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Viral Panic: Fear Has Been Useful in the Fight Against AIDS, Until It Wasn't 

Tuesday, Dec 16 2014
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"It was horrifying," prominent San Francisco AIDS doctor and epidemiologist Robert Grant recalls, adding that when he began studying the disease as a UC Berkeley graduate student in 1984, health workers were floating a raft of conflicting theories about its provenance. "We had the sense that it was infectious," he says, "but there were also theories that it was due to anal sex, the use of poppers, or intestinal infections." Up until the 1990s, people still clung to the myth that AIDS was spread by mosquitoes in Africa. Grant had to fend off increasingly fantastical notions, even as he struggled to understand the virus from a scientific perspective.

"I think the human imagination fills in the gaps whenever you don't know something," he says. "It's as if humanity needs a disease to pin all its fears on."

Disease panic has been one of society's most persistent tropes: Illness phobia begets xenophobia; an unexplained disease creates an Other.

Throughout the early 20th century, Americans pinned many of their anxieties on cancer, Grant says, citing a theory promulgated by Susan Sontag in her 1978 book Illness as Metaphor. Cancer then was considered a reflection of the patient's moral failing, rather than a biological process. That stigma slowly disappeared after the 1960s and 1970s, when medical advancements showed that cancer could be diagnosed and treated. A couple of decades later, Grant says, AIDS became the new plague.

As AIDS became more comprehensible and manageable, though, the scare rhetoric shifted to subsequent pandemics: SARS in 2003, avian flu in 2006, and Ebola in 2014. Each came with a similar narrative: A strange foreign agent corrupts the body before modern medicine can step in. Outbreaks are, in Grant's words, a "fine foil" for our fear of the unknown.

But panic has an upside.

Grant offers an analogy from the animal kingdom: Imagine a herd of wildebeests migrating through the Serengeti, and one of them spots a lion skulking in the brush. He sounds the alarm, and there's a stampede. The lion gives chase and kills a straggler, which incites the others to run faster.

"What's amazing is that group panic is helpful," Grant says. "The vast majority of wildebeests survive."

So too with the hysteria around HIV in the 1980s and '90s, when the virus was still a death sentence. In many ways it was productive, Grant says. It instilled the kind of anxiety that previous generations had about unwanted pregnancy, allowing high school sex ed teachers to promote condoms. It turned AIDS into a political cause, inspiring groups like the AIDS Coalition to Unleash Power (ACT UP), whose members chained themselves to a banister in the New York Stock Exchange in 1989 to protest the high price of AZT — at that time the only antiretroviral drug available for AIDS patients. It launched a safe-sex movement that stemmed the tide of new infections, and it encouraged solidarity within the gay community. The period of abject fear led to a period of compassion for AIDS victims; the virus became a cause celebre.

"Let's not forget that in the '80s we had a president who wouldn't even mention HIV in the news, because he thought it was attacking some other group [gays and intravaneous drug users] that he didn't need to care about," Grant says. Not for nothing did ACT UP adopt a pink triangle logo (modeled after the inverted triangle badge the Nazis forced gay men to wear during the 1930s) with the slogan "Silence = Death."

Fast-forward 30 years, Grant continues, and we're no longer doing emergency triage: HIV isn't curable, but it's treatable.

Parker Trewin — whose most searing memory of the AIDS epidemic was seeing a boyfriend's roommate tethered to an IV drip, with two months to live — says the stakes are wildly different now. Now 54, Trewin tested positive in 2003, but the virus is now undetectable in his blood; he only has to take two antiretroviral drugs per day to control it. Not to mention that many people who might have been at risk in the past can now stave off the virus entirely with Pre-Exposure Prophylaxis (PrEP) drugs, the AIDS equivalent of a birth control bill.

Supervisor David Campos stood on the steps of City Hall on a foggy morning in September, flanked by a motley retinue. Fellow Supervisor Scott Wiener towered over him at the dais, while a small army of activists dangled pink signs with slogans like "Access = Health," and "Where my PrEPsters at?" Among them was Eric Leue, the reigning Mr. Leather of Los Angeles, his burly frame swaddled by an electric blue shirt and "Mr. Leather" sash. Opposite Leue stood Adam Zeboski, the AIDS Foundation test counselor who recently gained social media fame as a self-proclaimed "Truvada Whore" of San Francisco — "Truvada" being Gilead Science, Inc.'s brand name for the AIDS prevention drug PrEP, "whore" being a swipe at the drug's detractors.

To Campos, PrEP could be the miracle drug that quashes HIV for good, in a city that has long been a symbol of the epidemic. He'd called this rally to drum up support for legislation that would allocate $800,000 to a city co-pay program for residents who can't afford the drug, and to hire "health navigators" who could help people get approval from their insurance carriers. The bill passed in October, although supervisors voted to eliminate the co-pay program and allocate only $301,600 for the navigators.


About The Author

Rachel Swan

Rachel Swan

Rachel Swan was a staff writer at SF Weekly from 2013 to 2015. In previous lives she was a music editor, IP hack, and tutor of Cal athletes.

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