Thirty years ago, Dr. Mary Guinan was among the first scientists to investigate the emerging -- and frightening-- AIDS epidemic in the United States. Then the disease was a death sentence, and the medical community seemed helpless in fighting its spread. We caught up with Guinan, now dean of the School of Community Health Sciences, to see how response to the disease has changed and what work is still left to be done.
How did you get involved with researching the AIDS epidemic?
I was working at Centers for Disease Control (CDC) in Atlanta, specializing in sexually transmitted infections. An unusual, deadly illness was recognized first in gay men, so we started looking at that population and the possibility that we were dealing with another sexually transmitted infection (STI). It was pretty frightening that there was something out there killing people, and we didn't know what it was or how fast it was spreading.
The CDC then formed a task force on AIDS and the investigation went all over the country. It took some time and there were all sorts of theories about what was causing it. We confirmed it was infectious and could be sexually transmitted but then realized it could be transmitted by infected blood or blood products, from mother to newborn during delivery, and through breast milk. All of these things were spotted before we knew exactly what the organism was.
When did you know that it was AIDS you were dealing with?
The first report of a problem was in 1981, but it wasn't until 1984 that the virus was discovered by a team of French scientists. Then, in 1985, a test became available so we could screen people for the virus, which was named human immunodeficiency virus (HIV).
What was your greatest challenge in fighting AIDS then?
There was a great deal of difficulty in getting the public to accept it as a problem in our society. The general population assumed that it was just gays and drug users who got it and that it didn't affect them. But it could affect anyone. The blood supply was contaminated and many of the early cases were transfusion-related.
Also, because there was no treatment for HIV, people thought, "Why get tested?" People did not want to know if they were infected because the general public feared people with AIDS -- it was a scourge, a shameful thing.
How has fighting AIDS changed over the course of 30 years?
I took care of AIDS patients in a county clinic one day a week as part of my duties at CDC. For 14 years, I took care of patients and every single one of them died. There was nothing anyone could do.
But in 1995, a treatment cocktail was developed and was shown to be effective. It was like a miracle. People were finally being treated. Instead of dying they became well. It was incredible to witness.
The greatest disappointment for me now is that, after 30 years, a vaccine still has not been developed to prevent HIV infection.
Will we see AIDS end in our lifetime?
We can stop the spread of disease. While we do not have a vaccine for HIV, we do have the tools to prevent its spread.
At this point we are identifying and treating people with HIV infection. The treatment is not a cure but it reduces the level of virus in the system to extremely low, undetectable levels. Therefore effective treatment of HIV-infected individuals does two things: First, it makes the patient well. Second, it renders them noninfectious, which prevents spread of the virus. That is why it is so important to identify and treat all HIV-infected people. Testing for HIV is the key strategy for identifying infected individuals. We need to and can reduce the fear of being tested.
Do many people continue to ignore information and precautions that have been uncovered regarding AIDS?
Most people are not getting infected through unsafe injection of illicit drugs. They are getting it from a partner, and their own substance use prevents them from taking proper steps to practice safe sex.
They often are unaware that their partner has been a drug user. It might not even be injection drug use, but it could be prescription drug use or alcohol. And, people who are under the influence take risks when they are having sex.
Guinan also was portrayed in a 1987 book and later an adapted HBO film in 1993, both called "And the Band Played On," which describes the early investigation into the discovery of AIDS in America. Your work in investigating AIDS was portrayed in the book and HBO film, "And the Band Played On." How did you get involved in that?
The movie was first a book by San Francisco-based reporter Randy Schilts. San Francisco was disproportionately affected with the virus and most of his columns were about this new disease. He interview me frequently about what we were doing. He was closely connected with the gay community. It's an interesting book.The movie was so controversial no one would make it. It went through several producers. HBO finally produced it because it was too controversial for mainstream Hollywood.
The actress who played me, Glenne Headly, called me and asked me to help supply dialogue. At the time I had been interviewed by national media such as 60 Minutes and Phil Donahue. The CDC sent her these taped interviews so she could review and study my mannerisms. It was an interesting experience, but I didn't have much time to think about it because we were still so heavily involved in our research of the disease.
