Robert R
Robert Lee Rayford (February 3, 1953 – May 15, 1969) sometimes identified as Robert R. due to his age, was an American teenager from St. Louis, Missouri whose chronic illness, which began in 1966 and ended with his death in 1969, are hypothesized to represent the earliest known case of HIV/AIDS in North America. Rayford's death was a mystery to his doctors, who could not account for his symptoms. A likely cause of his death wasn't suggested until 1987.
Rayford's reported symptoms during his illness – which included emaciation, Kaposi's sarcoma, and pneumonia – have been suggested to resemble the symptomatology of AIDS-related complex. A paper published in 1988 reported that Western blot testing of Rayford's preserved tissues revealed the presence of nine different antibodies to HIV-1. In a subsequent letter to the journal Nature, study author Robert Garry stated: "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." No such data was ever published by Sninsky and Kwok and no peer-reviewed publication subsequently reported the direct detection of HIV genetic material in Rayford's tissue samples using more modern immunoassay or DNA sequencing methods. The only published evidence of HIV positive status was derived from the very early antibody tests used experimentally on tissue samples. These tissue samples, which were kept in freezer storage at Tulane University in New Orleans, were lost in 2005 when the samples thawed and decayed after the storage facility was damaged by Hurricane Katrina.
Rayford's symptoms and the later reported detection of HIV antibodies in tissue samples has been posited to represent evidence of the presence of HIV/AIDS in North America prior to the beginning of the main HIV epidemic of the 1970s and 1980s. However, the presence of HIV was only inferred from the comparatively rudimentary antibody testing available in the 1980s, and - for reasons that are unclear - the samples were not definitively reanalyzed using more modern testing methods before their loss, leading Anthony Fauci to note that Rayford's status as the first identified case of HIV infection in North America was not "absolute[ly] nailed-down".
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