#aids and hiv

[im-enoch]

Shoutout to all my friends with STDs, you aren't "dirty" or "damaged", unfuckable or unloveable, you are valuable and super hot!!!!

[pandemic-info]

Referred to as "the Dusseldorf patient" to protect his privacy, researchers said he is the fifth confirmed case of an HIV cure. Although the details of his successful treatment were first announced at a conference in 2019, researchers could not confirm he had been officially cured at that time.

Today, researchers announced the Dusseldorf patient still has no detectable virus in his body, even after stopping his HIV medication four years ago.

[politijohn]

Source

This entire article is worth the read. Fuck Gilead

[h1p3rn0v4]

 El lenacapavir, administrado en forma de inyección dos veces al año, ha demostrado tener buenos resultados en la prevención del VIH. Detuvo la infección en un ensayo en el que participaron niñas y mujeres de Sudáfrica y Uganda, y ofreció una protección casi completa en un segundo ensayo en el que participaron principalmente hombres de Argentina, Brasil, México, Perú, Sudáfrica, Tailandia y Estados Unidos.

Gilead se ha enfrentado a presiones para que el lenacapavir esté disponible lo antes posible y al menor precio posible en todo el mundo. Ya está aprobado como tratamiento para el VIH y se vende por 42.250 dólares al año bajo el nombre de Sunleca en Estados Unidos. Los investigadores afirman que podría producirse de forma rentable por tan solo 40 dólares (30 libras esterlinas) por paciente y año.

[queersatanic]

Happy birthday, Duane.

[allthegeopolitics]

Fewer people contracted HIV last year than at any point since the rise of the disease in the late 1980s, the United Nations said Tuesday, warning that this decline was still far too slow. Around 1.3 million people contracted the disease in 2023, according to the new report from the UNAIDS agency. That is still more than three times higher than needed to reach the UN's goal of ending AIDS as a public health threat by 2030. Around 630,000 people died from AIDS-related illnesses last year, the lowest level since a peak of 2.1 million in 2004, the report said ahead of World AIDS Day on Sunday.

Continue Reading.

[bobwess]

HIV used to be a death sentence, and a fast one. Modern medication has done wonders to bringing people's life expectancy back to normal, decreasing transmission rates and risks, and even in a handful of cases completely curing the virus. There is some good news out there.

[reasonsforhope]

"A large clinical trial in South Africa and Uganda has shown that a twice-yearly injection of a new pre-exposure prophylaxis drug gives young women total protection from HIV infection.

The trial tested whether the six-month injection of lenacapavir would provide better protection against HIV infection than two other drugs, both daily pills. All three medications are pre-exposure prophylaxis (or PrEP) drugs.

Physician-scientist Linda-Gail Bekker, principal investigator for the South African part of the study, tells Nadine Dreyer what makes this breakthough so significant and what to expect next.

Tell us about the trial and what it set out to achieve

The Purpose 1 trial with 5,000 participants took place at three sites in Uganda and 25 sites in South Africa to test the efficacy of lenacapavir and two other drugs.

Lenacapavir (Len LA) is a fusion capside inhibitor. It interferes with the HIV capsid, a protein shell that protects HIV’s genetic material and enzymes needed for replication. It is administered just under the skin, once every six months.

The randomised controlled trial, sponsored by the drug developers Gilead Sciences, tested several things.

The first was whether a six-monthly injection of lenacapavir was safe and would provide better protection against HIV infection as PrEP for women between the ages of 16 and 25 years than Truvada F/TDF, a daily PrEP pill in wide use that has been available for more than a decade.

Secondly, the trial also tested whether Descovy F/TAF, a newer daily pill, was as effective as F/TDF...

The trial had three arms. Young women were randomly assigned to one of the arms in a 2:2:1 ratio (Len LA: F/TAF oral: F/TDF oral) in a double blinded fashion. This means neither the participants nor the researchers knew which treatment participants were receiving until the clinical trial was over.

In eastern and southern Africa, young women are the population who bear the brunt of new HIV infections. They also find a daily PrEP regimen challenging to maintain, for a number of social and structural reasons.

During the randomised phase of the trial none of the 2,134 women who received lenacapavir contracted HIV. There was 100 percent efficiency.

By comparison, 16 of the 1,068 women (or 1.5%) who took Truvada (F/TDF) and 39 of 2,136 (1.8%) who received Descovy (F/TAF) contracted the HIV virus...

What is the significance of these trials?

This breakthrough gives great hope that we have a proven, highly effective prevention tool to protect people from HIV.

There were 1.3 million new HIV infections globally in the past year. Although that’s fewer than the 2 million infections seen in 2010, it is clear that at this rate we are not going to meet the HIV new infection target that UNAIDS set for 2025 (fewer than 500,000 globally) or potentially even the goal to end Aids by 2030...

For young people, the daily decision to take a pill or use a condom or take a pill at the time of sexual intercourse can be very challenging.

HIV scientists and activists hope that young people may find that having to make this “prevention decision” only twice a year may reduce unpredictability and barriers.

For a young woman who struggles to get to an appointment at a clinic in a town or who can’t keep pills without facing stigma or violence, an injection just twice a year is the option that could keep her free of HIV.

What happens now?

The plan is that the Purpose 1 trial will go on but now in an “open label” phase. This means that study participants will be “unblinded”: they will be told whether they have been in the “injectable” or oral TDF or oral TAF groups.

They will be offered the choice of PrEP they would prefer as the trial continues.

A sister trial is also under way: Purpose 2 is being conducted in a number of regions including some sites in Africa among cisgender men, and transgender and nonbinary people who have sex with men.

It’s important to conduct trials among different groups because we have seen differences in effectiveness. Whether the sex is anal or vaginal is important and may have an impact on effectiveness.

How long until the drug is rolled out?

We have read in a Gilead Sciences press statement that within the next couple of months [from July 2024] the company will submit the dossier with all the results to a number of country regulators, particularly the Ugandan and South African regulators.

The World Health Organization will also review the data and may issue recommendations.

We hope then that this new drug will be adopted into WHO and country guidelines.

We also hope we may begin to see the drug being tested in more studies to understand better how to incorporate it into real world settings.

Price is a critical factor to ensure access and distribution in the public sector where it is badly needed.

Gilead Sciences has said it will offer licences to companies that make generic drugs, which is another critical way to get prices down.

In an ideal world, governments will be able to purchase this affordably and it will be offered to all who want it and need protection against HIV."

-via The Conversation, July 3, 2024

[oneinchbarrier]

[worldspotlightnews]

The US helped prevent AIDS from being a death sentence in Africa. Now the epidemic is at a crossroads | CNN

Tembisa, South Africa CNN  —  Fourteen-year-old Philasande Dayimani carries a burden that no child should carry. Last year, she started getting sores in her mouth and struggled to breathe. She says a clinic doctor told her to test for HIV. “It wasn’t easy for me to accept. Many people cry when they hear about their status. I also cried,” she says, seated in her small shack in Tembisa, an…

[queerasfact]

Condoman

In 1987, Indigenous sexual health worker Aunty Gracelyn Smallwood and her team felt that safe sex advertising wasn’t effectively targeting people in Australia’s remote Indigenous communities. In response, they created Condoman - “The Deadly Predator of Sexual Health” - who spoke to Indigenous people in language they could relate to, and removed stigma from conversations about sexual health. 

Condoman became something of a cult figure in Australia, and in 2009 he was relaunched with a suite of comics, animations, and merch, including branded condoms. He was also joined by his “deadly, slippery sister” Lubelicious, who promoted consent, the use of water based lube, and women’s health, for her sisters and sistergirls (an Indigenous term analogous to trans women).

We covered Condoman in our podcast on the AIDS epidemic in Australia.

Keep an eye on this blog throughout the week as we continue highlighting queer Aboriginal and Torres Strait Islander history and culture for NAIDOC Week.

[politijohn]

Source

[icemav86]

1980s/1990s safe sex posters part 2

[part 1]

[southeastasianists]

It was the mid-1980s when Paul Toh came of age as a gay man, decades before smartphones and dating apps made sex a lot more accessible right at your fingertips. Toh has been diagnosed with HIV since 1989. 

Now semi-retired with his own business distributing antiretroviral therapy medication and HIV pre-exposure prophylaxis (PrEP), the 59-year-old said that in those days, cruising in public parks, toilets, and back alleys of dirty shophouses along pre-cleanup Singapore River for sex was par for the course. 

Unsurprisingly, cruising in public made gay men easy targets for police officers. “They started going to these cruising grounds undercover, with the explicit intention of entrapping and arresting gay men,” Toh added.

Police raids in nightlife establishments with gay clientele also became common, with prominent gay discotheque Niche having its liquor license withdrawn by the police in 1989 and the Rascals incident of 30 May 1993, in which multiple patrons were arrested for not having their NRICs on them. This came to be remembered by veteran activists as Singapore’s Stonewall. 

Fear about the spread of AIDS was part of the reason why police intensified their clamp down on queer spaces. In April 1987, Singapore experienced its first AIDS-related death. And one year later, the Director of Public Affairs of the Singapore Police Department said in a Straits Times article that “homosexual activities have been strongly linked to the dreaded AIDS disease,” making it an “added reason in the public interest for police to disallow homosexuals to convert places licensed for entertainment into places where they can congregate.”

Iris’ Work of Fighting Stigma

76-year-old health advisor Iris Verghese was among the first health workers to rise to the occasion when Singapore reported its first HIV/AIDS cases. 

“I knew just as little about HIV/AIDS as everyone else,” said the retired nurse, who first joined Middle Road Hospital, a now-defunct treatment centre for sexually transmitted diseases, in 1974. As part of her job, Verghese was tasked with contact tracing people who had sexually transmitted infections. 

The job brought Verghese to brothels and nightclubs in Geylang’s red-light district, which meant she was no stranger to serving society’s Others with kindness. 

“A lot of it has to do with my faith.”

“I thought about my role models like Jesus and Mother Teresa—they didn’t care what illness you had. If they could hang out with people with leprosy, then who am I to refuse to care for those with HIV/AIDS?”

Verghese’s work is well-documented, and everyone has given her the accolades she deserves—from President Halimah Yacob to the Roman Catholic Archdiocese of Singapore to the Straits Times, which named her an everyday hero in 2019.

Plague, a 15-minute short film by Singaporean filmmaker Boo Junfeng, captures the emotional gravity of the care work performed by Verghese and health workers like herself. 

The emotionally-stirring film is inspired by Verghese’s work with HIV/AIDS patients in the ’80s and offers a look into the life of Jamie, a patient who stopped coming to the clinic for treatment and counselling.

In the film’s climax, set in the patient’s HDB flat, Verghese tries to dissuade Jamie from inflicting internalised stigma. Jamie insists on using disposable plastic cups and utensils and cleaning every surface he touches for fear of passing the virus to his loved ones.

Wanting to prove that HIV/AIDS is not transmissible through saliva, Verghese takes Jamie’s plastic cup and drinks from it. She then hands him a regular glass, beckoning for him to drink from it, only for him to swipe it away, breaking the glass and cutting himself in the process. 

Thus comes the true test of Verghese’s dedication to her profession as she steels herself to the drastically heightened risk. Now that her patient is bleeding, she is dealing no longer just with saliva, but with blood carrying the virus. 

In our interview, Verghese recalled many incidents like these. One that stuck with me was her counselling session with Singapore’s first HIV patient, a young gay professional, in 1985. “As I listened to him and gave him a hug, he broke down and cried,” she said. “He said he felt so good afterwards.”

Safe Sex Outreach in the 80s

“Things were very different in the ’80s and ’90s,” said Professor Roy Chan, Founding President of Action for AIDS Singapore (AfA). AfA is a non-government organisation founded in 1988 to fight HIV/AIDS infection in Singapore. 

“There was no internet then. When we set up AfA, we had to rely on word of mouth, phone calls, faxes, pagers, and so on. Mobilisation was not as easy then, but we overcame the obstacles we faced. It was very much more hands-on in those days,” Chan recalled. 

Chan set up AfA as a non-governmental organisation in 1988 to respond to the needs of people living with HIV/AIDS, regardless of their sexual orientation or gender identity, as well as to advocate for greater action and awareness around HIV/AIDS. 

AfA was also one of the first community groups in Singapore that served the needs of LGBTQ+ individuals—namely men who have sex with men—disproportionately affected by HIV/AIDS. 

“Back then, people didn’t have as much access to the internet as we do today, meaning that accurate information on HIV/AIDS was much harder to come by, making education efforts vital,” Chan recalled. “On the flip side, no internet meant the gay nightlife scene was more vibrant than what it is today.” 

Since the gay community in the 1980s and 1990s did not have the internet and mobile phone apps to meet other people online, they had to go to physical spaces to fulfil their need for connection, whether it was nightlife establishments or cruising grounds.

Gay clubs were hence crucial in AfA’s outreach programs on safe sex practices back in the ’80s—even if it meant risking the possibility of police raids.

Back then, there were very few places in Singapore where gay men felt safe enough to gather in abundance, making gay clubs a viable hub for outreach and education.

AfA’s outreach efforts endure today in the form of the Mobile Testing Van initiative on weekends. The van, parked outside popular gay nightlife spots in Singapore, aims to bring HIV testing closer to the public, bridging the fear and stigma of walking into a stand-alone clinic to get tested.

The Consequence of Outreach

The people brave enough to put themselves out there to serve a larger cause were but a small minority, especially given the cultural milieu of the time. 

“There was so much that was unknown about HIV/AIDS even among the medical community, much less the general public,” said Verghese.

“Even at Middle Road Hospital, two doctors resigned, and twenty-five nurses asked to be transferred out.”

AfA’s awareness campaigns and fundraiser drives drew a lot of publicity—and no doubt some backlash.

Still, beneath all the headlines and the star power lent by high-profile celebrity allies was the silence surrounding individual HIV/AIDS cases. 

“It was all very hush-hush. People didn’t want to talk about it. No one wanted to know who died of AIDS,” Verghese shared when I asked if the atmosphere in the 90s was similar to that depicted in films and drama series such as The Normal Heart and Pose. 

The shows portrayed the HIV/AIDS crisis in the disease’s epicentre in New York as being a time of deaths and countless funerals attended by surviving gay men. 

One exception to this veil of silence was Paddy Chew, the first Singaporean person to come out publicly as being a person living with HIV/AIDS. 

Chew—well-known for his one-man autobiographical play Completely With/Out Character—told Verghese and her husband that he wanted no crying at his funeral. 

“He asked me to arrange his funeral such that his ashes will be thrown into the sea from a Singapore Armed Forces boat,” said Verghese. She and Chew’s close friends were instructed to be dressed in their party best, with helium balloons that were to be released out at sea. 

“There was one helium balloon that drifted away from the other balloons. To me, that felt like it was Paddy’s soul saying goodbye to us one last time.”

A Tale of Two HIV Diagnoses

Perhaps by coincidence—or not, since Verghese was one of the very few nurses dedicated to caring for HIV/AIDS patients at the time—Toh’s then-partner was also one of Verghese’s patients. 

“My then-partner Freddie and I handled our HIV diagnoses very differently, but of course, we also came from very different backgrounds and life experiences,” said Toh. 

“I found out about my status because an ex-lover of mine had come down with pneumocystis pneumonia (PCP). I flew to Sydney for a diagnosis so that I wouldn’t be registered in the local system here if I was found to be positive.” 

On the other hand, Freddie found out about his HIV-positive status because he was a regular blood donor. Not only was his diagnosis inevitably recorded in the national registry, but Freddie also ran into legal trouble. He was charged in court for false disclosure of his sexual activity. 

“Because of how the entire trial turned out, Freddie was sentenced to imprisonment for twice the expected duration. It affected his entire outlook in life, feeling like he was being framed by a bigger power with an agenda, with the whole world against him,” said Toh, who cared for Freddie until he passed in 2008. 

Toh, on the other hand, took his diagnosis as an opportunity to re-evaluate his life and make the most of the eight years that the doctor told him back in 1989 he had left to live. 

“When I received my diagnosis, the only thing in my mind was this: it is the quality of life that matters, not the quantity.” And so, the two spent the next few years of their lives travelling the world, making their remaining years as meaningful as they could be. 

Anything for a Chance at Life

Maximising his remaining years did not stop at travel for Toh. Having managed to get his hands on antiretroviral therapy in Sydney in the form of azidothymidine (AZT), he went on to look for more effective forms of medication while the technology was being developed in real-time. Toh wanted to help other HIV patients like himself. 

In 1994, Toh joined the Asia Pacific Network of People with HIV/AIDS (APN+), a regional network advocating for the improvement of the lives of people with HIV/AIDS in the Asia-Pacific region, later becoming a Board member and secretariat.

“North America and Europe were progressing swiftly in their battle against HIV/AIDS thanks to the work of activists there putting pressure on their governments and the medical community to channel funding towards the research and development of suitable treatment for HIV/AIDS,” said Toh.

“In Asia, however, it’s a different story. We had to be street smart in our advocacy while also looking elsewhere for allies.”

This meant looking to donors in the West who could be persuaded to recognise the importance of HIV/AIDS advocacy in Asia.

“I was very lucky to have the opportunity to be one of the first few Asians who had access to HAART, said Toh. 

HAART (Highly active antiretroviral therapy) is a triple-combination of antiretroviral drugs discovered in 1996 by Professor David Ho. Toh had been invited to attend the 11th International Conference on AIDS in Vancouver, Canada, where the discovery of this triple cocktail was announced. 

Within three months of beginning HAART treatment in 1996, Toh saw his health improving tremendously, with his CD4 count—a measure for the immune system of PLHIV—increasing exponentially and his viral load becoming undetectable within the fourth month. 

Although Toh already had a supply of free antiretroviral medication from his healthcare provider in Sydney, he continued to look elsewhere for alternative sources for patients who were unable to afford the patented medication. 

“Unlike Taiwan, Hong Kong, and South Korea, where medication for HIV/AIDS was provided to patients for free, Singapore was the only Asian Tiger which did not do so,” said Toh. 

“Meanwhile, pharmaceutical companies in developing countries like Brazil, India, and Thailand were manufacturing their own generic antiretroviral medication in spite of patent laws, making it more affordable.”

While still not free, MOH announced in 2020 that HIV medication would become subsidised.

Singapore’s Very Own ��Buyers Club’

With patented HIV/AIDS medication in the ’80s continuing to be inaccessible to many who needed it, buyers clubs—similar to the one featured in the 2013 film Dallas Buyers Club—would soon emerge worldwide, including Singapore. 

“The funny thing was that Australia had easy access to HIV/AIDS medication, so there was a lot of stock available in Sydney,” said Verghese. A family vacation down under in 1987 turned into an informal research trip for her to network and gather the information that she needed to perform her job optimally. 

During her trip, she met HIV researcher Dr David Cooper, who brought her to Albion Street Centre (now known as The Albion Centre), which specialises in HIV/AIDS management. 

Through her newfound contacts, Verghese managed to get her hands on some of the unused stocks of medication in Sydney back to Singapore for her support group. 

“We even got the help of the Singapore Airlines flight attendants to pool together their unused baggage allowance to bring this medication back,” she recounted with a laugh. 

Antiretroviral medication was not the only asset that Verghese brought back. She learned a lot about the virus from the professionals she met in Sydney, allowing her to move faster than the national response and gather the information needed to tend to her patients. 

A Ground Up Initiative

“George Yeo was actually very impressed with what we were doing,” recounted Verghese. “He wanted to meet with the community to learn more about our efforts and arranged a closed-door meeting with us.”

The meeting was the culmination of months of sending letters to Yeo, the Minister of Health at the time. The dialogue session was held to discuss the government’s rule that mandated the bodies of AIDS sufferers to be buried or cremated within twenty-four hours of dying. 

This rule was finally lifted in December 2000, after four years of advocacy by AfA.

They argued that the policy was outdated, having been implemented in the mid-1980s when hardly anything was known about HIV/AIDS. 

“I think we’ve certainly had to prove ourselves as an organisation over the years,” Chan said. “There might have been concerns among some who thought of us as a gay rights organisation, or misconceptions that AfA worked solely on issues that concern gay people.”

“But we’ve proven ourselves over the years to be a serious and effective organisation tackling HIV/AIDS and sexual health with clear metrics of success, and the results and continued support from the government speak for themselves,” added Prof Chan. 

Toh, who served as AfA’s Executive Director from 2007-2009, concurs. 

“Actually, not many people know this, but MOH has been quite supportive of AfA over the years. Even during my term, they would hold closed-door discussions with us, intently wanting to work with us on eliminating HIV/AIDS,” said Toh. He reckoned that MOH did not want to be publicly seen as supporting something considered by society as ‘morally corrupt’ no matter how beneficial it is to wider society. 

The Fruits of Our Predecessors’ Labour Are Not Handed on a Silver Plate

The history of HIV/AIDS and its role in fomenting community-building among the LGBTQ+ community has always been a topic of fascination for me.

I can only imagine what it must have been like to see everyone in your social circles and communities succumbing, one by one, to an unknown disease. 

Covid-19 provided the closest representation of the tumultuous and uncertain time in the ’80s.

In the midst of writing this, however, the comparison became a much closer one. Monkeypox is now affecting men who have sex with men more than the rest of the general population. 

“It’s not the same thing,” Chan said, cautioning against making blanket comparisons between monkeypox and HIV/AIDS.

“For starters,” he intoned, “monkeypox is not an unknown disease. We’ve known about monkeypox for decades, so it is nothing close to HIV back in the ’80s.”

Admittedly, life is easier for a gay man like me, who came of age at a time when HIV/AIDS is no longer considered a significant threat. 

With common knowledge of medication as well as preventative measures like safer sex and pre and post-exposure prophylaxis (PrEP and PEP), it is easy for me and my peers to take for granted the freedoms that we now enjoy, thanks to decades of advocacy and destigmatisation. 

But as Prof Chan said, “It is important not to be complacent. The freedoms and advancements we have today were not handed on a silver platter. Earlier generations had to fight very hard for all of these things.”

[otherbombdotcom]

From the lack of care for community health, to the constant thread of eugenics, and disproportionate effect on people of color and queer people the similarities between the HIV/AIDS epidemic and the ongoing covid pandemic are eerie.

[vaspider]

My question about the AIDS crisis, I'm mostly asking you because like I said, I don't think I was googling the right things, so even if you could just suggest some things to google that would be more likely to get me answers, that would be really helpful.

I guess it's mostly how did AIDS (and to some extent, any STD) become so widespread? I know that it spread through sexual contact and shared blood, but can you really "six degrees of separation" (god, that sounds so flippant, but i genuinely can't think how else to describe it) a chain of sexual partners and shared needles through any two people with HIV in the entire world? Maybe it's just because I'm a bit of a hermit, but while I can understand how it was so devastating once it was already widespread, I guess I'm having trouble understanding how it got such a foothold in the first place. If the first person with HIV had happened to not have a lot of sex would the AIDS crisis never have happened?

I swear I have absolutely no judgement for people that like to have a lot of sex, maybe I just have an underestimate of the amount of sex the average person has because frankly I don't have any? So I hope this doesn't sound disrespectful or anything, it's just kind of hard for me to believe those "six degrees of separation" kind of things in general when it's not like, famous people, so the realization that theoretically any two people with the same STD, on different parts of the globe, would have this string of sexual partners connecting them almost feels like there has to be something I'm missing... But when I'm googling things like "how did HIV become so widespread" and "how do STDs spread" I'm just getting things about how you should use protection and histories of *where* HIV spread rather than answering this more specific question (probably didn't help I was trying to do this research at 1am)

I mean this as kindly as possible:

What is your proposed alternate theory as to the spread of a disease which is transmitted through contact with blood, semen (and pre-seminal fluid), rectal and vaginal fluids, and breast milk? The disease does not spread through saliva or through touch which does not involve those fluids.

There are relatively rare cases of HIV spread through accidental needle sticks - according to WebMD, there are approximately 385k accidental needle sticks among health care workers per year in the US. WHO says that .7% of the global population has HIV, so for some back-of-the-napkin math, at most, you'll have about 2,700 of those needle sticks involving someone with HIV. Since (again, according to that WebMD article on accidental needle sticks), in cases of an accidental needle stick where the patient has HIV, the health care worker only has about a 1 in 300 chance of catching it (as opposed to 1 in 3 for an unvaccinated person catching hepatitis B via accidental needle stick from an infected patient). So - nationwide - you have approximately 9 people per year catching HIV from a needle stick.

And, to be clear, that fucking sucks. However, according to the Bureau of Labor Statistics, in 2022 there were approximately 14.7 million health care workers in the US. Not all of these people have equal risk for accidental needle sticks, but there's only so much research I'm gonna do for rough math to answer an ask on Tumblr.

The average US health care worker has approximately - again, based on my back-of-the-napkin math - 0.00000544% chance of contracting HIV from an accidental needle stick. It's astronomically more likely that a random health care worker will die from tripping over an extension cord or breathing in a caustic chemical than that they will catch HIV.

The chances of getting HIV via blood transfusion before we started routinely testing for it were all but assured if you got blood from someone with HIV. Testing now is so stringent that you have about a one in two million chance of getting HIV from a transfusion. The last recorded case I could find was in 2010, and before that, it was 2002, and the 2010 case happened in part because the donor lied about his risk profile and often participated in anonymous and unprotected sex with partners of multiple genders. He really shouldn't have been accepted as a donor at all. Approximately 4.5 million Americans receive blood transfusions per year, so, like, nowadays, it is excessively unlikely, but even in the 80s, it was an edge case means of infection, not a main source of pandemic spread.

A breastfeeding parent with a detectable viral load has about a 15% chance of transmitting HIV through breast milk. Likewise, HIV can be - and was - transmitted to babies during birth because of contact with vaginal fluid or blood, but, again, these relative edge cases are not the things pandemics are made of.

I want to stress that I am not in any way minimizing the absolute tragedy of the AIDS crisis, and I am not dismissing the fact that these methods of transmission are possible and did cause significant disruption to blood banks, stress for pregnant people with HIV, and so on. They just simply are not major methods of transmission, and never were.

With all of that said... what is your proposed alternate method of transmission, with these facts in hand? What do you think happened? Genuinely, this question is so baffling to me.

I think it's important to understand that before the emergence of HIV, most of the STIs we had were at that point either considered an annoyance (warts, HPV) or were extremely easy to treat and cure (syphilis, once a death sentence, became basically a non-issue for most people in the US as long as they were getting tested relatively frequently, and most other common STIs even today can be cured with a single course or even a single dose of antibiotics).

With that in mind, a lot of people, including a lot of queer people, were having a lot of unprotected sex. For people who could become pregnant, the advent of the pill and access to legal abortion meant that they didn't have to become or stay pregnant if they didn't want to, and for cis gay men, the prevalence of antibiotics meant that the vast majority of STIs were a brief inconvenience at worst.

So allo people did one of the things that allo people (and some ace people!) love to do:

They fucked. A lot. They fucked without fear of much consequence in terms of infection, and because it was much riskier to bring someone home where you could be seen, a lot of gay men cruised, fucking in parks or in literal back alleys or the bathrooms of clubs. They worried about getting arrested or getting caught and having their names in the newspaper much more than they worried about STIs. Sex workers, including trans sex workers, fucked in cars or hotels or... wherever the money was, because survival sec work is ... survival.

So... yeah. What is your proposed alternate theory, here? I am truly baffled at what you think otherwise happened, given a disease with a very narrow route of infection.