O224 The early AIDS epidemic in the U.S.: views from Atlanta and Hollywood

In this presentation, I will describe the early history of the HIV/AIDS epidemic in the USA based on my own experiences at the U.S. Centers for Disease Control (CDC) and clips from a film, "And the Band Played On," based on a book of the same name written by Randy Shilts. Following the first report from Los Angeles in June 1981 of unusual illnesses occurring in young homosexual men, CDC assembled a small Task Force to investigate the disease. The Task Force determined that this outbreak was new and was occurring simultaneously in several U.S. cities. Those affected homosexual men were highly sexually active and often frequented gay bath houses. A case-control study done in the autumn of 1981 suggested that the disease was sexually transmitted, although a causative role for illicit drugs could not be excluded. A subsequent investigation of clusters of cases linked by sexual contact supported the hypothesis of a sexually transmitted disease. The emergence of cases in transfusion recipients and persons with haemophilia in 1982 suggested that the disease could be transmitted through blood and blood products, although this suggestion was initially rejected by the blood banking community. In March 1983, the US Public Health Service issued the first recommendations for prevention of this disease, now known as AIDS. In retrospect, these recommendations made before the identification of HIV were essentially correct and serve to illustrate the power of the epidemiologic method to understand the transmission and natural history of new infectious diseases in advance of identifying their causes.