HIV Is a Story First Written on the Bodies of Gay and Bisexual Men

by George Ayala, PsyD, and Andrew Spieldenner, PhD for the American Journal of Public Health

“Gay and bisexual men carry the burden of this community trauma, one that is often unaddressed because of public amnesia, HIV-related stigma, homophobia, gender inequities, racism, and classism.”

Whatever else it may be, AIDS is a story, or multiple stories, and read to a surprising extent from a text that does not exist: the body of the male homosexual.”

In 1980, Ken Horne, a gay sex worker in San Francisco, California, became the first person to be diagnosed with acquired immune deficiency syndrome (AIDS) in the United States. A year later, the Centers for Disease Control and Prevention’s (CDC’s) Morbidity and Mortality Weekly Report described five cases of Pneumocystis pneumonia among young “homosexual” men living in Los Angeles, California. By 1982, the term “gay-related immune deficiency” gained traction in the media and among health care professionals to describe the assumed inherent link between homosexuality and what would later be known as human immunodeficiency virus (HIV). The term “gay-related immune deficiency” reflected homophobic ignorance and the dearth of epidemiologic evidence that existed at the time. In 1983, frustrated by their shared experiences of stigma, gay men with AIDS at the Fifth Annual Gay and Lesbian Health Conference brought forth the Denver Principles, which catalyzed self-empowerment across health movements for decades to come.

As significant as these time markers are, the HIV story in the United States likely dates back two or more decades before the 1980s. Robert Rayford, a Black adolescent who grew up in the Old North neighborhood of St. Louis, Missouri, died of pneumonia in 1969, after enduring a severe chlamydia infection and Kaposi’s sarcoma. In 1987, western blot postmortem testing on Rayford’s tissue samples confirmed HIV infection. Although we may never know for certain, Rayford may have contracted HIV selling sex or, like too many gay and bisexual youths worldwide, because he was the target of sexual violence.

These early events remind us that HIV is a story first written on the bodies of gay and bisexual men. And the goal of this editorial commemorating the first published cases of AIDS is to underscore the critical importance of human rights for sexual minority men and women and as the basis of the HIV response.

Read The Full Article in the American Journal of Public Health

Ayala G, Spieldenner A. HIV Is a story first written on the bodies of gay and bisexual men. Am J Public Health. Published online ahead of print June 10, 2021:e1–e3. Acceptance Date: April 15, 2021. DOI:

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