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This study investigates the role of key authors in shaping early AIDS discourse on Usenet, a decentralized network that became an unexpected yet vital platform for public health communication between 1982 and 1986. Drawing on over 15,000 threads and 43,000 comments from six Usenet newsgroups—including net.med, net.motss, and net.singles—the research employs computational methods—such as sentiment analysis, Latent Dirichlet Allocation (LDA), Structural Topic Models (STMs), and network analysis—and historical interpretation to analyze the thematic, emotional, and networked dimensions of early digital health communication. Findings reveal that discussions on AIDS were marked by heightened negative sentiment, reflecting the pervasive fear, stigma, and emotional volatility that accompanied the epidemic’s initial spread, and that the discourse was predominantly shaped by scientific and medical themes, a characteristic shaped by the platform’s academically oriented user base and their need to navigate complex and rapidly evolving health information amidst widespread uncertainty. Crucially, several key authors emerged as central nodes in this communication network, acting as mediators who bridged specialized technical knowledge with broader social narratives. Their influence extended beyond simple content generation to shaping thematic priorities, emotional tone, and the adoption of critical terminologies, and as a result, fostering collaborative knowledge production and establishing trust within the community. These findings underscore the dynamic interplay between grassroots communication and emergent digital infrastructures in mediating public health crises. By situating these observations within broader sociological frameworks of power, influence, and digital publics, this study highlights the enduring significance of early online networks in shaping public health discourse.