Robert Lee Rayford | |
|---|---|
| Born | February 3, 1953 St. Louis, Missouri, U.S. |
| Died | May 15, 1969 (aged 16) St. Louis, Missouri, U.S. |
| Cause of death | Pneumonia, possibleAIDS-related complications |
| Known for | Alleged first knownAIDS death in the United States |
Robert Lee Rayford[1] (February 3, 1953 – May 15, 1969),[2] sometimes identified asRobert R. due to his age, was an American teenager fromMissouri who has been suggested to represent the earliest confirmed case ofHIV/AIDS in North America. This is based on evidence published in 1988 in which the authors claimed that medical evidence indicated that he was "infected with a virus closely related or identical to human immunodeficiency virus type 1."[3]
Rayford died ofpneumonia,[4] but his other symptoms baffled the doctors who treated him. A study published in 1988 reported the detection of antibodies against HIV.[5] Results of testing for HIV genetic material were reported at a scientific conference in Australia in 1999. However, the data has never been published in a peer-reviewed medical or scientific journal.
No confirmed photos of Rayford are known to exist.[6][7]
Robert Rayford was born on February 3, 1953, inSt. Louis, Missouri. As a single parent, his mother Constance had to raise both Robert and his sibling by herself. The Rayfords lived in theOld North neighborhood of St. Louis, where the 19th-century brick homes provided affordable housing for several working classAfrican-American families such as their own.[8] Not much of Rayford's personal life was disclosed.
In early 1968, Rayford, then 15 years old, admitted himself to the City Hospital in St. Louis.[4] His legs and genitals were covered in warts and sores. He had severe swelling of the testicles and pelvic region, which later spread to his legs, causing a misdiagnosis oflymphedema.
He had grown thin and pale and suffered fromshortness of breath. Rayford told the doctors that he had experienced these symptoms since at least late 1966.
Tests discovered a severechlamydia infection which had, unusually, spread throughout his body. Rayford declined arectal examination request from hospital personnel,[9] and was described as uncommunicative and withdrawn.[4]
Memory Elvin-Lewis, a doctor assigned to his case, recalled Rayford's shy and hesitant personality: "He was the typical 15-year-old who is not going to talk to adults, especially when I'm white and he's black. He was not a communicative individual. He knew the minute I walked into the room that I wanted something more from him—more blood, more lymph fluid, more something."[8]
Rayford gave contradictory statements regarding his sexual history. At one point Rayford claimed he was "the stud of all time". At another point he claimed a young woman from his neighborhood was his only partner forsexual intercourse, and attributed his condition to sexual contact with her.[8][10]
Doctors treating Rayford suspected that he was an underage sex worker and the recipient of receptiveanal intercourse, but never considered the possibility of him being a victim of child molestation.[9][10][11] Eventually, he was moved toBarnes-Jewish Hospital, which was originally Barnes Hospital before a hospital merger.[1]
In late 1968 Rayford's condition seemed to stabilize. By March 1969, his symptoms reappeared and worsened. He had increased difficulty breathing and hiswhite blood cell count had plummeted. The doctors found that hisimmune system was dysfunctional. He developed afever and died ofpneumonia[4] at 11:20 pm on May 15, 1969.
Anautopsy of Rayford's body, which was led by William Drake, uncovered several abnormalities. Small purplish lesions were discovered on Rayford's left thigh and in his internalsoft tissue, including "of the rectum and anus." Drake concluded that the lesions wereKaposi's sarcoma, a rare type ofcancer which mostly affected elderly men of Mediterranean orAshkenazi Jewish ancestry,[12] but was almost unheard of among black teenagers.[13] Kaposi's sarcoma was later designated anAIDS-defining illness.[14]
These findings baffled the attending doctors. In 1973, a review of the case was published in the medical journalLymphology.[15]
HIV, originally called "lymphadenopathy-associated virus", or LAV, was firstdiscovered in 1983, and at the time, it was rapidly spreading in thegay male communities ofNew York City andLos Angeles. In 1984, Marlys Witte, one of the doctors who, like Elvin-Lewis, had cared for Rayford before his death and also assisted in the autopsy, thawed andtested tissue samples that were preserved after Rayford's autopsy. The test results came back negative.[9]
In June 1987, Witte tested the tissue samples again usingWestern blot, the most sensitive test then available. TheWestern blot test found thatantibodies against all nine detectable HIV proteins were present in Rayford's blood. An antigen capture assay identified HIV antigens in tissue samples, but not in serum.[3] In a 1990 letter to the scientific journalNature, Robert F. Garry stated that efforts to directly detect HIV DNA were under way: "Proviral DNA has recently been detected in his tissues by PCR in collaboration with J. Sninsky and S. Kwok (Cetus Corporation, Emeryville, California) but nucleotide sequence analysis is not yet complete".[16]
In 1999, a conference abstract reported a study of testing for HIV DNA in Rayford's samples.[17] The abstract reported the detection of HIV genes in Rayford's samples, which were very similar to the HIV IIIB isolate, which was discovered in France in the 1980s and became widely used as a laboratory reference isolate. This study has never been published in a peer-reviewed scientific journal. Neither John Sninsky nor Shirley Kwok was listed as an author on the abstract. The abstract argues that laboratory contamination by the HIV IIIB isolate was unlikely because the DNA testing was done on Rayford's samples without being cultured.[17]
The last known tissue samples of Rayford were in a New Orleans lab and inadvertently destroyed duringHurricane Katrina in 2005, preventing further testing.[13]
Rayford never traveled outside theMidwestern United States and told doctors that he had never received ablood transfusion. If Rayford was indeed infected with HIV, as one group of researchers claims, the mode of acquisition is assumed to have been through sexual contact. Having never left the US, the researchers who claim that Rayford represented an early case of HIV infection presume that AIDS may have been present in North America before Rayford began to show symptoms of it in 1966.[2]
Rayford is believed to have never ventured into cosmopolitan cities such as New York City, Los Angeles, or San Francisco, where the HIV-AIDS epidemic was first observed in the United States.[18] The only possible international connection to St. Louis was the city's status as a hub for the airlineTWA. Doctors and others who investigated the case in the early 1980s speculated that Rayford may have been sexually abused or a victim ofchild prostitution.[9][11]
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