AIDS There, we said it. Acquired Immune Deficiency Syndrome had quite an 18th birthday. In fact, 1998 was so unreal that we wondered if someone had slipped a little Sustiva into our Ensure. Many of our positive friends were making like up-and-at-'em Lazaruses, while some neggies were getting infected with a "What else is new?" shrug. And as the nation commiserated over a stain, our interns worked overtime to track the strange, new meanings of familiar, old words: We had cocktails, of course, and compliance was PC'd into adherence. Drug holidays used to mean taking -- not tossing -- all the drugs in the medicine cabinet. Paunches once came from pies, not pills. Attempted murder -- that was 1998's term for serodiscordant sex. And while black leaders alarmed about their epidemic tried to get the Prez to pronounce a public emergency, everybody from Sex Panic! activists to Coburnians in Congress were sticking the post prefix to it. Yes, 1998 was a crazy dream. But we're over AIDS is over. Take a risk: Just put your lips around the four-letter word. It's still here, dammit.
Out with a bang!
Off the LA freeway, under circling news choppers broadcasting live, in front of a banner reading "Live Free, Love Safe or Die," PWA Daniel Jones blew his head off. Why? To avenge an HMO mix-up of his records and because he feared an ugly AIDS death. "He wanted his death to mean something," his sister said. We read it as flipping the bird to the post-AIDS chorus.
Slap a label on us
For PWAs who contemplate suicide when the protease "miracle" isn't enough, medical experts coined the term Lazarus Syndrome. It's official: People snatched from death by combo therapy aren't crazy to find themselves less than thankful -- they feel bad, sad and -- imagine! -- mad about all that AIDS has robbed them of. With psyches likened by some docs to those of Nazi concentration-camp survivors, shouldn't they demand government reparations?
But not that label
Once only stuck to gay or black men, AIDS Monster proved an equal-opportunity label when used to describe a female HIVer. Out of self-confessed bitterness toward the ex who infected her, Pamela Wiser, 29, went on an unsafe-sex binge in Tennessee, allegedly bedding 50 men. She was indicted in two counties on 12 counts of willfully exposing others to HIV.
After learning of Jerrime Day's liaison with a 16-year-old who later said she didn't know he had HIV, a Florida judge mandated that Day's future partners must sign on the dotted line, in front of a witness, before they have sex -- with or without a condom.
The year Donna Summer last had a hit
AIDS deaths were cut in half nationwide, and Castro Street ran wet with tears of joy last August after a headline in San Francisco's Bay Area Reporter trumpeted its first issue without an AIDS obit after some 880 with. That's 1982.
Time ain't on our side
In March, Time magazine's megaglitzy 200-page roundup edition of the past 75 years mentioned the AIDS epidemic only in passing. An '80s event that made the cut? Superman turned 50.
They read Newsweek
More than half of the 18- to 24-year-olds surveyed by The Wall Street Journal/NBC News named AIDS as the defining event of their generation, overshadowing the end of the Cold War and the Reagan era.
Canadian doc Maurice Genereux -- "a Pez dispenser for drugs," said a former patient -- was convicted on two counts of assisted suicide. Genereux admitted to being "too generous" when he gave two HIVers each a massive dose of Seconal, a sleeping pill -- knowing they planned the big sleep. One died; the other woke up in a hospital with a tube in his nose.
Hep got hip
HIV's ugly stepsister, hepatitis C, came of age. The New Yorker touted it as the next plague, the CDC launched an awareness campaign, the FDA approved a pricey ribavirin/interferon combo treatment, and an HIVer/hep C'er founded an activist group in San Francisco.
When POZ included "Free Back-to-School Condoms" in its September "youth" issue, it was eighty-sixed by a Barnes & Noble staffer. When the media picked up the story, the megabookseller first claimed the move was a coincidental stock "adjustment," then, after admitting it had had legal "concerns about POZ's distribution of condoms," renewed its traditional commitment to distribute POZ nationwide.
Do as I say, not ...
President Clinton, Monica Lewinsky and Ken Starr gave the nation's kids plenty of sex-ed -- and bless the lovebirds for their creative sex toy. But despite the First 'Fess-Up, "abstinence-only" attitudes continued to block HIV prevention and condom distribution in U.S. high schools. Still, a national survey found less sex and more condoms among teens in '98.
Like pulling teeth
In the year's only big legal win for people with HIV, the Supreme Court ruled that Maine dentist Randon Bragdon violated Sidney Abbott's rights by refusing to treat her because she had HIV. Abbott's disabled status was challenged because of her lack of debilitating symptoms, but the Supremes agreed that since HIV interfered with her ability to have kids, she was covered by the Americans with Disabilities Act. But as lower courts chip away at the law, this narrow focus left legal AIDS eagles wanting more.
While news about the potentially deadly interaction between ritonavir and the street drug ecstasy clubhopped from the UK to the U.S., Abbott Labs (no relation to Sidney) disregarded the pleas of British authorities to issue package warnings.
The way of the dinosaurs
A study stuck the final deadly lance in Glaxo Wellcome's cash bull AZT by showing that its promiscuous cross-resistance may sabotage future anti-HIV regimens. Meanwhile, Bristol-Myers Squibb's flagship nuke d4T outstripped Glaxo in the U.S. market, while BMS's d4T and Glaxo's 3TC proved as potent a combo as Glaxo's megamarketed Combivir (3TC/AZT).
The FDA approved DuPont Pharma's once-daily Sustiva (efavirenz). Anti-HIV agent No. 12, the festively named NNRTI has been alternately praised as a possible protease replacement and bashed as a grossly overpriced and understudied product. Along with its record-breaking price, Sustiva holds its own in unpleasantries: dizziness, dream disturbances and psychotic "episodes" likened to mild acid trips. Next up at the FDA: Glaxo's abacavir and Vertex's amprenavir. Then? The pipeline is almost desert dry.
Canada's Mounties rode in with a full-scale criminal probe into the Canadian Red Cross and the Canadian Blood Committee's role in the transmission of HIV to people with hemophilia in the early '80s.
The Bleeders Strike Back
Three former cabinet officials in France were charged with "involuntary homicide" for their role in that country's tainted-blood scandal.
The Return of Ricky
And last fall the U.S. Senate approved the Ricky Ray Bill, divvying up $1.7 billion among people who got HIV from blood transfusions in the early '80s.
Ghost in the Oval Office
Although he died last year of a barrage of OIs, ACT UP/DC's tart-tongued warrior Steve Michael "will haunt President Clinton forever," said an activist at his funeral -- where else? -- in front of the White House.
Lucky for them, the 50-odd docs who rolled up their sleeves to receive a vaccine "breakthrough" -- made of a weakened-but-still-live virus -- were turned away. Some monkeys that got a similar shot got sick or died.
In February, Nature readers followed Dr. David Ho into Central Africa where, he theorized, HIV originated in the 1940s: A study of 1,000-plus frozen blood samples helped his laboratory to pinpoint the supposed first documented AIDS death -- that of a man in the Belgian Congo -- to 1959.
Burnout and backlash combined to breed complacency among the deep-pocketed, and donations to AIDS service organizations plummeted nationwide. Behemoths GMHC and APLA downsized, and at least one ASO disappeared.
Even as AIDS activism in other communities was foundering, the Congressional Black Caucus urged the Prez to declare AIDS in the African-American community a "state of emergency." They won big: A $156 million plan was approved to tackle the problem. Hey, what about those funds for syringe swaps?
Magic Johnson's late-night talk show, The Magic Hour, was cancelled after just 65 episodes, thus freeing him to do important work in the fight against AIDS, like signing on in October to be Mike Tyson's financial adviser.
One in four people in Zimbabwe has HIV, the world's highest-ever rate. When asked at the 12th World AIDS Conference what she thought of the much-touted drug-company initiative to sell antiretrovirals at a reduced rate to the developing world, a leading longtime Zimbabwe activist snapped: "Forget combination therapy. The drugs we need are morphine, morphine and more morphine, so people can die with dignity."
To C or not to C?
A survey of 8,500 birth records revealed that poz women who had Cesarean sections transmitted HIV to their infants at half the rate of those who didn't. Combining C-section with antiretrovirals reduced infections even more. Don't try this at home.
AZT on the cheap
The results of a four-year study in Thailand confirmed what many researchers already suspected -- that a shorter, cheaper course of AZT helps to prevent mom-to-babe transmission. While many hailed it as a success, others slammed the study's ethics, which allowed thousands of infants whose moms took placebos to get HIV.
One pill makes you bigger ...
Viagra burst on the drug scene, putting spring -- and springtime -- back into the sex lives of HIVers with protease-age penis problems. The pill grossed $1 billion for Pfizer in its first year, but the euphoria had an edge. First came reports that mixing the blue diamonds with poppers can spell trouble, then rumors of a black market on the gay party circuit, and, finally, calls to criminalize prescribing Viagra to PWAs. Next up: Ladies get lucky, too!
And one pill makes you ...
"Buffalo hump," "protease paunch," "balloon breasts" -- just three examples of schoolyard-type slang used to describe the self-image-sabotaging symptoms of protease-induced lipodystrophy. While many docs pooh-poohed fat redistribution, they took seriously the sky-rocketing cholesterol rates, diabetes and heart attacks that gave some HIVers pause about going down that HAART road.
Early bird gets worm?
Some 75 percent of the nation's 800,000 or so people with HIV are antiretroviralers, many following docs' advice -- and ad hype -- to hit hard, hit early, even when CD4s are high and viral load low. But between side effects, toxicities and resistance, the creed of early intervention is losing some adherents. Leading AIDS researcher Dr. Jay Levy made headlines by boldly weighing in, "Premature initiation of treatment starts the clock ticking too soon, limiting future options and making therapy a necessity for the person's lifetime."
Like Sonny and Cher
After a feud dating back to the 1983 discovery of HIV, rival viral hunters Drs. Luc Montagnier and Robert Gallo shook hands in April over lunch and a pile of dough -- a $100,000 joint research prize from the Warren Alpert Foundation.
Exit, eradication ...
... Enter, remission. Virologists and immunologists finally agreed to bury the hatchet and embark on research that utilizes the best of both worlds. After suppressing viral production with combo therapy, they hope to reboost the immune system. If it works, HIVers may be able to cut combo therapy and control the virus.
If the genes fit
Adding to the "AIDS immunity" myth, National Cancer Institute biologists found that a mutation in the CCR5 gene can keep HIV from invading the immune system. But CCR5 discriminates: 15 percent of whites have the magic mutation -- perhaps a remnant of the 14th-century Black Plague in Europe -- while African and East-Asian immune systems miss out.
The 30-year-old cancer drug hydroxyurea was dusted off and given a twirl when it was found to block HIV replication, strengthen the immune system and help anti-HIV drugs work better. The old gal's a cheap date, too -- she lost her patent years ago.
The PEP squad
Postexposure prophylaxis (PEP) left the hospital and got plastered -- on San Francisco buses and in bars in a UCSF ad campaign encouraging gay men to take emergency antiretrovirals within 72 hours of unsafe sex. The city began a study to test whether PEP prevents seroconversion and encourages unsafe sex.
Death in the family
While en route to UNAIDS headquarters in Geneva, Dr. Jonathan Mann, the founding father of the global AIDS movement, and his wife, Dr. Mary Lou Clements-Mann, a distinguished HIV vaccine researcher, were killed in the crash of Swissair Flight 111.
Sleeping with the enemy
Miffed at ASO executive salaries passing the $150,000 mark, prickly Michael Petrelis and a handful of other longtime activists founded the AIDS Service Provider Accountability Project to study where AIDS donations go. But Petrelis raised hackles of more than just the fat cats when he hitched his wagon to HIVer-hater Rep. Tom Coburn (R-OK), who professed shock on the floor of Congress that AIDS charity execs had prioritized "lining their own pockets" over "saving lives."
Pocket full of Kaposi
In the first study to link Kaposi's sarcoma to sex via human herpes virus 8, University of California, San Francisco, researchers revealed that men with HIV and HHV-8 face a 50 percent chance of developing KS within a decade.
Ich bin ein Berliner
"Once I'm undetectable, can I go off therapy?" was the question on every HIVer's mind after learning that a Berlin patient and others had quit the cocktail and still kept their virus in check. But researchers refused to pay attention. Finally, Massachusetts General's Dr. Bruce Walker stepped up to the plate: If his patient's viral load remains undetectable over time, it could mean a new era in treatment strategy.
After cutting out of her "music group," the artist formerly known as Ginger Spice, Geri Halliwell, grabbed headlines when she accepted the position of Goodwill Ambassador for the UN, where she'll raise awareness of women's reproductive rights and combat HIV through safe-sex chat.
Proof that a low level of viral load in the blood doesn't mean less HIV in semen meant that even the most undetectable men should still reach for the rubbers, and disappointing discoveries about "HIV latency" in such reservoirs as the testicles, gut and lymph nodes derailed the eradication juggernaut.
At the 12th World AIDS Conference, University of California researchers reported the first documented case of multi-drug-resistant HIV transmission. The finding confirmed suspicions that particular resistances to HIV meds can be passed from partner to partner. The treatment outlook for those unlucky ones is, according to Dr. Anthony Fauci, "as bleak as it was in 1984."
That's so '80s
Exodus Ministries' homo- and AIDS-phobic full-page ads in The New York Times, The Wall Street Journal and The Washington Post served up a side order of hate at millions of readers' breakfasts. The gruesome gay-bashing death of 21-year-old Matthew Shepard in Wyoming gave the media a week of follow-up stories topped by his funeral -- complete with Rev. Fred "God Hates Fags" Phelps.
This sold house
AmFAR had to find a new party central when its head, Dr. Mathilde Krim, sold her Park Avenue manse for $12 million. This fall, Krim -- who had hosted the Kennedys, Kramers and countless AIDS galas -- swung open her doors for one last gathering, an impromptu memorial for Dr. Jonathan Mann. It was the end of an era.
For keeping 1 to 2 percent of HIVers' virus in check au naturel for 18 years and counting. Let's hope immune boosters share the wealth in '99.
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