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If the United States had known 20 years ago what it knows now about the transmission and progression of HIV, it would have most likely taken greater steps to contain the spread of the virus. However, it was then unknown that each diagnosed case of AIDS represented hundreds of cases of undiagnosed HIV in the greater population. It was also unknown that HIV's eight-year incubation coupled with its mode of sexual transmission would rapidly result in one of the worst epidemics in modern history.
In hindsight it is unfortunate that AIDS first broke out among a sector of american society which was as marginalized and sexually liberated as was the gay male sector of american society. Despite all the positive measures taken by the gay community to promote AIDS awareness and research after the epidemic broke out, the adversarial relationship they had with the Reagan administration and the promiscuity associated with their sexual revolution contributed towards the spread of AIDS.
In the HBO movie, And the Band Played On, adapted from Randy Shilts's best-selling book of the same title, it is suggested that the spread of the AIDS epidemic could have been contained had the health issue been given appropriate attention and funding from the outset. This may not be true. Whether or not AIDS could have been contained may have depended on the population it was affecting. If so, the fact that AIDS hit the homosexual population first may have been particularly unfavorable for two reasons. First, according to the best information on the risk of transmission associated with certain behaviors made available by the CDC, anal sex is the act mostly likely to transmit AIDS. Anal sex is practiced in the male homosexual population far more than in any other sector of american society. Second, the gay male population was considerably promiscuous in the early 1980s as a result of their recent sexual revolution. Sexually transmitted disease such as syphilis, gonorrhea, and HIV ran rampant through public bath houses, where gay men would engage in anonymous sex with other men. These two factors contributed significantly to the spread of AIDS.
While it is impossible to know if the AIDS epidemic could have been completely contained, it is certainly true that an earlier understanding of the HIV virus and its modes of transmission would have dissuaded some people from engaging in the types of high-risk behaviors associated with HIV transmission, and hence saved lives.
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"Is Was Unfortunate That AIDS Hit The Gay Community First." 123HelpMe.com. 22 Jul 2018
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Still, there are some positive consequences of the gay male community being the first group to contract AIDS. When it became clear that the U.S. government was not going to offer support to the homosexual community to fight the AIDS epidemic in the early 1980s, the gay male population realized the onus was on them to mobilize politically and promote AIDS awareness and funding. Several grass-roots political movements were founded, including the Gay Men's Health Crisis and the AIDS Coalition To Unleash Power (ACT UP). ACT UP was instrumental in fast-tracking AZT through the FDA testing process, which at the time was the only medication for AIDS patients. ACT UP was one of the most effective grass-roots political organizations of this century that fought its way into the public eye in March of 1987 by being the first and only political organization to actually shut down Wallstreet for five minutes. Funding for these grass-roots political efforts as well as AIDS scientific research was subsidized by donations from the relatively wealthy gay male population. If AIDS had first shown up in another marginalized sector of american society that did not have as many financial resources as the gay male population, the political actions of that marginalized group would have probably been less successful, and the development of treatments and tests for AIDS would have probably taken much longer.
In relation to other marginalized sectors of the american population that would have been similarly discriminated against by society and the government, it is definitely a positive consequence that AIDS first struck homosexuals, for the financial resources and political activism of the gay male community ensured that people with AIDS were treated with dignity and respect, as opposed to being dehumanized and quarantined. But notwithstanding the positive contributions made by the gay male community to promote public awareness and funding for the fight against AIDS, the epidemic is likely to have been less widespread had it first hit a sector of the american population that was more mainstream, such as middle-class, white heterosexuals. In conclusion it is unfortunate that AIDS first broke out among a sector of american society, which was as marginalized and sexually liberated as the homosexual male population because these two factors significantly contributed to the rapid spread of AIDS.