AIDS stigma in the United States was quick to gain strength, fueled by misperception and fear. Early names in the States for the illness we know today as HIV/AIDS—gay cancer, gay-related immunodeficiency or GRID, and gay compromise syndrome—cemented the disease’s close association with homosexuality,14,15,16,17 and informed early news reports that suggested same-sex activity itself caused AIDS. Though homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders in 1973, the general public and many in the medical community still considered same-sex activity to be a disease.18 In the early years of the pandemic, mainstream media often portrayed PLWHA as deviant “homosexual men [who had] multiple and frequent sexual encounters with different partners, as many as 10 sexual encounters each night, up to 4 times a week.”19
Early HIV activists and health care providers had few allies in Washington, DC. Indeed, President Ronald Reagan did not publicly discuss AIDS until 1985, by which time more than 15,000 people had already died of the disease.20,21 Seventy percent of medical doctors surveyed at the time said they felt ethically obligated to deliver care to PLWHA but would turn them away if allowed.22
Donna Gallagher is a nurse who worked in a hospital serving Boston’s Fenway neighborhood during those years. She recalls doctors donning HAZMAT “moon suits” to treat AIDS patients. She says her colleagues were in shock when she transferred from oncology to the AIDS unit to work with “those people.”
One gay activist from San Francisco remembers the overwhelming stigma and fear that prevailed in the early days of the epidemic. He recalls how “doctors who had seen you for years [would] not treat you, and we had to work hard to find funeral directors who would agree to bury our dead. And it was a time when burying our dead was a booming business.”
Ryan White HIV/AIDS Program grantees provide culturally and linguistically competent care—a critical part of combating stigma.
Almost from the beginning of the epidemic, stigma extended beyond that encountered by gay men. Identification of homosexuals, Haitians, injection drug users, and hemophiliacs as the four major AIDS risk groups only helped an increasingly alarmed public target its stigmatization of PLWHA. The Institute of Medicine’s Confronting AIDS reports, released in 1985 and 1986, support this assessment, noting that members of these groups—collectively known as the “4H Club”—had a greater chance of losing their jobs, housing, and access to social services.23