For an epidemic that would explode to claim hundreds of thousands of lives, AIDS surfaced very quietly in the United States, with a small notice on June 4, 1981 in a weekly newsletter published by the Centers for Disease Control in Atlanta, alerting doctors to five unusual cases of pneumonia that had been diagnosed in Los Angeles residents over the previous few months. All the patients were homosexual men who had come down with PCP (Pneumocystis carinii pneumonia), a lung infection usually seen only severely malnourished children or adults undergoing intensive chemotherapy. But until they got sick the California men were well nourished, vigorous adults, whose immune systems should have protected them from the infection. Within the year, similar cases were reported from all over the country: apparently healthy adults who were suddenly getting sick with rare infections and malignancies that healthy people should not get. Most were from New York City, California, Florida and Texas, and not all were homosexual men. Men and women who used intravenous drugs were also getting sick, as were men with hemophilia, the male and female sexual partners of people in these risk groups, immigrants from Africa and the Caribbean, and some of the infant children born to women at risk. All these varied people had one thing in common: almost absent levels of the white blood cells called T helper cells that keep the immune system functioning properly. Their defective immune systems left them vulnerable to one serious health problem after another. Although many problems could be treated, and even cured, others immediately arose. After their first serious problem, people were said to have AIDS, and once diagnosed with AIDS most survived for only a year or two. By 1984, the virus called H.I.V. was firmly established as the cause of the mysterious syndrome. H.I.V. can pass from one person to another through sexual contact or contact with infected blood, settle ...
