Washington Blade - October 8, 2004
Bryan Anderton

"In the period October 1980-May 1981, five young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at three different hospitals in Los Angeles, California," the MMWR wrote. "Two of the patients died."

Although the general public and medical providers may not have realized it at the time, the world had just been introduced to a public health nightmare that would become known as AIDS, or acquired immune deficiency syndrome, one of the 20th century's most devastating epidemics.

The story broke in the D.C. area on July 4, 1981, when the Washington Post wrote about a second MMWR report, linking the pneumonia cases to a group of patients - all gay men - who had been diagnosed with the rare skin disease Kaposi's sarcoma. The Washington Blade featured a front-page article the following week and a follow-up brief about the cases, which were being seen in New York City as well.

AIDS - which, in 1981, was known as Gay-Related Immunodeficiency - did not immediately concern many residents in metropolitan Washington D.C., news reports show.

"You have to remember that there had been other outbreaks of gonorrhea, syphilis and other [sexually transmitted diseases], so some people were much more concerned about that than AIDS," says Mark Meinke, the founder and chair of the Rainbow History Project, a group dedicated to preserving D.C.'s gay history.

But by early 1982, the first handful of AIDS cases had been reported in D.C. In a January 1982 health column in the Washington Blade, Dr. Richard DiGioia discussed what little was known about the disease, and theories about how it could be prevented.

"Promiscuity and drug abuse have not been proven to cause these diseases," DiGioia wrote. "But until the situation is more clear, decreasing the numbers of sexual partners and limiting drug use, especially nitrates, would be advisable."

ONCE IT BECAME obvious that AIDS was affecting D.C. residents, the local government and medical community responded, with prodding at various points from AIDS activists.

In January 1982, Whitman-Walker Clinic formed an AIDS Education Task Force to educate gay men about potential risky behaviors. By the following year, the clinic had hired its first AIDS program director and was printing AIDS-prevention pamphlets.

"There was a lot of incredible enthusiasm, which was the upside, but we also really didn't know what we were doing, because we had such little scientific evidence," says D.C. Council member Jim Graham (D-Ward 1), who served as the president and administrator of Whitman-Walker Clinic from 1981 until 1998. "There were still questions about, what if you washed your hands or if you got a good night's sleep? What if you took a shower with someone? There was so little authentic, reliable, scientific information. That made it very difficult."

Washington was also one of the first cities in the nation to establish a public contract with a health organization - in this case, Whitman-Walker -to provide AIDS services. In August 1983, the clinic received $17,500 from the city for the establishment and operation of the D.C. AIDS Infoline.

"[Then-Mayor] Marion Barry, to his everlasting credit, recognized the need instantly and committed his administration from the beginning," Graham says. "There wasn't any hemming and hawing."

BUT THIS DIDN'T necessarily mean that everyone was ready to acknowledge the seriousness of the situation. Graham and Meinke said there were a number of clubs and bathhouses locally that were hesitant about educating their clientele about the syndrome and offering customers condoms.

"Initially, a lot of the clubs wouldn't allow condoms to be distributed, because people were supposed to drink and have fun, and they felt like this was kind of ruining the party," Meinke says. "Everyone was having a damn good time in the '70s, it was a fabulous time, and no one wanted to spoil the party. But it was already spoiled."

In fact, many residents saw what was happening around them, and they wanted to know the facts. In April 1983, 1,200 people attended a forum at the Lisner Auditorium at George Washington University to learn more about the disease. To many, it was the first major sign that the local gay population realized the disease was affecting them.

"We knew that there was something happening that was being reported in San Francisco and New York, but we knew within our own community many of our friends were getting sick, so this mysterious disease was around," says Bishop Rainey Cheeks, pastor of Inner Light Ministries, a church with a predominantly gay African-American congregation. "There was this feeling in the air that something was happening."

Cheeks learned he was HIV-positive in the early 1980s.

WHILE VERY EARLY reports focused on the disease mostly affecting white gay males, many in D.C. recognized early on that it was also having a devastating effect on other racial and ethnic groups, and increasingly affecting women and children.

One of the first signs was the fact that the Clubhouse, a popular black gay dance club at the time on Upshur Street in Northwest Washington, was seeing a huge drop in its clientele. After noticing this trend, Cheeks and a few others banded together to form an informal group that would one day become Us Helping Us: People Into Living Inc., a nonprofit organization created to help black gay and bisexual men with HIV/AIDS.

"The truth is, we were just doing what we needed to do to save ourselves," Cheeks says about the group's formation. "At the Clubhouse, we noticed that so many of our members were getting sick, and I just felt compelled to do something - to go help people out, to go clean someone's house, to go fix somebody a meal.

"If I knew someone was ill, I would get them to the club on the night when an entertainer was there just to get them out of the house so they could see a show," Cheeks says. "That's how the name came about - us helping us."

By 1985, African Americans accounted for half of all new AIDS diagnoses in D.C. In addition to Us Helping Us, other HIV/AIDS service groups geared toward helping black residents locally - Best Friends, the Abundant Life Clinic, and Impact-D.C., among others - were formed.

Other organizations, like ENLACE, LLEG (the National Latina/o Lesbian, Gay, Bisexual & Transgender Organization) and La Clinica del Pueblo, rose to meet the needs of D.C.'s gay Latino population, which was growing and also being affected by HIV/AIDS.

Health statistics show that AIDS has disproportionately affected D.C.'s African-American population. While 60 percent of D.C. residents are black, they account for 75 percent of the total AIDS diagnoses through 2002, the last year for which data was available from the local Health Department's HIV/AIDS Administration.

The disease, in particular, has hit black women hard. Women overall accounted for 30 percent of D.C. residents diagnosed with AIDS in 2002. Of those women diagnosed that year, 89 percent were black.

TO THOSE WHO were active in the gay community and within D.C.'s healthcare system, the 1980s and early '90s were an incredibly painful time, observers say. It was not unusual for people to suddenly realize they'd lost most of their friends to the disease.

"I was reminding someone recently that 17 years ago I did 17 funerals in one month," Cheeks says. "Churches didn't want to bury people who were dying of AIDS, and people wouldn't feel safe going to church because you'd hear these horrible gay-bashing sermons. It was a hard time."

Graham also was growing increasingly frustrated.

"By the late '80s, I felt that I was bound to a post and beaten every day by the tragedy that surrounded us," he says. "It was a true trench warfare experience. Many, many deaths.

"The deaths were horrific, but not only the deaths but all of the compelling opportunistic diseases, some of which were heretofore unheard of. Horrendous symptoms," Graham says. "It was both, not just the deaths but what led to the disease, and all we could do, really, was help treat some of the symptoms of some of the diseases."

The same ordeal was playing out in major cities across the country. Entire communities were hit hard. And many gay men and lesbians who weren't activists before AIDS suddenly took up the cause.

The group ACT UP was formed in New York City in 1987, and led the way among gay residents around the country when it came to staging protests to challenge the government's and churches' response to AIDS. That same year, activists banded together at the National March on Washington and then on the national Mall for the city's first display of the AIDS Quilt, a project begun by the San Francisco-based Names Project.

In the years following 1987, ACT UP and other groups regularly staged protests and demonstrations throughout the area, at places such as the U.S. Food & Drug Administration, the National Institutes of Health, on the steps of Congress and at the White House.

IN THE MEANTIME, medical advances slowly made their way to the public.

In 1985, Whitman-Walker became the first organization in the city to offer HIV testing. But according to Graham, there was an internal debate as to whether the clinic should even offer the test.

"It was an issue of, 'What can they even do about it? What are the medical responses?'" Graham recalled this week. "The attitude was, 'Why should I be treated? What's the point?'"

This changed somewhat by 1987, when the first drug to combat the disease, AZT, became available to the public. Two years later, a second drug, ddl, was introduced.

Trials - which ultimately proved unsuccessful - began on HIV vaccines, and continue today.

In the early '90s, health professionals began suggesting combining various drugs to treat the disease, and by 1995, protease inhibitors had been introduced to combat its progression. Suddenly, health professionals realized that patients, as long as they could afford the expensive medications, and handle some of their side effects, could manage the syndrome in many cases, prolonging their lives but not curing the disease.

According to Graham, many in the health community who had dealt with AIDS thought the news was too good to be true.

"You had received so many promises by that time that had proven to not be effective, that when it finally happened you didn't even want to believe it," Graham says. "We were really shell shocked."

TODAY, THE NUMBER of AIDS cases in D.C. is on the rise again, after almost a decade of steady decline.

The District's AIDS cases peaked in 1993, with 1,342 ongoing cases at the time. The city's reported AIDS-related deaths also peaked that year, at 742.

By 2000, the number of ongoing AIDS cases was 681, the city's lowest levels in 12 years. The following year saw a slight increase to 686, but by 2002, the last year for which data was available, the rate had jumped 37 percent to 943 cases.

AIDS-related deaths, on the other hand, were at an all-time low of 41. According to a report released by the HIV/AIDS Administration last year, D.C. has the highest number of AIDS diagnoses per capita of any major U.S. city.

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