Fauci, AIDS, and the Anti-Gay Backlash

A health official’s misinformation fueled widespread panic

As we witnessed with the COVID-19 pandemic, the onset of the AIDS epidemic caused widespread panic. It was especially tragic in the early days when, like with the coronavirus, there were unanswered questions about the virus’s origin and the manner in which it could spread. Initial reports found nearly all who contracted AIDS were homosexual men, intravenous drug users, hemophiliacs, and Haitians. About 700,000 Americans have died from AIDS since the disease was first reported four decades ago.

In the early 1980s, there were sporadic reports about a serious flu-like illness affecting otherwise healthy, young gay men. There were also reports of young men dying from a rare form of cancer called Kaposi's sarcoma.  A handful of doctors and researchers were trying to piece together what led to the illness. It was the Centers for Disease Control (CDC) that introduced to the general public the existence of the virus that eventually came to be known as AIDS.

In June 1981, the CDC published a column in its Morbidity and Mortality Weekly Report reporting five young men had been treated in Los Angeles hospitals for Pneumocystis carinii pneumonia, an infection that usually afflicts immunosuppressed patients. Two of the five patients died. The CDC reported, “[t]he fact that these patients were all homosexuals suggests an association between some aspect of a homosexual lifestyle or disease acquired through sexual contact.”

The following month, The Bay Area Reporter, a newspaper serving the gay community in San Francisco, published a story about an illness, characterized by dry cough, fever and shortness of breath it called “Gay Men’s Pneumonia.”

That same July, the New York Times reported 41 homosexual men had been diagnosed with Kaposi’s sarcoma and that one doctor who had treated nine of the patients “found severe defects in their immunological systems.”

In an article titled “New Homosexual Disorder Worries Health Officials” published the following May, the New York Times reported a disorder it called “GRID, for gay-related immunodeficiency.”  By then, the die had been cast. Reporting by the New York Times and elsewhere left much of the public with the impression this was a disease that mostly affected the gay community.

AIDS quickly became a topic of public conversation. It was referred to as GRID, gay flu, gay plague, and similar names. The illness, most people believed, was confined to gay men, intravenous drug users, and Haitians. A joke making the rounds asked, “What is the most difficult thing about getting AIDS?” “Convincing your parents you are Haitian,” was the punchline.

In the May 6, 1983 issue of the Journal of the American Medical Association (JAMA), a pair of articles discussed possible transmission scenarios of AIDS. “Immune Deficiency Syndrome in Children,” authored by James Oleske, MD, MPH, and others, focused on eight Newark, NJ children who were born into families “with recognized risks for AIDS.”  Four of the eight infants died.

The paper’s comments section had this conclusion:

It is difficult for us to conclude that we and others have simultaneously experienced a sudden upsurge in congenital immune defects or congenital viral infections of the usual type. It seems more plausible to us that the illnesses in these youngsters were related in some way to household exposure.

Further, the Oleske article conjectured that some type of contact with infected patients may have contributed to the spread and “that sexual contact or drug abuse is not required for transmission” of the virus.

The second article published in the JAMA reached a different conclusion regarding transmissibility. Arye Rubinstein, MD, and others wrote “Acquired Immunodeficiency With Reversed T4/T8 Ratios in Infants Born to Promiscuous and Drug-Addicted Mothers.”  The article reviewed the cases of “seven children who were small for gestational age at birth and subsequently have exhibited failure to thrive, lymphadenopathy, parotitis, hepatosplenomegaly, interstitial pneumonia, and recurrent infections.”

The mothers appeared to either have had multiple sex partners or were intravenous drug-addicts, a pair of high-risk categories for developing AIDS. Rubinstein and his fellow authors surmised it was very likely the infants contracted the virus during the mothers’ pregnancies; a fact well-understood today.

A third article appeared in the same JAMA issue. It was an editorial written by Anthony Fauci, MD, a senior official with the National Institutes of Health. Fauci warned, “Perhaps even more important is the possibility that routine close contact, as within a family household, can spread the disease.” At the time, there was uncertainty at how the virus was being transferred from patient to patient, but there was no evidence it was by surface contact. But the damage was done. Fauci’s editorial launched a wave of public hysteria that received widespread media play.

San Francisco Chronicle journalist Randy Shilts, in his book “And the Band Played On,” documented how Fauci reached this false conclusion:

Arye Rubinstein was astounded that Anthony Fauci could be so stupid as to say that household contact might have anything to do with spreading AIDS. Rubinstein had never been a great admirer of New Jersey’s Dr. Oleske; they had antithetical views of AIDS in children. To Rubinstein, the mode of transmission was fairly obvious and fit quite well with existing epidemiological data on AIDS. The mother obviously infected the child in her womb. The fetus and parent shared blood as surely as an intravenous drug user, hemophiliac or blood transfusion recipient. The fact that none of the infants in Oleske’s study were over one year old reinforced this notion.

…

What  was Fauci’s problem?

Upon investigation, Rubinstein learned that Anthony Fauci had not bothered to read his paper before writing the JAMA editorial. Instead, he just read Oleske’s conclusions and started running off at the mouth.

Fauci had been chief of the National Institutes of Health (NIH) Laboratory of Immunoregulation since 1980. He would be promoted to director of the National Institute of Allergy and Infectious Diseases in 1984, a position he holds today. In May 1983, Fauci was the highest ranking US health official to start flogging the wild claim AIDS could be contracted from common surfaces.

Four weeks after his JAMA article appeared, Oleske clarified the transmission risks stating, “Casual everyday contact is okay. You don’t get it from the air, a plate, a glass.” Oleske was trying to minimize hysterical reactions to the surface contact theory. Meanwhile, Fauci continued pushing his baseless claim.

After his editorial appeared, Fauci embarked on a little press junket warning the public AIDS could possibly be caught by touching common objects.  United Press International quoted Fauci, “The finding of AIDS in infants and children who are household contacts of patients with AIDS or persons with risks for AIDS has enormous implications with regard to ultimate transmissibility of this syndrome.”

Fauci told ABC News, “If the close contact of a child is a household contact perhaps there will be a certain number of cases of individuals who are just living with, and in close contact with, someone with AIDS, or the risk of AIDS, who does not necessarily have to have intimate sexual contact or share a needle but, just the ordinary contact one sees in normal interpersonal relations.”

In 2011, former US Surgeon General C. Everett Koop, MD, ScD, reminisced about the early days of HIV. Koop noted Fauci was actively promoting the unfounded surface contact theory. Koop wrote, “Tony Fauci, Director of AIDS Research at NIH, insisted we check out any study that didn’t seem to rule out spread of AIDS by casual contact.” Koop lumped Fauci’s theory into a category of “all kinds of unsubstantiated claims about mosquitoes and toilet seats.”

A National AIDS forum was held in Denver in June 1983 to counter growing discrimination against gays over the virus, and to push back against Fauci’s claim it could be spread by daily contact. The forum’s statement titled “Denver Principles” stated, “available evidence does not support the view that AIDS can be spread by casual, social contact.”

The ugly rumors that AIDS could be passed from person-to-person by an act as simple as a handshake came during a vulnerable time for the gay community. Widespread public acceptance of homosexuals was still in its infancy around the beginning of the AIDS epidemic. Scare stories persisted that AIDS could be caught by touching the same door knobs, telephones, and public restrooms that were used by someone infected with AIDS.

An immediate spike in discrimination against gays and hate crimes targeting homosexual men and women occurred as Fauci’s misinformation over transmissibility spread.  The US Justice Department reported fear of AIDS as a contributing factor in the increase of anti-gay violence. Families were broken up, and AIDS patients were being isolated over contagion worries.

Gallup reported a few years later that 3 in 5 Americans wanted people with AIDS to carry a card announcing they were infected. One in three respondents to Gallup believed employers should be able to fire AIDS-infected workers.  

As AIDS began taking a growing number of lives, it appeared AIDS research was moving at a snail’s pace. Some of the delay in federal AIDS efforts may have been due by the belief the virus was confined to the gay community. As the head of AIDS research for the NIH, Fauci admitted in late 1986, “The disease didn’t at first get the attention it deserved to have gotten.”

In a 1988 appearance before a US House committee, Fauci testified his office had not yet begun testing several drugs, such as aerosol pentamidine, that had been designated a high priority more than a year earlier. Fauci blamed drug sourcing, a sluggish bureaucracy, and uncertainty on testing procedures as some of the reasons for his department’s delays in launching drug evaluations.

Fauci’s key role in federal AIDS research was not lost on some in the gay community. In a profanity-laced Village Voice open letter published on May 31, 1988, activist Larry Kramer blasted Fauci as “an incompetent idiot.” Kramer co-founded the Gay Men’s Health Crisis, one of the nation’s first non-profits dedicated to raising money for AIDS research. Kramer’s chief complaint was Fauci accomplished nothing in four years despite a staggering budget of $374 million. In his letter, Kramer noted that nearly half the 24 drugs identified for possible AIDS treatment had not been entered into trials.

The non-profit AIDS Coalition To Unleash Power (ACT UP) was founded in New York in 1987 to put pressure on what it called the “negligence” and “complacency” of NIH and other government and medical organizations. ACT UP did not see a sense of urgency in federal health efforts to stem the spread of AIDS, and to find a cure.

Today, an estimated 1.2 million people in the US are living with HIV, the virus that causes AIDS.

Mark Hyman is an Emmy award-winning investigative journalist.