1981

April 24: Sandra Ford, a drug technician at the U.S. Centers for Disease Control (CDC) in Atlanta, Georgia, writes a memo detailing unusual requests for the drug pentamidine —one of 10 drugs that are used so rarely that the federal government stockpiles the nation’s supply through a special arrangement with the Food and Drug Administration.

Pentamidine is typically used to treat severely immunocompromised patients with a rare form of pneumonia—and past requests for the drug have always come to Ford with an explanation about the patient's underlying condition. But the requests Ford has been receiving since February 1 have no explanations—all the patients are young, previously healthy, gay men and almost all live in New York City. Ford's memo is the first alert to CDC that mysterious cases of immune system collapse are occurring among gay men.

May 18: In an article for the biweekly gay newspaper The New York Native, Dr. Lawrence Mass becomes the first journalist to write about the unusual illnesses affecting gay men. The column, titled “Disease Rumors Largely Unfounded,” reports a curious increase in cases of PCP in the city—most of which (5 or 6 of 11) have been among gay men with no obvious immunodeficiencies. Dr. Steve Phillips, a CDC Epidemic Intelligence Officer who has been assigned to the New York City Department of Health, tells Mass, “What distinguished these victims is not how or where they were exposed so much as why they got the disease.”

June 5: CDC publishes an article in its Morbidity and Mortality Weekly Report (MMWR): "Pneumocystis Pneumonia—Los Angeles.” The article describes cases of the rare lung infection, Pneumocystis carinii pneumonia (PCP), in five young, previously healthy gay men. Unlike more familiar forms of pneumonia, PCP generally affects only those with severely weakened immune systems, including those undergoing chemotherapy for end-stage cancer.

The article’s authors, Los Angeles immunologist Dr. Michael Gottlieb, local internal medicine specialist Dr. Joel Weisman, CDC epidemiologist Dr. Wayne Shandera, and their colleagues report that all the men have other unusual infections as well, indicating that their immune systems are not working. Two have already died by the time the report is published and the others will die soon after.

This edition of the MMWR marks the first official reporting of what will later become known as the AIDS (Acquired Immunodeficiency Syndrome) epidemic.

NOTE: The report does not mention the race of the patients. That omission, accentuated by media coverage in the early years of the epidemic, will lead to a widespread belief that AIDS affects only white, gay men—with devastating long-term effects for Black and Latinx communities.

June 5-6 : The Associated Press, the Los Angeles Times, and the San Francisco Chronicle report on the MMWR article. Within days, CDC receives reports from around the nation of similar cases of PCP, KS, and other unusual opportunistic infections (OIs) among gay men.

June 5: On the same day the MMWR is published, New York dermatologist Dr. Alvin Friedman-Kien calls CDC to report a cluster of cases of a rare and unusually aggressive cancer—Kaposi’s Sarcoma (KS)—among gay men in New York and California. Like PCP, KS is associated with people who have weakened immune systems.

June 16 : A 35-year-old, white gay man who is exhibiting symptoms of severe immunodeficiency is admitted to the Clinical Center at the National Institutes of Health (NIH) . The Clinical Center is a research hospital—meaning that all patients are participants in research protocols. A team of NIH's clinician/researchers from multiple specialties work together to treat him, but the patient is battered by an unending stream of bizarre maladies that clearly point to immune collapse. He never leaves the Center and dies on October 28.

June 16 : In a conversation with his mentor, Harvard virologist Myron Essex, CDC epidemiologist Dr. Donald Francis suggests that cases of immune deficiency among gay men could be the result of a new retrovirus . He is also convinced that whatever is causing the immunodeficiencies is transmitted in the same way as Hepatitis B (i.e., via sex and blood). Francis is one of CDC's most valued experts on epidemics—having worked on the teams that eradicated smallpox and contained the first Ebola outbreak, as well as on the Hepatitis B studies that have recently culminated in the creation of a vaccine. He will join the CDC team in Atlanta trying to identify the cause of the immune problems killing gay men.

July 2:The Bay Area Reporter, a weekly newspaper for the gay and lesbian community in San Francisco, publishes its first mention of “Gay Men’s Pneumonia.” The short item encourages gay men who are experiencing progressive shortness of breath to see their physicians.

July 3 : CDC publishes " Kaposi's Sarcoma and Pneumocystis Pneumonia Among Homosexual Men — New York City and California ," a new MMWR with information on KS and PCP among 26 gay men (25 white and one Black).

July 3: On the same day the MMWR update is released, the New York Times publishes an article entitled "Rare Cancer Seen in 41 Homosexuals.” At this point, the term “gay cancer” enters the public lexicon.

August 11: Acclaimed writer and film producer Larry Kramer holds a meeting of over 80 gay men in his New York City apartment to discuss the burgeoning epidemic. Kramer invites Dr. Friedman-Kien to speak, and he asks the group to contribute money to support Friedman-Kien's research because he has no access to rapid funding. The plea raises $6,635. By the end of the year, Kramer and his friends will raise a total of $11,806.55 for research on KS, PCP, and other OIs. Friedman-Kien will also successfully petition the American Cancer Society for $50,000 in emergency research funds and $10,000 each from four private foundations for an additional $90,000.

September 15: The National Cancer Institute (NCI) and CDC cosponsor the first conference to address the new epidemic. Fifty leading clinicians attend the event in Bethesda, MD, to discuss KS and other OIs and to develop recommendations for further studies in epidemiology, virology, and treatment.

September 19: British medical journal,The Lancet, is the first peer-reviewed medical journal to publish a report on the burgeoning epidemic: "Kaposi's Sarcoma in Homosexual Men--A Report of Eight Cases." One of the authors, Dr. Linda Laubenstein, is a specialist in hematology and oncology, and serves as a clinical professor at the New York University Medical Center. She has been treating young gay men for KS since 1979. By May 1982, she has seen 62 patients with KS -- a fourth of the national total recorded at the time.

September 21: San Francisco dermatologist Dr. Marcus Conant oversees the opening of the nation’s first KS clinic at the University of California, San Francisco (UCSF) Medical Center. He co-directs the clinic with oncologist Dr. Paul Volberding. The two physicians, with their colleagues Dr. Constance Wofsy and Dr. Donald Abrams, will guide much of the early response to the burgeoning epidemic in San Francisco.

December 10: Bobbi Campbell, a San Francisco nurse, becomes the first KS patient to go public with his diagnosis. Calling himself the “KS Poster Boy,” Campbell publishes his first newspaper column, “Gay Cancer Journal,” for the San Francisco Sentinel. The column documents his experiences living with KS.

December 31 : By year’s end, the number of new cases of KS, PCP, and OIs among gay men and related deaths have risen dramatically—and cases among heterosexual men and women (particularly among those who inject drugs and their sex partners) have begun to appear. The reports of new cases and deaths in 1981 range widely, from 1) A low of 185 diagnosed cases and 78 deaths to, 2) A high of 337 diagnosed cases, and 3) A high of 268 deaths.*

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1982