Ronald Reagan, the President of the United States from 1981 to 1989, oversaw the United States response to the emergence of the HIV/AIDS crisis. His actions, or lack thereof, have long been a subject of controversy and have been criticized by LGBTQ and AIDS advocacy organizations.

AIDS was first medically recognized in 1981, in New York and California, and the term AIDS (acquired immunodeficiency syndrome) was adopted in 1982 to describe the disease. Lester Kinsolving, a reporter in the White House press pool, attempted to ask early questions on AIDS during White House press briefings, but his questions were not taken seriously. The 1985 illness and death of Rock Hudson from AIDS marked a turning point in how Reagan and much of the American public viewed AIDS, with major policy shifts and funding increases coming in the wake of his death. Reagan did not publicly acknowledge AIDS until 1985 and did not give an address on it until 1987.

Reports on AIDS from Surgeon General C. Everett Koop in 1986 and a commission led by James D. Watkins in 1988 were provided to the Reagan administration and offered information about AIDS and policy suggestions on how to limit its spread. Towards the end of his presidency in 1988, Reagan took some steps to implement policies, mainly those suggested in the Watkins Commission report, to stop the spread of AIDS and help those who were infected. These policies included notifications to those at risk of infection and barring federal discrimination against civilian employees with AIDS, though these actions have been criticized as not wide enough in their scope and too late in the crisis to prevent the deaths of tens of thousands of Americans.

As gay men, transgender women, and LGBTQ people in general were disproportionately afflicted with AIDS, some critics have suggested that Reagan's lack of action was motivated by homophobia, though other commentators have put forth alternate explanations such as political inconvenience or ignorance. A common belief at the time held that AIDS was a "gay plague", and many social conservatives of the time, including some in the White House, believed the response to the crisis should center homosexuality as a moral failing. Reagan's response to AIDS is generally viewed negatively by LGBTQ and AIDS activists, as well as epidemiologists, while other commentators and scholars have defended aspects of his AIDS response. Criticism of Reagan's AIDS policies led to the creation of art condemning the government's inaction such as The Normal Heart, as well as invigorating a new wave of the gay rights movement.

Background HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a disease characterized by a greatly weakened or destroyed immune system, caused by human immunodeficiency virus (HIV), which attacks the body's immune system. AIDS was first identified in mid-1981, as doctors in Los Angeles and New York City noticed a series of clusters of unusual infections, specifically Kaposi's sarcoma and Pneumocystis pneumonia, in sexually active gay men, diseases which are normally only found in immunocompromised patients. The disease was initially known as GRID (gay-related immune deficiency), and for a short period as the "4H disease" for "Homosexuals, Heroin addicts, Hemophiliacs and Haitians" as the predominately affected groups. As HIV has the ability to infect any person, AIDS had taken over as the term of choice by mid-1982.

HIV was first identified as the cause of AIDS and isolated in parallel by researchers Luc Montagnier in France and Robert Gallo in the United States in 1983 and 1984. Without treatment, HIV is inevitably fatal, with a median survival time of 8–10 years. The first treatment for HIV/AIDS, AZT, was not approved by the Food and Drug Administration (FDA) until 1987. In the United States, AIDS disproportionately affected, and continues to affect, members of the LGBTQ community, with gay men and transgender women being the most at risk.

Ronald Reagan Pre-presidential views on homosexuality Ronald Reagan was an actor in the 1940s and 50s, and entered politics in 1966 to run for Governor of California, a position which he won and subsequently served in from 1967 to 1975. In 1967, while Reagan was in his first year in office as Governor, two close advisors of Reagan, Richard Quinn and Phil Battaglia (his chief of staff), were outed as gay in an article by Jack Anderson. Reagan had campaigned on ending "moral decline", and as many in this period viewed consorting with homosexual men as counter to this goal, Reagan chose to fire the men rather than face political backlash. However, Reagan was reportedly privately outraged that the sex lives of private citizens was considered to be newsworthy material. In 1978, three years after leaving the governorship, Reagan publicly opposed the Briggs Initiative, which would have banned gay men and lesbian women from teaching in California public schools; his opposition was key to the defeat of the initiative. Reagan and his wife after 1952, Nancy, were also friends with a number of openly gay men, as well as men whose homosexuality was an open secret, such as Roy Cohn, Jerry Zipkin, Truman Capote, and Ted Graber. Nancy in particular had many gay men in her inner circle, and at one point the Reagans even invited Graber to spend a night at the White House along with his partner.

1980 presidential election

Ronald Reagan was elected as President of the United States on November 4, 1980, and took office on January 20, 1981. The evangelical group Christians for Reagan, organized by Christian Voice, paid for a barrage of ads in Southern states during the final weeks of the election that attacked Reagan's opponent Jimmy Carter for what they described as his gay-friendly views. The conservative Christian movement Moral Majority, led by Jerry Falwell, also backed Reagan, running television ads, fundraising and registration drives on his behalf. In the end, Reagan won two-thirds of the white evangelical vote (a voting bloc Carter had won in the 1976 presidential election) and swept every Southern state save for Carter's home state of Georgia, with white evangelical voters greatly favoring Reagan even in comparison to conservative congressional candidates.

Reagan administration response

Emergence of AIDS First mention by the White House

On October 15, 1982, the White House answered its first question about the AIDS crisis, marking the first official statement from the White House on AIDS. At a regular White House press briefing, reporter Lester Kinsolving asked a question about AIDS, leading to the following exchange with White House Press Secretary Larry Speakes:

Subsequent questions from Kinsolving

Kinsolving, despite being personally against homosexuality, continued to press Speakes on the AIDS issue over the following years. On June 12, 1983, a second exchange on the topic of AIDS occurred between Kinsolving and Speakes, in which Speakes said that the President was "briefed on the AIDS situation a number of months ago", the first public indication that Reagan was aware of the AIDS epidemic. As part of that same exchange, Speakes also jokingly insinuated that Kinsolving was gay himself, saying at a mention of fairy tales that "Lester's ears perked up when you said fairy."

On December 11, 1984, Kinsolving asked another question about AIDS, his last such exchange for which known records exist. Speakes noticed Kinsolving making his way to the front and called on him, leading to the following exchange:

Though they did not attract contemporary attention, Speakes' responses to Kinsolving's questions were later criticized for not treating the AIDS epidemic seriously after they were featured in the 2015 documentary short film When AIDS Was Funny.

1983 meetings On June 21, 1983, Reagan held a meeting with the National Gay Task Force representatives Virginia Apuzzo and Jeff Levi, alongside members of his own administration, including staff from the Department of Health and Human Services. This marked the first time the Reagan administration had met with representatives of the LGBTQ community. The meeting was described as a "get-acquainted" meeting, and discussed concerns about the AIDS epidemic and basic solutions to it, such as encouraging condom usage to mitigate spread.

However, Reagan was dissatisfied with his meeting with the task force, and in August of that year scheduled another meeting on the AIDS epidemic, this time without any representatives of the LGBTQ community, instead choosing to meet with conservative activists. Attendees of this meeting included Director of the Office of Public Liaison Faith Whittlesey, National Director of the Conservative Caucus Howard Phillips and Moral Majority representative Ron Goodwin. Goodwin advocated for closing gay bathhouses and requiring blood donors to provide sexual histories, while Phillips encouraged Reagan to put out a statement condemning homosexuality as a moral wrong and "link[ing] this statement to the AIDS outbreak", and pushed for a position of only discussing the AIDS pandemic in the context of homosexuality as a moral failing of AIDS victims. Many conservatives of the era echoed similar sentiments. Pat Buchanan, who would become the White House Communications Director for Reagan in 1985, wrote acerbically in a column on June 23, 1983: "The poor homosexuals. They have declared war on nature, and now nature is exacting an awful retribution."

According to historian Jennifer Brier, these meetings and the attitudes prevailing in them deeply complicated epidemiologists' efforts. While public health leaders and epidemiologists from the Center for Disease Control (CDC) and National Institute of Health (NIH) attempted to gain control of the epidemic, they also had to contend with Reagan's conservative advisors and aides, who wanted AIDS education to "fit the model of social and religious conservatism that posited gay men as sick and dangerous". Brier further writes that, "Staff members were flooded with material with vitriolic attacks on homosexuality." Following these 1983 meetings, there are no records of internal White House conversations on AIDS for two years. In a 2006 interview, Margaret Heckler, who was Reagan's Secretary of Health and Human Services from 1983 to 1985, stated that she had never gotten the chance to speak with Reagan about the AIDS crisis, as the Reagan administration's cabinet meetings were highly structured and AIDS had never been put on the agenda.

1984 election

In the 1984 presidential election, Reagan was re-elected as president, defeating Democratic challenger Walter Mondale in a landslide election. His support among evangelicals increased compared to 1980, as he won 78% of the evangelical vote, a group among whom many held antipathy for homosexuals and those with AIDS. Neither Mondale nor Reagan made any public statement on the AIDS during the campaign, and no reporter raised the issue with the candidates.

Funding for AIDS treatment and research