HIV/AIDS represents one of the greatest public health crises of the latter half of the twentieth century and the first half of the twenty-first century. The disease affects thousands of families in Colorado alone and has motivated a public response unlike any other in the last fifty years. Today, HIV/AIDS remains a death sentence for those infected, although nearly three decades of research into pharmaceuticals has enabled the afflicted to enjoy a relatively decent quality of life for decades after their diagnosis.
Beginning of the AIDS Crisis
In the spring of 1982, the MD Anderson Hospital of the University of Texas issued a typewritten, one-page public health announcement. The notice’s ordinary appearance could not conceal its extraordinary news:
For approximately one year a significant increase in the occurance [sic] of a rare cancer, Kaposi’s Sarcoma, and an apparently related syndrome of diseases and infections known as “opportunistic infections” have occurred primarily in gay men living in urban areas . . . Kaposi’s Sarcoma, Pneumocystis Carinii Pneumonia (PCP), or the combination of the two are the most serious and sometimes deadly with a combined average fatality rate of 53% . . . Atlanta’s Centers for Disease Control reports 7–10 cases and 3–4 deaths per week.
The announcement concluded with an ominous warning in all caps: “THE DANGER IS REAL AND IT CAN KILL YOU!!!!!”
By year’s end, eight Coloradans suffered from the mysterious syndrome, now renamed AIDS (Acquired Immunodeficiency Syndrome). AIDS is the late stage of HIV (Human Immunodeficiency Virus) and constitutes a severe breakdown of the body’s immune system. The virus can be transmitted through the exchange of blood, semen, vaginal fluid, or breast milk. Homosexual men and drug users who share needles are the most widely affected populations. Because the virus hits densely populated metropolitan areas the hardest, Denver has been Colorado’s largest breeding ground for AIDS.
Responses in Colorado
Before there were any cases of AIDS in Colorado, Denver’s Gay and Lesbian Community Center pulled together a task force—the precursor of the Colorado AIDS Project (CAP) directed by Julian Rush. An early fund-raiser at the Paramount Theatre, optimistically named the “Celebration of Hope,” provided the organization with starting funds.
By 1984, the number of known AIDS cases had climbed to nearly 10,000 nationwide, with eighty in Colorado. The Colorado AIDS Project relied on grants and small-scale events, such as its annual cocktail party, for its survival. In those days, CAP, along with the Denver Health Department, was one of the only support agencies for Coloradans with HIV/AIDS.
Realizing that nongovernmental organizations such as CAP had more credibility with the gay community, the health department left direct intervention to CAP and focused on prevention. CAP did little intervention with needle users who had contracted HIV simply because, in those first years, there were still so few of them in Colorado. Project Safe, a federally funded organization supported by the University of Colorado, began working directly with intravenous drug users.
Rush worked out of a makeshift office at St. Paul’s Methodist Church in Denver, where he was assistant pastor. He was the Colorado AIDS Project’s only staff member. The organization began with about $20,000, two desks, and two phones on the same landline. Volunteers helped many clients, often on a one-on-one basis. After two years, Rush hired a part-time secretary, then a full-time secretary, and then a grant-funded education coordinator.
Organizations such as CAP received help from gay communities that, in the early 1980s, mobilized in a way they had never done before. “They decided that nobody else is going to do anything about this, so we’re going to take charge,” recalled Rush. According to Rush, during the 1980s, most Americans knew little about the gay community and spoke even less about it, but soon the term gay and AIDS began to be co-identified. Additionally, both the epidemic and the term AIDS became predominantly identified with white gay men. “One of the biggest struggles we had was to convince people that AIDS was a problem,” said Rush. It wasn’t until four years after the founding of CAP that the Colorado Trust offered funding to the group, and other foundations began to follow suit.
AIDS Deaths Mount
By August 1985, Colorado reported 123 AIDS cases; eighty-four had been fatal. Of the total, 106—or 86 percent—were gay or bisexual men, and six were drug users. Among the remainder, only one was a child. In September Governor Dick Lamm, speaking to a group of medical professionals, declared that there were “two types of people with AIDS, the dying or the dead.” He added that victims “should be made comfortable and given relief from pain,” but “high-cost, high technology ‘heroic’ medical efforts shouldn’t be used on ‘overtreating’ the hopelessly terminally ill.” Leaders of Denver’s gay community criticized Lamm’s comments as “lacking sensitivity” but “agreed with his logic.”
Amid debates over AIDS policies in schools and the workplace, health officials were concerned that the fear of AIDS was diverting attention from high-risk groups and adequate prevention. An immunology specialist claimed that he spent “more time comforting those who fear AIDS than . . . treating patients who have contracted the disease.” A seventeen-year-old boy who tested positive for HIV found that he had been banned from his Denver school in October 1985. That same week, against the urgings of the Colorado Board of Health, Colorado Springs’s largest school district announced that students with AIDS or the HIV virus would be barred from school and placed in the home schooling program; infected employees would be placed on leave without pay. A week later, the Weld County school board did the same thing.
AIDS Beyond Denver
Colorado began taking measures to protect its prison inmates, who were vulnerable to the virus by the sharing of needles and through sexual contact, rape, and a lack of information. In September 1985, the Rocky Mountain News reported that “all new inmates entering Colorado’s prison system will be tested for the deadly disease AIDS.” A year later, a new isolation unit opened in the medium-security Territorial Correctional Facility in Cañon City for inmates who had been exposed to the virus, and eight of the unit’s sixteen spaces filled immediately. The unit supplemented an AIDS isolation unit at the nearby maximum-security Centennial Correctional Facility. Testing centers opened in Boulder, Loveland, Fort Collins, Greeley, Colorado Springs, Sterling, Pueblo, and Grand Junction, in addition to two centers in Denver. AIDS cases gradually began appearing in Colorado Springs, Fort Collins, and Boulder, and on the Western Slope. By the end of 1986, Colorado reported a cumulative total of 358 AIDS cases.
In May 1987, health officials reported the first case of AIDS in northeastern Colorado but declined to specify the exact location. In fact, rural populations across the nation developed the highest rate of increase in AIDS cases due to a nearly all-encompassing lack of education about the virus. Increasing numbers of agencies formed to educate the public about the ways AIDS could and could not be transmitted and to work with HIV-infected Coloradans.
Several events propelled CAP through the 1980s. Annual fund-raising parties continued successfully, and in the late 1980s, a touring musical review called “Heart Strings” stopped in Denver on a national tour, enabling CAP to involve segments of the community it had not attracted before. Staff and volunteers became aware of “AIDS walks” sponsored by other cities, such as Boston, which generated money and visibility. The Denver group received instructions and even personal help from the AIDS Walk Boston group, and the 1987 AIDS Walk Denver raised more $150,000.
Responses to the Virus
Azidothymidine (AZT), a drug introduced in 1986 that slows the action of HIV in some users, was made more widely available to people with AIDS. In 1987 the AIDS Drug Assistance Program began providing medications to low-income individuals with HIV in all fifty states. After five years as executive director of CAP, Rush was officially appointed by the Methodist Church as its representative to the project.
By 1990 HIV was attacking an increasingly younger population. According to the American Association for World Health, young men in their twenties were forging a second wave of the AIDS epidemic. During the 1980s, the median age of HIV infection was above thirty. During the period from 1987 to 1991, it dropped to twenty-five. In 1968 35 percent of young women and 55 percent of young men reported having sexual intercourse by age eighteen; by 1988, those numbers rose to 56 and 73 percent, respectively. Another factor in the drop in the median age of AIDS patients was a sense of invulnerability among young people, causing many to think they would not contract the disease.
In addition, greater numbers of children were being born with HIV because of vertical transmission—the passing of the virus from mother to baby. The mothers had usually been exposed through injection drug use or sexual contact with an intravenous drug user. Despite the increasing number of Coloradans contracting the virus, Rush saw the growing number of clients that the Colorado AIDS Project furnished with case management and medical treatment as clear signs that the project was succeeding.
December 1, 1988, marked the first World AIDS Day, held after a summit of health ministers from around the world called for a spirit of social tolerance and a greater exchange of information on HIV/AIDS. CAP participated with other members of the AIDS Coalition for Education (ACE), an organization of metropolitan Denver agencies.
On August 18, 1990, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act went into effect. Named for an Indiana teen who took it upon himself to educate the public after contracting the disease, the act aimed to improve the quality and availability of care for people with HIV/AIDS and their families. The program made grants available for health care, support services, and early intervention for low-income people. Still, nationwide advances in the awareness of AIDS, education, and services for victims could not prevent the epidemic from raging on. By 1990 Colorado had reported 2,027 AIDS cases since its first incidence was detected.
As of 2013, 11,624 people in Colorado were living with HIV, at a rate of 266 per 100,000 people. Of those people living with diagnosed HIV, 88 percent were men and 12 percent were women. In 2014 there were 401 new HIV diagnoses in Colorado, at a rate of 9 per 100,000 people. In 2013 106 Coloradans with diagnosed HIV died, at a rate of 2 per 100,000 people. Today, social awareness of HIV and AIDS has risen dramatically thanks in large part to public sex education programs, public outreach, and drastically improved knowledge of the condition itself.
Adapted from Steven G. Grinstead, “‘The Danger is Real and It Can Kill You!’ The Arrival of AIDS in Colorado,” Colorado Heritage Magazine 19, no. 1 (1999).