AIDS Policy in the 1980s: Politics, Stigma, and Public Health

Introduction: AIDS Before It Had a Name

Today, it is hard to remember a time before AIDS Walks through Central Park, before television advertisements proclaimed that "AIDS affects everyone," before AIDS became a public health enemy number one. But one must look back to the days when AIDS was a disease of secrecy and shame to truly learn from the illness as it exists today. Most members of Generation Y mercifully cannot remember a time when AIDS was not even a name, but something called "the gay cancer." In 1980s America, the disease of Acquired Immune Deficiency Syndrome was thought to affect only those marginalized by society because of their sexuality.

Randy Shilts's book And the Band Played On serves as an important journalistic and contemporary historical document of the early history of AIDS in America. It remains relevant today, even now that AIDS is no longer automatically a death sentence and drug cocktails can prolong the lives of sufferers, to say nothing of the importance of preventative techniques. The book and its film adaptation, as well as P. Siplan's AIDS and the Policy Struggle in the U.S., paint a vivid portrait of how stigma and political concerns — regardless of medical need — affect the treatment of disease and public health. The treatment of a disease is never purely medical and without outside influence; public and political circumstances of the moment inevitably shape the response when a disease becomes an epidemic.

The Reagan Administration and Political Neglect

Politically speaking, AIDS could not have emerged at a worse time in American history. The country was hard hit by the recession of the early 1980s. President Reagan was focused primarily on advancing his conservative economic agenda of supply-side economics, which required increasing defense spending, cutting taxes on the wealthy and corporations, and reducing government expenditure. Both the U.S. Senate and the U.S. House of Representatives were under Republican control, so the Reagan administration was especially concerned with seizing the political moment and pushing its legislative agenda through as quickly as possible.

Reagan was also a social conservative who wished to make government less intrusive in individuals' lives on health matters, yet he was equally unwilling to side with gay and lesbian Americans, who were often persecuted under local ordinances. Reagan preferred that the federal government defer to state governments, which gave states considerable leeway to enact restrictive statutes against homosexuality. His initial hostility to government spending — combined with his administration's cultural hostility toward gay and lesbian people as a group — meant that when AIDS first came to the public health spotlight, little was budgeted to enable federal contributions to research or to release public health measures to curtail the epidemic.

Social Stigma and the Limits of Gay Political Power

Social stigma also affected the development of policies related to HIV. Gay lobbying groups had little voice in Republican-dominated Washington and commanded little public sympathy in the hearts and minds of voters across the nation. Gay and lesbian votes tended to be concentrated in specific urban areas, and thus many politicians could remain blissfully unaware of — or resistant to — the lobbying efforts of pro-gay organizations and groups seeking to raise awareness about the disease.

The government demonstrated its stigma against gay and lesbian people first by refusing to recognize these individuals as living legitimate or worthy lives in general, and then by ignoring the voices of those who represented the community. Power in Washington shaped the future of HIV awareness, prevention, and treatment programs, both because of the groups initially affected and because the disease was primarily spread through sexual contact at a time when the administration was actively seeking to limit sexual education in schools and to return to so-called traditional family and religious values.

Thus the concept of stigma operated on two levels simultaneously: on a social level, in which many heterosexual people refused to care about AIDS because it was perceived as a "gay cancer," and on a political level, in terms of how the United States government reacted. Rather than countering such hostility through education, awareness, and compassion, the government merely confirmed the narrow prejudices of the heterosexual majority against a minority group. Of course, illness is notably nondiscriminatory and nonpolitical, and eventually the disease spread to affect both Republicans and Democrats alike.

Works Cited

Shilts, Randy. And the Band Played On.

Siplan, P. AIDS and the Policy Struggle in the U.S. Georgetown Press, 2000.