Anything to keep the virus from spreading, even if it meant making it a little easier to be a heroin addict that day.
#WHY DO GAY MEN GET HIV MOSTLY FREE#
By 1997, England and Wales were giving out 25 million free syringes per year. Germany even got needle vending machines. Almost immediately after those first tests, Western European countries installed needle-exchange programs, gave out free syringes, and established opiate-substitution treatment. (Des Jarlais says genetic tests have since shown that the epidemic in Amsterdam originated in New York.) No one knew how severe the epidemic was among drug users until 1984, when the still-under-development antibody test found that 50 percent of drug users in New York City and Edinburgh and 30 percent in Amsterdam were already infected.
It arrived earlier than in Europe, and it had a more fertile spreading ground thanks to the higher prevalence of drug use.
All of this, combined with the virus’s devious characteristic of being maximally spreadable right after infection, laid the infrastructure for the disease to maraud through one population and jump to others.ĭon Des Jarlais, research director of the de Rothschild Chemical Dependency Institute in New York, says HIV in drug users followed a similar trajectory as HIV in gay men. The United States had higher rates of STDs and intravenous-drug use (epidemiologists used to call shooting up “the American disease”) before AIDS arrived. These clusters were also engaged in riskier behavior. Engel’s book quotes Frances FitzGerald, writing in The New Yorker in 1986, saying “the sheer concentration of gay people in San Francisco may have had no parallel in history.” The United States has more people than any Western European country, as well as more mobility, giving rise to larger numbers of and more tightly grouped gay men and intravenous-drug users. Which leads to the next factor explaining the larger scale of the HIV epidemic in the United States: the clustering of our high-risk populations. “But the disease wasn’t able to spread through them like it went through American gays,” he says. James Curran, dean of the Rollins School of Public Health at Emory University, points out, Belgium and France had significant central African and Haitian populations Haiti was a destination for them, too. surveillance reports, from 1983, announces 14 cases of AIDS, then adds: “seven of the cases were known to have had contact with US nationals, suggesting that the present UK situation is simply part of the American epidemic.”īut it isn’t just that the virus arrived in the United States earlier. By the mid-’70s, Port-au-Prince is a popular tourist and cruise-ship destination-“a gay Bangkok” is how Engel’s book puts it-and the virus jumps from male prostitutes to gay American vacationers, to their friends and lovers back home. The virus finally finds a host country in Haiti, ferried to and fro in the veins of guest workers in Africa.
A few isolated cases make it from there to the United States and Western Europe, but it fails to catch fire. Jonathan Engel, the author of The Epidemic: A Global History of AIDS, walks me through the timeline: AIDS first appears in humans in central Africa in the 1950s. In 1985, when Germany started reporting, it had 170 AIDS deaths. In 1982, the first year of nationwide CDC surveillance, 451 people died of AIDS in America. Looking at the data on AIDS deaths, you see that the virus hit the United States early-and hard.