On June 5, 1981, the U.S. Centers for Disease Control and Prevention’s newsletter Morbidity and Mortality Weekly Report published a story about five young, previously healthy gay men who had come down with a rare lung infection, pneumocystis pneumonia. This was the first public mention of what the CDC would name in just over a year the Acquired Immune Deficiency Syndrome. The AIDS epidemic had begun in the United States.
Karl Vidt, who became a prominent local HIV/AIDS advocate—including a multi-year term as chair of the Santa Clara County World AIDS Day committee—said that during 1981-82 people in Santa Clara County thought AIDS was “something affecting people in San Francisco.”
A crisis emerges
In 1983 that attitude changed rapidly. AIDS arrived in Santa Clara County with the first diagnosis being confirmed by the public health department in April. The first signs of AIDS-related fear followed shortly afterwards.
The Santa Clara County Public Health Department’s AIDS Program was formed in 1983 to conduct community education. Utilizing a small grant from the state, the team began to educate people in jails, gay bars, and elsewhere. They also distributed condoms. In November, Santa Clara County obtained its first state funding for AIDS.
In 1985, the first HIV tests became available and the Public Health Department opened Santa Clara County’s first HIV clinic. Numbers were climbing: 53 deaths, 148 people living with HIV/AIDS.
Dr. Marty Fenstersheib took on the difficult role of telling people they were HIV positive. In a 2012 San Jose Business Journal interview, he recalled the reactions of those earliest patients, “They would run out, bang doors, sometimes they’d cry, sometimes they’d scream. It was horrible.”
In January 1986, BAYMEC, led by BAYMEC co-founder Ken Yeager, successfully secured the support of the Santa Clara County Board of Supervisors to make a substantial commitment to funding AIDS-related services. Even as the County was facing tight budget times, they were committing critical dollars to AIDS services. Yeager was also named chair on the new Santa Clara County AIDS Task Force. The epidemic, and the lack of an adequate government response to it, was becoming the dominant issue in the LGBTQ community.
Life expectancy from diagnosis to death was around two years. People got sick and died very fast. Tens of thousands of families learned for the first time that their sons were gay only after they became sick. Often parents had to simultaneously come to grips with their son’s sexuality and their deaths.
The total death count continued to climb from 1986 to 1990: 96, 172, 265, 296, 433.
As the 1980s came to a close, the death toll from AIDS continued to rise, reaching 124 new deaths in Santa Clara County in 1989. By 1990, total deaths reached 433 with more than a thousand people living with HIV/AIDS.
The early 1990s were some of the darkest times of the AIDS epidemic. Death tolls continued to increase locally and nationally. 1993 and 1994 were the years of highest deaths in Santa Clara County: 219 in 1993 and 220 in 1994.
AIDS patients continued to die at a rapid pace. At the end of 1994, the Public Health Department produced an analysis of the first 10 years of the epidemic in the county. It revealed that through 1990 more than 90% of individuals diagnosed with AIDS had died within the same year. In both 1983 and 1986, every single individual in Santa Clara County died the same year they were diagnosed with AIDS.
Thankfully, 1995 would bring some hope for HIV/AIDS sufferers. A medical breakthrough, whose impact continues to be felt today, dramatically transformed an AIDS diagnosis from a likely death sentence to a serious but manageable health condition.
Finally, a breakthrough
Public pressure and the growing death toll from AIDS led the Food and Drug Administration to approve the protease inhibitor Saquinavir for use outside of clinical trials in June 1995. The era of the AIDS cocktail had begun. It would not become widely used in the U.S. until 1996, but the earliest results were extremely promising.
By 1997 the full effects of the “cocktail” were becoming apparent to public health officials in Santa Clara County as the year-end statistics showed that only 67 people died of AIDS-related causes. That is a drop of almost 50% compared to the previous year.
Almost overnight, HIV/AIDS went from being a near-certain death sentence to a manageable health condition if diagnosed and treated. This change was extremely welcome after more than a decade of darkness, when friends and loved ones got sick, wasted away, and then died with blinding speed.
From 1984 when the first AIDS deaths were reported in the county to the end of 2017, there had been a total of 2,498 deaths from AIDS. A tragic loss.
While HIV/AIDS has been a treatable condition for almost a quarter-century, it is still a health crisis that impacts thousands in our community.
African-American and Hispanic residents continue to be disproportionately impacted, with rates among African-Americans more than four times higher than rates among non-Hispanic Whites.
We have come so far since those early dark days. But much work still needs to be done.