Blood

PUBHLTH 405
Social History of Infectious Disease
University of Michigan School of Public Health

Jon Zelner
[email protected]
epibayes.io

Agenda

  • Understanding the role of the blood supply in the HIV crisis.

  • 1983: Year in Review 1

  • Projects

Starting Questions

On your own:

  • How did the advent of Factor VIII increase the risk of HIV infection among people with hemophilia?

  • How is this risk similar and different to risk posed by the bathhouses in Episode 3?

With a partner:

  • By the end of the episoe, where are we in Rosenberg’s trajectory when it comes to the national response to AIDS?

Calling John Snow!

“Who can doubt that the case of John Harnold…was the true cause of the malady in Blenkinsopp…And if cholera be communicated in some instances, is there not the strongest possibility that it is so in the others - in short, that similar effects depend on similar causes.”

Blood system provided a tragic natural experiment

  • Even if the number of people who received transfusions and developed AIDS was small, it was not possible to explain this risk without understanding the cause of AIDS as a bloodborne pathogen.

  • To CDC researchers, a baby who had received a transfusion and subsequently developed AIDS - while having no other potential risks - was definitive proof.

  • What were the concerns of those who stopped short (e.g. community blood banks) of endorsing the bloodborne theory?

Fast doubling rate implied transmission

What does the number of cases among hemophilia patients over this period reflect? (Figure from from (Stehr-Green et al. 1988))

1983: Year in Review

Ward 86 opens in San Francisco

January 1983

HIV Identified for the first time

February 1983

Stigmatizing “4H Club” moniker comes out of CDC report

March 1983

Larry Kramer publishes “1,112 and Counting”

March 14, 1983

How to Have Sex in an Epidemic published

May 1983

Denver Principles adopted at the National AIDS Forum

June 12, 1983

“I Will Survive” radio documentary broadcast in LA

June 19, 1983 (Start at 5:22)

Pat Buchanan Op-Ed calling AIDS retribution for homosexuality is published in NY Post

Argued that gays should be banned from food-handling jobs. June 23, 1983

Race, class, and sexualityare invoked to stoke stigma

Moral Majority Report, July 1983

Stanford Blood Bank begins screening for low CD4 counts in blood donations

July 1, 1983

MMWR report rules out casual contact as an HIV transmission risk factor

September 9, 1983

MMWR report rules out casual contact as an HIV transmission risk factor

September 9, 1983

“Keeping people away”…very literally.

October 12, 1983

December 1983: First TV depiction of HIV on St. Elsewhere

(Start at 32:17)

Next Time

References

Chase, Sophia. 2012. “The Bloody Truth: Examining America’s Blood Industry and Its Tort Liability Through the Arkansas Prison Plasma Scandal.” William & Mary Business Law Review, April.
Stehr-Green, J K, R C Holman, J M Jason, and B L Evatt. 1988. “Hemophilia-Associated AIDS in the United States, 1981 to September 1987.” American Journal of Public Health 78 (4): 439–42. https://doi.org/10.2105/AJPH.78.4.439.