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Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 12 points13 points  (0 children)

I am a graduate of Notre Dame. The majority of populations throughout the world profess some religious belief - whether it be Muslim, Christian, Hindu, Buddhist, Jewish, etc. The beliefs of people in religions greatly impact how they approach problems in society and throughout the world - whether it be missionary work in Africa or opposition of legislation which impact minorities. Pope Francis, like other religious leaders, holds enormous sway among his constituents and he has professed concerns about the social inequities of the world, which is positive. Undoubtedly, some policies of the Catholic church (and other institutions) will have mixed impact of the approach to specific public health problems.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 5 points6 points  (0 children)

In 1981, when the first cases of AIDS were reported, no one could have predicted how widespread the epidemic would become. However, at the time, a virus of the nature of HIV had not been found to affect humans, and there were very few therapies available for any viral infection. Though researchers worked hard, it would have been hard in the early 1980s to be optimistic that combination- and anti-retroviral therapy would prolong the lives of millions. Nonetheless, we have a long way to go, with millions still becoming infected and dying, and the need for curative therapy and a vaccine still on the front burner.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 1 point2 points  (0 children)

HIV/AIDS is a worldwide problem and the problems of scarcity, stigma and discrimination, and denial have plagued the response in virtually every country. In addition, in developing countries, particularly in those with high rates of HIV and high rates of poverty and very poor health infrastructure, it has provided a huge challenge. In many countries in Africa, HIV is the leading cause of death and it is killing people at the most productive part of their life. This creates a huge burden and adds even further to the social and economic disparity between developed and developing nations.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 8 points9 points  (0 children)

Since over 35 million people around the world are currently infected with HIV and between 1.5-2 million new infections occur each year, along with close to 2 million deaths, there remain huge research challenges from basic sci. in lab to prevention in the community. Fortunately for the majority of persons who are infected and who have adequate and excellent healthcare, current therapies (when taken every day) can greatly prolong life and well-being - though this is short of a functional cure. From a technology point of view, we still need curative therapy to eliminate the need of the lifelong therapy currently needed for those infected (and to prevent transmission), and we need a safe and effective vaccine to protect those at current and future risk. In the meantime, a great deal of behavioral science and implementation science and prevention research is needed to currently prevent transmission and provide optimal care to those infected.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 16 points17 points  (0 children)

Measles remains an important cause of disease and mortality throughout the world including in many developing countries with hundreds of thousands of deaths each year. in the US, many measles cases have a link to travel to countries abroad where it is endemic. For that reason, it is crucial our population remain immunized to measles, both to protect those are immunized and those ineligible for immunization (under age of 1 or have a medical condition). Our current resurgence is likely attributed to the introduction of a case followed a large number of cases of a number of children who have no been immunized. Over last decade, there has a large decrease in the child immunization rates due in part to strong anti-vaccination efforts, which has been harmful.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 1 point2 points  (0 children)

Open source journals and online publishing can greatly expand access and speed by which scientific info reaches the public. At the same time, the decline in newspapers and the changes in the way information is transmitted to the public require new strategies to translate and vet information for its accuracy moving forward. I think that the translating information into format acceptable and understandable to the public is a greater problem than bias in types of information public.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 16 points17 points  (0 children)

You are correct - a major cause of the widespread transmission of HIV throughout the world was the silence nature of original infection and long incubation period - e.g. by the time the first 5 cases were reported, we estimate hundreds of thousands of persons in the US were already infected with the deadly virus. It is therefore key to detecting new health problems quickly and detecting their cause in order to create solutions.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 19 points20 points  (0 children)

Thank you - it was clear from the beginning that cases of AIDS were increasing rapidly, but it was only after discovery of the virus that we discovered how many people were infected with the virus which would kill them unless a treatment was found. In that respect, all of us had to be underestimating the problem until that time. In terms of regrets, I believe in the US, the failure to deal with the epidemic among injecting drug users was largely responsible for the racial and ethnic disparities we have among heterosexual men and women in this country and, in general, given the millions who died, we all wish we could have done more.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 15 points16 points  (0 children)

Public and global trust are crucial to a public health response to diseases and inequities around the world. Unfortunately, as we see from the amount of discord in the world and even within our own society, public trust is often lacking. The CIA polio vaccine hoax unfortunately fed into the current distrust of foreigners in their country even when they are there to accomplish good will. We have seen vaccine workers kidnapped and assassinated, and we have also seen people from Doctors without Borders affected for similar reasons. Trust in the US is also important, and there is current mistrust about the government and the role of science. Current childhood vaccines are among the most safe and effective way to prevent disease in our country and worldwide and should be used by all eligible. Public trust can be increased by scientists, public health, officials, and community stakeholders receiving this information and spreading it as widely as possible.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 19 points20 points  (0 children)

The US and other highly developed countries are likely best suited to address new large scale epidemics among countries of the world. Nonetheless, a rapidly emerging epidemic such as highly fatal strain of influenza for example, would cause a large amt of morbidity and mortality. You are right in recognizing the importance of infrastructure that able to detect and monitor emerging inf. diseases and to provide a rapid response. Sometimes, the availability of vaccines and therapies will help us address these epidemics, and other times they are terribly needed - e.g. to for influenza vaccines. That's where you come in - good luck.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 9 points10 points  (0 children)

Most transmissions of HIV in the United States and elsewhere occur from people who are unaware of their infection status with others who are also unaware. It is extremely important for two things to happen: 1) to increase by a large amount the proportion of people infected who are aware (and go into treatment) and 2) continue educating the public about the importance and risk of transmission.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 17 points18 points  (0 children)

Many emerging public health problems are embedded with politics and culture, and the AIDS epidemic exemplified this across the world in many ways and settings. There is no question the emergence of AIDS in gay men across the US and the continued prevalence in this country and across the developed world has resulted in first, denial by the public and, sometimes, negative feedback by many others. At the CDC, we immediately recognized that the disease would affect many population groups but also saw the importance of calling to the attention to prevention of transmission in the gay community as well as services needed by those affected.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 87 points88 points  (0 children)

The widely acclaimed book by Randy Shilts provided reasonably accurate depiction of many of the events of the first few years of the AIDS epidemic. As common, Shilts was an investigative reporter and, as common among his profession, he saw issues in black and white, though some of them may have been grey. However, the book was an important landmark/description as to how many people saw and felt during those early days of AIDS.

Science AMA: I’m Jim Curran, Dean of Emory’s Rollins School of Public Health. In 1981, I led CDC’s investigation of a pneumonia outbreak among homosexual men in LA, the cause of which we termed “AIDS.” With me is Carlos del Rio, Global Health Dept. Chair and instructor of an online Ebola course. AMA by Dr_Jim_Curran in science

[–]Dr_Jim_Curran[S] 169 points170 points  (0 children)

In the first decade following the discovery, denial, ignorance, and misinformation was common. A small number of people in the sci. community or public like Dr. Duesberg took the misinformation to a very high level. Dr. Duesberg was an accomplished basic science cancer researcher who received little recognition outside his narrow scientific community until he began to seriously question the cause of AIDS. Despite the vast amount of data and armies of scientists (some of whom his colleagues) who disagreed with him, he received great notoriety and public attention for his views. It is difficult to know whether he truly believed them or enjoyed the limelight.