In a place so ordinary: North Carolina and the problem of AIDS, 1981--1997

At the end of the 20th Century, many observers viewed HIV/AIDS as a chronic disease akin to cancer or diabetes. Despite its explosive growth and tragic history, HIV disease had become normalized in America. The disease had also disproportionately come to affect Blacks in the Southern United States. The literature and historiography surrounding AIDS, however, has largely continued to portray the epidemic as a northern, coastal, and urban problem.;In this study, I look at the twin processes AIDS normalization and southernization in North Carolina. Drawing on five interconnecting stories, I follow the epidemic's transformation from "abnormal" to "normal" in the Tarheel state and analyze what the "normalization" meant in practical terms. An investigation of the state's AIDS organizations reveals how traditional service organizations eclipsed gay organizations as the epidemic unfolded. A history of the AIDS drug, zidovudine, shows the role anti-viral therapy had on the politics, perception, and experience of AIDS at the end of the 1990s. An account of the state response to HIV/AIDS reveals how AIDS policies were negotiated and how "normalization" avoided returning to the "pre-AIDS" status quo. An examination of the disproportionate effect of HIV on African Americans in North Carolina highlights why therapeutic advances and funding increases could not overcome the historic disparities that fueled the epidemic among African Americans in the state. Finally, an overview of Jesse Helms's impact on AIDS policy provides a cursory look at the political influences and limitations that social conservatives had on AIDS policies, and indicates how scope the of the AIDS epidemic has even curbed some of the most iv oppositional combatants in the AIDS culture wars. I have drawn, for each of these, on archival data, oral histories, legal and government documents, newspaper reports, unpublished accounts, and health records. The study unfolds in three stages, from the years 1981--1986, when AIDS exceptionalism emerged, through 1986--1992, when exceptionalism institutionalized in the state and AIDS therapies emerged that began making normalization a reality, to the years 1992--1997, when AIDS became manageable and more conventional AIDS policies replaced AIDS exceptionalism in North Carolina.