AIDS — Past and Future

Abstract

The AIDS epidemic in the United States officially began with the publication in the June 5, 1981, issue of Morbidity and Mortality Weekly Report (MMWR), the bulletin of the Centers for Disease Control (CDC), of a report on five cases of Pneumocystis carinii pneumonia from the University of California at Los Angeles (UCLA) Medical Center (Figure 1).1 It was November 1980 when I saw my first patient with pneumocystis pneumonia; within two months I saw two more such patients; within five months I had seen a total of five. Pneumocystis was then a rare infection, occurring only in patients with underlying immune deficiency, but my five patients were young homosexual men who had previously been healthy. In an earlier era, the arcane and increasingly disturbing events that led to that initial CDC publication might have found a place in Berton Roueché's medical detective stories in the New Yorker. (The epigraph above is from his 1947 collection entitled Eleven Blue Men.2) The events are chronicled in And the Band Played On,3 by the late San Francisco journalist Randy Shilts, and in a more recent article of my own.4