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197. The AIDS Crisis · Who Did What Now With Katie Charlwood

• 0:10
  Speaker 1: Hello, delicious friends, and welcome to Who Did What Now?
• 0:14
  Speaker 1: The history podcast that is not your history class with me,
• 0:18
  Speaker 1: your host Katie Charlwood, History harlot and reader of books.
• 0:24
  Speaker 1: If I sound sick, it's because I am. So. I
• 0:29
  Speaker 1: was in London at the weekend because the Donegal International
• 0:32
  Speaker 1: Rally was in Donegal and typically every year I leave,
• 0:36
  Speaker 1: and so that's.
• 0:37
  Speaker 2: What I did.
• 0:38
  Speaker 1: So I left doney Goal and I went to London,
• 0:42
  Speaker 1: and I brought the children because they also do not
• 0:45
  Speaker 1: like all the rally stuff because it's loud and all.
• 0:48
  Speaker 2: This type of stuff. So we get to London and.
• 0:54
  Speaker 1: It's our second day in London at our first sort
• 0:59
  Speaker 1: of notes like or first like fill day, and by
• 1:03
  Speaker 1: the evening time, I have a searing headache that is
• 1:07
  Speaker 1: penetrating from my eyeballs to deep into my skull. Like
• 1:12
  Speaker 1: it felt like it was trying to push my eyeballs
• 1:14
  Speaker 1: out of my head but also crush my nose at
• 1:16
  Speaker 1: the same time. So I was like saying, his headache,
• 1:19
  Speaker 1: I'll get some pain colors after the show. It'll be fine.
• 1:24
  Speaker 1: It was not fine. In the interval, I was holding
• 1:28
  Speaker 1: like a glass coke bottle against my eye because it
• 1:32
  Speaker 1: was the only thing cooling it down. We ended up
• 1:35
  Speaker 1: getting ice cream, so I thought this could work, right,
• 1:39
  Speaker 1: and it temporarily did. Apparently the ice coldness just helped.
• 1:43
  Speaker 1: I don't know, because it pulls the blood from your
• 1:45
  Speaker 1: head down to your stomach. But yeah, I ended up
• 1:49
  Speaker 1: like at the end of the musical, I was gone,
• 1:54
  Speaker 1: Like the kids had to tuck me in, Like I'm
• 1:58
  Speaker 1: talking like that evening I had feet, sweats, confusion, like
• 2:02
  Speaker 1: they made up this little bomb bunk for me and
• 2:06
  Speaker 1: like it's so cute. So like my daughter she puts
• 2:08
  Speaker 1: some water bottle there and they put the bin next
• 2:11
  Speaker 1: to me, and I'm I'm like shaking on this blanket.
• 2:14
  Speaker 1: They have their doneer a, they getting their jommius, they
• 2:16
  Speaker 1: go to bed. They're done right, They're they're ten and eleven.
• 2:19
  Speaker 1: And I yeah, that being said, I saw a Hercules
• 2:25
  Speaker 1: the musical. Why Hercules, you say, Well, my daughter is
• 2:31
  Speaker 1: like looking at the big sort of Gresshian urn on
• 2:34
  Speaker 1: the on the stage and she's like, what's Hercules? And
• 2:41
  Speaker 1: I was like, Oh, it's Hercules. The character's name is Hercules.
• 2:45
  Speaker 1: Like I was like, I try to get you to
• 2:46
  Speaker 1: watch this movie with me one hundred times. You guys
• 2:48
  Speaker 1: didn't want to do it, and she goes, I don't
• 2:50
  Speaker 1: remember that. So yeah, So Hercules was being played by
• 2:56
  Speaker 1: Philippe Verano, whose name I have probably dred, and oh
• 3:01
  Speaker 1: my god, he was amazing, like absolutely amazing. Didn't even
• 3:04
  Speaker 1: occur to me that he was the swing. And here's
• 3:07
  Speaker 1: the thing. It was the kid's first musical and I am.
• 3:10
  Speaker 2: So glad it was.
• 3:12
  Speaker 1: They caught confetti, they laughed at the side jokes and
• 3:15
  Speaker 1: my boy, oh, well, like he had his ear defenders
• 3:18
  Speaker 1: on and so he was like, we were prepared like
• 3:21
  Speaker 1: for this, We had snacks the whole shebang, like we
• 3:24
  Speaker 1: were good. You know. Well he had this like panda
• 3:29
  Speaker 1: with him as well, for like tactile comfort, and so
• 3:33
  Speaker 1: like he's got this stuffy, plushy motherfucker and he's waving
• 3:37
  Speaker 1: it like at the cast at the at the curtain call.
• 3:41
  Speaker 2: It's a curtain call, I know.
• 3:43
  Speaker 1: The bit where they all bow at the end, right,
• 3:45
  Speaker 1: I don't know everything. And so he says that, you know,
• 3:49
  Speaker 1: they were like waving back or looking at him and stuff,
• 3:53
  Speaker 1: and I was like, I was too busy trying not
• 3:56
  Speaker 1: to die from pain.
• 3:57
  Speaker 2: But it was a really good Joe.
• 4:00
  Speaker 1: I didn't know if I was gonna make it through
• 4:01
  Speaker 1: the second half. I did and it was really really good.
• 4:06
  Speaker 1: And also I should know the name of the actress
• 4:09
  Speaker 1: who played Magara, but she may be the most beautiful
• 4:12
  Speaker 1: woman I've ever seen in my life anyway, so oh yeah,
• 4:17
  Speaker 1: So like, my boy was also convinced that like Givender
• 4:22
  Speaker 1: going hm Hercules now that herk Dailey's and Meg like
• 4:25
  Speaker 1: the actors were a real life boyfriend and girlfriend. But
• 4:28
  Speaker 1: I'm like, that's acting, okay.
• 4:31
  Speaker 2: But yeah.
• 4:33
  Speaker 1: Also, his favorite character was Hades, because of course it
• 4:36
  Speaker 1: was the boy watched Star Wars. I'm dressed as Kylo
• 4:42
  Speaker 1: Wren for two halloweens in a row. Like for someone
• 4:44
  Speaker 1: so full of empathy, he really does like a villain.
• 4:48
  Speaker 1: And in fairness, his sister when she saw Capop Demon Hunters,
• 4:53
  Speaker 1: she didn't want to be a demon hunter. She wanted
• 4:55
  Speaker 1: to be a demon specifically, the demon version of baby Saja,
• 5:00
  Speaker 1: not the K pop boy band Saja boy right no
• 5:04
  Speaker 1: no no, no, no no. She wanted to be the
• 5:06
  Speaker 1: demon version specifically. So I'm not entirely sure what that
• 5:10
  Speaker 1: says about me as a parent. Finally, I got blocked
• 5:18
  Speaker 1: news about me. This is what happened last night. I
• 5:23
  Speaker 1: got blocked by Bernard the Elf on threads because I
• 5:27
  Speaker 1: told him to be a big boy and deal with
• 5:29
  Speaker 1: the consequences of his actions. But I know what you're thinking.
• 5:33
  Speaker 1: You're thinking, Katie, please quidor jibber jabber in fact me,
• 5:39
  Speaker 1: in fact you, I will.
• 5:40
  Speaker 2: But first we've got to get.
• 5:43
  Speaker 1: Our source on. Our sources are and the band played
• 5:49
  Speaker 1: on on Politics. People and the AIDS Epidemic by Randy Schultz.
• 5:57
  Speaker 2: Let the record show.
• 6:00
  Speaker 1: History of Act Up New York nineteen eighty seven to
• 6:03
  Speaker 1: nineteen ninety three by Sarah Schulman, The Life and Death
• 6:08
  Speaker 1: of Ryan White by Paul m Renfro, Play Years, A
• 6:15
  Speaker 1: Doctor's Journey through the AIDS Crisis by ross A Slottin.
• 6:20
  Speaker 1: And of course we have articles from The New Yorker,
• 6:27
  Speaker 1: the New York Times, we have the La Times. We
• 6:31
  Speaker 1: have our old favorites, biography dot com and history dot com.
• 6:39
  Speaker 2: Io.
• 6:39
  Speaker 3: Sitting comfortably good, then let's begin. Those of us who
• 6:48
  Speaker 3: are a little bit older will have at least some knowledge,
• 6:51
  Speaker 3: if not a full recollection of the AIDS crisis. However,
• 6:57
  Speaker 3: the way that we discuss history now this often gets
• 7:02
  Speaker 3: I'm gonna say, side stepped, and so a lot of
• 7:05
  Speaker 3: younger people tend to not know that much about the subject.
• 7:09
  Speaker 1: And by that I mean when I mentioned the AIDS crisis,
• 7:13
  Speaker 1: they look at me like a cow looks at an
• 7:14
  Speaker 1: oncoming train. No, l like this is a part of
• 7:22
  Speaker 1: history that changed the entire world. And that's not hyperbole. Now,
• 7:28
  Speaker 1: just for clarification, I'm not gonna be able to cover
• 7:32
  Speaker 1: every single thing here, So before anyone starts bumping their
• 7:34
  Speaker 1: gums about well you forgot about no, I fucking didn't.
• 7:40
  Speaker 1: I have a lot of information to provide and a
• 7:42
  Speaker 1: finite time to say it. Okay, I am going to start, however,
• 7:46
  Speaker 1: talking about EastEnders. Do Do Do Do Do, Do Do Doo.
• 7:54
  Speaker 1: I was going to go into the theme song there, but
• 7:55
  Speaker 1: I chose not to. You're welcome. I don't know if
• 7:57
  Speaker 1: my throat could take it. So my first memory of
• 8:04
  Speaker 1: any sort of understanding of AIDS was in the London
• 8:08
  Speaker 1: based soap opera EastEnders on the BBC. This is where
• 8:13
  Speaker 1: everyone founds out that longtime resident Mark Fowler was HIV
• 8:17
  Speaker 1: positive and Peggy Mitchell, played by the legend Barbara Windsor,
• 8:24
  Speaker 1: shouts like in the pub she's the landlady of the
• 8:28
  Speaker 1: pub of the Queen Vic right, and there's this whole
• 8:33
  Speaker 1: scene and I might not be getting this verbatim, by
• 8:36
  Speaker 1: the way, but she just goes, why you don't get
• 8:39
  Speaker 1: it at home with your family? Yes, I know that
• 8:42
  Speaker 1: is a terrible impression of Barbara Windsor, but so she
• 8:47
  Speaker 1: yells it all across the Queen vic Everyone goes silent,
• 8:51
  Speaker 1: the glasses do that clinky chinky thing, and the camera
• 8:55
  Speaker 1: pans on all these different faces who are just sort
• 8:59
  Speaker 1: of judging and looking, and Mark proclaims that he contracted
• 9:07
  Speaker 1: the infection from his wife, who dies or has died.
• 9:12
  Speaker 1: At this point, I'm not entirely sure because this is
• 9:17
  Speaker 1: all from memory. That being said, the character was a
• 9:22
  Speaker 1: habitual drug user in his teens, and I think the
• 9:25
  Speaker 1: whole point was that he didn't have an exact point
• 9:28
  Speaker 1: of origin, which a lot of people don't, you know,
• 9:31
  Speaker 1: And it was to show that so many different people
• 9:35
  Speaker 1: from different walks of life contract HIV. So the Terence
• 9:42
  Speaker 1: Higgins Trust, which is like the UK's leading HIV and
• 9:46
  Speaker 1: AIDS charity, worked with the production team for the duration
• 9:50
  Speaker 1: of Mark Fowler's story, which was thirteen years and the
• 9:56
  Speaker 1: biggest peak in requests for HIV testing in Britain was
• 10:00
  Speaker 1: seen in January nineteen ninety one when Mark Fowler was
• 10:05
  Speaker 1: diagnosed HIV positive.
• 10:07
  Speaker 2: Right, it was like a massive.
• 10:11
  Speaker 1: Deal, right, So that's how I learned about it, And
• 10:16
  Speaker 1: it was like a big talking point of sort of.
• 10:19
  Speaker 2: TV history for years.
• 10:23
  Speaker 1: So that being said, I'm gonna focus across the pond,
• 10:31
  Speaker 1: and I'm going to talk about the AIDE crisis in
• 10:34
  Speaker 1: the US, because the age crisis didn't just happen in America, right.
• 10:41
  Speaker 1: The epidemic was enabled by a series of institutional failures
• 10:45
  Speaker 1: gel surprise, numerous and I do mean numerous organizations. They
• 10:51
  Speaker 1: were responsible for protecting public health and failed to carry
• 10:55
  Speaker 1: out their duties effectively. Like they failed to do their job.
• 11:01
  Speaker 1: As a result, countless people suffered unnecessarily, leaving a legacy
• 11:07
  Speaker 1: of pain and loss that it continues to affect societies
• 11:12
  Speaker 1: across the Western world decades later. And although I'm going
• 11:17
  Speaker 1: to be focusing primarily on the AIDS crisis in the
• 11:21
  Speaker 1: nineteen eighties in the US, well the story starts much earlier,
• 11:28
  Speaker 1: thousands and thousands of miles away and earlier in time
• 11:34
  Speaker 1: in Central Africa. See to understand the whole. Like where
• 11:40
  Speaker 1: the disease started, it is necessary to understand and examine
• 11:45
  Speaker 1: epidomology behind it. Now, scientists cannot be completely, one hundred
• 11:52
  Speaker 1: absolutely certain about every single detail of HIV's emergence. The
• 11:57
  Speaker 1: widely accepted consensus is that the virus cre lost from
• 12:00
  Speaker 1: chimpanzees to humans during the period between the eighteen nineties
• 12:06
  Speaker 1: and the nineteen twenties in what is now known as
• 12:11
  Speaker 1: the Democratic Republic of Congo, which, yes, if you know
• 12:17
  Speaker 1: your history, that timeframe is round about when King Leopold
• 12:22
  Speaker 1: the Second of Belgium tyrannically ruled the Congo under the
• 12:26
  Speaker 1: guise of aid and diplomacy that was in reality a
• 12:30
  Speaker 1: reign of torture and terror. So back to chimpanzees, right,
• 12:36
  Speaker 1: They carried a related virus known as SIV simean immunodeficiency virus,
• 12:46
  Speaker 1: so contact between humans and infected animals happened, probably during
• 12:53
  Speaker 1: hunting and the preparation of bush meat. After a while,
• 12:58
  Speaker 1: the virus adapted to humans, eventually evolving into HIV, which
• 13:02
  Speaker 1: is the virus responsible for it kills the praise men
• 13:10
  Speaker 1: say an animal and does are gone to say whether
• 13:12
  Speaker 1: they want to eat it or fuck it, and sometimes
• 13:15
  Speaker 1: the choice isn't mutually exclusive. I swear like it's I
• 13:22
  Speaker 1: feel like I should be surprised, or but I'm not
• 13:26
  Speaker 1: because hunters are like, I'm gonna eat a monkey now,
• 13:31
  Speaker 1: because bush meat is a weird term, it relates to
• 13:34
  Speaker 1: a few animals, but especially to non human primates, which
• 13:38
  Speaker 1: does feel like it is the closest thing one can
• 13:40
  Speaker 1: get to cannibalism from a legal perspective, so they do believe.
• 13:46
  Speaker 1: Typically it probably transferred to humans as a result or
• 13:49
  Speaker 1: undercooked meat, or through like chimp blood getting into human
• 13:53
  Speaker 1: cuts and winds, etc. Now, again, normally a hunter will
• 13:59
  Speaker 1: be able to fight SIV. But virus is adapt That
• 14:04
  Speaker 1: is why you have to get a different flu vaccine
• 14:07
  Speaker 1: because there are different strains of viruses because they change. Okay,
• 14:14
  Speaker 1: so yeah, viruses adapt, and this one adapted itself to
• 14:21
  Speaker 1: the new host and became known as HIV so HIV
• 14:25
  Speaker 1: one human immunodivision say virus. See there is another strain
• 14:32
  Speaker 1: of that virus, HIV two. Now this is significantly less
• 14:36
  Speaker 1: infectious and far less widespread than HIV one, which is
• 14:41
  Speaker 1: why most people haven't heard of it or know that
• 14:43
  Speaker 1: there are different strains see HIV two originated from a
• 14:48
  Speaker 1: different primate species, the city Mangabey monkey rather than chimpanzees,
• 14:55
  Speaker 1: and the jump to humans probably happened through much the
• 14:59
  Speaker 1: same process HIV one, close contact with infected blood during
• 15:04
  Speaker 1: hunting or butchering. Now, unlike HIV one, which would go
• 15:12
  Speaker 1: on to conquer the globe with I'm going to say
• 15:14
  Speaker 1: alarming efficiency, HIV two remained quite confined to several countries
• 15:22
  Speaker 1: in West Africa. Like HIV one became a pandemic, and
• 15:29
  Speaker 1: HIV two never really made out of the regional part.
• 15:36
  Speaker 1: So the earliest confirmed case of HIV comes from a
• 15:41
  Speaker 1: blood sample collected in nineteen fifty nine from a man
• 15:45
  Speaker 1: living in what is now the Democratic Republic of Congo.
• 15:49
  Speaker 1: At the time, nobody knew what they were looking for,
• 15:54
  Speaker 1: and it was only decades later when scientists analyzed the
• 15:57
  Speaker 1: preserved sample that the idea to find the HIV within it,
• 16:02
  Speaker 1: making it the first very viable case on record. Now,
• 16:08
  Speaker 1: I know that you know that this does not mean
• 16:12
  Speaker 1: that HIV suddenly appeared in nineteen fifty nine, that no.
• 16:18
  Speaker 1: See genetic analysis, yeah, we're doing science suggests that it
• 16:24
  Speaker 1: had already been circulating amongst humans for decades by then, right,
• 16:30
  Speaker 1: probably since the early twentieth century, like that turn of
• 16:34
  Speaker 1: the century time. Now, the nineteen fifty nine sample is
• 16:39
  Speaker 1: just the earliest surviving piece of evidence that we have
• 16:43
  Speaker 1: managed to find. Like it's the confirmed case. It's not
• 16:48
  Speaker 1: the patient zero, and we will be getting into patient
• 16:51
  Speaker 1: zero later kind of. Soe now this is important, right, see,
• 16:59
  Speaker 1: because this demolishes one of the most persistent misconceptions about
• 17:06
  Speaker 1: AIDS that it somehow like popped up out of nowhere
• 17:11
  Speaker 1: in nineteen eighties America. But by the time doctors in
• 17:16
  Speaker 1: Los Angeles and New York began noticing clusters of unusual illnesses,
• 17:21
  Speaker 1: HIV had already been silently spreading through human populations for generations.
• 17:27
  Speaker 2: The virus was.
• 17:30
  Speaker 1: Around for a while, it was all news, but humanity
• 17:35
  Speaker 1: effectively was just late to the party. By nineteen eighty
• 17:41
  Speaker 1: and nineteen eighty one, doctors in places like Los Angeles,
• 17:47
  Speaker 1: San Francisco, and New York, et cetera, began noticing something.
• 17:53
  Speaker 2: Very odd.
• 17:56
  Speaker 1: Right, gay men who had previously been very very healthy,
• 18:00
  Speaker 1: like they're young, they're healthy, they're strong, you know, suddenly
• 18:05
  Speaker 1: they're developing diseases that most doctors really saw outside of
• 18:10
  Speaker 1: patients with severely weakened immune systems, cases of Caposi circoma,
• 18:17
  Speaker 1: a rare cancer that typically affected elderly men from the Mediterranean,
• 18:22
  Speaker 1: old men in the Mediterranean and young men in San Francisco.
• 18:27
  Speaker 1: Feels like a different demographic, but here we are. There
• 18:33
  Speaker 1: were also things like pneumocyitis korenan pneumonia, which started appearing
• 18:40
  Speaker 1: with I'm gonna say alarming frequency because these were illnesses
• 18:45
  Speaker 1: that normally showed up in clusters amongst healthy people in
• 18:49
  Speaker 1: their twenties and their thirties. They would leave purple spots
• 18:56
  Speaker 1: on the skins of sufferers and it was one of
• 18:59
  Speaker 1: the many illnesses that would become the mark of HIV.
• 19:06
  Speaker 1: At first, nobody knew what was causing it. Doctors were
• 19:11
  Speaker 1: seeing the symptoms, but the underlying diseases remained invisible. By
• 19:17
  Speaker 1: the end of nineteen eighty one, roughly two hundred and
• 19:20
  Speaker 1: seventy cases of these unusual illnesses had been reported to
• 19:23
  Speaker 1: the United States, and the majority were amongst gay men.
• 19:29
  Speaker 1: And what made the situation so scary was that these
• 19:34
  Speaker 1: diseases were usually associated with people whose immune systems had
• 19:38
  Speaker 1: already been compromised by conditions such as cancer, organ transplants
• 19:44
  Speaker 1: severe infections. Even seeing them suddenly appear in otherwise healthy
• 19:50
  Speaker 1: adults was like finding a smoke alarm going off in
• 19:52
  Speaker 1: every room of the entire house and nobody could see
• 19:58
  Speaker 1: the fire. Now today we know that that fire was HIV.
• 20:03
  Speaker 1: At the time, however, researchers had no fucking clue what
• 20:08
  Speaker 1: they were dealing with. They knew that something was destroying
• 20:11
  Speaker 1: the immune systems of their patients, they just didn't know
• 20:14
  Speaker 1: what the culprit was. Now this raises another question, how
• 20:22
  Speaker 1: did HIV arrive in the United States in the first place.
• 20:28
  Speaker 1: For many, many years, the blame was unfairly concentrated on
• 20:34
  Speaker 1: a single man, creating one of the most enduring myths
• 20:39
  Speaker 1: of the AIDS epidemic. This man was Getting Duga, a
• 20:45
  Speaker 1: flight attendant from Quebec, Canada see now. Because his job
• 20:50
  Speaker 1: involved constant international travel, and because he appeared in early
• 20:55
  Speaker 1: epidemiological investigations, he was labeled by many people as patient zero,
• 21:01
  Speaker 1: the supposed individual who brought HIV to America. It was
• 21:07
  Speaker 1: a dramatic story, which is usually a warning sign that
• 21:10
  Speaker 1: the story is.
• 21:11
  Speaker 2: About to be wrong.
• 21:14
  Speaker 1: Duga was openly gay, attractive, sociable. In part of the
• 21:20
  Speaker 1: post sexul revolution culture that emerged in many North American
• 21:23
  Speaker 1: cities during the seventies. He traveled frequently between metor urban centers,
• 21:28
  Speaker 1: and naturally, because he was so charming and amazing, had
• 21:32
  Speaker 1: a large social network. When investigators later mapped connections between
• 21:38
  Speaker 1: early age cases, his name appeared repeatedly. Unfortunately, a misunderstanding
• 21:43
  Speaker 1: turned him from a participant in a scientific study into
• 21:47
  Speaker 1: a public villain. In the research notes, he had been
• 21:51
  Speaker 1: identified as patient O, the O standing for outside California.
• 21:59
  Speaker 1: Somewhere along the line, people read the letter OH as
• 22:01
  Speaker 1: the number zero, and the myth was.
• 22:03
  Speaker 2: Born like it is.
• 22:09
  Speaker 1: Impressive and terrifying that humanity's ability to turn paperwork into conspiracy,
• 22:18
  Speaker 1: Like it's his skill, and it really should never be underestimated,
• 22:22
  Speaker 1: because people can craft bullshit from anything in reality. Later
• 22:31
  Speaker 1: genetic studies showed that HIV was already circulating in the
• 22:35
  Speaker 1: US before Douga even became ill. The virus had likely
• 22:40
  Speaker 1: entered North America years earlier and was spreading through multiple
• 22:44
  Speaker 1: networks long before anyone had heard the term AIDS. Douga
• 22:49
  Speaker 1: was not the source of the epidemic. He was one
• 22:53
  Speaker 1: of its victims. He was diagnosed with a Caposi circoma
• 22:58
  Speaker 1: around nineteen eighty and eventually died from complications related to
• 23:02
  Speaker 1: AIDS in nineteen eighty four.
• 23:07
  Speaker 2: For decades, however, he.
• 23:11
  Speaker 1: Carried the reputation of being the man who started the
• 23:14
  Speaker 1: epidemic in America, a reputation that modern research has thoroughly discredited.
• 23:22
  Speaker 1: Like he died of kidney failure as a result of
• 23:27
  Speaker 1: AIDS related complications, he was a victim to a disease,
• 23:35
  Speaker 1: and people pinned. They pinned the blame on him because
• 23:39
  Speaker 1: they want to have someone to blame, and they want
• 23:43
  Speaker 1: to have someone to attack. And the thing is, the
• 23:49
  Speaker 1: real story is much less dramatic and far more troubling.
• 23:54
  Speaker 1: HIV did not arrive because of one reckless individual. It
• 23:58
  Speaker 1: spread quietly through human plant populations. For years, well medicine,
• 24:03
  Speaker 1: public health systems, and government struggled to recognize what was happening.
• 24:08
  Speaker 1: The epidemic was not the work of a single patient zero.
• 24:12
  Speaker 1: It was the result of a virus that had been
• 24:14
  Speaker 1: moving through communities long before anyone knew it existed. See
• 24:22
  Speaker 1: In nineteen eighty two, Gaetan Duga was undergoing chemotherapy for
• 24:27
  Speaker 1: cancer when he was interviewed by the CDC, which is
• 24:30
  Speaker 1: the US Center for Disease Control and Prevention. They asked
• 24:34
  Speaker 1: him questions about his sexual activity, and the CDC at
• 24:38
  Speaker 1: this point started making the connection between HIV AIDS and
• 24:42
  Speaker 1: sexual activity, like they realized it was a sexually transmitted infection.
• 24:50
  Speaker 1: And Douga, he is doing his best to provide all
• 24:53
  Speaker 1: of the information in this study. He wants to help,
• 24:58
  Speaker 1: and he is being honest, and he he estimates that
• 25:01
  Speaker 1: he'd had some seven hundred and fifty partners in the
• 25:04
  Speaker 1: previous few years. And so the CDC gets a list
• 25:09
  Speaker 1: of contacts from his address book because that's a thing
• 25:12
  Speaker 1: people had, and he ends up becoming patient fifty seven.
• 25:18
  Speaker 1: The CDC right, fifty seven, not zero, And on the
• 25:25
  Speaker 1: thirtieth of March nineteen eighty four he died of kidney failure.
• 25:33
  Speaker 1: And of course there was no singular moment when the
• 25:36
  Speaker 1: truth suddenly became clear. The CDC initially tried to correct
• 25:40
  Speaker 1: the emerging narrative, emphasizing that Gates and Duga was not
• 25:44
  Speaker 1: the origin of the outbreak, but by then the media
• 25:47
  Speaker 1: had already found its villain and dug its claws in
• 25:53
  Speaker 1: and public perception is rarely corrected after it has been created,
• 25:58
  Speaker 1: especially not as quickly the idea of patient zero had
• 26:03
  Speaker 1: taken hold and du Gad had it.
• 26:09
  Speaker 2: He was the blame game. That was that.
• 26:12
  Speaker 1: It would take decades before this false narrative was properly dismantled.
• 26:20
  Speaker 1: Like by twenty sixteen, genetic and epidemiological research had confirmed
• 26:26
  Speaker 1: beyond reasonable doubt that Gates and Duga had not introduced
• 26:30
  Speaker 1: HIV AIDS to North America, and that it had been
• 26:35
  Speaker 1: present in the US long before he was ever diagnosed. Basically,
• 26:41
  Speaker 1: patient zero was never a starting point, but just an
• 26:46
  Speaker 1: early case that was misread, misleveled, and mythologized. And yet
• 26:53
  Speaker 1: the myth stuck because it was simpler and more convenient
• 26:59
  Speaker 1: than reality. By the early nineteen eighties, scientists were beginning
• 27:05
  Speaker 1: to connect a series of otherwise unrelated clinical reports clusters
• 27:11
  Speaker 1: of rare illnesses appearing in young, otherwise healthy men, primarily
• 27:15
  Speaker 1: in these big cities. Okay, they fairly noticed, Oh it's
• 27:21
  Speaker 1: happening over there and over there and over there. And
• 27:24
  Speaker 1: at that time the condition did not have a name.
• 27:26
  Speaker 1: There was no HIV and no AIDS in public language,
• 27:31
  Speaker 1: only this growing awareness that something unusual was happening. Now,
• 27:39
  Speaker 1: the thing about HIV is like people might know the name,
• 27:44
  Speaker 1: but they don't really know anything about it. In most cases,
• 27:50
  Speaker 1: infection begins with a short fluw like illness, occurring two
• 27:55
  Speaker 1: to six weeks after exposure. Symptoms can include fittigue, favor,
• 28:01
  Speaker 1: sore throat, and sometimes a rash. After this brief initial phase,
• 28:06
  Speaker 1: symptoms typically disappear. They go dormant, sometimes for years. This
• 28:14
  Speaker 1: is the clinical latency stage, during which a person may
• 28:18
  Speaker 1: feel entirely healthy while the virus continues to replicate and
• 28:22
  Speaker 1: remain transmissible. The reason the HIV is so effective as
• 28:28
  Speaker 1: a pathogen is precisely this and is this long dormant period.
• 28:37
  Speaker 1: During latency, the virus targets CD four T cells, which
• 28:41
  Speaker 1: are key components of the immune system responsible for coordinating
• 28:45
  Speaker 1: the body's respond to infection. As CD four counts gradually decline,
• 28:51
  Speaker 1: the immune system becomes weaker, leaving the body vulnerable to
• 28:56
  Speaker 1: infections it would normally suppress without any difficulty. AIDS or
• 29:02
  Speaker 1: Acquired immune deficiency syndrome refers to the most advanced stage
• 29:08
  Speaker 1: of the HIV infection. It is diagnosed when CD four
• 29:13
  Speaker 1: T cell levels fall below two hundred cells per of
• 29:16
  Speaker 1: cubic millimeter of blood or when specific opportunistic infections appear,
• 29:23
  Speaker 1: regardless of count. These infections can include neumocitis, pneumonia, toxoplasmosis,
• 29:33
  Speaker 1: candidy isis right, candidy isis thrush okay, and certain cancers
• 29:41
  Speaker 1: such as caposis or coma, which we mentioned earlier. Basically,
• 29:47
  Speaker 1: the immune system becomes so depleted that even minor pathogens
• 29:51
  Speaker 1: can become life threatening. One commonly repeated line puts it bluntly.
• 29:59
  Speaker 1: You do not die from A itself, but from the
• 30:02
  Speaker 1: infections your immune system can no longer control. It is
• 30:06
  Speaker 1: an accurate simplification, it is not a comforting one. Today
• 30:13
  Speaker 1: HIV is a manageable chronic condition thanks to anti retroviral therapy,
• 30:21
  Speaker 1: But in the early eighties there was no treatment, no
• 30:23
  Speaker 1: established name for the syndrome, and no clear understanding of
• 30:26
  Speaker 1: what was causing it. For those first recognized patients, infection
• 30:33
  Speaker 1: was effectively a death sentence. When I was in Toronto,
• 30:40
  Speaker 1: we ended up over in I don't know the probably
• 30:46
  Speaker 1: Toronto's version of the West Village, and we were in
• 30:50
  Speaker 1: this park and they had this monument with all of
• 30:55
  Speaker 1: these names on it. It was these sort of pillars
• 30:57
  Speaker 1: like one after the other, and it was all members
• 31:02
  Speaker 1: of the gay community who had succumbed to HIV and AIDS,
• 31:10
  Speaker 1: and some of the pillars at the end were blank
• 31:14
  Speaker 1: because they knew there.
• 31:14
  Speaker 4: Was more to come. And I stopped. I read all
• 31:21
  Speaker 4: the names because history doesn't mean anything without people.
• 31:28
  Speaker 2: This is a sidebar.
• 31:29
  Speaker 1: Sorry, and.
• 31:31
  Speaker 2: I have to I don't know. It's a thing.
• 31:34
  Speaker 1: We have an interesting relationship with death in Ireland. We
• 31:42
  Speaker 1: respect the dead, we revere the dead, but we were
• 31:44
  Speaker 1: also honest about the dead, and so honestly, so many
• 31:52
  Speaker 1: people and the first three four rows of those pillars,
• 32:01
  Speaker 1: they were let down by society. They were accused and
• 32:08
  Speaker 1: blamed as if there was something wrong with them for
• 32:12
  Speaker 1: them getting ill. They were the less dead, and it
• 32:19
  Speaker 1: was their community that continued to support them through this.
• 32:24
  Speaker 1: And they deserve to be remembered. They deserve to be considered,
• 32:33
  Speaker 1: and they deserve for you to stop and give them
• 32:37
  Speaker 1: a moment of your time when you see their names.
• 32:46
  Speaker 1: The first widely cited report appeared in June nineteen eighty
• 32:49
  Speaker 1: one in the CDC's Morbidity and Mortality Weekly Report. It
• 32:56
  Speaker 1: described five young men in Los Angeles diagnosed with neuroscida pneumonia.
• 33:01
  Speaker 1: Two of hume who had already died, all were men
• 33:05
  Speaker 1: who had sex with men, and all showed severely depleted
• 33:09
  Speaker 1: immune function. It was the first official signal that something
• 33:14
  Speaker 1: new and series was emerging, even if no one yet
• 33:18
  Speaker 1: had the language.
• 33:19
  Speaker 2: To describe it.
• 33:21
  Speaker 1: A second report published in July nineteen ninety one, documented
• 33:27
  Speaker 1: twenty six additional cases, again predominantly amongst gay men, with
• 33:32
  Speaker 1: patients presenting with neumrocidas, pneumonia, and composi sir coma. Over
• 33:37
  Speaker 1: the following years, it became increasingly clear that these were
• 33:39
  Speaker 1: not isolated anomalies, but part of a growing epidemic. Hospitals
• 33:44
  Speaker 1: across the United States began reporting similar cases with disturbing consistency,
• 33:49
  Speaker 1: even though the condition itself still had no official name.
• 33:54
  Speaker 1: In the early stages, the syndrome was referred to in
• 33:57
  Speaker 1: some media and informal discussions as grid grid gay related
• 34:02
  Speaker 1: immune deficiency. The term very briefly appeared in public discourse,
• 34:07
  Speaker 1: including a nineteen eighty two New York Times article. However,
• 34:10
  Speaker 1: it was never adopted into scientific literature. It quickly became
• 34:15
  Speaker 1: clear that the name was both misleading and scientifically unsound.
• 34:20
  Speaker 1: More importantly, it reinforced the dangerous assumption that the disease
• 34:24
  Speaker 1: was confined to gay men. At the time, there was
• 34:29
  Speaker 1: a widespread and deeply damaging misconception that this was a
• 34:34
  Speaker 1: gay disease or even moral judgment expressed in biological form.
• 34:40
  Speaker 1: Now I say misconception, its actual downright bullshit.
• 34:47
  Speaker 4: See.
• 34:48
  Speaker 1: Some narratives went even further, framing the illness is some
• 34:54
  Speaker 1: kind of punishment. Now, I know you're surprised, but none
• 34:58
  Speaker 1: of this had any scientific basis, but it reflected the
• 35:02
  Speaker 1: social climate of the early nineteen eighties, when stigma, shock,
• 35:06
  Speaker 1: and lay traveled faster than evidence. As surveillance expanded, it
• 35:12
  Speaker 1: became obvious that the pattern did not fit those assumptions.
• 35:16
  Speaker 1: Cases began to appear in other populations, including hemophiliacs who
• 35:21
  Speaker 1: were infected through contaminated blood products, and hyacian patients who
• 35:25
  Speaker 1: were unfairly and baselessly stigmatized in early reporting. In nineteen
• 35:30
  Speaker 1: eighty three, the CDC outlined what became as the four
• 35:34
  Speaker 1: H risk groups homosexuals, heroin users, hemophiliacs, and hyacians. While
• 35:43
  Speaker 1: intended as early epidemological shorthand, the classification had serious unintended consequences.
• 35:52
  Speaker 1: It reinforced the false impression that the HIV was confined
• 35:56
  Speaker 1: to specific marginalized groups. In reality, these categories reflected patterns
• 36:02
  Speaker 1: of early detection and transmission routes, not exclusivity. The virus
• 36:07
  Speaker 1: itself did not respect identity labels or social boundaries. The
• 36:13
  Speaker 1: consequences were severe. Heighten communities faced discrimination and job loss.
• 36:20
  Speaker 1: Gay men were further stigmatized at a time when stigma
• 36:22
  Speaker 1: had already shaped nearly every aspect of public and private life,
• 36:27
  Speaker 1: and perhaps most critically, many outside these labeled groups concluded
• 36:32
  Speaker 1: incorrectly that they were not at risk. That misunderstanding allowed
• 36:40
  Speaker 1: the virus to spread more widely because public awareness did
• 36:45
  Speaker 1: not catch up with reality as quickly as it should. HIV,
• 36:52
  Speaker 1: as it turned out, did not belong to any group.
• 36:55
  Speaker 1: I belonged to biology. The term AIDS came in wider
• 37:00
  Speaker 1: use around late eighty two, when the CDC adopted it
• 37:05
  Speaker 1: to describe the growing syndrome, a severe immunal deficiency that
• 37:08
  Speaker 1: was being observed across multiple patient groups. Described the outcome
• 37:15
  Speaker 1: rather than the cause, but this stage the cause was
• 37:23
  Speaker 1: still unknown. The breakthrough began to emerge in eighty three,
• 37:27
  Speaker 1: when research teams in Europe and the US identified independently
• 37:32
  Speaker 1: a retrovirus associated with the condition. In Paris, doctor Luke
• 37:37
  Speaker 1: Montaigne and his team at the Pastio Institute investigated samples
• 37:41
  Speaker 1: from patients in early stages of EIDs, which was then
• 37:45
  Speaker 1: sometimes referred to as pre AIDS or arc AIDS related complex.
• 37:53
  Speaker 1: From these samples, they isolated a retrovirus which showed a
• 37:56
  Speaker 1: clear preference for infecting T cells, but particularly the CED
• 38:01
  Speaker 1: four limphocytes. The virus was initially named LAV limphandenopathy associated virus.
• 38:10
  Speaker 1: Although will its role in causing AIDS is not fully established,
• 38:14
  Speaker 1: it was still a strong candidate for the underlying agent.
• 38:18
  Speaker 1: Their findings were published in Science in May eighty three,
• 38:21
  Speaker 1: although at the time the significance of this discovery was
• 38:25
  Speaker 1: not universally recognized and like around the same period, the
• 38:30
  Speaker 1: American researcher doctor Robert Gio and his team were conducting
• 38:34
  Speaker 1: similar investigations, so he identified Gio did what he called
• 38:40
  Speaker 1: HTLV three Human talum potropic virus type three, a retrovirus
• 38:47
  Speaker 1: found in a significant proportion of patients with AIDS or
• 38:51
  Speaker 1: early immune dificiency symptoms. His work, also published in Science
• 38:55
  Speaker 1: in eighty four, strengthened the growing consensus that a retroviral
• 38:59
  Speaker 1: AID was responsible for a time, the scientific community faced
• 39:06
  Speaker 1: an uncomfortable overlap, two different names, two research groups, and
• 39:10
  Speaker 1: what appeared to be the same virus. It would later
• 39:14
  Speaker 1: be confirmed that LAV and HDLV three were in fact
• 39:18
  Speaker 1: the same virus, now known universally as HIV human immuno
• 39:25
  Speaker 1: deficiency virus. In hindsight, this moment marked the transition from
• 39:32
  Speaker 1: speculation to identification. Now the disease still had no cure
• 39:37
  Speaker 1: and treatment options were practically non existent, but the scientific
• 39:42
  Speaker 1: world had finally isolated the agent responsible. What remained was
• 39:47
  Speaker 1: the far harder task catching up with a virus that
• 39:50
  Speaker 1: had already been circulating silently four years. Basically, the French
• 39:58
  Speaker 1: and American teams had isolated the same virus, and they
• 40:01
  Speaker 1: both wanted credit for discovering the virus that they both had.
• 40:05
  Speaker 1: Now this leads to a scientific dispute that was as
• 40:09
  Speaker 1: much about priority as it was discovery.
• 40:13
  Speaker 2: Right So, America.
• 40:15
  Speaker 1: Argued that their team had demonstrated not only the presence
• 40:18
  Speaker 1: of the virus but its causal role in aids. The
• 40:21
  Speaker 1: Montaigne group, however, pointed out a more cautious phrasing in
• 40:25
  Speaker 1: their original paper the role of the virus and causing aids.
• 40:30
  Speaker 1: They noted remained to be fully established. Basically, one side
• 40:36
  Speaker 1: framed the virus as the confirmed cause and the other
• 40:38
  Speaker 1: explicitly left the question open. This dispute did not entirely
• 40:44
  Speaker 1: fade away. Questions of attribution, research ethics, and priority continued
• 40:50
  Speaker 1: four years, reflecting how high the stakes had become in
• 40:53
  Speaker 1: the race to understand the epidemic. Like Eventually, they're both
• 40:58
  Speaker 1: recognized for their contributions, though in different ways, with the
• 41:02
  Speaker 1: scientific consensus acknowledging that each had played a significant role
• 41:06
  Speaker 1: in identifying and characterizing the virus. In two thousand and eight,
• 41:13
  Speaker 1: Luke Montaigne, alongside Francois Bersinouci, was awarded the Nobel Prize
• 41:18
  Speaker 1: in Physiology or Medicine for the discovery of HIV. Doctor
• 41:23
  Speaker 1: Gaio notably was not included in the prize, a decision
• 41:27
  Speaker 1: that reignited discussion about how scientific credit is assigned in
• 41:31
  Speaker 1: collaborative and competitive research environments.
• 41:34
  Speaker 2: But that's another story for another day.
• 41:38
  Speaker 1: Basically, discovery wasn't like one single moment, but a contested
• 41:45
  Speaker 1: process unfolding under immense pressure. While scientists debated naming rights
• 41:52
  Speaker 1: and priority, the virus itself continued its work uninterrupted, spreading
• 41:58
  Speaker 1: through populations far faster than the politics of recognition could
• 42:03
  Speaker 1: keep up. How had HIV spread so quickly and why
• 42:07
  Speaker 1: was it so focused within gay communities. Well, part of
• 42:12
  Speaker 1: the problem was the sexual revolution of the nineteen seventies.
• 42:17
  Speaker 1: So behavior and sexuality and relationships had been changing right.
• 42:22
  Speaker 1: Casual sex outside traditional monogamous relationships was becoming more accepted,
• 42:27
  Speaker 1: and sex was spoken about in a way that it
• 42:29
  Speaker 1: had never been before. In terms of both hetero and homosexuality.
• 42:35
  Speaker 1: It became normal ish to have more than one sexual partner.
• 42:40
  Speaker 1: And the eighties came a decade after the Stonewall Riots,
• 42:44
  Speaker 1: which changed the attitudes of LGBTQ plus people nationwide. Pre Stonewall,
• 42:51
  Speaker 1: much of the gay life in the United States operated
• 42:53
  Speaker 1: under enforced and visibility. Part of this as a result
• 42:56
  Speaker 1: of mcartheism, I say, part of quite a lot of
• 42:59
  Speaker 1: this because of McCarthyism, Like probably most of that is
• 43:03
  Speaker 1: because of McCarthyism. So for many people, homosexuality was something
• 43:09
  Speaker 1: to conceal rather than express openly. Marriage to opposite sex partners,
• 43:15
  Speaker 1: long term secrecy and what was politely called double lives
• 43:19
  Speaker 1: were of common survival strategies in a society that was
• 43:22
  Speaker 1: to put it mildly, not particularly welcomed. After a stonewall
• 43:27
  Speaker 1: in nineteen sixty nine, the dynamics shifted dramatically. Queer communities
• 43:33
  Speaker 1: became more visible, politically active, and socially organized. Pride marches
• 43:38
  Speaker 1: replaced silence with public pressure, and in cities like San
• 43:41
  Speaker 1: Francisco and New York, gay culture developed visible neighborhoods, social venues,
• 43:46
  Speaker 1: and community institutions. People were no longer just surviving. They
• 43:50
  Speaker 1: were increasingly living openly, and this visibility marroed socially and politically,
• 43:58
  Speaker 1: and it also meant like something less poetic. Epidemiologically, sexual
• 44:05
  Speaker 1: networks became easier to form, more interconnected, and more visible
• 44:09
  Speaker 1: to both community researchers and later public health officials. Not
• 44:13
  Speaker 1: uniquely so, heterosexual populations also experienced changing norms in the
• 44:18
  Speaker 1: same era, but in certain urban gay mail networks, partner
• 44:23
  Speaker 1: change rates were higher on average, particularly in specific social
• 44:26
  Speaker 1: settings like bars and bathhouses. Right. This is again just
• 44:31
  Speaker 1: a structural observation, although people try to turn this into
• 44:36
  Speaker 1: a moral judgment, and this is where the bollocks comes in. Right. So,
• 44:43
  Speaker 1: there was this massive wave of disinformation basically trying to
• 44:48
  Speaker 1: state that HIV could be transmitted casually through shared food,
• 44:55
  Speaker 1: through kissing, by using the same toilet, or sweating coughing.
• 45:02
  Speaker 1: Even I need this to be clear, it cannot. Transmission
• 45:09
  Speaker 1: requires specific bodily fluids, blood, semen, vaginal fluids, rectal fluids,
• 45:17
  Speaker 1: and breast milk. In other words, it is not a
• 45:21
  Speaker 1: socially contagious virus. It is a biologically specific one. You
• 45:27
  Speaker 1: don't need to be bleaching all your doorknobs. The actual
• 45:32
  Speaker 1: roots of transmission matter because HIVA is not equally efficient
• 45:36
  Speaker 1: in all contexts. One of the highest risk forms of
• 45:40
  Speaker 1: sexual transmission is receptive anal intercourse, and this is due
• 45:44
  Speaker 1: to anatomy. The rectal lining is thinner and more prone
• 45:48
  Speaker 1: to microtears than vaginal tissue, providing easier access to the bloodstream.
• 45:54
  Speaker 1: Estimates vary by studying conditions, but the risk per single
• 45:58
  Speaker 1: act of unprotected receptor of anal sex is significantly higher.
• 46:03
  Speaker 1: Oftenside is roughly an order of magnitude greater than unprotected
• 46:07
  Speaker 1: receptive vaginal intercourse. Now basically, bum tissue tears easier. Like,
• 46:15
  Speaker 1: that's it, there's an easier access rooted now. Condoms did
• 46:22
  Speaker 1: exist by the late seventies and early eighties, but widespread
• 46:26
  Speaker 1: explicit saper sex education tailored to HIV did not yet
• 46:30
  Speaker 1: exist because the virus itself had not been identified. In
• 46:35
  Speaker 1: the earliest years of the epidemic, people were effectively trying
• 46:38
  Speaker 1: to avoid a pathogen that they did not know existed,
• 46:41
  Speaker 1: using tools designed for pregnancy prevention and other known sexually
• 46:45
  Speaker 1: transmitted infections. Now there's a mismatch right there. As for
• 46:51
  Speaker 1: the spread in places like New York and San Francisco,
• 46:54
  Speaker 1: it reflected a combination of dense social networks, high mobility,
• 46:59
  Speaker 1: delay to medical recognition, and a virus that can remain
• 47:03
  Speaker 1: asymptomatic four years as well still being transmissible like that.
• 47:09
  Speaker 1: That's the important part. HIV does not announce itself immediately,
• 47:13
  Speaker 1: which meant and had already spread wildly before anyone realized
• 47:17
  Speaker 1: there was a pattern at all. By the time the
• 47:20
  Speaker 1: pattern became visible, the virus had a head start measured
• 47:23
  Speaker 1: in years, not months, and at that point public health
• 47:28
  Speaker 1: was not dealing with the beginning of an outbreak. It
• 47:31
  Speaker 1: was dealing with the middle of one that it had discovered.
• 47:35
  Speaker 1: There were more bathhouses, gay bars, clubs, and in certain cities,
• 47:39
  Speaker 1: a growing sense that being openly gay was at least possible,
• 47:42
  Speaker 1: if not universally safe. That visibility translated into denser sexual
• 47:49
  Speaker 1: networks and more opportunities for transmission. At the same time,
• 47:55
  Speaker 1: the United States was also in the middle of a
• 47:57
  Speaker 1: major intravenous drug crisis, which provided another efficient route for
• 48:02
  Speaker 1: HIV spread through needles.
• 48:04
  Speaker 2: They shared needles.
• 48:06
  Speaker 1: By nineteen eighty five, the contrast and outcomes was already stark.
• 48:11
  Speaker 1: Germany had recorded roughly one hundred and seventy AGS related
• 48:14
  Speaker 1: to deaths at this point, and the United States was
• 48:17
  Speaker 1: already approaching seven thousand. And that's the ones that were
• 48:22
  Speaker 1: registered now. Population size explains like part of the gap,
• 48:28
  Speaker 1: but not all of it, and certainly not neatly, And
• 48:33
  Speaker 1: what filled the remaining space was stigma, confusion, and delay.
• 48:45
  Speaker 1: In the early years, HIV AIDS was wildly and incorrectly
• 48:50
  Speaker 1: labeled the gay plague, a term enthusiastically amplified by parts
• 48:54
  Speaker 1: of the media and eagerly adopted by those already inclined
• 48:57
  Speaker 1: to see homosexuality as DV. For some religious groups, the
• 49:02
  Speaker 1: epidemic was framed less as a public health crisis and
• 49:06
  Speaker 1: more as moral accounting punishment delivered by biology.
• 49:10
  Speaker 2: On behalf of God.
• 49:12
  Speaker 1: The arrival of intravenous drug users, and other groups. As
• 49:15
  Speaker 1: recognized risk categories did little to soften this narrative. It
• 49:19
  Speaker 1: just expanded the list of people. Some were comfortable blaming
• 49:25
  Speaker 1: reality as usual refused to cooperate with moral storytelling. Invints
• 49:34
  Speaker 1: acquired it from mother to child, transmission during pregnancy, birth,
• 49:37
  Speaker 1: or breastfeeding. Heterosexual men and women were infected through sexual contact.
• 49:43
  Speaker 1: Hemophilac contracted HIV through contaminated blood products. HIV did not
• 49:49
  Speaker 1: require identity. It required exposure rich or poor, men or women,
• 49:56
  Speaker 1: straight or gay, young or old, black or white. The
• 50:00
  Speaker 1: virus did not read the cultural commentary. But fear doesn't
• 50:07
  Speaker 1: behave rationally, as we've seen with every other fucking moral
• 50:10
  Speaker 1: panic in existence. When people do not understand a disease,
• 50:16
  Speaker 1: they tend to overgeneralize it, and when they overgeneralize it,
• 50:20
  Speaker 1: they tend to locate it in other people. The social
• 50:24
  Speaker 1: reflex built a wall between effected communities and the wider public.
• 50:28
  Speaker 1: Part protection, part panic, part avoidance, and the consequences they
• 50:34
  Speaker 1: will not abstract. In the eighties, and a's diagnosis often
• 50:39
  Speaker 1: meant immediate social exile alongside medical crisis. Many people lost
• 50:44
  Speaker 1: their jobs once their status became known, which meant a
• 50:46
  Speaker 1: loss of income, insurance, and access to a care in
• 50:50
  Speaker 1: a system already struggling to respond. Public fear translated into
• 50:56
  Speaker 1: real world avoidance. People were austracized not because of what
• 51:00
  Speaker 1: HIV could casually do, but because of what people incorrectly
• 51:04
  Speaker 1: believed it could do casually, And that belief that it
• 51:08
  Speaker 1: could be transmitted to everyday contact persisted four years despite
• 51:14
  Speaker 1: no scientific evidence supporting it. And this is like a
• 51:18
  Speaker 1: feedback loop. Fear produced misinformation. Misinformation reinforced stigma and stigma
• 51:24
  Speaker 1: discourage testing and treatment, and even today, echoes of that
• 51:28
  Speaker 1: period remain. Studies have shown that men who have sex
• 51:34
  Speaker 1: with men can experience higher levels of depression, anxiety, and
• 51:37
  Speaker 1: substance use in context where stigma is severe, along with
• 51:43
  Speaker 1: reduced engagement in healthcare services. Right, it is the stigma.
• 51:49
  Speaker 1: The stigma is an underlying factor in all this. It
• 51:54
  Speaker 1: breeds and compresses the broader lesson is uncomfortable but consistent.
• 52:08
  Speaker 1: HIV spread faster, and not because of who people were,
• 52:12
  Speaker 1: but because of what they did not know and society
• 52:15
  Speaker 1: refused to understand in time because fear filled the information gap.
• 52:21
  Speaker 1: Oh and doesn't sound familiar at all and where fair leads,
• 52:26
  Speaker 1: clarity tends to arrive late, if at all. And I'm
• 52:31
  Speaker 1: gonna talk about Princess Diana for a second. Even though
• 52:33
  Speaker 1: you all know my feeling's honor right, brown clock can
• 52:37
  Speaker 1: still be right twice a day. In nineteen ninety one,
• 52:41
  Speaker 1: Princess Diana made one of the most iconic public gestures
• 52:46
  Speaker 1: of the early AIDS era when she visited the newly
• 52:49
  Speaker 1: opened HIV AIDS ward at London's Middlesex Hospital and shook
• 52:53
  Speaker 1: hands with a patient without wearing gloves. Now, remember, people
• 52:57
  Speaker 1: still thought this could be spread casually. It can't, and
• 53:04
  Speaker 1: Diana was already like properly briefed on transmission routes. So
• 53:09
  Speaker 1: this was an ignorance. This was deliberate right. She knew
• 53:12
  Speaker 1: that she was safe, she knew she had notting to lose.
• 53:15
  Speaker 1: The only thing she could do is be seen as
• 53:18
  Speaker 1: a good person for doing this. So a very simple act,
• 53:23
  Speaker 1: but a very public correction of a persistent myth in
• 53:25
  Speaker 1: an era where people with AIDS were still often avoided.
• 53:29
  Speaker 2: It did real cultural works, and.
• 53:31
  Speaker 1: She had her continued advocacy through HIV charities, helping sheft
• 53:35
  Speaker 1: public attitudes in the UK. Even if her role like
• 53:38
  Speaker 1: most public figures, was a mix of genuine engagement and
• 53:41
  Speaker 1: careful visibility. Now, the reality for people with AIDS in
• 53:48
  Speaker 1: the nineteen eighties and early nineties was not just medical,
• 53:51
  Speaker 1: it was social exile. Stigma framed the illness as a
• 53:54
  Speaker 1: moral failure rather than a viral infection, and that narrative
• 53:58
  Speaker 1: did damage. So who did the actual day to day
• 54:02
  Speaker 1: support work. A large share came within the LGBTQ communities themselves,
• 54:09
  Speaker 1: particularly from lesbian activists, whose contribution is often underplayed now.
• 54:15
  Speaker 1: The community wasn't perfectly unified by the seventies. There was
• 54:19
  Speaker 1: a real cultural divide between gay men and lesbians around politics,
• 54:23
  Speaker 1: gender roles, priorities. But AIDS changed the equation fast. Gay
• 54:28
  Speaker 1: men were hit earliest and hardest, and formal institutions were
• 54:33
  Speaker 1: slow to respond. In that gap, community networks became survival infrastructure,
• 54:39
  Speaker 1: and lesbians in particular stepped into caregiving, fundraising, and hospital
• 54:45
  Speaker 1: support roles at scale. The crisis didn't erase differences, it
• 54:50
  Speaker 1: just made survival more important. Most of the population became
• 54:56
  Speaker 1: terrified of catching this disease. In shock horror, we realized
• 55:00
  Speaker 1: they weren't willing to care for the gay men to
• 55:02
  Speaker 1: come into the disease en mass. Meanwhile, the hospitals were
• 55:07
  Speaker 1: full of lesbians volunteering their time going to the rooms
• 55:10
  Speaker 1: of AIDS patients to talk to them, feed them, hold them.
• 55:14
  Speaker 1: There were some of the only people willing to treat
• 55:16
  Speaker 1: them as human beings. Many of these men's had been
• 55:21
  Speaker 1: rejected by their families, so many members of the gay
• 55:24
  Speaker 1: community were wasting away in their hospital beds. AIDS was
• 55:28
  Speaker 1: a lonely, isolating illness, and lesbian women provided the kindness
• 55:33
  Speaker 1: and compassion that nobody else would or could. Lesbians were
• 55:43
  Speaker 1: actually one of the lowest risk groups for catching HIV,
• 55:46
  Speaker 1: and it's through their empathy and care that a lot
• 55:52
  Speaker 1: of these people are even remembered. I being told a
• 55:58
  Speaker 1: story about the leathers, so like, there's a big leather
• 56:02
  Speaker 1: community in the gay scene. And the reason like people
• 56:07
  Speaker 1: talk about oh kink of pride when they see leathers
• 56:10
  Speaker 1: and leathers isn't the kink leathers is not that. And
• 56:13
  Speaker 1: the reason the leathers are worn it pride is because
• 56:16
  Speaker 1: the lesbians carried them on a lot of the time
• 56:24
  Speaker 1: when someone was diagnosed in there put into hospital a
• 56:27
  Speaker 1: lot of their items, their lives, everything they'd collected was
• 56:31
  Speaker 1: fucking incinerated. People destroyed it, they burned it. They were
• 56:36
  Speaker 1: again they're afraid of touching it and catching the aids,
• 56:38
  Speaker 1: you know what I mean. And so.
• 56:42
  Speaker 2: They seeople loved their leathers and the lesbians are the
• 56:47
  Speaker 2: reason that they managed to care for them and have
• 56:51
  Speaker 2: this pass on.
• 56:52
  Speaker 1: So you don't get to have that opinion. You don't
• 56:55
  Speaker 1: get to say that that's not allowed a pride when
• 56:59
  Speaker 1: this is one of the few physical remaining items of
• 57:06
  Speaker 1: an entire generation, generations, even several generations of men whose
• 57:13
  Speaker 1: lives were just wiped out. In ninetee eighty three, sexually
• 57:26
  Speaker 1: active homosexual men were banned from giving blood across America
• 57:29
  Speaker 1: in an effort to prevent HIV from being spread to
• 57:32
  Speaker 1: blood transfusions. This band led to blood reserves across the
• 57:37
  Speaker 1: country severely depleting, and HIV sufferers needed blood to fight
• 57:41
  Speaker 1: the disease, and so Lesbian Blood Drive started popping up.
• 57:45
  Speaker 1: Bands of lesbian women came together to donate blood specifically
• 57:50
  Speaker 1: to men with AIDS. On the sixteenth of July eighty three,
• 57:56
  Speaker 1: the first drive happened and two hundred women showed up.
• 58:00
  Speaker 1: Similar tribes were wearing up all over the country and
• 58:02
  Speaker 1: continued all the way through the eighties and nineties and more.
• 58:05
  Speaker 1: Gay men who survived the epidemics say they were saved
• 58:08
  Speaker 1: physically and mentally by the lesbian community, the scientific and
• 58:15
  Speaker 1: medical communities working overtime to try and fight this disease.
• 58:18
  Speaker 1: But what about everyone else? Now this may shock you,
• 58:22
  Speaker 1: but they were kind of hoping it would just go away.
• 58:26
  Speaker 1: Being queer was such a taboo that people didn't even
• 58:29
  Speaker 1: want to think about queer people existing, let alone help them.
• 58:34
  Speaker 1: And what about the media, Well, it doesn't exactly help
• 58:36
  Speaker 1: by calling AIDS the gay disease. For the first couple
• 58:39
  Speaker 1: of years, disinformation or you know, just shitty journalism led
• 58:45
  Speaker 1: many people to think that it could only affect gay men.
• 58:49
  Speaker 1: And then, of course it was the drug users, which
• 58:51
  Speaker 1: is another group of the less dead. The next finger
• 58:55
  Speaker 1: the Haysi men. So now straight white people.
• 58:57
  Speaker 2: Were totally in the clear.
• 58:59
  Speaker 1: But no so while talking heads and newspapers turning out
• 59:02
  Speaker 1: bullshit bases dehumanizing victims of the disease as degenerates, it
• 59:06
  Speaker 1: didn't actually inform anyone of any preventative measures that they
• 59:10
  Speaker 1: could take. The stories were mostly sensationalized bullshit. There was
• 59:20
  Speaker 1: no push to tell men to work on laws to
• 59:22
  Speaker 1: help prevent spreading of the disease. They didn't say that
• 59:26
  Speaker 1: anyone was at risk, right, just the promiscuous and the homosexuals,
• 59:32
  Speaker 1: two things that the conservative media definitely did not want
• 59:35
  Speaker 1: to be seen as promoting. And like it wasn't until
• 59:39
  Speaker 1: Rock Hudson, like famous Golden Age of Hollywood star, announced
• 59:44
  Speaker 1: that he was HIV positive, did the media suddenly proclaim,
• 59:47
  Speaker 1: Oh no, no one is free from AIDS.
• 59:52
  Speaker 2: Suddenly they cared.
• 59:54
  Speaker 1: Right at this time, Rock Hudson was firmly in the closet,
• 59:59
  Speaker 1: so they were like, wh oh, anyone can catch it?
• 1:00:02
  Speaker 2: Oh no, Like it's it's such a whole thing.
• 1:00:07
  Speaker 1: But there was a sharp rise an organized anti gay
• 1:00:12
  Speaker 1: activism across the United States. Even after a stonewall legal
• 1:00:16
  Speaker 1: and social progress was uneven by an engine eighty only
• 1:00:19
  Speaker 1: about two dozen states still criminalized sort of me reflecting
• 1:00:25
  Speaker 1: how recently these laws had begun to shift rather than disappear. Now,
• 1:00:30
  Speaker 1: the postal Meal period had seen real momentum in LGBTQ
• 1:00:33
  Speaker 1: plus rights and visibility. You know, communities were more politically organized,
• 1:00:38
  Speaker 1: public presence increased, and activists were already openly discussing possibilities
• 1:00:44
  Speaker 1: like same sex marriage. Ideas at that time still sounded
• 1:00:48
  Speaker 1: speculative instead of imminent, and then AIDS arrived and the
• 1:00:52
  Speaker 1: trajectory changed abruptly. It triggered a major backlash. In many
• 1:00:57
  Speaker 1: parts of the country, existing prejudice was amplified rather than challenged,
• 1:01:01
  Speaker 1: and a public health panic often merged seamlessly with moral judgment.
• 1:01:08
  Speaker 1: Political resistance to LGBTQ plus rights intensified, and earlier gains
• 1:01:12
  Speaker 1: in visibility and acceptance stalled or reversed.
• 1:01:15
  Speaker 2: In some areas.
• 1:01:17
  Speaker 1: It's what had been for a brief period a forward
• 1:01:19
  Speaker 1: moving rights movement became entangled in a public health crisis
• 1:01:23
  Speaker 1: that many were quick to interpret through a moral lens
• 1:01:27
  Speaker 1: and not a medical ones. A virus had arrived in
• 1:01:30
  Speaker 1: the middle of a culture war, and neither side it
• 1:01:33
  Speaker 1: in more encouragement to make it worse. Conservative American political
• 1:01:39
  Speaker 1: organizations sought to mobilize conservative Americans to become politically active,
• 1:01:45
  Speaker 1: and issues that they thought were important were of course,
• 1:01:48
  Speaker 1: the issues were the fact against homosexuality. They had to
• 1:01:52
  Speaker 1: save their children from the immoral gaze, and the AIDS
• 1:01:55
  Speaker 1: crisis grew, so the moral majority feeling that God was
• 1:02:00
  Speaker 1: backing them up. Hann Ronald Reagan, the fortieth President of
• 1:02:04
  Speaker 1: the United States president between eighty one and eighty nine,
• 1:02:10
  Speaker 1: basically oversaw the whole crisis. The Reagan administration has quite
• 1:02:14
  Speaker 1: a bit to answer for here, and not just in hindsight.
• 1:02:18
  Speaker 1: With the benefit of anatly organized timeline. Eighty one, AIDS
• 1:02:22
  Speaker 1: had been identified as a new and groding medical crisis,
• 1:02:25
  Speaker 1: eighty two, the CDC was actively investigating it. Eighty three
• 1:02:29
  Speaker 1: eighty four, the virus responsible had been identified, and yet
• 1:02:33
  Speaker 1: within roughly three years of the epidemic entering public view,
• 1:02:37
  Speaker 1: there were already thousands of confirmed cases in the US
• 1:02:40
  Speaker 1: and thousands of deaths, with many more infections undiagnosed. And
• 1:02:45
  Speaker 1: the response from the White House, however, was selective silence.
• 1:02:52
  Speaker 1: Reagan did not publicly address AIDS until eighty five, and
• 1:02:56
  Speaker 1: at that point, over five thousand the Americans had already died.
• 1:03:01
  Speaker 1: And this wasn't a situation where the administration was unaware.
• 1:03:04
  Speaker 1: They just chose not to make it a public priority.
• 1:03:07
  Speaker 1: Whether it was political caution, cultural discomfort with homosexuality, or
• 1:03:11
  Speaker 1: fear of alienating conservative voters, the outcome was the same.
• 1:03:16
  Speaker 1: Federal leadership arrived late to a rapidly escalating crisis. Like
• 1:03:27
  Speaker 1: one journalist and like in the early eighties, asked questions
• 1:03:29
  Speaker 1: about AIDS, And it was eighty two, and he asked
• 1:03:33
  Speaker 1: the Press secretary about the CDC's report, And the response
• 1:03:37
  Speaker 1: was essentially non response, deflection, minimization, and at times openly dismissal.
• 1:03:44
  Speaker 2: Like this gay plague.
• 1:03:48
  Speaker 1: This framing of it was still common enough in public
• 1:03:51
  Speaker 1: discourse that it shaped how seriously the questions were taken.
• 1:03:56
  Speaker 1: By eighty four, it was asked for the president would
• 1:04:00
  Speaker 1: take steps to restrict access to food service or military
• 1:04:04
  Speaker 1: rules for people with AIDS, referencing public health presidents like
• 1:04:07
  Speaker 1: typhoid controls. The question itself reflected the confusion of the era,
• 1:04:12
  Speaker 1: mixing legitimate containment concerns with misunderstanding about transmission, but at
• 1:04:17
  Speaker 1: least it acknowledged, like the scale you know. The Press
• 1:04:21
  Speaker 1: secretary's reply, again was evasive, including a drinking suggestion that
• 1:04:28
  Speaker 1: the journalist asking the questions might want to get himself tested. Now,
• 1:04:35
  Speaker 1: this is revealing, not just the fact that this is
• 1:04:40
  Speaker 1: humor in tone. A serious public health crisis was being
• 1:04:44
  Speaker 1: discussed in a room where laughter was still an acceptable
• 1:04:47
  Speaker 1: reaction like the journalist, which is interesting was actually I
• 1:04:55
  Speaker 1: think it was consolving.
• 1:04:57
  Speaker 2: He was.
• 1:05:00
  Speaker 1: Opposed to gay rights, which is like why he's like
• 1:05:03
  Speaker 1: asking all these questions about it and why he wants
• 1:05:06
  Speaker 1: the government to comment on it. But they were just
• 1:05:10
  Speaker 1: like oh ho ho ho, watch out get tested, Like
• 1:05:15
  Speaker 1: it's not just a political delay, Like it's an institutional
• 1:05:20
  Speaker 1: delay at scale any fast moving epidemic, and that gap mattered. Now. Allegedly,
• 1:05:29
  Speaker 1: Ronald Reagan and his personal life was not homophobic, and
• 1:05:33
  Speaker 1: because he was like big, super cool friend of Rock Hudson,
• 1:05:39
  Speaker 1: like he didn't want to like publicly condone, you know,
• 1:05:44
  Speaker 1: civil rights for the LGBTQ community, but like privately he's
• 1:05:49
  Speaker 1: like whatever you do in your bedroom is what you do.
• 1:05:51
  Speaker 1: And it's like it's not just about sex, man, but
• 1:05:55
  Speaker 1: nothing there, you know there, But listen, listen, Ronald Reagan
• 1:06:02
  Speaker 1: had gay friends and he was the first president. And
• 1:06:08
  Speaker 1: like he's promoting like abstinence only education, which is again bullshit,
• 1:06:16
  Speaker 1: Like he doesn't even mention AIDS until eighty five and
• 1:06:20
  Speaker 1: it's in a passing response to a question at a
• 1:06:22
  Speaker 1: press conference, and he's just like family values. The next
• 1:06:27
  Speaker 1: year in abstinence is right, like that's it right. By
• 1:06:32
  Speaker 1: the late eighties, eight had moved from an ignored crisis
• 1:06:36
  Speaker 1: to an unavoidable one. In ninety, the former President Reagan
• 1:06:41
  Speaker 1: probably reflected on the epidemic following the death of Ryan White,
• 1:06:48
  Speaker 1: a teenage hemophiliac from Indiana who had become one of
• 1:06:51
  Speaker 1: the most visible faces of HIV AIDS in the United States.
• 1:06:56
  Speaker 1: Ryan White contracted HIV from a contaminated blood transfusion and
• 1:07:00
  Speaker 1: was barred from attending school in his community due to
• 1:07:03
  Speaker 1: fear and misinformation about transmission. After his death in April
• 1:07:09
  Speaker 1: nineteen ninety, Reagan stated that society owed it to Ryan
• 1:07:14
  Speaker 1: to make sure that the fear and ignorance that chased
• 1:07:16
  Speaker 1: him from his home in school will be eliminated, like
• 1:07:19
  Speaker 1: this kid got HIV from a blood transfusion, and teachers
• 1:07:25
  Speaker 1: and parents protested about having this child.
• 1:07:31
  Speaker 2: In their class.
• 1:07:33
  Speaker 1: Now. Ryan White never wanted to be a poster boy.
• 1:07:36
  Speaker 2: He hated the effect that he.
• 1:07:39
  Speaker 1: Was labeled the innocent victim because it implied that others
• 1:07:44
  Speaker 1: were somehow guilty. He says that he was just like
• 1:07:48
  Speaker 1: everyone else with AIDS, no matter how he got it.
• 1:07:53
  Speaker 1: In his case, helped chief public perception and even prompted
• 1:07:56
  Speaker 1: support from communities that had themselves been heavily affected by
• 1:07:59
  Speaker 1: the epidemic, but it also highlighted the uncomfortable truth public
• 1:08:06
  Speaker 1: empathy was often shaped less by medical facts than perceived similarity.
• 1:08:14
  Speaker 1: The disease wasn't understood by the general public, like imagine
• 1:08:21
  Speaker 1: your kid has a disease and it's not contagious, right,
• 1:08:26
  Speaker 1: not in that environment, and the teachers are worried about.
• 1:08:30
  Speaker 2: Catching it, Like what the fuck?
• 1:08:39
  Speaker 1: So after he passed away In April nineteen ninety, Congress
• 1:08:46
  Speaker 1: passed the Ryan White Care Act, which I think to
• 1:08:50
  Speaker 1: this day is still the largest fairly funded HIV AIDS
• 1:08:53
  Speaker 1: assistance program in the United States. It continues to provide
• 1:08:58
  Speaker 1: treatment support for low income and insured people living with HIV.
• 1:09:04
  Speaker 1: At the same time, grassroots activism remained essential. From the
• 1:09:09
  Speaker 1: early eighties onwards, Queer organizations and allied groups had already
• 1:09:13
  Speaker 1: begun building networks for education, save for sex outreach and
• 1:09:16
  Speaker 1: mutual aid, because waiting for official responses was simply not
• 1:09:20
  Speaker 1: an option. If anything, the epidemic made it brutally clear
• 1:09:24
  Speaker 1: the communities often had to be their own first responders.
• 1:09:29
  Speaker 1: In the mid eighties, it was clear the HIV AIDS
• 1:09:31
  Speaker 1: was not just a medical crisis, it was a social one.
• 1:09:33
  Speaker 1: With paperwork, landlords refused to rent people with HIV, employers
• 1:09:38
  Speaker 1: quietly and sometimes not so quietly, pushed them out. Insurance
• 1:09:43
  Speaker 1: didn't always cover care, and in the absence of strong
• 1:09:45
  Speaker 1: institutional support, activists end up doing everything the system was
• 1:09:49
  Speaker 1: supposed to do.
• 1:09:52
  Speaker 4: So.
• 1:09:52
  Speaker 1: One of the most powerful examples, I think is the
• 1:09:55
  Speaker 1: Aid's Memorial Quilt. It was conceived in eighty five but
• 1:09:59
  Speaker 1: active Cleve Jones as a way to remember friends who
• 1:10:02
  Speaker 1: had died from AIDS. The idea was simple and devastating.
• 1:10:06
  Speaker 1: One panel, one life name, stitched into fabric, because official
• 1:10:11
  Speaker 1: records and polite society were not doing enough remembering on
• 1:10:14
  Speaker 1: their own. It began with a list of forty names,
• 1:10:17
  Speaker 1: and even that number sounds small until you remember it
• 1:10:21
  Speaker 1: was just personal loss, not national statistics. Forty people gone
• 1:10:28
  Speaker 1: from one activist's immediate world alone. The quilt began growing
• 1:10:33
  Speaker 1: in parallel with public demonstrations, including the nineteen eighty seven
• 1:10:37
  Speaker 1: March on Washington for Lesbian gay rights. Early panels were
• 1:10:41
  Speaker 1: displayed in San Francisco, including a public hanging on City
• 1:10:44
  Speaker 1: Hall's balcony during Gay Freedom day, roughly two hundred thousand
• 1:10:49
  Speaker 1: people gathered an information both nearby offered instructions so other
• 1:10:55
  Speaker 1: could make their own panels. Grief, as it turns out,
• 1:11:00
  Speaker 1: is scalable. By the time it was displayed in Washington,
• 1:11:05
  Speaker 1: it contained around one thousand, nine hundred and twenty panels.
• 1:11:10
  Speaker 1: Every name was read aloud while crowd stood listening and crying.
• 1:11:15
  Speaker 1: It was part memorial, part protest, part attempt to make
• 1:11:21
  Speaker 1: the numbers feel like people again. The project kept expanding.
• 1:11:26
  Speaker 1: By nineteen eighty eight, it toured twenty US cities in
• 1:11:29
  Speaker 1: just four months. Families, especially mothers, would arrive with new
• 1:11:35
  Speaker 1: panels sown for sons and.
• 1:11:37
  Speaker 2: Daughters they had lost.
• 1:11:39
  Speaker 1: Within a year, it had grown to eight thousand panels.
• 1:11:43
  Speaker 1: Today it includes more than forty eight thousand names and
• 1:11:47
  Speaker 1: ways and estimated fifty four tons. It remains one of
• 1:11:53
  Speaker 1: the largest community memorials ever created a physical record of
• 1:11:58
  Speaker 1: an epidemic that haffished show systems were slow to fully acknowledge,
• 1:12:04
  Speaker 1: and it's still growing. In the late nineteen eighties, Truman
• 1:12:11
  Speaker 1: options were still extremely limited. Doctors could manage opportunistic infections
• 1:12:16
  Speaker 1: and ease symptoms, but there was no cure. HIV infection
• 1:12:21
  Speaker 1: was for most patients at the time still effectively terminal.
• 1:12:26
  Speaker 1: Then came azt zadoviurine zeroviurine one of those. It was
• 1:12:33
  Speaker 1: first developed in the sixties as a cancer drug, later
• 1:12:36
  Speaker 1: repurposed in the eighties when researchers realized it could inhibit
• 1:12:39
  Speaker 1: HIV replication. On paper, it was a breakthrough. In practice,
• 1:12:46
  Speaker 1: it was complicated. Azat was rushed through clinical trials under
• 1:12:51
  Speaker 1: intense pressure. The standard long term testing process was shortened
• 1:12:55
  Speaker 1: significantly due to the urgency of the epidemic. Earlier results suggested,
• 1:13:01
  Speaker 1: which is mortality entreated patients compared to placebo groups, leading
• 1:13:07
  Speaker 1: to ethical concerns about continuing to withhold the drug. The
• 1:13:10
  Speaker 1: trail was halted early and as t was made widely available.
• 1:13:16
  Speaker 1: Side effects, however, were severe nausea, headaches, gastro intestinal distress,
• 1:13:22
  Speaker 1: and in some cases bone marrow suppression requiring blood transfusions.
• 1:13:28
  Speaker 1: It was not subtle medicine. It was closer to control
• 1:13:32
  Speaker 1: toxicity with a hoped for benefit, and even the data
• 1:13:36
  Speaker 1: was messy. Patients were often receiving multiple treatments from different providers,
• 1:13:41
  Speaker 1: making outcomes harder to attribute cleanly. Some even shared or
• 1:13:46
  Speaker 1: pulled medication to ensure everyone had access, which, while understandable,
• 1:13:51
  Speaker 1: didn't exactly improve the integrity of the study. Design still
• 1:13:55
  Speaker 1: eased marked the beginning of anti retrovile therapy, not a
• 1:13:59
  Speaker 1: victory line, but at least the first moment with the
• 1:14:02
  Speaker 1: medical response shipped from purely reactive care to something resembling intervention.
• 1:14:08
  Speaker 1: On March nineteenth, nineteen eighty seven, AZT went on sale
• 1:14:13
  Speaker 1: and immediately introduced itself as the most expensive prescription drug
• 1:14:18
  Speaker 1: in history at the time, around eight thousand dollars a
• 1:14:21
  Speaker 1: year per patient, which today would sit well over what
• 1:14:24
  Speaker 1: seventeen thousand dollars for a life saving medication. It also
• 1:14:29
  Speaker 1: doubled as a masterclass and how quickly urgent medical breakthrough
• 1:14:33
  Speaker 1: can become. Who exactly can afford to stay alive?
• 1:14:37
  Speaker 2: Which is fucking bullshit.
• 1:14:39
  Speaker 1: No, I can't afford to lose my voice. In the US,
• 1:14:43
  Speaker 1: many people with HIV AIDS were already marginalized, gay men,
• 1:14:46
  Speaker 1: intravenous drug users, sex workers, and others already sitting on
• 1:14:49
  Speaker 1: the edges of healthcare access, so it was not exactly
• 1:14:52
  Speaker 1: a fair playing field, and even calling it a market
• 1:14:55
  Speaker 1: feels generous when the entry fee is survival like whatas suggested,
• 1:15:01
  Speaker 1: drug companies stood to make hundreds of millions in profit
• 1:15:05
  Speaker 1: from AZT within a year. Now, depending on your temperament,
• 1:15:10
  Speaker 1: that's either innovation funding itself or healthcare discovering capitalism in
• 1:15:15
  Speaker 1: real time.
• 1:15:18
  Speaker 2: Get fucked.
• 1:15:21
  Speaker 1: Access problems predictably followed. A black market emerged almost immediately,
• 1:15:27
  Speaker 1: because desperation tends to ignore law. Everyone wanted the miracle drug,
• 1:15:32
  Speaker 1: and the only issue is it wasn't really miraculous. Early
• 1:15:36
  Speaker 1: optimism faded fast. ACT initially showed improvements in T cell counts.
• 1:15:42
  Speaker 1: Later evidence suggests that at high early dosing schedules famously
• 1:15:46
  Speaker 1: four hundred mg every four hours, toxicity became a serious problem,
• 1:15:52
  Speaker 1: bone marrow suppression, severe side effects, and in some cases
• 1:15:55
  Speaker 1: overall worsening health meant the drug's promise did not neatly
• 1:15:58
  Speaker 1: match its early hype. Eventual dosages were revised, and EASYT
• 1:16:04
  Speaker 1: was later used in combination therapies, but not before a
• 1:16:07
  Speaker 1: lot of damage and disillusionment had already accumulated. By the nineties,
• 1:16:13
  Speaker 1: things began to shift slowly. Public awareness increased, stigma stated
• 1:16:18
  Speaker 1: to listen, not disappear, listen, and governments began investing more
• 1:16:25
  Speaker 1: seriously in research and prevention. Condomnious entered public health messaging openly,
• 1:16:31
  Speaker 1: which seems obvious now but was once treated like controversial content.
• 1:16:38
  Speaker 1: Abstinence only approaches were still floated despite consistently underwhelming results in.
• 1:16:43
  Speaker 2: The real world.
• 1:16:45
  Speaker 1: It doesn't fucking work. It doesn't work like the studies.
• 1:16:51
  Speaker 2: The evidence is.
• 1:16:52
  Speaker 1: There, it doesn't fucking work like I don't know how
• 1:17:00
  Speaker 1: many ways I can say this before people understand abstinence
• 1:17:05
  Speaker 1: only education, abstinence only values doesn't fucking work. High profile
• 1:17:12
  Speaker 1: deaths also garnered attention. So you have got like Freddie Mercury,
• 1:17:17
  Speaker 1: Anthony Perkins, liberace like public figures whose illnesses made denial
• 1:17:24
  Speaker 1: harder to maintain, and infection rates eventually began to stabilize
• 1:17:28
  Speaker 1: in some regions, though globally the crisis it's far from over.
• 1:17:33
  Speaker 1: Policy responses were mixed. In many places, HIV positive individuals
• 1:17:37
  Speaker 1: faced legal restrictions around employment and healthcare, blood donation, immigration,
• 1:17:42
  Speaker 1: and travel. Some measures were grounded in legitimate safety concerns
• 1:17:46
  Speaker 1: like blood donation. Others reflected stigma addressed up as regulation,
• 1:17:51
  Speaker 1: and the distinction was not awfully maintained, and.
• 1:17:56
  Speaker 2: The skill of laws.
• 1:17:59
  Speaker 1: Like we always want to compress it intonate figures, and
• 1:18:05
  Speaker 1: there was always a way of trying to make it analytical,
• 1:18:10
  Speaker 1: but that's not how the world works entire Friendship groups
• 1:18:14
  Speaker 1: were white out communities describe years where funerals were not
• 1:18:17
  Speaker 1: occasional events, but there was like several per calendar months,
• 1:18:25
  Speaker 1: one after another, week after a week. It wasn't just mortality,
• 1:18:30
  Speaker 1: it was repetition. Hint. Today HIV is no longer the
• 1:18:36
  Speaker 1: automatic death sentence it was in the eighties. In the US,
• 1:18:40
  Speaker 1: over a million people were living undiagnosed with HIV by
• 1:18:44
  Speaker 1: the late twenty tens, with a significant portion of infections
• 1:18:47
  Speaker 1: still undiagnosed. Globally, worldwide, tens of millions still live with HIV,
• 1:18:54
  Speaker 1: with around one point seven million new infections.
• 1:18:57
  Speaker 3: What was it.
• 1:19:00
  Speaker 2: In twenty eighteen?
• 1:19:01
  Speaker 1: I think awareness has improved. Roughly four fifths people living
• 1:19:05
  Speaker 1: with HIV globally know their status, but gaps remain. Sub
• 1:19:10
  Speaker 1: Saharan Africa has carried a disproportionate burden of the epidemic,
• 1:19:15
  Speaker 1: especially in the early two thousands, shooed by a mix
• 1:19:18
  Speaker 1: of healthcare and equality, delayed policy responses, and stigma. Some
• 1:19:23
  Speaker 1: of it aerially familiar to early Western responses, but the
• 1:19:29
  Speaker 1: key shift in modern treatment is anti retroviral therapy. HIV
• 1:19:33
  Speaker 1: is still not cured, but it is now medically manageable.
• 1:19:37
  Speaker 1: With consistent treatment, many people achieve and undetectable viral lot,
• 1:19:42
  Speaker 1: and that word matters. Undetectable means the virus is so
• 1:19:45
  Speaker 1: suppressed it cannot be transmitted sexually. The idea undetectable equals
• 1:19:53
  Speaker 1: untransmirable has fundamentally changed both prognosis and public perception. Treatment
• 1:20:00
  Speaker 1: isn't a RaSE HIV, but it can reduce it to
• 1:20:02
  Speaker 1: a level which no longer defines a person's health or their.
• 1:20:05
  Speaker 2: Risk to others. It's not a finish line medication.
• 1:20:10
  Speaker 1: Adhering still matters, Monitoring still matters, and access still matters.
• 1:20:14
  Speaker 1: But compared to the nineteen eighties, when diagnosis was effectively
• 1:20:18
  Speaker 1: a countdown to your death, the difference is night and day,
• 1:20:23
  Speaker 1: or science eventually caught up. It just took longer than
• 1:20:28
  Speaker 1: the virus did. Today, HIV usually involves a combination of drugs,
• 1:20:34
  Speaker 1: often called a cocktail. The formal name is highly active
• 1:20:40
  Speaker 1: anti retroviral therapy. Today, HIV treatment usually involves a combination
• 1:20:46
  Speaker 1: of drugs a cocktail. The target of virus in different
• 1:20:50
  Speaker 1: stages of its life cycle. The formal name for this
• 1:20:53
  Speaker 1: is highly active antiretroviral therapy or HEART, which, despite sounding
• 1:20:59
  Speaker 1: like something order any very intense pharmacy, has one of
• 1:21:02
  Speaker 1: the biggest medical turning points over the modern era. It's
• 1:21:07
  Speaker 1: not a one size fits all system. People respond differently
• 1:21:10
  Speaker 1: and finding the right combination can take time. But you
• 1:21:14
  Speaker 1: don't need to eliminate the virus to live a normal
• 1:21:17
  Speaker 1: life with it. Many people on treatment maintain an undetectable
• 1:21:23
  Speaker 1: viral load. It's controlled, not gone, and that's not optimism,
• 1:21:32
  Speaker 1: it's evidence based public health. If you're undetectable and stale treatment,
• 1:21:38
  Speaker 1: you cannot sexually transmit HIV, and life expectancy for someone
• 1:21:44
  Speaker 1: diagnosed today with access to treatment and consistent care can
• 1:21:48
  Speaker 1: be close to that of general population. Like HIV no
• 1:21:54
  Speaker 1: longer progresses to AIDS. In most cases, where treatment is
• 1:21:57
  Speaker 1: started and maintained properly, it is shifted from a fatal
• 1:22:01
  Speaker 1: diagnosis to a chronic, manageable condition. It is still serious,
• 1:22:05
  Speaker 1: it is still real, but is no longer the automatic
• 1:22:09
  Speaker 1: endpoint it once was. Now there are also rare documented
• 1:22:15
  Speaker 1: cases of apparent cures or long term emission following specialized
• 1:22:19
  Speaker 1: procedures like stem cell transplants, but these are exceptional, medically complex,
• 1:22:25
  Speaker 1: and not widely applicable. In other words, science has opened
• 1:22:28
  Speaker 1: the door, it's not kicked it down, and even so
• 1:22:33
  Speaker 1: precautions still matter. Undetectable status only applies when treatment is consistent,
• 1:22:38
  Speaker 1: and it does not predict against other sectry transmitted infections.
• 1:22:43
  Speaker 1: Condoms remain important, and so does regular testing for anyone
• 1:22:46
  Speaker 1: sexually active, especially with multiple partners. Contraception prevents pregnancy, it
• 1:22:53
  Speaker 1: does not prevent infections, a distinction that for some reason
• 1:22:57
  Speaker 1: still needs a reading. Testing access varies by countries. In
• 1:23:02
  Speaker 1: the UK, sexual health clinics offer free testing and at
• 1:23:05
  Speaker 1: home kits that are available through improved services, allowing people
• 1:23:09
  Speaker 1: to test privately and receive results remotely. In Ireland you
• 1:23:13
  Speaker 1: can actually send away for a test. You can send
• 1:23:17
  Speaker 1: away for a private test and you do all the
• 1:23:21
  Speaker 1: bits at home, you seal it up, you post it
• 1:23:23
  Speaker 1: away and they give your results completely free sexual health testing.
• 1:23:31
  Speaker 1: The point is simple, testing exists and avoiding it doesn't
• 1:23:35
  Speaker 1: make risk disappear. So pre exposure profile ACCESS or PREP
• 1:23:42
  Speaker 1: is another major prevention tool. It is a medication taken
• 1:23:46
  Speaker 1: by HIV negative individuals. Before exposure to significantly reduce the
• 1:23:51
  Speaker 1: risk of infection. When it is taken correctly, it produces
• 1:23:55
  Speaker 1: the risk of sexual transmission by over ninety percent, even
• 1:23:59
  Speaker 1: more when combined with condom use. It is highly effective,
• 1:24:04
  Speaker 1: but again only protects against HIV, not other infections. Now,
• 1:24:11
  Speaker 1: modern HIV treatment is one of those rare cases where
• 1:24:13
  Speaker 1: medicine actually did the thing it keeps promising and the
• 1:24:17
  Speaker 1: press releases. It turned a once fatal diagnosis into something
• 1:24:21
  Speaker 1: people live.
• 1:24:22
  Speaker 2: With long term.
• 1:24:23
  Speaker 1: It's not cured in the Hollywood sense, but controlled enough
• 1:24:27
  Speaker 1: that the virus mostly minds its own business.
• 1:24:29
  Speaker 2: A few mind dules.
• 1:24:32
  Speaker 1: At the extreme end of treatment, let's talk about stem
• 1:24:36
  Speaker 1: cell transplantation, the closest thing. HIV medicine has two boss
• 1:24:40
  Speaker 1: level intervention, which not subtle. First, the patient's immune system
• 1:24:45
  Speaker 1: is wiped out using chemotherapy, which is already a cheerful start,
• 1:24:50
  Speaker 1: then replaced with donor stem cells that then rebuild a
• 1:24:53
  Speaker 1: new immune system from scratch. In a handful of cases,
• 1:24:57
  Speaker 1: this has led to long term HIV remission. The trick
• 1:25:03
  Speaker 1: originally was that some donors carried a rare mutation called
• 1:25:08
  Speaker 1: c c R five Delta three two. It's kind of
• 1:25:12
  Speaker 1: like removing the virus's favorite entry door into cells and
• 1:25:16
  Speaker 1: sort of welding it shut. No entry point, no infection pathway,
• 1:25:21
  Speaker 1: no problem, least in theory, and this is what happened
• 1:25:25
  Speaker 1: in landmark cases like the Berlin patient where a stem
• 1:25:29
  Speaker 1: cell transplant performed for cancer just happened to also not
• 1:25:32
  Speaker 1: KHIV into remission. Later cases sometimes referred to as in
• 1:25:37
  Speaker 1: like the circles as Geneva patient and second Berlin patient
• 1:25:42
  Speaker 1: suggested something even more interesting. Remission might still be possible
• 1:25:47
  Speaker 1: even when the genetic setup isn't perfectly textbook. In other words,
• 1:25:51
  Speaker 1: nature occasionally improves that. Being said, this is not like
• 1:25:59
  Speaker 1: a treatment plan is the last resort medical gamble with
• 1:26:02
  Speaker 1: a very expensive ticket and serious risks chemotherapy toxicity, immune collapse,
• 1:26:08
  Speaker 1: graft versus host disease, and all the other charming features
• 1:26:12
  Speaker 1: of rebooting a human immune system from scratch. It is
• 1:26:16
  Speaker 1: only done when someone already needs a stem cell transplant
• 1:26:19
  Speaker 1: for something like cancer. HIV remission, when it happens is
• 1:26:23
  Speaker 1: essentially the universe.
• 1:26:24
  Speaker 2: Thrown in a bonus round for you.
• 1:26:26
  Speaker 1: For everyone else, the actual workers of HIV is far
• 1:26:29
  Speaker 1: less dramatic and far more effective, and that is your
• 1:26:34
  Speaker 1: anti retroviral therapy. People live normal lifespans, go to work,
• 1:26:42
  Speaker 1: argue IT bills, and generally do everything except die from HIV,
• 1:26:45
  Speaker 1: And like it's still nineteen eighty five, scientists are still
• 1:26:49
  Speaker 1: chasing a functional cure, basically trying to get to a
• 1:26:52
  Speaker 1: point where the virus is controlled without lifelong medication. Now
• 1:26:56
  Speaker 1: the ideas on the table are very very twenty first century.
• 1:27:00
  Speaker 1: Gene editing, which is like crisp perstel attempts to disable
• 1:27:04
  Speaker 1: HIV's ability to integrate into cells, and you've got engineer
• 1:27:08
  Speaker 1: immune cells, like CRT therapies, bored from CANC treatment, neutralizing
• 1:27:16
  Speaker 1: antibodies that tried to cover every viral infection HIV can
• 1:27:19
  Speaker 1: throw out, and vaccine research that has been like five
• 1:27:23
  Speaker 1: to ten years away for about the.
• 1:27:24
  Speaker 2: Last twenty years now.
• 1:27:26
  Speaker 1: None of these are routine treatments yet most are still
• 1:27:29
  Speaker 1: in trials, in early studies, or like the scientific equivalent
• 1:27:33
  Speaker 1: of don't try this at home. So the situation is
• 1:27:36
  Speaker 1: now oddly split. On one side, we already have treatments
• 1:27:40
  Speaker 1: so effective the HIV can be medically invisible and non
• 1:27:43
  Speaker 1: transmissible with adherents. On the other, researchers are still trying
• 1:27:49
  Speaker 1: to see if they can go one step further and
• 1:27:51
  Speaker 1: actually remove it entirely. We're not cre achieved yet, but
• 1:27:56
  Speaker 1: we're also very far from the era where diagnosis was
• 1:27:59
  Speaker 1: just a down with paperwork.
• 1:28:03
  Speaker 2: And that is.
• 1:28:06
  Speaker 1: Where I will leave you today. That is the nineteen
• 1:28:10
  Speaker 1: eighties Eights Crisis.
• 1:28:15
  Speaker 2: It's one of those things I wanted to share.
• 1:28:19
  Speaker 1: I know it's a very dense, information dense episode, and
• 1:28:23
  Speaker 1: I understand that it's not the most joyful thing, but
• 1:28:28
  Speaker 1: I think the fact that we're here and people are
• 1:28:33
  Speaker 1: still trying, we're still trying to improve the lives of
• 1:28:38
  Speaker 1: people with HIV, We're trying to reduce the transmission of it.
• 1:28:42
  Speaker 1: Like there were so many positive aspects that are coming
• 1:28:46
  Speaker 1: out now, and I know it doesn't help everyone who
• 1:28:49
  Speaker 1: suffered before, but the fact that we are moving forward,
• 1:28:55
  Speaker 1: the fact that it's no longer a death sentence, it's
• 1:29:01
  Speaker 1: it's something, and I know I've been trying to do
• 1:29:04
  Speaker 1: it like relatively jolly stuff for pride because the world
• 1:29:10
  Speaker 1: is on fire and everything's terrible, but here.
• 1:29:13
  Speaker 2: We are the AIDS crisis, and with that.
• 1:29:17
  Speaker 1: It is recommendation time for reading Disaster Gate Detective Agency
• 1:29:23
  Speaker 1: by lev A C. Rosen for listening Kelly Minogue spinning
• 1:29:29
  Speaker 1: around as a banger and I'll hear nothing against it.
• 1:29:32
  Speaker 1: And for watching You Know What The Fall. I've recommended
• 1:29:36
  Speaker 1: it before, I'll recommend it again Late Pace. It's so
• 1:29:40
  Speaker 1: beautiful and it is probably one of the most visually
• 1:29:44
  Speaker 1: beautiful movies.
• 1:29:44
  Speaker 2: I have ever seen in my life.
• 1:29:46
  Speaker 1: So go watch that and I will chat to you
• 1:29:49
  Speaker 1: next time. Adios. Au revoir of Way to Say My
• 1:29:53
  Speaker 1: Friends Bye Bye,