Joseph Sonnabend

Joseph Adolph Sonnabend (6 January 1933 – 24 January 2021) was a South African physician, scientist and HIV/AIDS researcher, notable for pioneering community-based research, the propagation of safe sex to prevent infection, and an early multifactorial model of AIDS.

As one of the first physicians to notice among his gay male patients the immune deficiency that would later be named AIDS, during the 1980s and 1990s he treated many hundreds of HIV-positive people. During the height of the AIDS crisis, Sonnabend helped create several AIDS organisations, including the AIDS Medical Foundation (now amfAR), which pioneered community-based research, and the PWA Health Group, the first and largest formally recognised buyers' club.

Sonnabend became controversial for advocating that gay men change their sexual behaviors to avoid sexually transmitted infections, rather than to just have fewer sexual partners, as advocated by Gay Men's Health Crisis and other gay community organizations, and for hypothesizing a multi-factorial model of causation, including for a period of time after discovery of HIV.

He trained in infectious diseases at the University of the Witwatersrand in Johannesburg and the Royal College of Physicians of Edinburgh. During the 1960s he conducted research at the National Institute for Medical Research in London, where he worked under Alick Isaacs, a pioneer of interferon research.

Early AIDS work Sonnabend was one of the first physicians to notice among his gay male patients the immune deficiency that would later be named AIDS. His background in microbiology, virology, infectious diseases This suggestion conflicted with the view that a single agent was likely responsible, which Sonnabend did not rule out.

Sonnabend's "multifactorial model" led him to argue from very early in the emerging pandemic that frequent unprotected anal sex increased the risk of what would come to be known as AIDS. This was the inspiration for How to Have Sex in an Epidemic, At the time, attempts to change sexual behaviour and the recommendation of condoms for gay sex met with criticism from many prominent gay community figures.

Role in founding AIDS organisations To help fund his research and that of other scientists—and because the CDC were dismissive of his expertise and uninterested in his assistance Sonnabend served as medical director of CRI/CRIA until 1996. Dr Krim described that "he's the only doctor I know who goes to every funeral". This non-profit organisation was the first and largest formally recognised AIDS buyers' club,

Controversies As a revered physician, Sonnabend was renowned for protecting and promoting patients' rights. He did not shy away from criticising the scientific establishment when he felt it was failing to put patients' interests first. He often disagreed with mainstream opinion on AIDS. In 2006 he expressed his view that high doses of AZT had "killed thousands" during the late 1980s and early 1990s.

Until the late 1990s Sonnabend continued to assert that the issue of AIDS causation "remained open" and that many factors might be involved. This led some researchers and activists to associate him with "AIDS denialists" who deny that HIV has any role in AIDS—a charge that Sonnabend denied:

I was kind of surprised to find myself on the outside. I had rather thought that I represented a kind of academic caution that I took for granted to be the norm. I always believed my criticisms were reasonable and not radical.

The effects of modern medication helped to change Sonnabend's views on AIDS causation, leading him to assert that, "the evidence now strongly supports a role for HIV." He also suggested that much of the funding for fighting AIDS in Africa has been misspent:

Assessments of Sonnabend's career Despite his unconventional and often controversial opinions, mainstream AIDS researchers have in recent years become less critical of Sonnabend, recognising his devotion as a physician and patients' champion. According to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases:

He is one of the true soldiers in the war against HIV. He is a model for a real translation of care to the patient. In terms of the controversy surrounding his work, I think, in general, at the end of the day, most would agree that his contributions have been positive. He is an outstanding man. His relationship with her was documented in the 2015 film Some Kind of Love.

He composed music throughout his life, and discussed his music on the radio programme Outlook on the BBC World Service in 2018.

He died in January 2021 "after extensive health challenges" and a memorial service was held on 12 April 2021 at Judson Memorial Church in Manhattan, including music composed by Sonnabend and where eulogists included Ivy Kwan Arce, Sean Strub, Kyle Clifford, Rebecca Jordan-Young, Rebecca Pringle Smith, Jack Waters, Ash Kotak, and Miriam Lewis Sabin.