History of HIV/AIDS

The history of HIV/AIDS in Washington, which continues to unfold through the present day, is decades-long and vast, filled with countless players and innumerable events. The following is a brief overview of HIV/AIDS in our region.

HIV in Washington

Signs of AIDS preceded the first diagnosed case in Seattle in November 1982, but Seattle never received the kind of attention around “gay cancer” or GRID (Gay-Related Immuno-Deficiency) that Los Angeles, San Francisco, and New York did.

AIDS was known, named, and linked to gay men by the time the first case received attention in Seattle.  The city council promptly set aside funds for AIDS treatment and research, becoming the second municipality in the United States to do so in 1983.

-Kevin McKenna and Michael Aguirre, A brief history of LGBTQ Activism in Seattle

Mid 1980s
Activism and Women

Gender divisions softened during the 1980s.  More lesbian spaces opened on Capitol Hill, including communal houses.  Many lesbians became involved in AIDS activism, often as caregivers for sick gay men in the group Chicken Soup Brigade.  The Northwest AIDS Foundation (NWAF) gained a seat at the table with Seattle-King County Public Health (SKCDPH) in the mid-1980s and received funding from SKCDPH for outreach in the gay community.  ACTUP (AIDS Coalition to Unleash Power) first formed in New York City as a radical protest organization that sought to draw more public attention and funds to AIDS research in 1987, and the ACTUP chapter in Seattle was quite active by decade’s end.  For example, they picketed centers of clinical trials for AIDS treatment, demanding quicker trials for faster relief.

-Kevin McKenna and Michael Aguirre, A brief history of LGBTQ Activism in Seattle

Late 1980s
Communities Coming Together

People of color responded to AIDS by forming organizations focusing on non-white AIDS patients.  One of the major groups was the People of Color Against AIDS Network (POCAAN) established in 1987. Like NWAF, POCAAN received funding from SKCDPH for outreach to communities of color.  The main goal of POCAAN was to educate gay men of color about safe sex, AIDS awareness and treatment.  These groups provided a space where gay people of color and AIDS patients could feel culturally welcomed.  Specifically, Entre Hermanos addressed its audience in Spanish and English while also combating homophobia in Latino culture.

-Kevin McKenna and Michael Aguirre, A brief history of LGBTQ Activism in Seattle

Late 1980s
Political Changes

Cal Anderson became the first gay member of the Washington State legislature when he was appointed in 1987 to serve Seattle’s 43rd District (central Seattle) in the state house.  He won election to the state senate in 1994, but served less than one year before dying of complications related to AIDS.

In early 1988, the state legislature, acting on recommendations from the Governor’s Advisory Council on HIV/AIDS, considered legislation to protect the civil rights of people living with HIV. The proposal also sought to mandate AIDS education in state schools, beginning in the fifth grade, with an emphasis on sexual abstinence (1988 Wash. Laws). To calm potential parental blowback, school districts would make materials available to parents and guardians before AIDS-centered lessons were taught. The state’s workforce would also receive education. Known as the AIDS Omnibus Act, it passed the state legislature by one vote.

Lobbyists who worked on the bill considered it a success. Viewed by many as the most progressive AIDS-centered legislation during that era, other states used it as a model. Nestled in its 25 pages was a state-assured guarantee that no one would be tested for HIV without consent — unless, as stipulated in a list of exemptions, the person was convicted of a sex offense. In short order, Washingtonians would witness how the requirement would play out.

-Rosette Royale, HIV/AIDS in Western Washington

Late 1980s
Needle Exchange Starts in Tacoma

The world’s first needle exchange programs appeared in 1983 in Amsterdam, the Netherlands, a response to local health officials seeking a solution when a pharmacy stopped selling IV drug users sterile needles and syringes. Shown to lower HIV rates, legal exchange programs arose in other countries. Not so in the U.S. — until a Tacoma man named Dave Purchase started a program in August 1998 by placing a folding chair and TV tray close to a house known to draw heroin users. He exchanged free needles. Soon supported by the Pierce County Health Department, it’s considered the first legal and publicly funded needle exchange program in the country.


In folksy tales of a bygone era, neighbors are known to borrow from each other. ACT UP Seattle members heard what Purchase had done in Tacoma and decided to apply similar tactics in the Emerald City. There was one problem: Exchanging used needles for clean ones without a prescription was illegal. To activists, potentially saving lives overrode legality.


In March 1989, ACT UP Seattle set up a needle-exchange table downtown that moved from location to location, not only to offer access to as many injection drug users as possible, but to evade police (Royale interview). Local public health officials knew the exchange program was in full swing, and some had even given it their blessing. Even so, health officials reasoned any needle exchange program should be run by health officials. Within a couple of months, the health department secured county funding and took over the program. Within years, local needle exchange annual volume surpassed 500,000 syringes.

-Rosette Royale, HIV/AIDS in Western Washington

Early 1990s
Bailey-Boushay House

In 1991, 321 people died of AIDS-related complications in King County. The ongoing death toll, contextualized with research funded by the public health department’s 1986 Robert Wood Johnson Foundation grant, demonstrated the need for AIDS hospice care. Volunteers created AIDS Housing of Washington, and together located a site on a major roadway in Madison Valley. A 35-bed nursing facility was planned. Money was raised. But the project faced a major roadblock: opposition from neighbors.


When community members learned one of numerous developers opposed to the facility sat on the board of the Seattle Art Museum, ACT UP Seattle planned to protest the museum’s upcoming gala. Museum staff tried, but failed, to convince activists to cancel their planned action. Instead, the developers caved. The facility was built. Operated by Virginia Mason Hospital, Bailey-Boushay House opened on June 24, 1992. It was the nation’s first long-term care facility and outpatient health program for people living with AIDS in the country.

-Rosette Royale, HIV/AIDS in Western Washington

Mid 1990s
Introduction of Effective Therapies

An AIDS hospice, a needle exchange program, statewide legislation protecting (most) people living with AIDS: Washington had scored multiple wins. But larger, nationwide victories were on the horizon.

In 1994, researchers announced HIV transmission from mother to infant had been reduced when mothers used AZT, a controversial drug that local people living with AIDS had tested in early trials. The same year, Saquinavir, a type of drug known as a protease inhibitor that prevents viral replication, was approved for people living with HIV. Medication, while not always affordable, was available. In 1996, the CDC announced its first decline in AIDS-related deaths since it began gathering data.

The nationwide epidemic had peaked — at least for some. AIDS still had its tenterhooks in the lives of women, people of color, and injection drug users. Globally, HIV/AIDS had become the world’s fourth-leading cause of death.

-Rosette Royale, HIV/AIDS in Western Washington

Since 2010
Current Treatment

By 2010, there were up to 20 different treatment options and generic drugs, which helped lower costs.

As of 2017, studies have shown that a person living with HIV who is on regular antiretroviral therapy which reduces the virus to undetectable levels in the blood is NOT able to transmit HIV to a partner during sex. The current consensus among medical professionals is that “undetectable = untransmittable.”

-CDC online

WA State

By 2018, the AIDS crisis had claimed 8,043 lives in Washington state, and more than 14,000 people in Washington were living with HIV. Roughly 90 percent of those were aware of their status, including in King County, which had achieved a medical milestone known as “90-90-90:” 90 percent of residents knew their status; 90 percent of that group were taking antiretrovirals; and 90 percent of that group had suppressed viral counts. King County was one of the first regions — if not the first — in the country to reach that goal.

-Rosette Royale, HIV/AIDS in Western Washington

Remembrance of those we've lost to HIV/AIDS

Finding and reading a name can help you connect with personal memories. The collection of names can show the vast impact of HIV/AIDS.