from that antagonistic beginning
to our exceedingly warm relationship
now where we've come to totally love and respect each other.
There's no question that for the kids,
that's why I am going to be a spokesman for this HIV virus
because I want them to understand
that safe sex is the way to go.
I think sometimes we think only gay people can get it,
it's not going to happen to me, and here I
am saying that it can happen to anybody, even Magic Johnson
it can happen to.
I've seen people that you would not
have given ten cents, turn into heroes overnight
caring for somebody, accepting the worst obligations, the most
difficult duties, and doing it with so much dedication, so
much love, so much affection, that they became heroes.
Rock Hudson.
William [INAUDIBLE] Henderson.

It's very difficult. It's very emotional to do these panels.
We tried to show who she was, and who she left behind.
What we are publishing in a few days' time is approximately--
When the virus was discovered, the events that unfolded
were obviously enormous number of things scientifically.
And on a personal side, and on the more social side,
political side, whatever you want to call it,
there was also an enormous amount of tension.
Well, a conflict appeared between Luc Montagnier
from the Institut Pasteur in Paris
and Dr. Robert Gallo from the Cancer Institute
about who actually was the one who was the discoverer of HIV
as the cause of AIDS.
It is such a complicated issue of people
coming at it with different personalities,
different vantage points, both doing
very, very important work.
So I tend to look at the benefit of the discovery of two very
important scientists, who by different pathways,
came to the advance that we have a virus
and the virus is the cause of this disease.
What gnaws at me sometime is that that was probably
the most productive period of my life and the best laboratory
I could ever imagine.
And I think we lost a good four to five years of AIDS research.
There is no question about that.
So we continued.
I had good young people, but when you say, how was I able to
stand it?
The reality is, I wasn't.
We started with AZT in 1986-
And that addressed one of the first steps
in the virus's lifecycle, the step of reverse transcription.
That led to other drugs of that same type, some of which
were a little better than AZT which
could be combined with AZT.
Then we came to a stage of a new step
in the virus's lifecycle, the protease enzyme.
And by 1996, we had new drugs that
could interfere with that in a dramatic way
and when we combine those drugs with the older drugs
we had the first really major advance against the disease.
Can you breathe in and out for me?
So three years ago when I ended up sick in the hospital,
I sort of thought that that might
have been my turn because I had watched
one friend after another get progressively sick and die.
But I was just very lucky that I didn't get sick until the time
that I did and, at that point, protease inhibitors were just
around the corner.
I don't know what's going to happen to John.
My best hope is that whatever tricks
we do with his medications now, being somebody who's
used up pretty much everything, that we'll
make it to the next stage.
That we'll make it to where there are some new medications
available for him.
But I don't know.
About 6 o'clock in the morning I get up and take vit--
During the day, I'll take two of the [INAUDIBLE],
2 and 1/2 milliliters of Norvir--
I take three--
Twice a day I take Combivir, which AZT and prednisone.
While you take that, you have to--
Sodium levels have gone down, so I'm
taking sodium and Trimoline--
And those are just for nasal.
To help with the digestive track.
For herpes virus--
Good morning, how are you?
I'm fine.
How are you?
How was your weekend?
It was really good.
No problems with your medicine?
None whatsoever.
What do you want to drink today?
Some water, please.
Any shortness of breath?
Any headaches?
Any trouble swallowing?
For the initiative to have done for me what you have done
which is captivated this virus.
And I mean it's now-- I'm non-detectable in just two
months, so what can happen in the future?
I never know and I won't, if I was to stop coming.
That's why I come every day.
If you can name one thing that still is a goal that has yet
to be beyond the reach of the scientific community
is what it takes to make a safe and effective vaccine.
So to me, if you're going to focus
in on one area of research that's
essential to complete the picture of the research
approach to HIV/AIDS, it would be
the development of a safe and effective vaccine.
Science has failed in the vaccine so far.
You know and that's, in my mind, is a black mark in the field.
You may say it's not doable.
Some people have said that, like the late Albert Sabin.
I don't think that's the case.
And I think we can do significantly better.

In some ways it seems so overwhelming
as to a young person.
How do you fight this epidemic?
But at this age, it's just I see myself
as learning as much as I can, and understanding
all the roots, biologically, socially, kind of what's
being done, and understanding how I can best contribute
is just to get out there and do what I can do and do things
as best as I can do them.
AIDS emerged fairly recently and so many
people, many of the leaders in scientific and sociological
research, needed to adapt everything
they knew to this new disease.
And so, if we too can take up that spirit of being
able to adapt, being able to change,
being able to question critically everything
we think we know, then the next 25 years
could be a time of tremendous change.
We have been hit relatively hard.
For example, there have been well over 750,000 cases
of HIV/AIDS with over a half a million deaths in this country.
There are currently approximately one million
people living with HIV/AIDS.
The very sobering issue is that, although we
had a very steep acceleration of infections and cases
in the early to mid-80s which then plateaued and came down,
we have plateaued at a level that's unacceptably high.
We have about 40,000 new infections per year.
What has changed is what we call the demography
of the infection.
Excuse me. can I have your time for a moment?
Basically, I work with the organization
called Metro TeenAIDS and the program
called The Street Scene.
Metro TeenAIDS is the only organization
in the metropolitan Washington, DC area that
focuses all of our resources solely
on young people and the prevention of HIV and AIDS.
Have you had sex?
All right.
Do you always, sometimes, or never use condoms?
That's good.
I do this because I feel that it's a need in the population
because a lot of people are ignorant about HIV/AIDS.
And even if they do know some facts,
they probably don't know all.
Heterosexual, gay, bisexual, other.
Are you straight?
I'm straight.
All right.
What's been going on?
Get me a little interview?
We need to just like stop this where it is.
It's something that has the ability
to kill a mass amount of people in our areas.
Young people can teach adults so much about HIV and AIDS.
Just by, if adults just stop and listen to them,
they can teach us so much about protecting ourselves,
about decision making, about how to handle peer pressure.
Because I think adults forget that we
tend to repeat the same things, the same mistakes, if we
don't learn a lesson.
Young people are in the midst of learning these lessons
and they can really teach us and remind us where we need to be.
I can preach all day on AIDS Alabama.
I mean and I get emotional when we talk about AIDS Alabama.
Because they are truly the people that saved my life.
Living with HIV/AIDS in Alabama is tough.
I'm not going to kid you.
We find ourselves in a situation where
we don't have enough money to provide medications
for low income people that find out they're positive.
And I have to admit that I have a real moral dilemma when
I have to tell someone, I'm so sorry, you have HIV disease,
but unfortunately, you won't be able to get medications
because there is a waiting list.
How do we pay for care?
How do we get people into care?
And how do we make sure that there's
uniform access in this country, right now, so that everyone can
be treated equally?
That's the challenge.
I'm Richard Williams and I'm 32 years old.
I live in Birmingham, Alabama.
I have full blown AIDS.
I was diagnosed with AIDS in 1997-
Being gay and my religious beliefs are contradictory.
And so it's always been a problem for me.
So how do you solve it?
I try to remain abstinent, but it gets lonely
and it gets hard sometimes.
Another problem that we face in the South,
especially in rural America, is stigma.
We had a church right here in Birmingham, Alabama,
which has a million people.
This church had a sign up that said,
AIDS is God's curse on a homosexual lifestyle.
HIV needs to be moved from the moral arena
to the medical arena.
It's a disease.
We need to help people with a disease.
Well, there's one person that I think
is important in the historical perspective of HIV
among several other people.
One of them is Dr. Jonathan Mann.
Well, the great merit of Jonathan Mann
was to put AIDS on the world map and to create the first program
at a time, when for most people, it was definitely
not clear that this would become one of the biggest
global issues of our time.
Will the fruits of international science on AIDS
be made available to the whole population of the world
or will those fruits, when they come,
the vaccine, the treatment, will it only
be available for the rich?
It's a question of fundamental equity.
It's a question of fundamental justice.
But that doesn't mean it will happen.
Well, I think that the United States,
along with other developed countries,
has an important responsibility not only to their own nation
when it comes to HIV/AIDS, but be
but also to the whole global community with HIV.
And I'm very pleased to see that over the past few years,
particularly with programs like the President's Emergency
Plan for AIDS Relief, the PEPFAR program that President
Bush established, $15 billion over five years
to prevent seven million infections,
treat two million people with HIV
and care for ten million people, including AIDS orphans,
is a major program.
The international commitment to begin
treating millions of people in developing countries with HIV
must be sustained.
Otherwise, literally millions of people
who are on life saving drugs will give up their life
for want of the resources to continue.
This is a disease, an infection, that's entirely preventable.
That's where victory will be, in prevention,
behavioral modification, prevention of mother to child
transmission, topical microbicides,
treating drug abusers, needle exchange, condom
use, prevention, vaccination.
All of those together is where we need to go.
I think one of the most important lessons that's really
come out in the past 25 years is the importance
of telling the story and continuing to tell the story.
And having folks who are both infected and affected
be able to recount who they are, and their journey,
and their struggles, and also their successes,
their accomplishments.
Because as long as those stories are
being told, that hopefully we won't
forget that we're not done.
It's not over yet.
We still have a long way to go.