3.7.14: HIV/AIDS Epidemic

In 1981, a report was published of a rare lung infection in five young, otherwise healthy, gay men. On the same day the report was published, the CDC got a call from a physician in New York city, who reported a rare, aggressive cancer in several patients with weakened immune systems. Eventually, more cases were discovered of what would eventually be known as Human Immunodeficiency Virus (HIV), which could lead to Acquired Immune Deficiency Syndrome (AIDS). The disease was spread through unprotected sex, and the use of infected needles or direct exposure to infected blood (through a blood transfusion, for example). It attacked the human body’s immune system, weakening the ability to fight off other infections and diseases, so that many people died from things like pneumonia or cancers that progressed rapidly. Although cases were found in women, infants, and people of all races across the globe, the disease rapidly reached epidemic proportions in the gay community, and soon became known in America as the “gay white man’s disease”. This fueled anti-LGBTQ rhetoric, and left other populations out of research and preventative measures. HIV/AIDs was so deadly that nearly half of the cases reported in the first year perished by the end of the year.

In 1983 the virus was isolated in a French lab, increasing hopes of a vaccine being developed. But the first blood test developed would only detect antibodies in the blood supply - and was at first primarily used to test blood in blood banks rather than diagnose individuals with the infection. While initial efforts focused on safe-sex education, prevention, and harm-reduction, it took several years of advocacy from civil rights groups, celebrities, and minority leaders to prompt the U.S. government to focus funding on AIDS research and healthcare. The Aids Coalition to Unleash Power (ACT UP) protested against the slow progress that was being made and the narrow definition of the disease as affecting only gay men (Timeline of the HIV and AIDS Epidemic, n.d.).

The first drugs to be developed for AIDS treatment were antiretroviral therapies (ARVs), and were not particularly effective. In the 1990s, a combination of ARVs was found that decreased the risk of death by 60-80% yet it was still sold at a high cost which excluded many poorer countries from providing it to their citizens. Over decades, and with extensive pressure, both testing and drugs have become more accessible. The World Health Organization (WHO) expanded testing and treatment access in the 2010s and set continued goals with the hope to end AIDs altogether by 2030. Early treatment with ARVs can suppress the virus to an undetectable level, preventing sexual transmission to partners. By 2015, some ARVs were also approved for prophylactic use, decreasing the risk of contracting the virus from a partner or injection use. While research, testing, and treatments have expanded to this date, the stigma around HIV (and its association with homosexuality and drug injection) still persists - and prevents adults and children from getting care (World Health Organization, n.d.-b).

Figure \(\PageIndex{1}\): ACT UP Demonstration on the lawn of Building 1. A mass "die-in" on the lawn of Bldg. 1 closed the demonstration as ranks of uniformed officers, some on horseback, protected NIH headquarters during the "Storm the NIH" demonstration on May 21, 1990.. (Copyright; NIH History Office from Bethesda, Public domain, via Wikimedia Commons)