Safe(r) Sex Time Line

late 1970s Epidemic levels of Hepatitis among gays [K]

late 1970s Virtually ignored epidemic of "Junkie Pneumonia" (PCP). [P]

by 1978 HIV present in SF and NYC gay populations. (based on later retesting of frozen blood samples from hepatitis Cohort Studies) [K]

1980 First Merck hepatitis B Vaccine Cohort Studies of gays. [K]

Oct. 1980- First Awareness of a possible epidemic of PCP

May 1981 (pneumonocistis carinii pneumonia) among Gay men.[P] Five cases among gay men are noticed and reported to CDC. [K]

June 5, 1981 CDC publishes first brief report of "gay pneumonia" [K]

1981 26 cases of Karposi's Sarcoma (KS) in gay young men of NY and SF reported since early 1979. [K]

1981 CDC begins a case-control study to identify AIDS-related behaviors that implicates a large number of partners thus suggesting it is a STD. [K]

1982 First Safe(r) Sex pamphlets published by gay community in SF, Houston, and NY, recommending reduction in number of partners, eliminating exchange of bodily fluids, and avoiding sex with unknown persons or strangers in locales such as bathhouses. No recommendations of some sexual acts as safer than others. [K]

1982-1984 Dominant behavioral response to AIDS, if any, is to reduce the number of sexual partners, not a change in sexual acts performed. [K]

March 1983 Research establishes that AIDS is distributed sexually and parentally - i.e., via the exchange of body fluids.

1983 Identification of a possible virus carrying AIDS.[P] [NAS]

1983 Gay activists produce pamphlet How to have sex in an Epidemic which urges continuation of the standard range of gay sexual acts (reflected in the hanky code) with some variations in their conduct [P] modifying what you do by using, e.g., condoms, not by reduction in number of partners. This begins a practice of AIDS activist pamphlets focusing on the avoidance of specific "unsafe" practices. [K]

1983 First Public Health Service Guidelines which sate in their entirety, " "Sexual contacts should be avoided with persons known or suspected to have AIDS, Members of high-risk groups should be aware that multiple partners increase the probability of developing AIDS."

1983 Emergence of the "Safe Sex" terminology.[P]

1983 First studies documenting heterosexual transmission of HIV virus through unprotected vaginal intercourse. [NAS]

1983-1987 Many "Safe Sex" guidelines brand all anal intercourse, with or without condom protection, as unsafe and some even recommend against the distribution or promotion of condoms as promoting unsafe sex. [K]

1984 Announcement of an antibody test (ELISA) for HIV (then called HTLV-III) which was designed to have a low false negative rate at the cost of having a high false-positive rate. [P]

1984 ELISA test used on frozen blood samples form the 1980 Hepatitis B Vaccine tests, establishing HIV infections dating back to at least 1978. [K]

Mid 1984 An estimated 50% of gay men in NY and SF are HIV+ [K]

1984 Medical establishment begins to equate safe sex with reduction in number of partners.[P]

1984 Research shows there is no clear-cut relationship between HIV+ status and number of sexual partners, refuting earlier 1981 CDC preliminary case-control studies. [K]

1984 Condom use begins to become significant among gay men. [K]

by late 1984 Association between AIDS and HIV+ clearly established by research [ NAS]

late 1984 Beginning of the Heterosexual AIDS Panic leads to the first promotion of the idea that safe sex centers on the use of condoms.[P]

1984-1985 Most AIDS Activist groups advise against taking the test on grounds of fears of surveillance used politically against gays, the high false-positive rates of the test, and the absence of any treatment for those who are positive. [P]

1984 San Francisco AIDS Foundation begins to stress the social acceptability of Safe(r) Sex. [K]

Sept. 1984 Legal forced closure of all gay bathhouses in San Francisco

1984- A growing number of epidemiological studies show that transmission of AIDS via oral sex including ingestion of semen is at best a rare possibility. [K]

1984-1988 Levels of HIV infected cells in bodily fluids including semen and vaginal fluids usually low, but high rates (up to 5%) found in semen of some HIV+ persons.

by 1985 Studies have established that HIV virus not transmitted by insect bites or bodily fluids other than semen and blood. [NAS]

1985 Widespread HIV testing (ELISA) becomes available. CDC promotes its widespread usage. [P]

Spring 1985 San Francisco Gay Activists begin to argue that taking the test would promote behavioral change towards safe sex. [P]

1985 Rock Hudson dies leading to first widespread coverage of AIDS in the mainstream media [P]

1985 Names Project's AIDS memorial Quilt begins. [C]

1985 Legal closure of NYC gay bathhouses.

1985 First International AIDS Conference (CDC) Atlanta. [P]

1985-1986 Gay activists groups focus on when and how the AIDS test should be administered - e.g., promoting community-based anonymous testing.[P]

1985-1993 Free infectious HIV virus is not found at high levels in tears, saliva, ear secretions, breast milk, vaginal fluid, and seminal fluid [L]

by 1986 Most American AIDS prevention organizations opt for promoting safe sex as opposed to strategies for risk reduction, whereas the rest of the world evolves a risk-reduction safer sex approach. [K]

by 1986 Most Safe Sex pamphlets are advocating the avoidance of specific practices . [K]

1986 U. S... Surgeon General Koop's Surgeon General's Report on Acquired Immune Deficiency Syndrome warns of the dangers of the AIDS epidemic to the entire population and urges heterosexual to adopt safe sex practices to prevent the epidemic spread of AIDS into the larger heterosexual population-thus escalating the Heterosexual AIDS Panic. [K]

mid-1986 Emergence of a professional AIDS Service Industry preempts gay community based efforts, shifting gay AIDS activists from "experts" to" lobbyists. Beginning of the de-gaying of AIDS fueled by the Heterosexual AIDS Panic, effectively divorcing AIDS service Organizations from their Gay Liberation roots. [P]

1986-1987 Effectiveness of condoms as a barrier to AIDS transmission finally established. Subsequent studies establish condoms as providing "significant, although not complete, protection against infection with HIV-1" [K]

1986-1987 Condom Advertisement Controversies lead to a focus on use of condoms as the core of Safe(r) Sex. [P]

1986-1991 Condom breakage studies establish a failure rate of around 2-3% leading to recommendations that gays use condoms stronger than normal for vaginal sex.[K]

1987 Helms Amendment passed prohibiting AIDS funding to any projects that "promote homosexuality" which becomes interpreted as including any gay-positive material, thereby effectively removing the promotion of nonhomophobic gay Safe(r) Sex from federally-funded AIDS prevention efforts. [P]

1987 Reported AIDS serioconversion rates in San Francisco fall below 2% which is wisely interpreted by AIDS Activists as showing the efficacy of Safe(r) Sex Campaigns. [P]

1987 Northwestern Multi-cohort Study Group epidemiological study claims to find "a strong link between HIV infection and rectal trauma, a composite variable consisting of receptive anal fisting, enemas before sex, and physical signs of disruption of the tissue lining the rectum. They also confirmed the association between receptive anal intercourse and HIV infection." [NAS]

1987-1988 Emergence of ACT-UP [P]

by 1988 Research overwhelmingly has established minimal risk of oral transmission of HIV, though studies tend not to distinguish cases with and without ingestion of semen. Dangers of possible infection due to cuts or sores in the mouth are purely speculative. On this basis AIDS organizations in Canada, Australia, and the UK urge oral sex as being "closer to no risk" American AIDS guidelines continue to advise against unprotected oral sex. [K]

May 1988 Journal of the American Dental Association study reports and unidentified component of saliva prevents HIV infection of lymphocytes. [K]

1988 Publication of Randy Shilts, And the Band Played On which attributes the AIDS epidemic to rampant gay sexual morality and calls for the gay community to return to the monogamistic sexual mores of the dominant heterosexual culture.

1988-1991 Bowl mucosa contains cells that can be directly infected by HIV [L]

1988-1992 Evidence begins to accumulate that there has been a modest upturn in new HIV+ infection rates in San Francisco, suggesting that there is an increase in unprotected anal sex. [K] [R]

1988- Scattered unrefereed case-study reports of alleged oral transmission of HIV virus in letters to medical journals.

by 1989 AIDS Volunteer groups largely dominated by white middle-class values and staffed by gay male and heterosexual female volunteers. [P]

late 1980s Outside America, most AIDS agencies are promoting even unprotected oral sex as a reasonable AIDS reduction strategy, reflecting the fact that most gay men refuse to suck cocks with rubbers on them. Avoidance of unprotected anal intercourse under most circumstances continues to be a tenet of safer sex advice. [K]

by 1990 American safe sex guidelines arguably are the most conservative in the world promoting safe sex over safer sex risk reduction. [K]

1990-1992 Levels of HIV infected cells up to 50 times higher than free HIV virus levels found in blood of HIV+ persons. [L]

1991-1993 Presence of HIV virus in seminal fluid does not generally correlate with clinical state. [L]

1990-1992 Studies fail to support the claim that repeated exposure to HIV through multiple HIV positive partners, intravenous drug use, contaminated blood or blood products affects progression of disease of causes infection by more than one HIV strain; some evidence form HIV vaccine studies that exposure to HIV proteins may reduce loss of CD4+ cells and stabilize the clinical state. [L]

by 1992 Virtually no government AIDS funding is aimed at gay or bisexual men in either the US or Britain. [K]

1992 The Helm's Amendment is overturned as a result of a successful legal challenge by the American Civil Liberties Union and the Center for Constitutional Rights. [K]

1992-1993 Absence of free HIV virus in sweat, feces, and urine established [L]

1993 New York Times publishes an article estimating that one in three gay men in San Francisco is engaging in unsafe sex, primarily anal intercourse without condoms. Controversy erupts, with questionable counter-claims by SF Public Health and AIDS-prevention organizations.

1993 European studies show low serioconversion incidence (15%) of HIV- women having unprotected vaginal intercourse with HIV+ male partner. [NAS] There apparently are no comparable studies for heterosexual or homosexual anal intercourse mixed-status couples.

by 1995 Significant resurgence of vintage 1970s style promiscuity in NY, SF, and other cities taking place in newly opened sex clubs, back rooms in bars, etc., with an increase in unSafe(r)-Sex activities such as unprotected oral sex. [R]

Sources:

[P]: Cindy Patton, Inventing AIDS (New York: Routledge, 1990.

[R]: Eric Rofes, Reviving the Tribe: Sexuality and Culture in the Ongoing Epidemic. (New York: Harrington Park Press, 1996.

[K]: Edward King, Safety in Numbers (New York: Cassell, 1993)

[J]: William I. Johnston, HIV-Negative: How the Uninfected are Affected by AIDS (New York: Insight Books, Plenum Press, 1995)

[NAS] Eve K. Nichols, Mobilizing Against AIDS., revised and enlarged edition. (Cambridge, MA: Harvard University Press for the Institute of Medicine, National Academy of Sciences, 1989).

[C]: Emmanuel Cooper, The Sexual Perspective: Homosexuality and Art in the last 100 Years in the West. new edition. New York: Routledge, 1994.

[L] Jay A. Levy, "Review: The Transmission of HIV and Factors Influencing Progression to AIDS", American Journal of Medicine 95(July 1993): 86-90.