Photo Credit: Book cover provided by UNC Press / Author headshot by Douglas C. Lance

In 1985 researchers and reporters alike focused their attention on the city with the highest rate of AIDS diagnoses anywhere, a city that had become colloquially known as the “AIDS Capital of the World.” This city was neither New York City nor San Francisco, nor was it to be found in Haiti, all places that had become identified with the new disease. The place with the highest per capita rate of the most fearsome epidemic on earth was a small rural community in South Florida called Belle Glade. There, public health officials were baffled by the local epidemic, which looked altogether different from anything they had seen before.

The black soil in the fields that surround Belle Glade, also known as “Muck City,” is unbelievably rich. Since the draining of the Everglades began over a century ago, that soil has yielded countless bushels of potatoes, sweet corn, and string beans, along with tons of sugarcane. The soil is so rich because, for millennia, nearby Lake Okeechobee would overflow with heavy rains, depositing loamy black silt—the “muck” that gives Belle Glade its nickname—on the land where the town and its surrounding farms now sit. The soil is so rich, in fact, that it sometimes catches fire.

For as long as Belle Glade has produced vegetables and sugar for the rest of the country, it has attracted migrant workers from other parts of the U.S. South and the Caribbean. These men and women are overworked and underpaid. Zora Neale Hurston described life there during the 1920s in Their Eyes Were Watching God, including the “hordes of workers [that] poured in” during picking season, “permanent transients with no attachments and tired looking men with their families and dogs in flivvers.” During the 1930s, U.S. Sugar used the promise of good pay to lure Black workers to its brand-new mill in nearby Clewiston. When they arrived, the migrants found themselves plunged into debt peonage, working under white overseers who promised a beating or worse to those who tried to escape. Some decades later, Belle Glade featured prominently in the 1960 CBS documentary Harvest of Shame, which exposed terrible working conditions for migrant farm laborers across the country. “We used to own our slaves,” one farmer told reporters. “Now we just rent them.”

By the 1980s, conditions in Belle Glade had changed very little. If anything, they had gotten worse. Year-round Black residents crammed into the derelict apartment buildings, mobile homes, and shacks that dotted the old “colored town” in southwest Belle Glade. Their bodies bore scars from the field knives and machetes used to harvest lettuce, corn, and cane. During the cutting season, as many as ten thousand migrant workers flooded in from Haiti, Jamaica, and the Bahamas to work in the fields. In the midst of the sugarcane harvest, prostitution and drug use flourished. Injection drugs, popular in the early 1980s, gave way to crack cocaine as the decade wore on. A concurrent rise in rates of gonorrhea and syphilis pointed to crack’s power to lower sexual inhibitions, as users sought out multiple partners and sometimes traded sex for the drug. Not unlike the combustible soil that surrounded it, Belle Glade was fertile ground for HIV.

In the early 1980s, Dr. Ron Wiewora ran the town’s public health clinic out of a trailer on Avenue D, which runs west to east through the middle of “colored town.” By 1984 he noticed a growing number of residents seeking treatment for AIDS. He began keeping track of these patients and their connections to one another—whether they had shared needles or had been sexual partners. Around the same time, a pair of researchers from the Institute of Tropical Medicine in Miami were also homing in on Belle Glade. One of them, Dr. Mark Whiteside, treated a vegetable packer for cryptosporidiosis, a parasitic infection frequently seen in people with AIDS. The vegetable packer led Whiteside and his partner, Dr. Carolyn MacLeod, back to Belle Glade.

For Wiewora, Whiteside, and McLeod, the outbreak in Belle Glade didn’t make any sense. Most of the reported AIDS cases in America were among gay men in big cities like New York, San Francisco, and Los Angeles. But about half of the Belle Glade cases were in women, and almost all of those diagnosed were straight. The small community’s per capita AIDS rate was also five times higher than New York City’s and seven times higher than San Francisco’s.

Few of the patients they saw fit into the identified risk groups of gay men or intravenous drug users, so Whiteside and MacLeod looked for explanations that didn’t involve sex or shared needles. They proposed that the disease might be tied in some way to poverty: to the rats that scurried through apartments and shacks, or to the human excrement that lined Belle Glade’s streets and yards. Perhaps poverty and malnutrition made residents more susceptible to infection from mosquito bites, which didn’t seem to be a factor anywhere else. Whiteside presented this theory in April 1985 at the First International AIDS Conference in Atlanta. His theory—and Belle Glade—became a media sensation.

It’s easy to see why: Whiteside pointed to casual contact and the environment as vectors of transmission. The map of Belle Glade that he presented in Atlanta used stars to indicate where residents with AIDS had lived; it looked like the one that John Snow had created to trace an 1854 cholera outbreak in London to a single water pump on Broad Street, or like the maps of tuberculosis cases that Progressive Era reformers drew up to convince others of the links between poverty and disease. But both cholera and tuberculosis were much easier to spread than HTLV-III (later HIV), the newly discovered AIDS virus, was believed to be. If he was right, the deadly new disease would not confine itself to gay men or drug users, two groups that many Americans—consciously or not—saw as expendable.

Meanwhile, news reporters and TV cameras flooded to Belle Glade. As the town’s dubious notoriety grew, the local economy took a major hit. Visitors driving through Belle Glade wore surgical masks and refused to stop at the town’s fast food joints. High schools in the region balked at sending their sports teams to Belle Glade for away games. “We opened our arms to this study,” City Commissioner Harma Miller later recalled of Whiteside and MacLeod’s research, “and they bashed us with it.”

But the attention also brought in money from federal agencies and private foundations, which set up shop to study the AIDS epidemic in Belle Glade and to come up with solutions. They disproved Whiteside and MacLeod’s more alarming theories but added to researchers’ knowledge about heterosexual transmission of HIV. The two researchers had been wrong about many things, but they were right about one: many more people would be affected by the disease.

The AIDS outbreak in Belle Glade was a harbinger of the epidemic to come. The South has been the epicenter of HIV infection in the United States for some time, and African Americans have come to make up a near majority of those newly diagnosed with the virus each year. Black women are also at much greater risk for HIV than women from other groups—in 2017 they were nearly fifteen times more likely to be diagnosed with HIV than their white counterparts. But even though the relatively high rate of heterosexual transmission has distinguished the HIV epidemic in Black America, Black gay and bisexual men have been among the hardest hit: according to a 2016 estimate, one in two will contract HIV within their lifetime. For Black transgender women, solid numbers are hard to come by, but the Centers for Disease Control and Prevention estimates that 44 percent are living with HIV, compared to 14 percent for transgender women as a whole.

In short, AIDS has devastated Black America and continues to do so. My book, To Make the Wounded Whole, tells the story of how African Americans organized to fight back.

By the middle 1980s a small but growing number of African Americans knew firsthand that AIDS was not just a white gay disease. African American medical professionals such as Rashidah Hassan, a nurse and infectious disease control specialist in Philadelphia, or Pernessa Seele, an immunologist at Harlem Hospital, had seen Black people with AIDS come through their hospital doors who did not fit media stereotypes. The members of Gay Men of African Descent (GMAD) lost the group’s founder, Charles Angel, to AIDS in 1986. Reggie Williams, the African American executive director of the National Task Force on AIDS Prevention (NTFAP), received his own diagnosis of AIDS-related complex in 1986 as well. Others, such as Dázon Dixon Diallo in Atlanta, focused their energy on educating Black women about AIDS. Over time, a diverse constellation of activists, including Black writers, religious leaders, medical professionals, and recovering drug users, would pursue grassroots strategies for fighting the spread of HIV and AIDS among African Americans. Since AIDS (and now COVID-19) continues to wreak havoc on Black communities in the United States, understanding the work of African American AIDS activists is now more important than ever.


From To Make the Wounded Whole: The African American Struggle Against HIV/AIDS by Dan Royles. Copyright © 2020 by Dan Royles. Used by permission of the University of North Carolina Press.


Dan Royles (@DanRoyles) is an assistant professor of history at Florida International University, specializing in 20th Century American History, African American History, History of Sexuality, and History of Public Health and Medicine. To Make the Wounded Whole is available for purchase from UNC Press.