In 1982, U.S. Representative Henry WaxmanExit Disclaimer convenes the first congressional hearings on AIDS at the Los Angeles Gay and Lesbian Community Services Center in Hollywood, California. At the hearing, Dr. James Curran, head of the Center for Disease Control’s (CDC) Task Force on Kaposi’s Sarcoma and Opportunistic Infections, estimates that tens of thousands of people may already be affected by the disease.

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President Ronald Reagan and his administration have traditionally been considered slow to respond to the AIDS pandemic. Reagan did not, in fact, mention the word AIDS until September 1985, when he responded to reporters’ questions. His first speech about the disease was delivered to the College of Physicians in Philadelphia in 1987.

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The Reagan administration’s response was not only ineffective but also excruciatingly silent for the first five years of the epidemic. Without a substantial federal response, this obscure infection evolved into an epidemic that erased a generation of Americans in the span of half a decade. When discussing the Reagan administration’s early response to AIDS, historians tend to follow one of two positions: avoid mentioning the disease in its entirety, or blame Reagan’s homophobia for the deaths of thousands of Americans. Most Reagan biographers fall into the

The Reagan presidency relied on homophobic rhetoric to attract a Christian, far-right base within the Republican party, known as the Religious Right. Leading up to the 1980s, the Religious Right influenced the Republican Party to adopt socially conservative positions, which included anti-gay beliefs. Howard Clayton explains that “the growing Religious Right meant that GOP candidates increasingly chose homophobic policies.” Therefore, many Reagan administration 8 officials gained political support by expressing anti-gay attitudes and apathy towards people with AIDS. Before joining the Reagan administration, White House Communications Director Pat Buchanan disparaged people with AIDS during the onset of the epidemic. Buchanan regarded the disease as moral punishment for “the poor homosexuals [who] have declared war on nature, and now nature is exacting an awful retribution.” Although Buchanan released this statement before 9 his confirmation to the Reagan administration, his sarcastic and hateful message resonated with many conservative voters, who continued their support after his confirmation. Similarly, Reagan repeatedly appealed to anti-gay constituents during his 1980 presidential campaign. Reagan severed any affinity to the gay community: “[the gay movement] isn't just asking for civil rights; it's asking for recognition and acceptance of an alternative

lifestyle which I do not believe society can condone, nor can I.” In addition to describing gay 10 Americans as “abominations,” Reagan established a clear anti-gay position for his presidency. In 1984, Reagan declared that his administration would “resist the efforts of some to obtain government endorsement of homosexuality.” Whether these statements reflected his personal 11 beliefs or served as political hyperbole, Reagan earned the votes and support of the Religious Right. The Reagan administration could not afford to lose this political base. Therefore, a silent stance on the AIDS epidemic allowed Reagan to maintain his political support by neglecting the deadly issue facing the gay community. While Reagan maintained his silence, his administration silenced other officials who attempted to properly address the AIDS epidemic. Since the administration prioritized political expediency, any deviation from the conservative ideology was immediately met with hostility. The Surgeon General under Reagan, Dr. C. Everett Koop, accounts his exclusion in his autobiography, Koop: Memoirs of America’s Family Doctor: But for an astonishing five and a half years I was completely cut off from AIDS. I was told by the assistant secretary for health, my immediate boss, that I would not be assigned to cover AIDS. The department took its cue from him. Even though the Centers for Disease Control commissioned the first AIDS task force as early as June 1981, I, as Surgeon General, was not allowed to speak about AIDS publicly until the second Reagan term. Whenever I spoke on a health issue at a press conference or on a network morning TV show, the government public affairs people told the media in advance that I would not answer questions on AIDS, and I was not to be asked any questions on the subject

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From 1981 to 1986, the Reagan administration refused to address the epidemic voluntarily. There were only a few moments of broken silence; however, the discussions about AIDS from the Reagan administration remained brief and trivial. Within these five years, the White House Press Secretary, Larry Speakes, delivered the only public remarks about AIDS after several questions about the epidemic from a reporter. Ironically, Speakes was the only White House official to “speak” on AIDS during this period. His answers minimized the disease and reassured the public that AIDS was not a priority for the Reagan administration. On October 15th, 1982, the reporter Lester Kinsolving questioned Secretary Speakes about the emerging epidemic: KINSOLVING: Larry, does the President have any reaction to the announcement—the Centers for Disease Control in Atlanta, that AIDS is now an epidemic and over 600 cases? SPEAKES: What’s AIDS? KINSOLVING: Over a third of them have died. It is known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing that one in every three people that get this have died. And I wondered if the President is aware of it? SPEAKES: I don’t have it. Do you? (Laughter.) KINSOLVING: No, I don’t. And I am relieved…

SPEAKES: How do you know? (Laughter.) KINSOLVING: In other words, the White House looks on this as a great joke? SPEAKES: No, I don’t know anything about it, Lester.15 The chummy jokes and eruption of laughter throughout this questioning reflected the administration’s homophobic perceptions during the beginning of the epidemic. Speakes not only refrained from providing a substantial answer to Kinsolving’s questions but also expressed absolute ignorance on the subject itself. Despite the CDC’s official case definition of AIDS and numerous weekly reports on the epidemic, the Reagan administration demonstrated no knowledge of the disease. This showed the lack of urgency to address an epidemic that predominantly affected gay Americans. The White House’s public disinterest in AIDS continued for years. On December 11th, 1984, more than two years later, Kinsolving again questioned Speakes on the administration’s reaction to new information on AIDS: KINSOLVING: An estimated 300,000 people have been exposed to AIDS, which can be transmitted through saliva. Will the President, as Commander-in-Chief, take steps to protect Armed Forces food and medical services from AIDS patients or those who run the risk of spreading AIDS in the same manner that they forbid typhoid fever people from being involved in the health or food services? SPEAKES: I don’t know. KINSOLVING: Could you—Is the President concerned about this subject, Larry... KINSOLVING: No, but, I mean, is he going to do anything, Larry? SPEAKES: Lester, I have not heard him express anything on it. Sorry. KINSOLVING: You mean he has no—expressed no opinion about this epidemic? SPEAKES: No, but I must confess I haven’t asked him about it. (Laughter.) KINSOLVING: Would you ask him Larry? SPEAKES: Have you been checked [for AIDS]? (Laughter.) KINSOLVING: I didn’t hear an answer?

A fundamental policy of the Reagan administration was the rigid economic program of “Reaganomics.” With a primary objective to reduce government spending, the funding of public health service agencies was extremely limited. Under the scourge of AIDS, the severe cut in federal funding for the CDC and other health agencies became incredibly insufficient. Although the budget for AIDS-related efforts increased from $8 million in 1982 to $508 million in 1986, the federal funding remained insignificant to effectively combat the disease.19 The Reagan administration routinely refused to allocate additional funding towards AIDS research, prevention, and control. In the Encyclopedia of AIDS: A Social, Political, Cultural, and

Scientific Record of the HIV Epidemic, Raymond Smith details the Reagan administration’s rejection of a congressional supplement to the CDC. According to Smith, the Reagan administration claimed that “the CDC did not need the money and opposed any congressional supplemental appropriations designed to fund the federal government AIDS policy efforts.”20 Similarly, Randy Shilts notes the Reagan administration’s reluctance to grant appropriate funding. The spending allocated to public health agencies was “woefully inadequate,” yet, “the Reagan administration put forward no new initiatives for AIDS funding.” There was no 21 political motivation for the Reagan administration to increase AIDS-related funding. After several years of insufficient funding, the United States Congress held a hearing in 1987 on the federal response to AIDS. The opening statement depicts the Reagan administration's efforts “to have been, at best, slow and inadequate.” After testimony from 22 various doctors and researchers on the frontlines of the epidemic, the congressional committee concluded: “The Federal administration has been very reluctant to recognize the true dimensions of and propose an adequately funded federal response to AIDS.” The defunding of public 23 health service agencies ill-prepared the United States for the AIDS epidemic, while the underfunding deprived health agencies of valuable resources to research the disease and potentially prevent AIDS from reaching an epidemic level. Although a suitable budget for AIDS-related efforts was attainable, the Reagan administration remained committed to reducing

On July 25, 1985, a publicist for Rock Hudson revealed Hudson was suffering from AIDS. As a beloved Hollywood actor, Hudson personified American masculinity. Thus, his startling announcement of an AIDS diagnosis electrified the entire country. Rock Hudson marked a turning point in the AIDS epidemic: AIDS was no longer a distant issue exclusively for gay Americans and drug abusers. Americans now held a legitimate concern of the epidemic’s threat to national public health. Most strikingly, Hudson’s AIDS diagnosis presented the first inklings of awareness for his close friend, President Ronald Reagan. According to Reagan’s son, “the whole picture changed” for the president following Hudson’s diagnosis. The suffering of a 24 friend and the growing consciousness of a national epidemic encouraged Reagan to finally consider action against AIDS. Nearly three months following this disclosure, Hudson died. So did Reagan’s silence

After Hudson’s death, the Reagan administration faced domestic pressure to contain a public health crisis. Although the long-held silence had to be broken, the Reagan administration defined the epidemic as a financial triumph and moral issue to continue appeasing their conservative base. In September of 1987, more than four years after the first reported case, Reagan mentioned AIDS publicly for the very first time in a press conference. Claiming AIDS has been a “top priority” since 1981, Reagan praised the administration’s “vital contributions” while adhering to “budgetary restraints.” By framing the federal response as a success accomplished 25 under Reaganomics, Reagan adhered to his constituency’s conservatism without legitimizing homosexuality. To avoid a fallout from the Religious Right, the president's comments on AIDS remained limited. It would be another two years before Reagan delivered a major speech on the epidemic. In 1987, Reagan addressed the College of Physicians of Philadelphia, the United States’ oldest medical academy, to favor moral education as the best solution against AIDS. Reagan considered the federal government's role to avoid “value neutral” information because, to Reagan, “when it comes to preventing AIDS, don`t medicine and morality teach the same lessons?” As the Surgeon General, Dr. Koop expressed frustration with the Reagan 26 administration’s commitment to a moral crusade as its AIDS response. Koop explained that Reagan “reasoned anecdotally instead of examining the evidence and drawing conclusions.” To 27 the Reagan administration, the AIDS epidemic emerged because Americans had “abandoned traditional morality, and it would not get out of the situation until we returned to that morality.”28 The Reagan administration displaced national anxieties about AIDS to instead blame homosexuality in accordance with Christian heteronormativity. By approaching AIDS as a moral issue, the Reagan administration remained aligned with its conservative base while addressing the epidemic. This strategy did not effectively reduce the spread of AIDS or lessen the strain on public health agencies, but it maintained the political expediency that Reagan prioritized. The second major AIDS speech Reagan delivered was at a dinner honoring the American Foundation for AIDS Research (amfAR) in 1987. Reagan introduced his address with a joke: A man had just been elected chairman of his community's annual charity drive. And he went over all the records, and he noticed something about one individual in town, a very wealthy man. And so, he paid a call on him, introduced himself as to what he was doing, and he said, "`Our records show that you have never contributed anything to our charity." And the man said, "Well, do your records show that I also have a brother who, as the result of a disabling accident, is permanently disabled and cannot provide for himself? Do your records show that I have an invalid mother and a widowed sister with several small children and no father to support them?" And the chairman, a little abashed and embarrassed, said, "Well, no, our records don't show that." The man said, "Well, I don't give anything to them. Why should I give something to you?29 The crowd at the dinner reacted with laughter. Reagan then began to praise the many contributions to the fight against AIDS. Although this joke served as a humorous way to warm up an audience, it reflects the overall federal response to AIDS. Described as a “fable” by Shilts,

Reagan’s joke reveals the unimportance of AIDS to the administration. If Reaganomics 30 promised and enacted reductions in federal spending for essential government agencies, then why would the administration allocate sufficient spending to fight a disease that only disadvantaged gay Americans and drug abusers? The Reagan administration consistently sided with their conservative ideology when discussing AIDS, allowing politics to drive their solutions against the epidemic. By upholding the conservative moral standard as a more important and effective approach, the Reagan administration only accomplished its political goals, which would not attack the health crisis at its roots. THE DEFENSE The Reagan administration received numerous criticisms for mishandling the AIDS outbreak and early epidemic. Therefore, Reagan historians avoid acknowledging the epidemic to present his presidency in a positive light. Jennifer Brier is one of the few Reagan biographers to mention AIDS and to dedicate an entire chapter on the administration’s response in A Companion to Ronald Reagan. Brier does not shy away from briefly judging the federal response; however, she concentrates on the benefits of the administration’s silence: …AIDS did more to politically rally progressives than conservatives at the end of the twentieth century and in the process became a central pillar in the political opposition to Reagan. In this respect his silence made it easier to hear all the protest chants.31

Although the federal inaction on AIDS brought several communities together and strengthened the liberal opposition against Reagan, it was at the expense of thousands of American lives for several years. Brier’s attempt to redeem the Reagan administration fails to acknowledge the needless deaths caused by inaction. Furthermore, progressive political opposition is not effective when an epidemic is slaughtering its members. Despite the initial stigmatization, the AIDS epidemic did not exclusively target gay communities. The politicization of the AIDS epidemic only served to benefit the Reagan administration, a strategic silence that endangered the entire nation. THE DANGERS During the first five years of the AIDS epidemic, historians can observe a story of extermination and expediency. When the United States could combat this disease, the federal government abandoned its citizens. The silence from the Reagan administration represented the Christian conservative base; Reagan embodied this political base’s lack of sympathy and abundance of homophobia. By demonizing homosexuality and dismissing the disease, the Reagan administration's deliberate silence secured the support of the Religious Right and other homophobic voters. Reagan understood how to communicate with his conservative constituency, even if nothing was said at all. However, the silence from the Great Communicator did not come without consequences. The federal government's inaction resulted in thousands of American deaths, slowly and painfully deteriorating from an incurable, lifelong disease. By the end of Reagan’s first term in 94 1985, there were over 12,000 American deaths from AIDS. Yet, this tide of death that swept through the United States was only the first wave. By 1990, there were 120,453 reported deaths, nearly ten times more than in 1985. In 2000, the total death count jumped to 448,060. , By 32 2019, AIDS had claimed the lives of 675,000 Americans. Many of these deaths were 33 preventable, but due to the Reagan administration’s politicization, the United States failed to initially implement a productive strategy on a seemingly nonpartisan health issue. The dangers of politicizing the AIDS epidemic resulted in needless American deaths and a false sense of security; AIDS threatened every American, regardless of sexual orientation or political preference. By stigmatizing a community of Americans based on their sexuality during a calamity, the attempts to deliver a vaccine or cure become complicated and sluggish. This politicization pushed Americans to indulge in homophobic speech and apathy, discouraging efforts to properly address the epidemic. Americans died while the administration adopted homophobic rhetoric, overlooked medical findings, downplayed the significance of the disease, and denied sufficient funding. Tens of thousands of American deaths were expendable for the administration’s political goals. Amidst this egregious institutional indifference, one cannot help but ask: would they have waited until all that was left was complete silence?

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The Division of AIDS (DAIDS) was formed in 1986 to develop and implement the national research agenda to address the HIV/AIDS epidemic. Toward that end, the division supports a global research portfolio to advance biological knowledge of HIV/AIDS, its related co-infections, and co-morbidities. With the ultimate goal of creating an “AIDS-Free Generation,” the division develops and supports the infrastructure and biomedical research needed to:

1. halt the spread of HIV through the development of an effective vaccine and biomedical prevention strategies that are safe and desirable;

2. develop novel approaches for the treatment and cure of HIV infection;

3. treat and/or prevent HIV co-infections and co-morbidities of greatest significance; and

4. partner with scientific and community stakeholders to efficiently implement effective interventions.

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On the public front, AIDS hits the cover of Newsweek in August with activist Bobbi Campbell and his partner, embracing a radical image of love and visibility. By September, the CDC confirms the major routes of HIV transmission, including sex, shared needles, and blood products, while ruling out spread through casual contact.

As the death toll nears 600, discrimination cases, international surveillance, and Congressional hearings begin to shape a more urgent response. 1983 marks a turning point when AIDS is no longer an unnamed mystery; it’s a recognized epidemic with a rising movement behind it.

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U.S. President Ronald Reagan says the word “AIDS” in public for the first time in 1985 calling it “a top priority” and defending his administration against criticisms that funding for AIDS research is inadequate.

In June 1993, President Bill Clinton established the White House Office of National AIDS Policy (ONAP), marking a significant commitment to addressing the HIV/AIDS crisis in the United States. As a key component of the White House Domestic Policy Council, ONAP is responsible for coordinating ongoing government efforts to reduce the number of HIV infections nationwide. The Office prioritizes prevention through comprehensive education initiatives and plays a crucial role in coordinating care and treatment for individuals living with HIV/AIDS.

Additionally, ONAP collaborates with the National Security Council and the Office of the Global AIDS Coordinator, working alongside international organizations to ensure that America's response to the global pandemic is harmonized with broader prevention, care, and treatment strategies worldwide.

1988 Congress passes the first comprehensive AIDS legislation—the Hope Act of  

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1990, U.S. Congress enacts The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. U.S. Congress enacts the Americans with Disabilities Act (ADA), which prohibits discrimination against persons living with HIV.

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The Joint United Nations Programme on HIV/AIDS (UNAIDS) is established to coordinate a global response to the pandemic.

2003 During his State of the Union address, President George W. Bush announces his Emergency Plan for AIDS Relief (PEPFAR), a five-year, $15 billion initiative to fight HIV/AIDS, primarily in Africa and the Caribbean.

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In 2013 

• President Obama issues an Executive Order directing Federal agencies to prioritize supporting the HIV care continuum as a means of implementing the National HIV/AIDS Strategy. The HIV Care Continuum Initiative aims to accelerate efforts to improve the percentage of people living with HIV who move from testing to treatment and—ultimately—to viral suppression.

• President Barack Obama signed the HIV Organ Policy Equity (HOPE) Act (pictured), which will allow people living with HIV to receive organs from other HIV-positive donors. The HOPE Act has the potential to save the lives of about 1,000 HIV-positive patients with liver and kidney failure annually

Despite decades of research, activism, and treatment advances, HIV/AIDS remains a significant global health challenge, with close to $40 million people worldwide living with HIV,  53% being women and girls. Approximately 88.4 million people have acquired HIV since the start of the epidemic, and 42.3 million have died from AIDS-related illnesses. Stigma and discrimination still create barriers to testing, treatment, and support for many affected communities; however, global organizations and governments continue to work on expanding access to healthcare, combating misinformation, and addressing social inequalities that fuel the epidemic. Prevention strategies, such as Pre-Exposure Prophylaxis (PrEP) and widespread education, have helped reduce new infections in many regions.

Innovations in research bring hope, with ongoing trials for vaccines and potential cures. Meanwhile, the legacy of early activists and celebrities who spoke out against HIV/AIDS continues to inspire new generations to advocate for awareness, compassion, and funding.

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• In 2025, abrupt and significant cuts to U.S. foreign aid jeopardized critical HIV/AIDS programs across the globe. Countries like South Africa and Eswatini, which rely heavily on American funding through PEPFAR and USAID, faced immediate shortfalls, leading to the closure of treatment centers and the scaling back of prevention efforts. Global health leaders, including UNAIDS, warned that without urgent action, these cuts could result in over 6 million new HIV infections and 1.6 million additional AIDS-related deaths by 2030, threatening decades of progress in the global fight against HIV/AIDS.

At the end of 2023, 30.7 million people out of a total of 39.9 million people living with HIV worldwide were on life-saving treatment — four times higher than the 7.7 million who were on treatment in 2010. Since 2010, AIDS-related deaths have been halved and new HIV infections among children have been reduced by 62%.

At a special event at the UN General Assembly, co-convened by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, leaders pledged to sustain and accelerate investments, political leadership and policy reforms that will continue the momentum needed to end AIDS and sustain progress beyond 2030.

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• We work to expand access to and improve prevention, diagnosis, and treatment approaches; develop new prevention tools; and advocate for needed resources and policy changes.