In the past few weeks, various commentators have drawn parallels between the Trump administration’s mishandling of the covid-19 outbreak and the Reagan administration’s callous inaction on HIV/AIDS. To be sure, the 1980s and 1990s AIDS epidemic — and the ugly political and interpersonal responses to it — can teach us a great deal about societal reactions to contagion and the relationship between the federal bureaucracy and the U.S. health-care system.
Yet we must qualify and contextualize the comparison between covid-19 and HIV/AIDS. These are distinctly different illnesses, and conflating the two may obscure more than it reveals about today’s pandemic. People living with HIV/AIDS were (and remain) stigmatized and reviled in ways that those with covid-19 have not been.
However, this may change if President Trump and his acolytes continue to racialize the virus and if politicians on either side of the aisle remain beholden to a for-profit health-care system that privileges those with the ability to pay. To guarantee the coronavirus pandemic remains distinct from the 1980s and 1990s AIDS crisis — and similar stigmas do not attach to those who test positive for coronavirus — we must name the abject injustices visited upon people with HIV/AIDS in the 1980s, 1990s and beyond.
The history of HIV/AIDS diverges significantly from that of the new coronavirus, primarily because of the former’s inextricable association with historically subjugated populations — particularly gay men, people of color and intravenous drug users. In 1981, medical officials began to identify and trace mysterious cancer cases affecting young gay men in Los Angeles and New York City. “Rare Cancer Seen in 41 Homosexuals,” read one New York Times headline printed in July of that year.
Just a month or so later, writer and activist Larry Kramer presciently recognized the urgency of the situation and the existential threat this “rare cancer” posed to gay men. “The men who have been stricken don’t appear to have done anything that many New York gay men haven’t done at one time or another,” Kramer observed. “We’re appalled that this is happening to them and terrified that it could happen to us. … This is our disease and we must take care of each other and ourselves.”
But the federal government refused to act. The following year — just weeks after the Centers for Disease Control and Prevention first dubbed the illness “acquired immune deficiency syndrome” — President Reagan’s press secretary addressed the issue of AIDS for the first time. “What’s AIDS?” he remarked in response to a reporter’s question. “It’s known as the gay plague,” the journalist replied, after which the press room erupted in laughter. “I don’t have it!” Reagan’s press secretary affirmed. “Do you?”
This flippant exchange did not necessarily typify the Reagan administration’s response to HIV/AIDS — simply because there wasn’t much of a concerted response at all. Reagan’s fealty to social conservatives antagonistic to LGBTQ+ people — especially the so-called Religious Right — precluded any decisive action on the epidemic. Reflecting and intensifying the antigay context, some state and local officials such as New York mayor Ed Koch used the AIDS crisis “as a mechanism for policing same-sex desire,” in the words of the late theorist Thomas Yingling. The implementation of other, more effective programs and policies promoted by activists and doctors — namely viable sex education and needle exchange initiatives — would have certainly minimized transmission rates and saved lives. But Reagan did nothing.
Not until September 1985 did Reagan actually utter the acronym “AIDS” in public. By that point, some 13,000 Americans had already died of the disease, while 100,000 others had contracted HIV/AIDS. Even the actor Rock Hudson — a longtime friend of Ronald and Nancy Reagan — could not secure their assistance. Seeking an experimental drug treatment for AIDS in July 1985, Hudson called on the first lady, who refused to help.
In the wake of policymakers’ inaction, grass-roots organizers took charge to raise the profile of HIV/AIDS, to find new, effective modes of treatment and to provide care and support to people who’d become ill. Launched in 1987, the activist group ACT UP helped generate awareness about HIV/AIDS by staging demonstrations on Wall Street (protesting corporate price-gouging on AIDS drugs) and at the Food and Drug Administration (FDA) office in Washington, D.C. Such efforts ultimately forced the FDA to permit access to experimental drug treatments for people living with HIV/AIDS.
Reagan’s own surgeon general, C. Everett Koop, a conservative Christian who opposed abortion, set out to dispel many of the myths and stigmas swirling around HIV/AIDS. Koop advocated for explicit, honest AIDS prevention campaigns promoting safe sex and harm reduction. “Many people … are not receiving information that is vital to their future health and well-being because of our reticence in dealing with the subjects of sex, sexual practices, and homosexuality,” Koop explained in 1987. “This silence must end,” he declared in a way that aligned with ACT UP’s famous “Silence = Death” project established that same year.
It wasn’t until 1987 that President Reagan actually delivered a speech concerning the AIDS crisis — only after it became abundantly clear that people outside the LGBTQ+ community were also suffering. Yet Reagan’s unwillingness to intervene decisively and aggressively carried over into George H.W. Bush’s presidency. Without a robust public health response from the federal government, the epidemic intensified through the mid-1990s, when at last a new wave of “high-active antiretroviral therapy” medications made the disease decidedly more manageable and survivable.
But the damage had been done: As of Oct. 31, 1995, over half a million Americans had contracted AIDS, of whom some 311,000 had died.
While new therapeutics and treatments such as PrEP and PEP have made HIV less transmissible and AIDS more survivable, these remain out of reach for poor and marginalized people, including many LGBTQ+ people, people of color and others with limited access to suitable health care and resources. As historian Dan Royles trenchantly writes, “AIDS has devastated black America.” The enduring stigma around HIV/AIDS continues to facilitate its spread.
Simply put, such stigmas do not define the current coronavirus pandemic — despite the Trump administration’s disgraceful effort to link covid-19 with Chinese and East Asian peoples, which has stoked violence and harassment against Asian Americans. Indeed, so far, prominent (and wealthy) individuals who have tested positive for the virus — such as Tom Hanks, Chris Cuomo and Kevin Durant — have been hailed as brave for their transparency rather than reviled.
In late March, the official Twitter account for the New York chapter of ACT UP posted two images. The first displayed David Wojnarowicz’s famous black leather jacket, worn by the artist in 1988, emblazoned with the declaration: “IF I DIE OF AIDS — FORGET BURIAL — JUST DROP MY BODY ON THE STEPS OF THE F.D.A.” The second showed a surgical mask — images of which have become emblematic of the covid-19 pandemic — imprinted with a similar statement: “IF I DIE OF COVID-19 — FORGET BURIAL — DROP MY BODY ON THE STEPS OF MAR-A-LAGO,” Trump’s South Florida resort.
While the novel coronavirus and HIV/AIDS should certainly be placed in conversation with one another, the notion that the former closely mirrors the latter is overly simplistic and problematic. Yet the gap between the two can always shrink if the president and others continue to couch the coronavirus pandemic in racist and xenophobic terms — and if rich and famous Americans continue to obtain testing and treatment while others go undiagnosed and untreated.
Only by accurately chronicling the contemptible federal response to AIDS — and the “terrible” and “tremendous stigma” affixed to those living with it — can we ensure that the covid-19 outbreak remains distinct from the scourge of HIV/AIDS.