Sabrina: Hello, Dr. Engel. Thank you for agreeing to this interview. Dr. Engel: No problem.

Let's get started. Sabrina: Okay. What is the origin of AIDS and how did it begin? Dr. Engel: It probably started as a simian virus in monkeys that was nonfatal and that had been around for hundreds of thousands of years; and sometime in the 1920s and 30s, it mutated. Do you know what mutation is? It is when genes spontaneously change. So it mutated into a form that was infectious to human beings. It started in the Belgian Congo, so it was this virus that was sitting in the monkey population in the middle of the Belgian Congo. It suddenly becomes infectious to humans and one hundred percent fatal in human beings unlike in the monkey population. The question is how long would it take until it actually reached human beings and one of the things about this virus called HIV is that it actually is a very delicate virus and does not live in air and does not spread like the common cold virus. It's a very delicate virus and it is quite hard to get and it has to be through an open cut or open sore. It almost surely did transmit to human beings at various times. There are cases like we now know, in retrospect, that somebody had AIDS and then died mysteriously in the 50's and 60's. We now know that was AIDS. What probably happened towards the 60s and 70s was that there were several revolutionary wars in Africa that involved mercenaries. Mercenaries are professional soldiers that fight wars with other countries because someone else is paying them to fight. These mercenaries that went over to the Congo from Haiti, probably contracted AIDS either from a native Congolese person or from the monkey itself; they then brought the disease back to Haiti, which is in the Caribbean, and to the capital of Haiti which is Port-au-Prince. This was a very popular among gay men as a resort place in the 60s and 70s. Gay men probably picked it up from the Haitians in the 70s and then spread it out to the gay community. Sabrina: Some people think HIV causes AIDS and others disagree. What is your opinion? Dr. Engel: No reasonable person questions that HIV is actually the cause of AIDS. It is absolutely the cause of AIDS. We can model it; we can see it through an electron microscope. We are absolutely sure of it. Sabrina: In your opinion, what role did the media play in influencing public opinion about AIDS, back in the 1980's?

Dr. Engel: It started to spread in 1981 and peaked between 1985-1986. The media was fairly responsible. There was a lot of coverage in the media. People did not know much about AIDS. People thought it was a largely in the gay community. People didn't know how it started or how it was spreading. They did not know it was infectious disease. They thought it was only through drug abuse and people didn't really know what it was. I think the science reporters of that time did a fairly responsible job. I read a lot about the old news reports in Newsweek and Time and in the New York Times and the other big newspapers and they did a pretty good job. It was actually an interesting issue, almost a reverse issue. A lot of people sort of thought and said, "Weren't the media homophobic"? "Didn't the papers get the people frightened"?, "Didn't they say it was essentially a gay disease"? In a funny way it was the opposite. It was initially a gay disease where gay men were getting it and it was spreading easily between gay men than between heterosexual couples. And in fact what was actually happening in the media, was that they were saying that it wasn't just a gay disease but everyone was at a risk of getting it. What we now know and if you look at the fairly early analysis of the epidemiology, was that it was not that everybody was going to get it. In fact, it was a disease that was quite hard to get. The vast majority of people who were getting it were gay men or using IV drugs like heroin or having sex with people using heroin. But that was not most people, as most people don't shoot heroin. So it was actually misleading to suggest that it was a disease of everybody, when several scientists at the time knew that was probably not true. But the media was so concerned that they might be accused of being homophobic that they bent over backwards the other way. That even though they could have investigated and learnt that it was a gay disease; they didn't want to say it that way. So instead they said it was a disease of everybody and we all need to worry about it and that everybody can catch it. Part of the story was how this disease was presented to the public and how the gay population mobilized themselves to sell this disease to everybody. Roy: Federal health officials in 1987 sent a message that said anybody could get AIDS. What are your thoughts on this message? Dr. Engel: That was a pamphlet that was put out by Ronald Reagan's Surgeon General, Mr. C. Everett Koop, who was a very politically conservative man and a very responsible Surgeon General. There was a lot of pressure on the Reagan administration to distance itself from AIDS because it was seen as a gay disease and because the Republicans were at the time disapproving of the gay lifestyle. Mr. Koop said that Im hired to protect the nation's health and I'm

not hired to make a judgment of people's sex lifestyles. As far as I'm concerned, it's a threat to people's health and my job as the Surgeon General is to warn and inform people. So for the first time in history we sent a mailing to every single house in the country. The explicit pamphlet was about sex and sexual practices and how you get AIDS and help people. Many people were not comfortable with it but Koop said that it was a hundred percent fatal disease and it is not a time to worry if we offend people about pictures of genitals and body parts because people could die. Koop was a little bit of the hero of the story. He was a very conservative man and a very strong Catholic and disapproving of homosexuals but he felt it was not his place to be passing judgments on people's sex lives but to be saving lives. Roy: Do you think the media was not reporting the right information to people 25 years ago? Dr. Engel: They did the best they could. No one understood this. Members of the media were frightened about maligning gay people. Because there has been a long history anti-gay discrimination in this country just like there has been a history of anti-black discrimination, anti-catholic discrimination, and anti-Jewish discrimination. This country has a history of a lot of that. So the media bent over backwards not to be homophobic. In the end they might have misled people a little with the best of intentions. Roy: What you think of the modern media on HIV and AIDS today? Dr. Engel: The disease today in wealthy countries like the United States is largely under control, not spreading and people who are getting HIV or have HIV are getting treated with combination therapy, with anti- viral medications, which works. Basically people can live with AIDS for a long time. As a story it's dropped off. It's not a story here anymore but the story if there is one is in the poor countries of Africa and Russia and parts of Central Asia where there's bad HIV epidemic because of drug use and prostitution and the media has not done a very good job of covering it but in all fairness, our American media is very America focused and we as a people are not interested in news from other countries. I don't think we do a worse job of covering AIDS in foreign countries than we do of covering any foreign stories or foreign policies. Roy: Do you believe the concern of AIDS is beginning to fade away? Not many media organizations are putting stories on it. Does the world need to know more about AIDS?

Dr. Engel: I don't think people in the US are too concerned about it right now. It's a disease like any other disease and people should be aware. I do think people are basically aware of sexually transmitted diseases and are fairly cautious. Roy: Thank you. Dr. Engel: Good luck with your project. Sabrina: Thank you Dr. Engel for agreeing to this interview.