A Brief History of HIV/AIDS: Prelude to the Battle

1. St. Marks Baths

2. Brief History of HIV/AIDS

3. Pre-1981 – The Prelude • June 28, 1969 at 1:20am, an unexpected police raid was carried out on a bar in Greenwich Village, New York City. Usually, the patrons would submit to whatever humilities the police would dole out, but on that particular night, enough was enough. The riots lasted five days and ultimately launched the gay liberation movement.

4. The Bathhouses • Remember Bette Midler? • Originally steam baths • Became gay sex clubs • All sexually transmitted diseases went up dramatically • Nearly every patron became infected with HBV during the mid and late 1970s

5. 1981 – GRID • A very small number of gay men show up with very rare diseases in different cities • Docs tell local health officials, who tell the CDC • CDC sets up a surveillance system and a classification system based on symptoms • Same thing that is being done for SARS

6. Recognizing AIDS • As cases were identified, new patterns emerged • New case definition and acronym: • Acquired • Immuno- • Deficiency • Syndrome

7. The Epidemiology • Classic public health investigation • Physicians report cases • Public health investigators collect information and other contacts • Contacts are traced to figure out the network • Patterns are compared to other diseases • Same people, same places as HBV • Blood-borne • Sex or Needles

8. 1982 – 1983 • We know AIDS is blood-borne • We do not know what causes it • We know that it has the same epidemiology as hepatitis B, and infects many of the same people • We know that hepatitis b spreads quickly through gay bathhouses • It is pretty clear that HIV spreads in the same way • Sexual transmission • IV drug transmission

9. The Emergency Rule • Why make a rule before ordering the bathhouses to close? • Why do it as an emergency rule? • Who will want to oppose the rule? • What is the scientific justification for the rule? • That is the legal authority?

10. The Injunction • What is the rationale for the injunction? • What is the counter argument by the bathhouse owners and gay activists? • How do they argue that it easier to control AIDS by keeping the bathhouses open? • Why does the health department reject this approach? • What would be the burden on the health department to use this method?

11. The Court's Ruling • ... defendants and the intervening patrons challenge the soundness of the scientific judgments upon which the Health Council regulation is based .... They go further and argue that facilities such as St. Mark's, which attempts to educate its patrons with written materials, signed pledges, and posted notices as to the advisability of safe sexual practices, provide a positive force in combating AIDS, and a valuable communication link between public health authorities and the homosexual community. While these arguments and proposals may have varying degrees of merit, they overlook a fundamental principle of applicable law:  "It is not for the courts to determine which scientific view is correct in ruling upon whether the police power has been properly exercised. The judicial function is exhausted with the discovery that the relation between means and end is not wholly vain and fanciful, an illusory pretense.”