The Reagan Years: 1980s: AIDS Strikes Gay Rights Movement

But as early as September 1983, national data collected by the CDC showed that AIDS was disproportionately affecting African Americans. At that time, African Americans accounted for 26 percent of all AIDS cases, yet represented only 13 percent of the U.S. population. By 1984, the CDC reported that 50 percent of all pediatric AIDS cases were African American children. In 1986, the CDC documented that the cumulative incidence of AIDS among blacks and Hispanics was over three times the rate for whites.

Those statistics had nothing to do with race. AIDS, after all, was a virus that was spread through contact with infected blood or body fluids. The spread of AIDS in minority communities had everything to do with poverty, lack of access to quality health care, patterns of IV drug use, and communities already suffering from high levels of sexually transmitted diseases.

In those first years, the need to reach at-risk communities with educational programs was vital. There was no effective drug treatment until AZT was released to the public in 1987. But the public candor needed to create health campaigns that moved beyond abstinence to address sexual practices and IV drug use proved controversial. President Ronald Reagan did not publicly acknowledge AIDS until 1987.

The result was indifference, neglect and lack of federal funding for research and programs. The numbers show what happened: In mid-May, 1981, the CDC published its first reference to AIDS with five cases of unusual pneumonia reported in Los Angeles. By the end of 1981, 150 adults and nine children in the United States had died. The death toll only increased: 7,799 in December 1984; 20,849 in mid-1987. By 1988, nearly 107,000 cases of AIDS were diagnosed in the United States and more than 62,000 people had died.

During those years, San Francisco's AIDS activists wore tee-shirts with the slogan "silence equals death" and confronted the taboo topics of sexual activity and drug use by passing out condoms and sterile needles during demonstrations. While powerful as street theater, such tactics did not make a dent in the spread of AIDS among minority communities. In the late 1980s, the CDC began building partnerships with community-based organizations and faith communities to reach African Americans at risk of infection.

But the story of AIDS is not only that of a disease that spread unchecked. San Francisco's response to the growing epidemic was considered a national model. New organizations evolved from the grassroots structures of previous, politically engaged generations. The San Francisco chapter of Black and White Men Together, created in 1979-80, was the first to address AIDS prevention and education in the mid-1980s, creating the National Task Force on AIDS prevention.

The Bay Area's local and state agencies, hospitals, and health care workers formed partnerships with these community-based service providers. This model was considered the most effective response any city had mounted to deal with AIDS.

What began as a mysterious disease affecting hundreds of people is now a global pandemic, its progress quickened by poverty, fear, and ignorance. As early as 1982, 13 foreign countries reported deaths from AIDS. As of 2003, the United Nations and the World Health Organization estimated that 50 million people in the world are infected with AIDS and 16 million have died.