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It’s a Sin is a warning to Covid policymakers not to repeat the mistakes of the HIV epidemic

Ian Hamilton
·4-min read

“Those who cannot remember the past are condemned to repeat it,” said the Spanish philosopher George Santayana. So, Channel 4’s new series It’s a Sin is a timely reminder of how the HIV/Aids epidemic played out in 1980s Britain – and there are some clear lessons from this period that should inform our approach to the current Covid-19 pandemic.

For anyone aged under 40 and straight, this new series will be like watching a historical drama, but I remember this period clearly. I was a nurse in central London at the time. District nursing up to this point was largely about caring for older people with leg ulcers. That changed rapidly as a tsunami of referrals to visit young mostly gay and bisexual men arrived.

What It’s a Sin depicts so well is the confusion among not only the gay community but medicine, as to why this group was becoming ill with symptoms that up to then were rare in young people. In the absence of any scientific evidence, rumour and bigotry flourished, again not only among lay people but sadly healthcare professionals too. Something the first episode shows with the well-spoken character of Henry lying in a hospital ward on his own, isolated from other patients in the belief that his symptoms were contagious.

Not only did young gay men have to navigate the bigotry of society in relation to their sexuality, they had the all-consuming fear of this new virus and whether they would be next to die. None of which was helped by prejudice and misinformation which even without social media managed to circulate effectively. Sitting on the same toilet seat as someone with HIV was believed to be a way of contracting the virus – just one of many myths doing the rounds at the time.

Fortunately, much has changed and for the better in the last four decades. HIV is no longer a death sentence as evidence-based treatments have improved. Although we still have a long way to go to reduce the prejudice gay people still experience, and denying this is as much of a problem as the homophobes who spout their poison.

There are some clear parallels with the HIV crisis and Covid. The same confusion and misinformation that accompanied the emergence of HIV is visible with the coronavirus. Some of this is of course benign and more to do with the science catching up with the virus, as we are still doing with new variants and working out effective vaccines and how they should be given. But there are the all too familiar myths and ill-informed views circulating about Covid and the jabs.

The most effective way of dispelling these myths is by personal experience. Having the virus or knowing someone who has died seems to be the best way of transforming the views of Covid deniers and those who think the media is exaggerating the consequences of the latest wave of infections. Effective as this is, it’s hardly an intervention that we should rely on to win over doubters and naysayers.

There is much policymakers could learn from the HIV epidemic to help them respond to Covid, even a year on from its emergence in the UK. What was striking about the government, and a Conservative one at that, was its willingness to listen to the scientists and public health experts’ advice. As it became clear that intravenous drug users were at high risk of contracting HIV by sharing needles, the policy response was simple but effective: provide clean needles and syringes. This was one of many policy interventions that aimed to reduce transmission and did so efficiently and potently. Accompanying this was clear public messaging about HIV and transmission that is also thought to have reduced the spread of the virus and countered some bigoted ill-informed views.

Contrast this by reviewing the approach of our government to this pandemic, one year on, and we still have no strategy. We are still yo-yoing in and out of restrictions and are partly blind to rates of infection as the promised track and trace system is still to materialise in earnest. It will be a sin if our current cabinet repeats the mistakes of the HIV epidemic, which it seems determined to do.

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