St. Marks Baths
Brief History of HIV/AIDS
Pre-1981 – The Prelude
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June 28, 1969 at 1:20am, an unexpected police
raid was carried out on a bar in Greenwich Village,
New York City. Usually, the patrons would submit
to whatever humilities the police would dole out,
but on that particular night, enough was enough.
The riots lasted five days and ultimately launched
the gay liberation movement.
The Bathhouses
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Remember Bette Midler?
Originally steam baths
Became gay sex clubs
All sexually transmitted diseases went up
dramatically
Nearly every patron became infected with HBV
during the mid and late 1970s
1981 – GRID
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A very small number of gay men show up with
very rare diseases in different cities
Docs tell local health officials, who tell the CDC
CDC sets up a surveillance system and a
classification system based on symptoms
Same thing that is being done for SARS
Recognizing AIDS
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As cases were identified, new patterns emerged
New case definition and acronym:
 Acquired
 Immuno Deficiency
 Syndrome
The Epidemiology
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Classic public health investigation
 Physicians report cases
 Public health investigators collect information and
other contacts
 Contacts are traced to figure out the network
 Patterns are compared to other diseases
 Same people, same places as HBV
Blood-borne
 Sex or Needles
1982 – 1983
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We know AIDS is blood-borne
We do not know what causes it
We know that it has the same epidemiology as hepatitis
B, and infects many of the same people
We know that hepatitis b spreads quickly through gay
bathhouses
It is pretty clear that HIV spreads in the same way
 Sexual transmission
 IV drug transmission
The Emergency Rule
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Why make a rule before ordering the bathhouses
to close?
Why do it as an emergency rule?
Who will want to oppose the rule?
What is the scientific justification for the rule?
That is the legal authority?
The Injunction
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What is the rationale for the injunction?
What is the counter argument by the bathhouse
owners and gay activists?
 How do they argue that it easier to control AIDS
by keeping the bathhouses open?
Why does the health department reject this
approach?
 What would be the burden on the health
department to use this method?
The Court's Ruling
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... defendants and the intervening patrons challenge the
soundness of the scientific judgments upon which the Health
Council regulation is based .... They go further and argue that
facilities such as St. Mark's, which attempts to educate its patrons
with written materials, signed pledges, and posted notices as to
the advisability of safe sexual practices, provide a positive force in
combating AIDS, and a valuable communication link between
public health authorities and the homosexual community. While
these arguments and proposals may have varying degrees of
merit, they overlook a fundamental principle of applicable law: "It
is not for the courts to determine which scientific view is correct in
ruling upon whether the police power has been properly exercised.
The judicial function is exhausted with the discovery that the
relation between means and end is not wholly vain and fanciful, an
illusory pretense.”