Jun 02, 2006  |  By: Ryan Lee  | COMMENTS     

Twenty-five years ago this week, James Curran traveled from his Atlanta office to a hospital in New York City where he “reunited” with a patient whom he had never met, and whom the young scientist would never forget.

“I recall walking into NYU Medical Center and meeting a man who was almost precisely my age, who had come from a suburb of Detroit, as I had, and had attended a Catholic high school, as I had,” said Curran, who was then working as an epidemiologist at the Centers for Disease Control & Prevention.

“We were now back together, if you will, 20 years later, him with what I initially thought was a rare skin cancer that, frankly, I had never heard of until the week before, and me now investigating his case,” Curran said.

The “rare skin cancer” Curran was investigating was related to the appearance of pneumocystis carinii pneumonia in five gay men in Los Angeles, which the CDC first reported June 5, 1981.

The cluster of cases were the initial scientific observations of the disease that would come to be known as AIDS, which Curran said had already invaded the lives of a quarter-million gay men before the first five cases were reported.

“None of us could’ve known that then, but it’s this insidious nature that can take a virus which occurs slowly — the evidence occurs slowly — and allow it to persist so long,” Curran said.

“The fact that there were only a small number of cases initially, and the fact that they were predominately gay men, made it easier for people to deny that this was a large problem, and it even made it easy for the gay community to deny that it was a large problem.”

For many gay men, that sense of denial would soon diminish, as friends, lovers and scores of other young, previously healthy individuals died within a matter of weeks or months.

But as Curran and other researchers frantically searched for the cause of the unknown plague, American society — including government, media and the public — responded to the deaths of tens of thousands of gay men with what critics call systemic disinterest.

“Ronald Reagan had been elected with the support of evangelical Christians and the so-called ‘Moral Majority’ at the time, and that was a group that you would not predict would be interested in sexually transmitted diseases, or in new conditions predominately in gay men,” said Curran, who left the CDC in 1995 to become dean of the Rollins School of Public Health at Emory University.

Curran’s Emory office is just a few yards up Clifton Road in Atlanta from where he used to work with the CDC. There’s also not much distance between where America’s HIV prevention efforts were in the ‘80s and where they are today, Curran said.

“There were struggles with the domestic policy council and others in the Reagan administration just relating to a lot of the issues that AIDS deals with, and I think we see that today in the current administration, with the discomfort, politically, with their political constituents, and dealing with issues likes condoms, and sex education, and things like this,” Curran said.

“I don’t think domestic AIDS has been a high priority of the White House administration. Global AIDS has been the focus, and I think HIV prevention is not something they’re comfortable with, or their constituents are comfortable with,” he said. “HIV prevention works — it works if its hands are not tied by local, national or international political considerations.”

Politicizing prevention?

Some AIDS activists worry that HIV funding “guidance documents” issued by the current White House have accelerated “the erosion of evidence-based approaches.”

“When you look at guidance documents, there’s a lot of language that tells you very much about what the orientation is of the current political regime, and what is being promoted and what is not being promoted,” said Judy Auerbach, vice president for public policy of the American Foundation for AIDS Research. “That message gets out both formally and informally, and I think program planners and practitioners respond to it — they fund what they think they can get funding for, and they’re afraid to do things that they think they will be criticized for.”

Auerbach was part of a recent study issued by the Open Society Institute, a liberal New York-based human rights group, that praised President George W. Bush’s leadership fighting global AIDS, but accused the president of ignoring the domestic epidemic.

Conservative members of Congress have promoted audits of community-based organizations that teach explicit safe sex techniques, and forced abstinence-only proponents onto discussion panels at scientific conferences. ...