1981: the AIDS epidemic begins: since AIDS first made headlines 25 years ago this summer, 25 million people have died, and the toll is still rising.

• Author: Altman, Lawrence K.
• Position: TIMES PAST

When I was a doctor at Bellevue Hospital in New York in the late 1970s, my colleagues and I were baffled by a small number of patients who suffered strange, inexplicable ailments. Some had come down with uncommon infections; others had contracted unusual forms of more common infections. And still others had developed a rare cancer.

We did not know at the time that these were our first AIDS patients.

Twenty-five years ago this summer, my first article about these illnesses appeared in The New York Times. (In addition to being a physician, I'm also a Times reporter.) The article, on July 3, 1981, ran inside the paper, a single column of about 900 words. The headline read, "Rare Cancer Seen in 41 Homosexuals."

The article noted ominously that these cancer patients had severe deficiencies in their immune systems that could not be explained. "The cause of the outbreak is unknown," I wrote.

SLOW TO ACT

Looking back with the wisdom of hindsight, it seems as if doctors, the public, journalists, and governments were shockingly slow to recognize an epidemic in the making and take steps to try to contain it.

Because infectious diseases were no longer the major killers they had been even a few decades earlier, doctors had become vastly overconfident. Smallpox had just become the first disease in history to be eradicated and most doctors overlooked a basic fact of biology: that a new infectious disease could appear at any time.

By the end of 1981, there were only 152 cases reported of what would become known as AIDS. I did not meet anyone who predicted that in the next 25 years AIDS would kill 25 million people worldwide and infect 40 million more in one of the worst epidemics in history.

The disease was initially given a variety of names, including GRID (for Gay Related Immune Deficiency), because gay men were among the earliest victims. That name and others like it were misleading because they erroneously implied the disease affected only gay men. The Centers for Disease Control and Prevention (C.D.C.) named the disease AIDS (for Acquired Immune Deficiency Syndrome) in 1982.

MEDICAL MYSTERY

Researchers set out to investigate AIDS, but they were puzzled. Why did it seem to affect gay men? Could an infectious agent--something transmitted person to person--cause AIDS? If so, what was it?

In 1983, the first report that a virus, now known as H.I.V. (Human Immunodeficiency Virus), causes AIDS came from researchers in Paris. American scientists, initially skeptical, concurred two years later.

With new blood tests, scientists soon found that H.I.V. infected many women and heterosexual men too, and that the virus usually lies dormant in the body for about 10 years before producing AIDS. It thus became clear that AIDS was silently spreading around the world in the 1970s.

Scientists learned that the disease could be transmitted...