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Katy Charlewood (History Podcast Host)
Hello delicious friends, and welcome to who did what Now? The history podcast that is not Your history class with me, your host, Katy Charlewood, history harlot and reader of books. If I sound sick, it's because I am. So I was in London at the weekend because the Donegal International Rally was in Donegal. And typically every year I leave. And so that's what I did. So I. I left Donegal and I went to London and I brought the children because they also do not like all the rally stuff because it's loud and all this other stuff. So we get to London and it's our second day in London. Our first sort of. No, it's like our first, like, full day. And by the evening time, I have a searing headache that is penetrating from my eyeballs to deep into my skull. Like, it felt like it was trying to push my eyeballs out of my head but also crush my nose at the same time. So I was like, sinus headache. I'll get some painkillers after the show. It'll be fine. It was not fine. In the interval, I was holding, like, a glass Coke bottle against my eye because it was the only thing cooling it down. We ended up getting ice cream because I thought this could work, right? And it temporarily did. Apparently the ice coldness just helped, I don't know, because it pulls the blood from your head down to your stomach. But, yeah, I ended up, like, at the end of the musical, I was gone. Like, the kids had to tuck me in. Like, I'm talking, like, that evening I had fevers, sweats, confusion. Like, they made up this little bottom bunk for me. And, like, it's so cute. So, like, my daughter, she puts, like, water bottle there, and they put the bin next to me, and I'm. I'm like, shaking on this blanket. They have their dinner, they get in their jammies, they go to bed. They're done, right? They're 10 and 11. And, yeah, that being said, I saw Hercules the musical. Why Hercules, you say? Well, my daughter is, like, looking at the big sort of Grecian urn on the stage, and she's like, what's Hercules? And I was like, oh, it's Hercules. The character's name is Hercules. Like, I was like, I tried to get you to watch this movie with me a hundred times. You guys didn't want to do it. And she was. I don't remember that. So, yeah, so Hercules was being played by Philippe Vehrano, whose name I have probably butchered. And oh, my God, he was amazing. Like, absolutely amazing. Didn't even occult to me that he was the swing. And here's the thing. It was the kids first musical and I am so glad it was. They caught confetti. They laughed at the side jokes. And my boy, oh, well, like, he had his ear defenders on and so he was like, we were prepared, like for this. We had snacks, the whole shebang. Like, we were good, you know. Well, he had this like, panda with him as well for like, tactile comfort. And so, like, he's got this stuffy, plushy motherfucker and he's waving it like at the cast, at the. At the curtain call. Is it curtain call? I don't know the bit where they all bow at the end, right? I don't. I don't know everything. And so he says that, you know, they were like waving back or looking at him and stuff. I was like, I was too busy trying not to die from pain. But it was a really good show. I, like, I didn't know if I was gonna make it through the second half. I did, and it was really, really good. And also, I should know the name of the actress who played Megara, but she may be the most beautiful woman I've ever seen in my life. Anyway, so. Oh, yeah. So like, my boy was also convinced that Hercules. I keep on calling him Hercules now that Hercules and Meg, like the actors were real life boyfriend and girlfriend. But I'm like, that's acting.
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Katy Charlewood (History Podcast Host)
But yeah, also his favorite character was Hades, because of course it was. The boy watched Star wars and dressed as Kylo Ren for two Halloweens in a row. Like, for someone so full of empathy, he really does like a villain. And in fairness, his sister, when she saw K pop Demon hunters, she didn't want to be a demon hunter. She wanted to be a demon. Specifically the demon version of. Of Baby Saja. Not the K Pop boy band. Saja Boy. Right. No, no, no, no, no, no, no. She wanted to be the demon version specifically. So I'm not entirely sure what that says about me as a parent. Finally, I got blocked news about me. This is what happened last night. I got blocked by Bernard the elf on Threads because I told him to be a big boy and deal with the consequen. But I know what you're thinking. You're thinking, katie, please quit your jibber jabber. In fact me. In fact you. I will, but first we've got to get our source on. Our sources are and the band played on on politics, people and the AIDS epidemic by Randy Schultz. Let the record a Political History of Act Up New York, 1987-1993 by Sarah Schulman The Life and Death of Ryan White by Paul M. Renfro. A Doctor's Journey through the AIDS Crisis by Ross A. Slotin. And of course, we have articles from the New Yorker, the New York Times, we have the LA Times. We have our old favorites, biography.com and history.com. are you sitting comfortably? Good. Then let's begin. Those of us who are a little bit older will have at least some knowledge, if not a full recollection of the AIDS crisis. However, the way that we discuss history now, this often gets, I'm going to say, sidestepped. And so a lot of younger people tend to not know that much about the subject. And by that I mean when I mention the AIDS crisis, they look at me like a cow looks at an oncoming train. Moo. And like, this is a part of history that changed the entire world. And that's not hyperbole. Now, just for clarification, I'm not going to be able to cover every single thing here. So before anyone starts bumping their gums about. Well, you forgot about. No, I fucking didn't. I have a lot of information to provide and a finite time to say it. Okay, I am going to start, however, talking about eastenders. I was going to go into the theme song there, but I chose not to. You're welcome. I don't know if my throat could take it. So my first memory of any sort of understanding of AIDS was in the London based soap opera EastEnders on the BBC. This is where everyone found out that longtime resident Mark Fowler was HIV positive. And Peggy Mitchell, played by the legend Barbara Windsor, shouts, like, in the pub. She's the landlady of the pub of the Queen Vic. Right? And there's this whole scene, and I might not be getting this verbatim, by the way, but she just goes, why? You don't get it at home with your family? Yes, I know that is a terrible impression of Barbara Windsor, but. So she yells it all across the Queen Vic. Everyone goes silent. The glasses do that clinky chinky thing and the camera pans on all these different faces who are just sort of judging and looking. And Mark proclaims that he contracted the infection from his wife, who dies or has died at this point, I'm not entirely sure because this is all from memory. That being said, the character was a habitual drug user in his teens. And I think the whole point was that he didn't have an exact point of origin, which a lot of people don't, you know, and it was to show that so many different people from different walks of Life contract HIV. So the Terence Higgins Trust, which is like the UK's leading HIV and AIDS charity, worked with the production team for the duration of Mark Fowler's story, which was 13 years. And the biggest peak in requests for HIV testing in Britain was seen in January 1991, when Mark Fowler was diagnosed HIV positive. Right? It was like a massive deal, right? So that's how I learned about it and it was like a big talking point of sort of TV history for years. So that being said, I'm gonna focus across the pond and I'm going to talk about the AIDS crisis in the us. Because the AIDS crisis didn't just happen in America, right? The epidemic was enabled by a series of institutional failures. Kehl's surprise. Numerous, and I do mean numerous organisations. They were responsible for protecting public health and failed to carry out their duties effectively, like they failed to do their job. As a result, countless people suffered unnecessarily, leaving a legacy of pain and loss that continues to affect societies across the Western world decades later. And although I'm going to be focusing primarily on the AIDS Crisis in the 1980s in the US, well, the story starts much earlier, thousands and thousands of miles away and earlier in time in Central Africa. See, to understand the whole, like where the disease started, it is necessary to understand and examine the epidemiology behind it. Now, scientists cannot be completely 100 absolutely certain about every single detail of HIV's emergence. The widely accepted consensus is that the virus crossed from chimpanzees to humans during the period between the 1890s and the 1920s in what is now known as the Democratic Republic of Congo. Which, yes, if you know your history, that time frame is roundabout. When King Leopold II of Belgium tyrannically ruled the Congo under the guise of aid and diplomacy. That was in reality a reign of torture and terror. So back to chimpanzees, right? They carried a related virus known as siv, Semian Immunodeficiency virus. So contact between humans and infected animals happened probably during hunting and the preparation of bush meat. After a while, the virus adapted to humans, eventually evolving into hiv, which is the virus responsible for aids. It kills the priests, men see an animal and doss a coin to see whether they want to eat it or fuck it. And sometimes the choice isn't mut exclusive, I swear, like it's. I feel like I should be surprised or. But I'm not because hunters are like, I'm going to eat a monkey now. Cuz bishmi is a Weird term. It relates to a few animals, but especially to non human primates, which does feel like it is the closest thing one can get to cannibalism from a legal perspective. So they do believe, typically it probably transferred to humans as a result of undercooked meat or through, like, chimp blood getting into human cuts and wounds, etc. Now, again, normally a hunter will be able to fight off siv, but viruses adapt. That is why you have to get a different flu vaccine, because there are different strains of, of viruses, because they change. Okay? So, yeah, viruses adapt. And this one adapted itself to the new host and became known as HIV. So HIV 1, human immunodeficiency virus. See, there is another strain of the virus, HIV 2. Now, this is significantly less infectious and far less widespread than HIV 1, which is why most people haven't heard of it or know that there are different strains. See, HIV 2 originated from a different primate species, the sooty mangabe monkey rather than chimpanzees. And the jump to humans probably happened through much the Same process as HIV 1. Close contact with infected blood during hunting or butchering. Now, unlike HIV 1, which would go on to, like, conquer the globe with, I'm gonna say, alarming efficiency, HIV 2 remained quite confined to several countries in West Africa. Like HIV 1 became a pandemic, and HIV 2 never really made out of sort of like the regional part. So the earliest confirmed case of HIV comes from a blood sample collected in 1959 from a man living in what is now the Democratic Republic of Congo. At the time, nobody, Nobody knew what they were looking for. And it was only decades later, when scientists analyzed the preserved sample, that they identified the HIV within it, making it the first verifiable case on record. Now, I know that you know that this does not mean that HIV suddenly appeared in 1959. That. No, see, genetic analysis, yeah, we're doing science, suggests that it had already been circulating amongst humans for decades by then, right? Probably since the early 20th century, like that turn of the century time. Now, the 1959 sample is just the earliest surviving piece of evidence that we have managed to find. Like, it's the confirmed case, it's not the patient zero. And we will be getting into patient zero later, kind of. See, now this is important, right? See, because this demolishes one of the most persistent misconceptions about aids, that it somehow, like, popped up out of nowhere in 1980s America. But by the time doctors in Los Angeles and New York began noticing clusters of unusual illnesses, HIV had already been silently Spreading through human populations for generations. The virus was around for a while. It was old news, but humanity effectively was just late to the party. By 1980 and 1981, doctors in places like Los Angeles, San Francisco, New York, etc. Began noticing something very odd. Right? Gay men who had previously been very, very healthy. Like they're young, they're healthy, they're strong, you know, suddenly they're developing diseases that most doctors really saw outside of patients with severely weakened immune systems. Cases of Kaposi sarcoma, a rare cancer that typically affected elderly men from the Mediterranean. Old men in the Mediterranean and young men in San Francisco. Feels like a different demographic, but here we are. There are also things like pneumocytis carinine pneumonia, which started appearing with, I'm going to say, alarming frequency because these were not illnesses that normally showed up in clusters amongst healthy people in their 20s and their 30s. They would leave purple spots on the skins of sufferers and it was one of the many illnesses that would become the mark of hiv.
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Katy Charlewood (History Podcast Host)
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Katy Charlewood (History Podcast Host)
play social casino void where prohibited. Visit spinquest.com for more details. At first nobody knew what was causing it. Doctors were seeing the symptoms, but the underlying diseases remained invisible. By the end of 1981, roughly 270 cases of these unusual illnesses had been reported to the United States, and the majority were amongst gay men. And what made the situation so scary was that these diseases were usually associated with people whose immune systems had already been compromised by conditions such as cancer, organ transplants, severe infections. Even seeing them suddenly appear in otherwise healthy adults was like finding a smoke alarm going off in every room, like of the entire house and nobody could see the fire. Now today we know that that fire was hiv. At the time, however, researchers had no fucking clue what they were dealing with. They knew that something was destroying the immune systems of their patients. They just didn't know what the culprit was. Now this raises another question. How did HIV arrive in the United States in the first place? For many, many years, the blame was unfairly concentrated on a single man, creating one of the most enduring myths of the AIDS epidemic. This man was Gayton Dugan, a flight attendant from Quebec, Canada. See now because his job involved constant international travel and because he appeared in early epidemiological investig investigations, he was labelled by many people as Patient Zero, the supposed individual who brought HIV to America. It was a dramatic story, which is usually a warning sign that the story is about to be wrong. Duga was openly gay, attractive, sociable, and part of the post sexual revolution culture that emerged in many North American cities during the 70s. He traveled frequently between major urban centres and naturally, because he was so charming and amazing, had a large social network. When investigators later mapped connections between early AIDS cases, his name appeared repeatedly. Unfortunately, a misunderstanding turned him from a participant in a scientific study into a public villain. In the research notes, he had been identified as patient O, the O standing for outside California. Somewhere along the line, people read the letter O as the number zero. And the myth was born. Like it is impressive and terrifying that humanity's ability to turn paperwork into conspiracy, like it's a skill. And it really should never be underestimated because people can craft bullshit from anything in reality. Later genetic studies showed that HIV was already circulating in the US before Dugas even became ill. The virus had likely entered North America years earlier and was spreading through multiple networks long before anyone had heard the term aids. Degas was not the source of the epidemic. He was one of its victims. He was diagnosed with a Kaposi sarcoma around 1980 and eventually died from complications related to AIDS in 1984. For decades, however, he carried the reputation of being the man who started the epidemic in America, a reputation that modern research has thoroughly discredited. Like he died of kidney failure as a result of AIDS related complications. He was a victim to a disease and people pinned, they pinned the blame on him because they want to have someone to blame and they want to have someone to attack. The thing is, the real story is much less dramatic and far more troubling. HIV did not arrive because of one reckless individual. It spread quietly through human populations for years. Well, medicine, public health systems and government struggled to recognize what was happening. The epidemic was not the work of a single patient zero. It was the result of a virus that had been moving through communities long before anyone knew it existed. See, in 1982, Gaetan Dugin was undergoing chemotherapy for cancer when he was interviewed by the cdc, which is the US Centre for Disease Control and Prevention. They asked him questions about his sexual activity. And the CDC at this point started making the connection between hiv, AIDS and sexual activity. Like they realized it was a sexually transmitted infection. And Dugas, he is doing his best to provide all of the information in this study. He wants to help and he is being honest. And he estimates that he'd had some 750 partners in the previous few years. And so the CDC gets a list of contacts from his address book because that's a thing people had. And he ends up becoming patient 57 at the CDC. Right? 57, not zero. And on the 30th of March 1984, he died of kidney failure. And of course, there was no singular moment when the truth suddenly became clear. The CDC initially tried to correct the emerging narrative, emphasizing that Gaetan Dugin was not the origin of the outbreak. But by then, the media had already found its villain and dug its claws in. And public perception is rarely corrected after it has been created, Especially not as quickly. The idea of patient zero had taken hold, and Degas had it. He was the blame game. That was that. It would take decades before this false narrative was properly dismantled. Like by 2016, genetic and epidemiological research had confirmed beyond reasonable doubt that Gaetan Dugas did not introduce HIV AIDS to North America and that it had been present in the US Long before he was ever diagnosed. Basically, patient zero was never a starting point, but just an early case that was misread, mislabeled, and mythologized. And yet the myth stuck because it was simpler and more convenient than reality. By the early 1980s, scientists were beginning to connect a series of otherwise unrelated clinical reports. Clusters of rare illnesses appearing in young, otherwise healthy men, primarily in these big cities. Okay, they finally noticed, oh, it's happening over there and over there and over there. And at the time, the condition did not have a name. There was no HIV and no AIDS in public language, Only this growing awareness that something unusual was happening. Now, the thing about HIV is, like, people might know the name, but they don't really know anything about it. In most cases, infection begins with a short flu like illness, occurring two to six weeks after exposure. Symptoms can include fatigue, fever, sore throat, and sometimes a rash. After this brief initial phase, symptoms typically disappear. They go dormant, sometimes for years. This is the clinical latency stage, during which a person may feel entirely healthy while the virus continues to replicate and remain transmissible. The reason the HIV is so effective as a pathogen is precisely this, and is this long dormant period. During latency, the virus targets CD4 T cells, which are key components of the immune system responsible for coordinating the body's response to infection. As CD4 counts gradually decline, the immune system becomes weaker, Leaving the body vulnerable to infections it would normally suppress without any difficulty. Aids or Acquired Immune Deficiency syndrome refers to the most advanced stage of the HIV infection. It is diagnosed when CD4T cell levels fall below 200 cells per cubic millimeter of blood, or when specific opportunistic infections appear, regardless of count. These infections can include pneumocytis pneumonia, toxoplasmosis, candidiasis. Right, Candidiasis, thrush. Okay, and certain cancers such as Kaposi sarcoma, which we mentioned earlier. Basically, the immune system becomes so depleted that even minor pathogens can become life threatening. One commonly repeated line puts it, do not die. From AIDS itself, but from the infections your immune system can no longer control. It is an accurate simplification. It is not a comforting one. Today, HIV is a manageable chronic condition thanks to antiretroviral therapy. But in the early 80s, there was no treatment, no established name for the syndrome, and no clear understanding of what was causing it. For those first recognised patients, infection was effectively a death sentence. When I was in Toronto, we ended up over in, I don't know, the. Probably Toronto's version of the West Village. And we were in this park and they had this monument with all of these names on it. It was these sort of pillars, like one after the other. And it was all members of the gay community who had succumbed to HIV and aids.
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Katy Charlewood (History Podcast Host)
some of the pillars at the end were blank because they knew there was more to come.
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Katy Charlewood (History Podcast Host)
I stopped and I read all the names because history doesn't mean anything without people. This is a sidebar. Sorry. And I have to. I don't know. It's a thing. We have an interesting relationship with death in Ireland. We respect the dead, we revere the dead, but we are also honest about the dead. And so, honestly, so many people. And the first three, four rows of those pillars, they were let down by society. They were accused and blamed as if there was something wrong with them. For them getting ill, they were the less dead. And it was their community that continued to support them through this. And they deserve to be remembered, they deserve to be considered and they deserve for you to stop and give them a moment of your time when you see their names.
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Spinquest is a free to play social casino void where prohibited. Visit spinquest.com for more details. The first widely cited report appeared in June 1981 in the CDC's Morbidity and Mortality Weekly Report. It described five young men in Los Angeles diagnosed with pneumocytis pneumonia, two of whom who had already died. All were men who had sex with men, and all showed severely depleted immune function. It was the first official signal that something new and serious was emerging, even if no one yet had the language to describe it. A second report, published in July 1981, documented 26 additional cases, again predominantly amongst gay men with patients presenting with pneumocytis pneumonia and kaposi sarcoma. Over the following years, it became increasingly clear that these were not isolated anomalies, but part of a growing epidemic. Hospitals across the United States began reporting similar cases with disturbing consistency, even though the condition itself still had no official name. In the early stages, the syndrome was referred to in some media and informal discussions as grid grid Gay Related Immune Deficiency. The term very briefly appeared in public discourse, including a 1982 New York Times article. However, it was never adopted into scientific literature. It quickly became clear that the name was both misleading and scientifically unsound. More Importantly, it reinforced the dangerous assumption that the disease was confined to gay men. At the time, there was a widespread and deeply damaging misconception that this was a gay disease or even moral judgment expressed in biological form. Now I say misconception. It's actual, downright bullshit. See, some narratives went even further, framing the illness as some kind of punishment. Now, I know you're surprised, but none of this had any scientific basis. But it reflected the social climate of the early 1980s, when stigma shockingly travelled faster than evidence. As surveillance expanded, it became obvious that the pattern did not fit those assumptions. Cases began to appear in other populations, including haemophiliacs who were infected through contaminated blood products and Haitian patients who were unfairly and baselessly stigmatised. In early reporting in 1983, the CDC outlined what became as the 4H risk homosexuals, heroin users, haemophiliacs and Haitians. While intended as early epidemiological shorthand, the classification had serious unintended consequences. It reinforced the false impression that HIV was confined to specific marginalized groups. In reality, these categories reflected patterns of early detection and transmission routes, not exclusivity. The virus itself did not respect identity labels or social boundaries. The consequences were severe. Haitian communities faced discrimination and job loss. Gay men were further stigmatised at a time when stigma had already shaped nearly every aspect of public and private life. And perhaps most critically, many outside these labelled groups concluded incorrectly that they were not at risk. That misunderstanding allowed the virus to spread more widely because public awareness did not catch up with reality as quickly as it should. Hiv, as it turned out, did not belong to any group. It belonged to biology. The term AIDS came into wider use around late 82, when the CDC adopted it to describe the growing syndrome as severe immunodeficiency that was being observed across multiple patient groups described the outcome rather than the cause. But this stage, the cause was still unknown. The breakthrough began to emerge in 83, when research teams in Europe and the US identified independently a retrovirus associated with the condition. In Paris, Dr. Luc Montagnier and his team at the Pasteur Institute investigated samples from patients in early stages of age, which was then sometimes referred to as pre AIDS or ARC AIDS related complex. From these samples, they isolated a retrovirus which showed a clear preference for infecting T cells, particularly the CD4 lymphocytes. The virus was initially named LAV lymphadenopathy associated virus, although while its role in causing AIDS is not fully established, it would still look strong candidate for the underlying agent. Their findings were Published in Science in May. 83. Although at the time the significance of this discovery was not universally recognized. And like around the same period, The American researcher, Dr. Robert Gallo and his team were conducting similar investigations. So he identified. Gallo did what he called HTLV3, human T lymphotropic virus type 3A retrovirus found in a significant proportion of patients with AIDS or early immune deficiency symptoms. His work, also published in science in 84, strengthened the growing consensus that a retroviral agent was responsible. For a time, the scientific community faced an uncomfortable overlap. Two different names, two research groups, and what appeared to be the same virus. It would later be confirmed that Lev and HTLV3 were in fact the same virus, now known universally as hiv, Human immunodeficiency virus. In hindsight, this moment marked the transition from speculation to to identification. Now the disease still had no cure, and treatment options were practically non existent. But the scientific world had finally isolated the agent responsible. What remained was the far harder task. Catching up with a virus that had already been circulating silently for years. Basically, the French and American teams had isolated the same virus, and they both wanted credit for discovering the virus that they both had now. This leads to a scientific dispute that was as much about priority as it was discovery. Right. So America argued that their team had demonstrated not only the presence of the virus, but its causal role in aids. The Montanha group, however, pointed out a more cautious phrasing in their original paper. The role of the virus in causing aids, they noted, remained to be fully established. Basically, one side framed the virus as the confirmed cause, and the other explicitly left the question open. This dispute did not entirely fade away. Questions of attribution, research ethics and priority continued for years, reflecting how high the stakes had become in the race to understand the epidemic. Like eventually, they're both recognized for their contributions, though in different ways, with the scientific consensus acknowledging that each had played a significant role in identifying and characterizing the virus. In 2008, Luc Montagnier, alongside Francoise Bart Senussi, was awarded the Nobel Prize in Physiology or Medicine for the discovery of HIV. Dr. Gallo, notably, was not included in the prize, a decision that reignited discussion about how scientific credit is assigned in collaborative and competitive research environments. But that's another story for another day. Basically, discovery wasn't like one single moment, but a contested process unfolding under immense pressure. While scientists debated naming rights and priority, the virus itself continued its work uninterrupted, spreading through populations far faster than the politics of recognition could keep up. How had HIV spread so quickly? And why was it so focused within gay communities? Well, part of the problem was the sexual revolution of the 1970s. So behaviour and sexuality in relationships had been changing, right? Casual sex outside traditional monogamous relationships was becoming more accepted. And sex was spoken about in a way that it had never been before, in terms of both hetero and homosexuality. It became normal, ish, to have more than one sexual partner. And the 80s came a decade after the Stonewall riots, which changed the attitudes of LGBTQ people nationwide. Pre Stonewall, much of the gay life in the United States operated under enforced invisibility. Part of this is a result of McCarthyism. I say part of this. Quite a lot of this is because of McCarthyism, like, probably most of that is because of McCarthyism. So for many people, homosexuality was something to conceal rather than express openly. Marriage to opposite sex partners, long term secrecy and what was politely called double lives were common survival strategies in a society that was, to put it mildly, not particularly welcomed. After Stonewall in 1969, the dynamic shifted dramatically. Queer communities became more visible, politically active and socially organized. Pride marches replaced silence with public pressure. And in cities like San Francisco and New York, gay culture developed visible neighborhoods, social venues, and community institutions. People were no longer just surviving, they were increasingly living openly. And this visibility mattered socially and politically. And it also meant something less poetic. Epidemiologically, sexual networks became easier to form, more interconnected and more visible to both community researchers and, later, public health officials. Not uniquely so, heterosexual populations also experienced changing norms in the same era. But in certain urban gay male networks, partner change rates were higher on average, particularly in specific social settings like bars and bath houses. This is again, just a structural observation, although people try to turn this into immoral judgment. And this is where the bollocks comes in, Right? So there was this massive wave of disinformation, basically trying to state that HIV could be transmitted casually through shared food, through kissing, by using the same toilet, by sneezing or sweating. Right. Coughing, even. I need this to be clear. It cannot. Transmission requires specific bodily fluids. Blood, semen, vaginal fluids, rectal fluids, and breast milk. In other words, it is not a socially contagious virus. It is a biologically specific one. You don't need to be bleaching all your doorknobs. The actual routes of transmission matter because HIV is not equally efficient in all contexts. One of the highest risk forms of sexual transmission is receptive anal intercourse. And this is due to anatomy. The rectal lining is thinner and more prone to micro tears than vaginal tissue, providing easier Access to the bloodstream. Estimates vary by studying conditions, but the risk per single act of unprotected receptive anal sex is significantly higher, often said as roughly an order of magnitude greater than unprotected receptive vaginal intercourse. Now, basically, bum tissue tear is easier. Like, that's it. There's an easier access route. Now, condoms did exist by the late 70s and early 80s, but widespread, explicit, safer sex education tailored to hate HIV did not yet exist. Because the virus itself had not been identified in the earliest years of the epidemic. People were effectively trying to avoid a pathogen that they did not know existed, using tools designed for pregnancy prevention and other known sexually transmitted infections. Now, there's a mismatch right there. As for the spread in places like New York and San Francisco, it reflected a combination of dense social networks, high mobility, delayed medical recognition, and a virus that can remain asymptomatic for years while still being transmissible like that. That's the important part. HIV does not announce itself immediately, which meant it had already spread widely before anyone realized there was a pattern at all. By the time the pattern became visible, the virus had a head start measured in years, not months. And at that point, public health was not dealing with the beginning of an outbreak. It was dealing with the middle of one that it had discovered. There were more bath houses, gay bars, clubs, and in certain cities, a growing sense that being openly gay was at least possible, if not universally safe. That visibility translated into denser sexual networks and more opportunities for transmission. At the same time, the United States was also in the middle of a major intravenous drug crisis, which provided another efficient route for HIV spread. Through needles, through shared needles. By 1985, the contrast in outcomes was already stark. Germany had recorded roughly 170 AIDS related deaths at this point, and the United States was already approaching 7,000. And that's the ones that were registered. Now. Population size explains like part of the gap, but not all of it, and certainly not neatly. And what filled the remaining space was stigma, confusion, and delay,
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Spin Quest is a free to play social casino. Boyd, we're prohibited. Visit spinquest.com for more details. In the early years, HIV AIDS was widely and incorrectly labelled the gay plague, a term enthusiastically amplified by parts of the media and eagerly adopted by those already inclined to see homosexuality as deviant. For some religious groups, the epidemic was framed less as a public health crisis and more as moral accounting punishment delivered by biology on behalf of God. The arrival of intravenous drug users and other groups as recognised risk categories did little to soften this narrative. It just expanded the list of people. Some were comfortable blaming reality as usual, refused to cooperate with moral storytelling. Infants acquired it from mother to child transmission during pregnancy, birth or breastfeeding. Heterosexual men and women were infected through sexual contact haemophiliacs contracted HIV through contaminated blood products. HIV did not require identity, it required exposure. Rich or poor, men or women, straight or gay, young or old, black or white, the virus did not read the cultural commentary. But fear doesn't behave rationally, as we've seen with every other fucking moral panic in existence. When people do not understand a disease, they tend to overgeneralize it. And when they overgeneralize it, they tend to locate it in other people. The social reflex built a wall between affected communities and the wider public. Part protection, part panic, part avoidance, and the consequences they will not abstract. In the 80s, an AIDS diagnosis often meant immediate social exile alongside medical crisis. Many people lost their jobs once their status became known, which meant a loss of income, insurance and access to a care. In a system already struggling to respond, public fear translated into real world avoidance. People who were ostracized not because of what HIV could casually do, but because of what people incorrectly believed it could do casually. And that belief that it could be transmitted through everyday contact persisted for years, despite no scientific evidence supporting it. And this is like a feedback loop. Fear produced misinformation, misinformation reinforced stigma, and stigma discouraged testing and treatment. And even today, echoes of that period remain. Studies have shown that men who have sex with men can experience higher levels of depression, anxiety and substance use in context where stigma is severe, along with reduced engagement in healthcare services. Right, it is the stigma. The stigma is an underlying factor in all this. It is breeds and compresses. The broader lesson is uncomfortable, but consistent. HIV spread faster not because of who people were, but because of what they did not know. And society refused to understand in time because fear filled the information gap. Oh, that doesn't sound familiar at all. And where fear leads, clarity tends to arrive late, if at all. Now, I'm going to talk about Princess Diana for a second. Even though you all know my feelings on her right bronclock can still be right twice a Day. In 1991, Princess Diana made one of the most iconic public gestures of the early AIDS era when she visited the newly opened HIV AIDS ward at London's Middlesex Hospital and shook hands with a patient without wearing gloves. Now, remember, people still thought this could be spread casually. It can't. And Diana was already, like, properly briefed on transmission routes. So this wasn't ignorance, this was deliberate. Right? She knew that she was safe. She knew she had nothing to lose. The only thing she could do is be seen as a good person for doing this. So a very simple act, but a very public correction of A persistent myth in an era where people with AIDS were still often avoided. It did real cultural works. And she led her continued advocacy through HIV charities, helping shift public attitudes in the uk, even if a role, like most public figures, was a mix of genuine engagement and careful visibility. Now the reality for people with AIDS in the 1980s and early 90s was not just medical, it was social exile. Stigma framed the illness as a moral failure rather than a viral infection, and that narrative did damage. So who did the actual day to day support work? A large share came within the LGBTQ communities themselves, particularly from lesbian activists, whose contribution is often underplayed. Now, the community wasn't powerfully unified. By the 70s, there was a real cultural divide between gay men and lesbians around politics, gender roles, priorities. But AIDS changed the equation fast. Gay men were hit earliest and hardest, and formal institutions were slow to respond. In that gap, community networks became survival infrastructure, and lesbians in particular stepped into caregiving, fundraising and hospital support roles at scale. The crisis didn't erase differences, it just made survival more important. Most of the population became terrified of catching this disease. In shock, horror realized they weren't willing to care for the gay men, succumbing to the disease en masse. Meanwhile, the hospitals were full of lesbians volunteering their time, going to the rooms of AIDS patients to talk to them, feed them, hold them. There were some of the only people willing to treat them as human beings. Many of these men had been rejected by their families. So many members of the gay community were wasting away in their hospital beds. AIDS was a lonely, isolating illness and lesbian women provided the kindness and compassion that nobody else would or could. Lesbians were actually one of the lowest risk groups for catching hiv. And it's through their empathy and care that a lot of these people are even remembered. I remember being told a story about the leathers. So, like, there's a big leather community in the gay scene.
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Katy Charlewood (History Podcast Host)
the reason, like people talk about, oh, kink at Pride when they see leathers and leathers isn't the kink. Leathers is not that. And the reason the leathers are worn at Pride is because the lesbians carried them on. A lot of the time when someone was diagnosed and they were put into hospital, a lot of their items, their lives, everything they'd collected was fucking incinerated. People destroyed it, they burned it, they were again, they're afraid of touching it and catching the aids, you know what I mean? And so these people loved they're leathers. And the lesbians are the reason that they managed to care for them and have this pass on. So you don't get to have that opinion. You don't get to say that that's not allowed at pride, when this is one of the few physical remaining items of an entire generation, generations, even several generations of men whose lives were just wiped out. In 1983, sexually active homosexual men were banned from giving blood across America in an effort to prevent HIV from being spread through blood transfusions. This ban led to blood reserves across the country severely depleting. And HIV sufferers needed blood to fight the disease. And so lesbian blood drives started popping up. Bands of lesbian women came together to donate blood specifically to men with AIDS. On 16-7-83, the first drive happened and 200 women showed up. Similar drives were rearing up all over the country and continued all the way through the 80s and 90s and more. Gay men who survived the epidemic say they were saved by physically and mentally by the lesbian community. The scientific and medical community is working overtime to try and fight this disease. But what about everyone else? Now, this may shock you, but they were kind of hoping it would just go away. Being queer was such a taboo that people didn't even want to think about queer people existing, let alone help them. And what about the media? Well, it doesn't exactly help by calling AIDS the gay disease. For the first couple of years, disinformation or, you know, just shitty journalism led many people to think that it could only affect gay men. And then, of course, it was the drug users, which is another group of the less dead, the next finger at the Haitian men. So now straight white people were totally in the clear. But no. So while talking heads and newspapers churned out bullshit pieces dehumanising victims of the disease as degenerates, it didn't actually inform anyone of any preventative measures that they could take. The stories were mostly sensationalised bullshit. There was no push to tell men to work on laws to help prevent spreading of the disease. They didn't say that anyone was at risk, right? Just the promiscuous and the homosexuals. Two things that the conservative media definitely did not want to be seen as promoting. And like, it wasn't until Rock Hudson, like famous golden age of Hollywood star, announced that he was HIV positive did the media suddenly proclaim, oh no, no one is free from aids. Suddenly they cared, right? At this time, Rock Hudson was firmly in the closet. So they were like, whoa, anyone can catch it. Oh no. Like it's, it's such a whole thing. But there was A sharp rise in organized anti gay activism across the United States. Even after stonewall, legal and social progress was uneven. By 1980, only about two dozen states still criminalized sodomy, reflecting how recently these laws have begun to shift rather than disappear. Now, the post Domwell period had seen real momentum in LGBTQ rights and visibility. You know, communities were more politically organized, public presence increased, and activists were already openly discussing possibilities like same sex marriage. Ideas at that time still sounded speculative instead of imminent. And then AIDS arrived and the trajectory changed abruptly. It triggered a major backlash in many parts of the country. Existing prejudice was amplified rather than challenged, and a public health panic often merged seamlessly with moral judgment. Political resistance to LGBTQ rights intensified, and earlier gains in visibility and acceptance stalled or reversed in some areas. So what had been for like a brief period, a forward moving rights movement became entangled in a public health crisis that many were quick to interpret through a moral lens and not a medical ones. A virus had arrived in the middle of a culture war, and neither side needed more encouragement to make it worse. Conservative American political organizations sought to mobilize conservative Americans to become politically active. And issues that they thought were important were. Of course, the issues were the fight against homosexuality. They had to save their children from the immoral gaze. And the AIDS crisis grew. So the moral majority, feeling that God was backing them up, and Ronald Reagan, the 40th president of the United States, president between 81 and 89, basically oversaw the whole crisis. The Reagan administration has quite a bit to answer for here, and not just in hindsight, with the benefit of a neatly organized timeline. 81 AIDS have been identified as a new and growing medical crisis. 82 the CDC was actively investigating it. 83, 84 the virus responsible had been identified. And yet, within roughly three years of the epidemic entering public view, there were already thousands of confirmed cases in the US and thousands of deaths, with many more infections undiagnosed. And the response from the White House, however, was selective silence. Regan did not publicly address aids until 85, and at that point over 5,000Americans had already died. And this wasn't a situation where the administration was unaware of. They just chose not to make it a public priority. Whether it was political caution, cultural discomfort with homosexuality, or fear of alienating conservative voters, the outcome was the same. Federal leadership arrived late to a rapidly escalating crisis. Like one journalist and like in the early 80s, asked questions about AIDS, and it was 82 and he asked the press secretary about the CDC's report. And the response was essentially non response deflection. Minimization and at times openly dismissal. Like this gay plague. This framing of it was still common enough in public discourse that it shaped how seriously the questions were taken. By 84. It was asked whether the President would take steps to restrict access to food service or military roles for people with aids, referencing public health precedents like typhoid controls. The question itself reflected the confusion of the era, mixing legitimate containment concerns with misunderstanding about transmission. But at least it acknowledged, like, the scale, you know. The press secretary's reply again was evasive, including a joking suggestion that the journalist asking the questions might want to get himself tested. Now, this is revealing not just the fact that this is humour and tone. A serious public health crisis was being discussed in a room where laughter was still an acceptable reaction. Like, the journalist, which is interesting, was actually, I think it was consoling. He was opposed to gay rights, which is like, why he's like asking all these questions about it and why he wants the government to comment on it. But they were just like, oh, ho, ho, ho, watch out, get tested. Like, it's not just a political delay, like it's an institutional delay at scale in a fast moving epidemic. And that gap mattered. Now, allegedly, Ronald Reagan in his personal life was not homophobic. And because he was like, big, super cool friend of Rock Hudson, like, he didn't want to like, publicly condone, you know, civil rights for the LGBTQ community, but, like, privately he's like, whatever you do in your bedroom is what you do. And it's like, it's not just about sex, man. But nothing here nor there. But listen, listen, Ronald Regan had gay friends and he was the first president. And like, he's promoting, like, abstinence only education, which is again, bullshit. Like, he doesn't even mention aids until 85. And it's in a passing response to a question at a press conference. And he's just like, family values the next year and abstinence is right. Like, that's it, right. By the late 80s, AIDS had moved from an ignored crisis to an unavoidable 1 in 90. The former President Regan public reflected on the epidemic following the death of Ryan White, a teenage haemophiliac from Indiana who had become one of the most visible faces of HIV AIDS in the United States. Ryan White contracted HIV from a contaminated blood transfusion and was barred from attending school in his community due to fear and misinformation about transmission. After his death in April 1990, Regan stated that society owed it to Ryan to make sure that the fear and ignorance that chased him from his home and school will be eliminated. Like this kid got HIV from a blood transfusion and teachers and parents protested about having this child in in their class. Now, Ryan White never wanted to be a poster boy. He hated the fact that he was labelled the innocent victim because it implied that others were somehow guilty. He says that he was just like everyone else with aids, no matter how he got it. This case helped shift public perception and even prompted support from communities that had themselves been heavily affected by the epidemic. But it also highlighted the uncomfortable truth. Public empathy was often shaped less by medical facts than perceived similarity. The disease wasn't understood by the general public. Like imagine your kid has a disease and it's not contagious, right? Not in that environment. And the teachers are worried about catching it. Like what the
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Katy Charlewood (History Podcast Host)
to play social casino void where prohibited. Visit spinquest.com for more details. So after he passed away in April 1990, Congress passed the Ryan White Care act, which I think to this day is still the largest federally funded HIV AIDS assistance program in the United States. It continues to provide treatment support for low income and uninsured people living with hiv. At the same time, grassroots activism remained essential. From the early 80s onwards, queer organisations and allied groups had already begun building networks for education, safer sex, outreach and mutual aid because waiting for official responses was simply not an option. If anything, the epidemic made it brutally clear the communities often had to be their own first responders. In the mid-80s, it was clear that HIV AIDS was not just a medical crisis, it was a social one, with paperwork. Landlords refused to rent people with hiv. Employers quietly, and sometimes not so quietly, pushed them out. Insurance didn't always cover care, and in the absence of strong institutional support, activists end up doing everything the system was supposed to do. So one of the most powerful examples, I think, is the AIDS Memorial Quilt. It was conceived in 85 by activist Cleve Jones as a way to remember friends who had died from aids. The idea was simple and devastating. One panel, one life, names stitched into fabric because official records and polite society were not doing enough remembering on their own. It began with a list of 40 names, and even that number sounds small until you remember it was just personal loss, not national statistics. 40 people gone from one activist's immediate world alone. The quilt began growing in parallel with public demonstrations, including the 1987 March on Washington for Lesbian and Gay Rights. Early panels were displayed in San Francisco, including a public hanging on City Hall's balcony during Gay Freedom Day. Roughly 200,000 people gathered an information booth nearby, offered instructions so other could make their own panels. Grief, as it turns out, is scalable. By the time it was displayed in Washington, it contained around 1920 panels. Every name was read aloud while crowds stood listening and crying. It was part memorial, part Protest part attempt to make the numbers feel like people again. The project kept expanding. By 1988, it toured 20 US cities in just four months. Families, especially mothers, would arrive with new panels sewn for sons and daughters they had lost. Within a year, it had grown to 8,000 panels. Today it includes more than 48,000 names and weighs an estimated 54 tons. It remains one of the largest community memorials ever created. A physical record of an epidemic that official systems were slow to fully acknowledge. And it's still growing. In the late 1980s, treatment options were still extremely limited. Doctors could manage opportunistic infections and ease symptoms, but there was no cure. HIV infection was for most patients at the time, still effectively terminal. Then came azt. Zidovudine. Zidovudine, one of those. It was first developed in the 60s as a cancer drug, later repurposed in the 80s when researchers realized it could inhibit HIV replication. On paper, it was a breakthrough. In practice, it was complicated. AZT was rushed through clinical trials under intense pressure. The standard long term testing process was shortened significantly due to the urgency of the epidemic. Earlier results suggested reduced mortality in treated patients compared to placebo groups, leading to ethical concerns about continuing to withhold the drug. The trial was halted early and AZT was made widely available. Side effects, however, were severe nausea, headaches, gastrointestinal distress and in some cases bone marrow suppression requiring blood transfusions. It was not subtle medicine. It was closer to control toxicity with a hoped for benefit. And even the data was messy. Patients were often receiving multiple treatments from different providers, making outcomes harder to attribute cleanly. Some even shared or pulled medication to ensure everyone had access, which while understandable, didn't exactly improve the integrity of the study design. Still, AZT marked the beginning of antiretroviral therapy. Not a victory lap, but at least the first moment where the medical response shifted from purely reactive care to something resembling intervention. On March 19, 1987, AZT went on sale and immediately introduced itself as the most expensive prescription drug in history. At the time, around $8,000 a year per patient, which today would sit well over $17,000 for a life saving medication. It also doubled as a master class in how quickly urgent medical breakthrough can become who exactly can afford to stay alive. Which is fucking bullshit. No, I can't afford to lose my voice. In the U.S. many people with HIV AIDS were already marginalized. Gay men, intravenous drug users, sex workers and others already sitting on the edges of healthcare access. So it was not exactly a fair playing field. And even calling it a market feels Generous when the entry fee is survival. Like forecast suggested, drug companies stood to make hundreds of millions in profit from AZT within a year. Now, depending on your temperament, that's either innovation, funding itself, or healthcare. Discovering capitalism in real time. Get fucked. Access problems predictably followed. A black market emerged almost immediately because desperation tends to ignore law. Everyone wanted the miracle drug, and the only issue is it wasn't really miraculous. Early optimism faded fast. While AZT initially showed improvements in T cell counts, later evidence suggests that at high early dosing schedules, famously 400 milligrams every four hours, toxicity became a serious problem. Bone marrow suppression, severe side effects and in some cases overall worsening health meant the drug's promise did not neatly match its early hype. Eventual dosages were revised and AZT was later used in combination therapies, but not before a lot of damage and disillusionment had already accumulated. By the 90s, things began to shift slowly. Public awareness increased. Stigma stated to listen, not disappear listen. And governments began investing more seriously in research and prevention. Condom use entered public health messaging openly, which seems obvious now, but was once treated like controversial content. Abstinence only approaches were still floated, despite consistently underwhelming results. In the real world. It doesn't fucking work. It doesn't work like the studies. The evidence is there. It doesn't fucking work like I don't know how many ways I can say this before people understand. Abstinence only education, abstinence only values, doesn't fucking work. High profile deaths also garnered attention. So you've got like Freddie Mercury, Anthony Perkins, Liberace. Like public figures whose illnesses made denial harder to maintain and infection rates eventually began to stabilise in some regions, though globally the crisis is far from over. Policy responses were mixed in many places, HIV positive individuals faced legal restrictions around employment and healthcare, blood donation, immigration and travel. Some measures were grounded in legitimate safety concerns like blood donation. Others reflected stigma dressed up as regulation. And the distinction was not awfully maintained. And the scale of loss, like we always want to compress it into neat figures and there's always a way of trying to make it analytical. But that's not how the world works. Entire friendship groups were white out. Communities describe years where funerals were not occasional events, but there was like several per calendar month, one after another, week after week. It wasn't just mortality, it was repetition. And today HIV is no longer the automatic death sentence. It was in the 80s. In the US, over a million people were living undiagnosed with HIV. By the late 2000 and tens with a significant portion of infections still undiagnosed globally. Worldwide, tens of millions still live with HIV, with around 1.7 million new infections. What was it like in 2018? I think awareness has improved. Roughly 4/5 of people living with HIV globally know their status. But gaps remain. Sub Saharan Africa has carried a disproportionate burden of the epidemic, especially in the early 2000s, shaped by a mix of healthcare inequality, delayed policy responses and stigma. Some of it eerily familiar to early western responses. But the key shift in modern treatment is antiretroviral therapy. HIV is still not cured, but it is nomadically manageable. With consistent treatment, many people achieve an undetectable viral load. And that word matters. Undetectable means the virus is so suppressed it cannot be transmitted sexually. That idea, undetectable equals untransmittable has fundamentally changed both prognosis and public perception. Treatment doesn't erase hiv, but it can reduce it to a level where it no longer defines a person's health or their risk to others. It's not a finish line. Medication adherence still matters, monitoring still matters, and access still matters. But compared to the 1980s, when diagnosis was effectively a countdown to your death, the difference is night and day, or science eventually caught up. It just took longer than the virus did. Today, HIV usually involves a combination of drugs, often called a cocktail. The formal name is highly active antiretroviral therapy. Today, HIV treatment usually involves a combination of drugs, a cocktail, that target a virus in different stages of its life cycle. The formal name for this is highly active antiretroviral therapy, or haart, which, despite sounding like something you'd order in a very intense pharmacy, has one of the biggest medical turning points of the modern era. It's not a one size fits all system. People respond differently, and finding the right combination can take time. But you don't need to eliminate the virus to live a normal life with it. Many people on treatment maintain an undetectable viral load. It's controlled, not gone. And that's not optimism, it's evidence based public health. If you're undetectable and stay on treatment, you cannot sexually transmit hiv. And life expectancy for someone diagnosed today with access to treatment and consistent care can be close to that of general population. Like HIV no longer progresses to AIDS in most cases, where treatment is started and maintained properly, it has shifted from a fatal diagnosis to a chronic manageable condition. It is still serious, it is still real, but is no longer the automatic endpoint it once was. Now there are also rare documented cases of apparent cures or long term remission following specialised procedures like stem cell transplants. But these are exceptional, medically complex and not widely applicable. In other words, science has opened the door, it's not kicked it down. And even so, precautions still matter. Undetectable status only applies when treatment is consistent and it does not protect against other sexually transmitted infections. Condoms remain important and so does regular testing for anyone sexually active, especially with multiple partners. Contraception prevents pregnancy, it does not prevent infection, a distinction that for some reason still needs repeating. Testing access varies by countries. In the uk, sexual health clinics offer free testing and at home kits that are available through approved services, allowing people to test privately and receive results remotely. In Ireland, you can actually send away for a test, you can send away for a private test and you do all the bits at home, you seal it up, you post it away and they give you your results completely free sexual health testing. The point is simple testing exists and avoiding it doesn't make risk disappear. So pre exposure prophylaxis or PrEP, is another major prevention tool. It is a medication taken by HIV negative individuals before exposure to significantly reduce the risk of infection. When it is taken correctly, it reduces the risk of sexual transmission by over 90%, even more when combined with condom use. It is highly effective, but again only protects against hiv, not other infections. Now, modern HIV treatment is one of those rare cases where medicine actually did the thing it keeps promising in the press releases. It turned a once fatal diagnosis into something people live with long term. It's not cured in the Hollywood sense, but controlled enough that the virus mostly minds its own business, if you mind yours. At the extreme end of treatment, let's talk about stem cell transplantation. The closest thing HIV medicine has to boss level intervention, which not subtle. First, the patient's immune system is wiped out using chemotherapy, which is already a cheerful start, then replaced with donor stem cells that then rebuild a new immune system from scratch. In a handful of cases, this has led to long term HIV remission. The trick originally was that some donors carried a rare mutation called CCR5 delta 32. It's kind of like removing the virus's favorite entry door into cells and sort of welding it shut. No entry point, no infection pathway, no problem, at least in theory. And this is what happened in landmark cases like the Berlin patient, where a stem cell transplant performed for cancer just happened to also knock HIV into remission. Later cases, sometimes referred to in like the circles as Geneva patient and second Berlin patient suggested something even more interesting. Remission might still be possible even when the Genetic setup isn't perfectly textbook. In other words, nature occasionally improves. That being said, this is not like a treatment plan, right? It is a last resort medical gamble with a very expensive ticket and serious risks. Chemotherapy, toxicity, immune collapse, graft versus host disease, and all the other charming features of rebooting a human immune system from scratch. It is only done when someone already needs a stem cell transplant for something like cancer. HIV remission, when it happens, is essentially the universe throwing in a bonus round for you. For everyone else, the actual work cause of HIV is far less dramatic and far more effective, and that is your antiretroviral therapy. People live normal lifespans, go to work, argue about bills, and generally do everything except die from HIV. Like it's still 1985. Scientists are still chasing a functional cure, basically trying to get to a point where the virus is controlled without lifelong medication. Now the ideas on the table are very, very 21st century gene editing, which is like CRISPR style attempts to disable HIV's ability to integrate into cells. You've got engineered immune cells like CART therapies borrowed from cancer treatment, neutralizing antibodies that try to cover every viral infection HIV can throw out, and vaccine research that has been like 5 to 10 years away for about the last 20 years now. None of these are routine treatments yet. Most are still in trials and early studies or like the scientific equivalent of don't try this at home. So the situation is now oddly split. On one side, we already have treatment so effective the HIV can be medically invisible and non transmissible with adherence. On the other, researchers are still trying to see if they can go one step further and actually remove it entirely. We're not cure achieved yet, but we're also very far from the era where diagnosis was just a countdown with paperwork. And that is where I will leave you today. That is the 1980s AIDS crisis. It's one of those things I wanted to share. I know it's a very dense information, dense episode and I understand that it's not the most joyful thing, but I think the fact that we're here and people are still trying, we're still trying to improve the lives of people with hiv. We're trying to reduce the transmission of it. Like there are so many positive aspects that are coming out now and I know it doesn't help everyone who, who suffered before, but the fact that we are moving forward, the fact that it's no longer a death sentence, it's, it's something. And I, I know I've been trying to do like relatively jolly stuff for pride because the world is on fire and everything's terrible. But here we are, the AIDS crisis. And with that, it is recommendation time for reading Disaster Gay Detective Agency by Lev? AC Rosen. For listening Kelly Minogue spinning around is a banger and I'll hear nothing against it. And for watching, you know what the Fall I've recommended it before, I'll recommend it again. Lee Pays is so beautiful and it's probably one of the most visually beautiful movies I have ever seen in my life. So go watch that and I will chat to you next time. Adios. Au revoir. Au revoir de Seine, my friends. Bye bye.
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Who Did What Now — Episode 197: The AIDS Crisis
Host: Katy Charlewood
Date: June 23, 2026
In this episode, Katy Charlewood delivers a vivid, detailed exploration of the AIDS crisis—emphasizing the scientific, medical, social, and political aspects of the epidemic as it unfolded from the early 20th century up to the present day. Katy brings her trademark blend of irreverence and rigor to a heavy topic, balancing historical facts, personal anecdotes, sharp commentary, and genuine empathy.
“Genetic analysis… suggests that [HIV] had already been circulating amongst humans for decades by then, right? Probably since the early 20th century…” (14:58)
“The myth stuck because it was simpler and more convenient than reality.” (32:50)
“Stigma framed the illness as a moral failure rather than a viral infection, and that narrative did damage.” (59:28)
“Lesbians were actually one of the lowest risk groups for catching HIV. And it’s through their empathy and care that a lot of these people are even remembered.” (65:24)
“Ryan White never wanted to be a poster boy. He hated the fact that he was labelled the innocent victim because it implied others were somehow guilty.” (76:42)
“AZT marked the beginning of antiretroviral therapy. Not a victory lap, but at least the first moment where the medical response shifted from purely reactive care to something resembling intervention.” (90:03)
| Timestamp | Segment | |---|---| | 06:38 | Sources for episode and generational knowledge gap | | 09:20 | Origin of HIV in Central Africa | | 16:20 | US doctors observe mysterious illnesses | | 26:25 | Patient Zero myth explained (Gaétan Dugas) | | 35:53 | Toronto AIDS Memorial and the meaning of remembrance | | 41:23 | Early misleading terminology and the 4H shorthand | | 49:43 | The scientific dispute over the discovery of HIV | | 55:10 | Stigma, institutional failure, US policy lag | | 58:20 | Princess Diana’s iconic handshake | | 64:59 | Lesbian community’s crucial caregiving efforts | | 70:10 | Reagan’s administration: silence, minimization, and moral panic | | 73:45 | Rock Hudson and the shift in public perception | | 76:42 | Ryan White and the politics of the “innocent victim”| | 79:43 | Ryan White Care Act and ongoing federal support | | 81:05 | The AIDS Memorial Quilt | | 89:21 | Introduction and critique of AZT | | 95:33 | Modern treatment, undetectable = untransmittable | | 97:48 | Pre-exposure prophylaxis (PrEP) and testing | | 100:21 | Cutting-edge research: gene therapy, functional cures |
Katy maintains her signature conversational, irreverent, and unflinchingly honest tone throughout. She uses humor and asides (“bum tissue tear is easier. Like, that’s it.”), and is frank about her own emotions and opinions (“Get fucked. Access problems predictably followed.” [91:11]). Empathy and righteous anger underpin her critique of institutional responses, while she honors the resilience and ingenuity of marginalized communities.
Katy closes with a sober hope: though the crisis was marked by unimaginable loss, scientific progress and community activism have transformed a fatal diagnosis into a chronic condition. Stigma remains, but solidarity and innovation persist.
“It’s not cured in the Hollywood sense, but controlled enough that the virus mostly minds its own business, if you mind yours.” (99:34)
This episode is required listening for anyone interested in the complex history of HIV/AIDS—its tragedies, myths, activism, and ongoing struggle for dignity and scientific progress.