aids epidemic essay

• What Are HIV and AIDS?
• How Is HIV Transmitted?
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• Symptoms of HIV
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• Traveling Outside the U.S.
• Civil Rights
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• Limits on Confidentiality
• National HIV/AIDS Strategy (2022-2025)
• Implementing the National HIV/AIDS Strategy
• Prior National HIV/AIDS Strategies (2010-2021)
• Key Strategies
• Priority Jurisdictions
• HHS Agencies Involved
• Learn More About EHE
• Ready, Set, PrEP
• Ready, Set, PrEP Pharmacies
• AHEAD: America’s HIV Epidemic Analysis Dashboard
• HIV Prevention Activities
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• HIV Care and Treatment Activities
• HIV Research Activities
• Activities Combating HIV Stigma and Discrimination
• The Affordable Care Act and HIV/AIDS
• HIV Care Continuum
• Syringe Services Programs
• Finding Federal Funding for HIV Programs
• Fund Activities
• The Fund in Action
• About PACHA
• Members & Staff
• Subcommittees
• Prior PACHA Meetings and Recommendations
• I Am a Work of Art Campaign
• Awareness Campaigns
• Global HIV/AIDS Overview
• U.S. Government Global HIV/AIDS Activities
• U.S. Government Global-Domestic Bidirectional HIV Work
• Global HIV/AIDS Organizations
• National Black HIV/AIDS Awareness Day February 7
• HIV Is Not A Crime Awareness Day February 28
• National Women and Girls HIV/AIDS Awareness Day March 10
• National Native HIV/AIDS Awareness Day March 20
• National Youth HIV & AIDS Awareness Day April 10
• HIV Vaccine Awareness Day May 18
• National Asian & Pacific Islander HIV/AIDS Awareness Day May 19
• HIV Long-Term Survivors Awareness Day June 5
• National HIV Testing Day June 27
• Zero HIV Stigma July 21
• Southern HIV/AIDS Awareness Day August 20
• National Faith HIV/AIDS Awareness Day August 25
• National African Immigrants and Refugee HIV/AIDS and Hepatitis Awareness Day September 9
• National HIV/AIDS and Aging Awareness Day September 18
• National Gay Men's HIV/AIDS Awareness Day September 27
• National Latinx AIDS Awareness Day October 15
• World AIDS Day December 1
• Event Planning Guide
• U.S. Conference on HIV/AIDS (USCHA)
• National Ryan White Conference on HIV Care & Treatment
• AIDS 2020 (23rd International AIDS Conference Virtual)

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A Timeline of HIV and AIDS

The HIV.gov Timeline reflects the history of the domestic HIV/AIDS epidemic from the first reported cases in 1981 to the present—where advances in HIV prevention, care, and treatment offer hope for a long, healthy life to people who are living with, or at risk for, HIV and AIDS.

View a timeline of the current Ending the HIV Epidemic initiative .

Timeline Navigation

• June 5: The U.S. Center for Disease Control (CDC) publishes an article in its Morbidity and Mortality Weekly Report ( MMWR ): Pneumocystis Pneumonia—Los Angeles . The article describes cases of a rare lung infection, Pneumocystis carinii pneumonia (PCP), in five young, previously healthy gay men in Los Angeles. Los Angeles immunologist Dr. Michael Gottlieb, CDC’s Dr. Wayne Shandera, and their colleagues report that all the men have other unusual infections as well, indicating that their immune systems are not working. Two have already died by the time the report is published and the others will die soon after. This edition of the MMWR marks the first official reporting of what will later become known as the AIDS ( Acquired Immunodeficiency Syndrome ) epidemic.
• June 5: The same day that the MMWR is published, New York dermatologist Dr. Alvin Friedman-Kien Exit Disclaimer calls CDC to report a cluster of cases of a rare and unusually aggressive cancer— Kaposi’s Sarcoma (KS)—among gay men in New York and California. Like PCP, KS is associated with people who have weakened immune systems.
• June 5-6: The Associated Press, the Los Angeles Times , and the San Francisco Chronicle report on the MMWR article. Within days, CDC receives reports from around the nation of similar cases of PCP, KS, and other opportunistic infections among gay men.
• June 8: In response to these reports, CDC establishes the Task Force on Kaposi’s Sarcoma and Opportunistic Infections to identify risk factors and to develop a case definition for the as-yet-unnamed syndrome so that CDC can begin national surveillance Exit Disclaimer of new cases.,,
• June 16: A 35-year-old, white gay man who is exhibiting symptoms of severe immunodeficiency is the first person with AIDS to be admitted to the Clinical Center at the National Institutes of Health (NIH). He never leaves the Center and dies on October 28.
• July 2: The Bay Area Reporter , a weekly newspaper for the gay and lesbian community in San Francisco, publishes its first mention of “Gay Men’s Pneumonia.” The short item encourages gay men who are experiencing progressive shortness of breath to see their physicians.
• July 3: CDC releases another MMWR, “ Kaposi's Sarcoma and Pneumocystis Pneumonia Among Homosexual Men — New York City and California ,” with information on KS and PCP among 26 gay men (25 white and one black). On the same day, the New York Times publishes an article entitled “ Rare Cancer Seen in 41 Homosexuals Exit Disclaimer .” At this point, the term “ gay cancer Exit Disclaimer ” enters the public lexicon.
• August 11: Acclaimed writer and film producer Larry Kramer Exit Disclaimer holds a meeting Exit Disclaimer of over 80 gay men in his New York City apartment to discuss the burgeoning epidemic. Kramer invites Dr. Friedman-Kien to speak, and he asks the group to contribute money to support his research because he has no access to rapid funding. The plea raises $6,635—essentially the only new money, public or private, that will be raised to fight the epidemic for the remainder of the year.
• August 28: The latest MMWR article, “ Follow-Up on Kaposi’s Sarcoma and Pneumocystis Pneumonia ,” reports that CDC has received information on 70 additional cases of KS and/or PCP since the July 3 edition. Of the 108 cases reported to date, 107 are male, 94% of those whose sexual orientation is known are gay/bisexual, and 40% of all patients have already died.
• September 15: The National Cancer Institute and CDC cosponsor the first conference to address the new epidemic. Fifty leading clinicians attend the event in Bethesda, MD, to discuss KS and other opportunistic infections and to develop recommendations for further studies in epidemiology, virology, and treatment.,
• September 21: San Francisco dermatologist Dr. Marcus Conant Exit Disclaimer oversees the opening of the nation’s first KS clinic at the University of California, San Francisco Medical Center. He co-directs the clinic with oncologist Dr. Paul Volberding Exit Disclaimer . The two physicians, with their colleagues Dr. Constance Wofsy Exit Disclaimer and Dr. Donald Abrams Exit Disclaimer will guide much of the early response to AIDS in San Francisco Exit Disclaimer .
• December: At Albert Einstein Medical College in New York, pediatric immunologist Dr. Arye Rubinstein Exit Disclaimer treats five black infants who are showing signs of severe immune deficiency, including PCP. At least three are the children of women who use drugs and engage in sex work. He recognizes that the children are showing signs of the same illnesses affecting gay men, but his diagnoses are dismissed by his colleagues.
• December 10: Bobbi Campbell , a San Francisco nurse, becomes the first KS patient to go public with his diagnosis. Calling himself the “KS Poster Boy,” Campbell writes a newspaper column, “Gay Cancer Journal,” on his experiences living with KS for the San Francisco Sentinel . He also posts photos Exit Disclaimer of his KS lesions in the window of a local drugstore to alert the community to the disease and encourage people to seek treatment.
• By year’s end, there is a cumulative total of 337 reported cases of individuals with severe immune deficiency in the United States—321 adults/adolescents and 16 children under age 13. Of those cases, 130 are already dead by December 31.
• January 4: Gay Men’s Health Crisis Exit Disclaimer ( GMHC Exit Disclaimer ), the first community-based AIDS service provider in the United States, is founded in New York City. In May, volunteer Rodger McFarlane Exit Disclaimer sets up a GMHC information and counseling hotline on his home phone—he receives 100 phone calls from worried gay men the first night.
• April 13: U.S. Representative Henry Waxman Exit Disclaimer convenes the first congressional hearings on AIDS at the Los Angeles Gay and Lesbian Community Services Center in Hollywood, California. At the hearing, Dr. James Curran , head of the Center for Disease Control ’s (CDC) Task Force on Kaposi’s Sarcoma and Opportunistic Infections , estimates that tens of thousands of people may already be affected by the disease.
• May 9: San Francisco dermatologist Dr. Marcus Conant Exit Disclaimer and gay activist Cleve Jones join together to form The Kaposi’s Sarcoma Research and Education Foundation Exit Disclaimer . The goal is to provide information on Kaposi’s Sarcoma (KS) to local gay men. The organization will ultimately become the San Francisco AIDS Foundation Exit Disclaimer .
• May 11: The New York Times publishes the first mention of the term “GRID” Exit Disclaimer (Gay-Related Immune Deficiency), which some researchers are using to describe the new epidemic. The term will deepen the public perception that AIDS affects only gay men.
• May 31: The Los Angeles Times publishes the first front-page story on AIDS in the mainstream press: “Mysterious Fever Now an Epidemic.”
• June 18: CDC publishes “A Cluster of Kaposi's Sarcoma and Pneumocystis carinii Pneumonia among Homosexual Male Residents of Los Angeles and Orange Counties, California ”—a Morbidity and Mortality Weekly Report ( MMWR ) that makes the first connection between a potential sexually transmitted agent and the outbreaks of KS, Pneumocystis carinii pneumonia (PCP), KS, and other opportunistic infections among young gay men.
• June 27: A gay activist group in San Francisco publishes the first pamphlet on “safer sex” and distributes 16,000 copies at the International Lesbian & Gay Freedom Day Parade.
• July 16: CDC publishes another MMWR article, “ Epidemiologic Notes and Reports Pneumocystis carinii Pneumonia among Persons with Hemophilia A .” It is the first report of immunosuppression in patients with hemophilia who have no other known risk factors for AIDS. Two of the three patients profiled in the report have already died by the time of publication.
• September 24: CDC uses the term “ AIDS ” ( Acquired Immune Deficiency Syndrome ) for the first time in a new MMWR , and releases the first case definition for AIDS: “A disease at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease.”
• September 28: Rep. Phillip Burton and Rep. Ted Weiss join together to introduce the first legislation to allocate funding for AIDS research. The resolution dies in committee. Congress will not approve the first dedicated funding for AIDS research and treatment until July 1983.
• November 5: CDC’s “ Current Trends Acquired Immune Deficiency Syndrome (AIDS): Precautions for Clinical and Laboratory Staffs ” lays out the first set of precautions for clinical and laboratory staff working with people exhibiting signs of AIDS.
• December 10: CDC’s “ Epidemiologic Notes and Reports Possible Transfusion-Associated Acquired Immune Deficiency Syndrome (AIDS) -- California ” notes that a 20-month-old white infant who required multiple blood transfusions at birth has developed unexplained cellular immunodeficiency and opportunistic infections. Donor tracing reveals that one of the baby’s blood donors died of AIDS in August.
• December 17: CDC’s latest MMWR , “ Unexplained Immunodeficiency and Opportunistic Infections in Infants -- New York, New Jersey, California ,” reports another 22 cases of unexplained immunodeficiency and opportunistic infections in infants. The article states “It is possible that these infants had the acquired immune deficiency syndrome (AIDS),” but stops short of making a definitive diagnosis.
• January 1: Ward 86 Exit Disclaimer , the world’s first dedicated outpatient AIDS clinic, opens at San Francisco General Hospital. The clinic is a collaboration between the hospital and the University of California, San Francisco, and it draws staff who are passionate about treating people with AIDS. Over time, the staff develop the San Francisco Model of Care Exit Disclaimer , which emphasizes: treating patients with compassion and respect; providing an array of health and social services in one facility; and collaborating closely with the local health department and community organizations. The model eventually becomes the global gold standard for HIV patient care.
• January 4: The U.S. Center for Disease Control (CDC) hosts a public meeting to identify opportunities to protect the nation’s blood supply from AIDS . Representatives from the U.S. Food and Drug Administration (FDA), the National Institutes of Health (NIH), the blood services and hemophilia communities, and gay activists attend, but participants fail to reach consensus on appropriate action.
• January 7: CDC’s Morbidity and Mortality Weekly Report ( MMWR ) reports the first cases of AIDS in women: Epidemiologic Notes and Reports Immunodeficiency among Female Sexual Partners of Males with Acquired Immune Deficiency Syndrome (AIDS) -- New York .
• March 4: CDC’s MMWR article Current Trends Prevention of Acquired Immune Deficiency Syndrome (AIDS): Report of Inter-Agency Recommendations ,” notes that most cases of AIDS have been reported among gay men with multiple sexual partners, people who inject drugs, Haitians, and people with hemophilia. The report suggests that AIDS may be caused by an infectious agent that is transmitted sexually or through exposure to blood or blood products and issues recommendations for preventing transmission.
• March 14: AIDS activist Larry Kramer Exit Disclaimer publishes a blistering assessment of the impact of AIDS on the gay community in the New York Native . The essay, 1,121 and Counting Exit Disclaimer , is a frantic plea for that community to get angry at the lack of government support for sick and dying gay men and the slow pace of scientific progress in finding a cause for AIDS.
• May: Richard Berkowitz and Michael Callen—both men living with AIDS—publish a booklet on “safer sex” titled How to Have Sex in an Epidemic: One Approach Exit Disclaimer . It advocates condom use for gay men and focuses on self-empowerment for those living with AIDS.
• May 3: The Kaposi’s Sarcoma Foundation Exit Disclaimer sponsors the first AIDS Candlelight Vigils in San Francisco and New York Exit Disclaimer . It is the first time that people with AIDS come together in a public demonstration. Photos of the event are circulated around the world—shedding some of the first light on the growing health crisis and humanizing those who are affected.
• May 18: The U.S. Congress passes the first bill that includes funding specifically targeted for AIDS research and treatment—$12 million for agencies within the U.S. Department of Health and Human Services .
• May 20: Dr. Françoise Barré-Sinoussi Exit Disclaimer and her colleagues at the Pasteur Institute Exit Disclaimer in France report the discovery of a retrovirus that could be the cause of AIDS . In 2008, she will share the Nobel Prize in Medicine Exit Disclaimer for this discovery with her colleague, Dr. Luc Montagnier Exit Disclaimer .
• May 25: The New York Times publishes its first front-page story on AIDS Exit Disclaimer : “Health Chief Calls AIDS Battle ‘No. 1 Priority’.” The article reports on the federal response to the growing AIDS epidemic. By the time it is published, 1,450 cases of AIDS have been reported and 558 of those individuals have died.
• June 12: Eleven gay men living with AIDS take over the plenary stage at the National AIDS Forum in Denver Exit Disclaimer . They issue a statement on the rights of people living with AIDS to be at the table when policy is made, to be treated with dignity, and to be called “people with AIDS,” not “AIDS victims.” The statement becomes known as The Denver Principles Exit Disclaimer [PDF, 19KB], and it serves as the charter for the founding of the National Association of People with AIDS.
• July 1: The U.S. Public Health Service opens the National AIDS Hotline to respond to public inquiries about the disease. By July 28, the hotline has to be expanded Exit Disclaimer from three phonelines to eight, because 8,000-10,000 callers are phoning daily.
• July 25: After a petition by psychiatric nurse Cliff Morrison , San Francisco General Hospital opens Ward 5B Exit Disclaimer , the first dedicated in-patient AIDS ward in the U.S. Within days, its 12 beds are fully occupied. The ward is run by Morrison and an all-volunteer staff—from nurses to janitors—who offer compassionate, holistic care for AIDS patients.
• August: The National Institute of Allergy and Infectious Diseases begins publishing an informal newsletter, the AIDS Memorandum [PDF, 1.1MB], through which scientists can share unpublished research findings. This publication lasts for two years, until mainstream scientific journals begin expediting publication for articles on AIDS.
• August 1-2: The U.S. House of Representatives Subcommittee on Government Operations holds hearings on the federal response to AIDS Exit Disclaimer .
• August 8: AIDS activist Bobbi Campbell appears with his partner, Bobby Hilliard, on the cover of Newsweek magazine for the story, “Gay America: Sex, Politics, and the Impact of AIDS.” It is the first time two gay men are pictured embracing one another on the cover of a U.S. mainstream national magazine.
• September 2: In response to growing concerns about the potential for transmission of AIDS in healthcare settings, CDC publishes the first set of occupational exposure precautions for healthcare workers and allied health professionals.
• September 9: In its latest edition of the MMWR , “Current Trends Update: Acquired Immunodeficiency Syndrome (AIDS) -- United States,” CDC identifies all major routes of HIV transmission—and rules out transmission by casual contact, food, water, air, or environmental surfaces .
• September 30: After New York City physician Joseph Sonnabend Exit Disclaimer is threatened with eviction from his office building for treating patients with AIDS, the state’s Attorney General and Lambda Legal join Exit Disclaimer together to file the first AIDS discrimination lawsuit Exit Disclaimer .
• November 22-25: The World Health Organization Exit Disclaimer holds its first meeting to assess the global AIDS situation and begins international surveillance.
• April 23: U.S. Department of Health and Human Services Secretary Margaret Heckler announces that Dr. Robert Gallo and his colleagues at the National Cancer Institute have found the cause of AIDS Exit Disclaimer , a retrovirus they have labeled HTLV-III. Heckler also announces the development of a diagnostic blood test to identify HTLV-III and expresses hope that a vaccine against AIDS will be produced within two years.
• July 13: A Morbidity and Mortality Weekly Report from the U.S. Center for Disease Control states that avoiding injection drug use and reducing needle-sharing “should also be effective in preventing transmission of the virus .”
• August 15: AIDS activist Bobbi Campbell dies of AIDS-related illness Exit Disclaimer at age 32.
• October 9: The New York Times reports that new scientific evidence has raised the possibility that AIDS may be transmissible through saliva Exit Disclaimer . It will be another two years before proof emerges that this is not the case.
• October 10: San Francisco public health officials order bathhouses closed Exit Disclaimer due to high-risk sexual activity occurring in these venues.
• January 11: The U.S. Center for Disease Control (CDC) revises the AIDS case definition to note that AIDS is caused by a newly identified virus. CDC also issues provisional guidelines for blood screening.
• March 2: The U.S Food and Drug Administration licenses the first commercial blood test Exit Disclaimer , ELISA , to detect HIV. Blood banks begin screening the U.S. blood supply.
• April 15–17: The U.S. Department of Health and Human Services and the World Health Organization Exit Disclaimer host the first International AIDS Conference Exit Disclaimer in Atlanta, Georgia.
• April 10: CDC removes Haitians from the list of those at increased risk for AIDS Exit Disclaimer .
• April 22: AIDS activist Larry Kramer Exit Disclaimer ’s autobiographical play, The Normal Heart Exit Disclaimer , opens Off-Broadway at the Public Theater. The play covers the impact of the growing AIDS epidemic on the New York gay community between 1981-1984. It highlights the growing rifts between those—like the play’s protagonist, Ned Weeks (Kramer’s alter ego)—who are desperately banging on the doors of government and science in an attempt to stave off the annihilation of gay men, and those who focus instead on building new institutions that will care for the sick and the dying.
• May 1: As Is Exit Disclaimer , the first play about AIDS to make it to Broadway Exit Disclaimer , opens. The plot focuses on a gay couple who have broken up—but when one of them develops AIDS, his ex-partner comes back to take care of him—“as is.” The play gets excellent reviews and runs for 285 performances.
• July 25: Actor Rock Hudson Exit Disclaimer , who played leading roles in over 60 Hollywood films, announces he has AIDS Exit Disclaimer —the first major U.S. public figure to do so. His acknowledgment marks a turning point in public perceptions about the epidemic, and AIDS stories in the major print media more than triple in the next six months.
• August 27: Ryan White , an Indiana teenager who contracted AIDS through contaminated blood products used to treat his hemophilia , is refused entry to his middle school Exit Disclaimer . His family’s protracted legal battles to protect Ryan’s right to attend school call national attention to the issue of AIDS, and Ryan chooses to speak out publicly on the need for AIDS education.
• August 31: The Pentagon announces that, beginning October 1, it will begin testing all new military recruits for HIV infection Exit Disclaimer and will reject those who test positive for the virus.
• September 17: President Ronald Reagan mentions AIDS publicly for the first time Exit Disclaimer , calling it “a top priority” and defending his administration against criticisms that funding for AIDS research is inadequate.
• October 2: Rock Hudson dies of AIDS-related illness Exit Disclaimer at age 59. In his will, Hudson leaves $250,000 to help set up the American Foundation for AIDS Research Exit Disclaimer (amfAR). Actress Elizabeth Taylor serves as the organization’s founding National Chairman.
• October 2: The U.S. Congress allocates nearly $190 million for AIDS research Exit Disclaimer —an increase of $70 million over the Reagan Administration’s budget request. The House Appropriations Committee also urges President Reagan to appoint an “AIDS czar.”
• October 25: The New York State Public Health Council empowers local health officials to close gay bathhouses, bars, clubs Exit Disclaimer , and other places where “high-risk sexual activity takes place.”
• December 4: The Los Angeles County Board of Supervisors enacts strict regulations on local bathhouses to stop the spread of HIV. Bathhouse owners file suit to stop the regulations from going into effect, and, in August 1986, the court sides with the owners, saying that the venues offer opportunities to provide HIV/AIDS education.
• December 6: CDC publishes a Morbidity and Mortality Weekly Report with recommendations on preventing mother-to-child transmission of HIV . They include: delaying pregnancy until more is known about the risks of transmission and avoiding breastfeeding. As of December 1, there have been 217 reported cases of AIDS among children under age 13, and 60% of them have died by the time of publication.
• December 13: Pennsylvania toddler Dwight Burk Exit Disclaimer , aged 20 months, dies of AIDS. He is the first child of a hemophiliac to be born with AIDS.
• December 13: The Pasteur Institute Exit Disclaimer files suit against the U.S. Government Exit Disclaimer (USG) in the United States Court of Claims in Washington, DC. The suit asks for: recognition that French researchers were the first to discover the virus that causes AIDS; permission for companies it licenses to sell the blood test, without being sued by the USG for counterfeiting; and the right to share in royalties collected by the USG for sales of blood tests by its licensees.
• December 19: A Los Angeles Times poll finds that a majority of Americans favor quarantining people who have AIDS Exit Disclaimer . By year’s end, the United Nations Exit Disclaimer states that at least one HIV case has been reported from each region of the world Exit Disclaimer .[PDF, 49KB].
• January 16: The U.S. Center for Disease Control (CDC) reports that more people were diagnosed with AIDS in 1985 than in all earlier years combined . The 1985 figures show an 89% increase in new AIDS cases compared with 1984. Of all AIDS cases to date, 51% of adults and 59% of children have died. The new report shows that, on average, AIDS patients die about 15 months after the disease is diagnosed. Public health experts predict twice as many new AIDS cases in 1986.
• May 1: The International Committee on the Taxonomy of Viruses announces Exit Disclaimer that the virus that causes AIDS will officially be known as “ Human Immunodeficiency Virus Exit Disclaimer ” ( HIV ).
• July 18: At the National Conference on AIDS in the Black Community Exit Disclaimer in Washington, DC, a group of minority leaders meets with the U.S. Surgeon General, Dr. C. Everett Koop , to discuss concerns about HIV/AIDS in communities of color. This meeting marks the unofficial founding of the National Minority AIDS Council Exit Disclaimer .
• October: The Robert Wood Johnson Foundation Exit Disclaimer creates the AIDS Health Services Program , providing $17.2 million in funding for patient-care demonstration projects in 11 cities. The goal is to replicate the San Francisco Model of Care Exit Disclaimer nationwide—but with an emphasis on tailoring programs to meet the needs in local contexts .
• October: The U.S. Health Resources and Services Administration (HRSA) begins its AIDS Service Demonstration Grants program —the agency’s first AIDS-specific health initiative. In the program’s first year, HRSA makes $15.3 million available to four of the country’s hardest-hit cities: New York, San Francisco, Los Angeles, and Miami.
• October 22: The Surgeon General issues the Surgeon General’s Report on AIDS [PDF, 1.98MB]. The report makes it clear that HIV cannot be spread casually and calls for: a nationwide education campaign (including early sex education in schools); increased use of condoms; and voluntary HIV testing.
• October 24: CDC reports that AIDS cases are disproportionately affecting African Americans and Latinos . This is particularly true for African American and Latinx Exit Disclaimer children, who make up 90% of perinatally acquired AIDS cases.
• October 29: The Institute of Medicine (IOM), the principal health unit of the National Academy of Sciences Exit Disclaimer , issues a report, Confronting AIDS: Directions for Public Health, Health Care, and Research Exit Disclaimer . The report calls for a “massive media, educational and public health campaign to curb the spread of the HIV infection,” as well as for the creation of a National Commission on AIDS. The IOM estimates that the effort will require a $2 billion investment in research and patient care by the end of the decade.
• In February, AIDS activist Cleve Jones Exit Disclaimer creates the first panel of the AIDS Memorial Quilt Exit Disclaimer to honor his friend Marvin Feldman Exit Disclaimer , who died on October 10, 1986 of AIDS-related illness at age 33. The quilt panels are 3 feet wide by 6 feet long—the size and shape of a typical grave plot.
• February 1: The World Health Organization Exit Disclaimer (WHO) launches The Special Programme on AIDS to: raise awareness; formulate evidence-based policies; provide technical and financial support to countries; initiate relevant social, behavioral, and biomedical research; promote participation by nongovernmental organizations; and champion rights of those living with HIV. In 1988, it will be renamed the Global Programme on AIDS .
• February 4: Emmy-award winning pianist Liberace dies Exit Disclaimer at his home in California at age 67. His doctor claims that Liberace died of a heart attack, caused by an underlying brain infection. But the county coroner orders an autopsy, which proves that the entertainer died of AIDS-related illness Exit Disclaimer . The case demonstrates the powerful stigma of AIDS and leads to a national discussion about the rights of people living with AIDS to privacy Exit Disclaimer , both before and after death.
• March 12: AIDS activist Larry Kramer Exit Disclaimer founds the AIDS Coalition to Unleash Power Exit Disclaimer ( ACT UP Exit Disclaimer ) in New York City. Kramer’s goal is to create a political direct-action group that will force governments, elected officials, public health agencies, the pharmaceutical and insurance industries, and religious institutions to act to protect those at risk of HIV, and those who are sick with AIDS. TIME Magazine calls ACT UP “the most effective health activist [group] in history Exit Disclaimer ” for “pressuring drug companies, government agencies and other powers that stood in their way to find better treatments for people with AIDS — and, in the process, improving the way drugs are tested and approved in the U.S.”
• March 19: The U.S. Food and Drug Administration (FDA) approves the first medication for AIDS — AZT (zidovudine) Exit Disclaimer an antiretroviral drug initially developed to treat cancer.
• March 19: FDA issues regulations that expand access to promising new medications that have not yet been approved or licensed by the agency. This accelerates drug approval by 2-3 years.
• March 24: ACT UP stages its first protest Exit Disclaimer on Wall Street. Protestors demand immediate action on a variety of issues, including: having the FDA immediately release potentially life-saving investigational drugs to everyone with AIDS or AIDS-related complex Exit Disclaimer ; immediate abolition of government funded double-blind studies; availability of drugs at affordable prices; a massive public education to stop the spread of AIDS; policy to prohibit discrimination in AIDS treatment, insurance, employment, and housing; and establishment of a coordinated, comprehensive, and compassionate national policy on AIDS.
• March 31: President Ronald Reagan and French Prime Minister Jacques Chirac end an international scientific dispute Exit Disclaimer when they announce that researchers from the two countries will share credit for discovery of the AIDS virus. The countries agree that patent rights to a blood test that emerged from that discovery will also be shared, with most of the royalties to be donated to a new foundation for AIDS research and education.
• April 6-9: The U.S. Surgeon General, Dr. C. Everett Koop , hosts a workshop on children with HIV infection and their families. Participants include families affected by HIV, leading HIV researchers and clinicians, mental health professionals, public health officials, and representatives from the insurance, legal, and nonprofit organizations. The workshop report calls for numerous changes in the way the nation addresses pediatric HIV/AIDS [PDF, 7.46MB], including more access to trial medications and support for attending school.
• April 7: FDA declares HIV prevention as a new indication for male condoms .
• April 19: Princess Diana makes international headlines when she is photographed shaking the hand of an HIV-positive patient in a London hospital Exit Disclaimer . She goes on to become a passionate advocate for people living with HIV and to speak forcefully against HIV/AIDS-related stigma and discrimination.
• April 29: FDA approves a new, more specific test for HIV antibodies : the Western blot blood test kit.
• May 15: The U.S. Public Health Service adds HIV as a “dangerous contagious disease” to its immigration exclusion list Exit Disclaimer and mandates testing for all visa applicants. The HIV ban will not be lifted until January 4, 2010.
• May 31: President Reagan makes his first public speech about AIDS Exit Disclaimer .
• June 24: President Reagan signs an Executive Order creating the first Presidential Commission on AIDS Exit Disclaimer .
• August 4: A task force of the Society of Actuaries issues a report claiming that the cost of AIDS to insurance companies could exceed $50 billion Exit Disclaimer by the year 2000.
• August 5: A federal judge orders Florida’s DeSoto County School Board to enroll HIV-positive brothers, Ricky, Robert, and Randy Ray. The board had refused to allow the three boys, who have hemophilia , to attend. After the ruling, outraged town residents refuse to allow their children to attend school, and someone sets fire to the Ray house on August 28, destroying it Exit Disclaimer .
• August 14: CDC issues Perspectives in Disease Prevention and Health Promotion: Public Health Service Guidelines for Counseling and Antibody Testing to Prevent HIV Infection and AIDS .
• August 18: FDA sanctions the first human testing of a candidate vaccine against HIV .
• August 21: CDC issues Recommendations for Prevention of HIV Transmission in Health-Care Settings . The recommendations call for healthcare workers to practice universal precautions .
• September 30: CDC launches the first AIDS-related public service announcements , America Responds to AIDS , to kick off the newly designated AIDS Awareness Month in October. The campaign is a multipart public-awareness initiative that “focuses on reaching a wide range of audiences variously defined by identity or behavior…” The campaign reaches millions, becoming a central prong in the “everyone is at risk” strategy of AIDS prevention.
• October: A Gallup poll finds that 68% of those polled call AIDS “the most urgent health problem facing the world Exit Disclaimer .
• October 11: The AIDS Memorial Quilt Exit Disclaimer goes on display for the first time on the National Mall in Washington, DC. The display features 1,920 4x8 panels and draws half a million visitors.
• October 14: In a 94-2 vote, the U.S. Senate adopts the Helms Amendment Exit Disclaimer , which requires federally financed educational materials about AIDS to stress sexual abstinence and forbids any material that “promotes” homosexuality or drug use.
• October 22: AIDS becomes the first disease ever debated on the floor of the United Nations General Assembly Exit Disclaimer (UNGA). The UNGA resolves to mobilize the entire United Nation’s system in the worldwide struggle against AIDS and designates the WHO to lead the effort.
• November: Journalist Randy Shilts’ book about the early years of the HIV/AIDS epidemic, And the Band Played On: Politics, People and the AIDS Epidemic , is published.
• November: Debra Fraser-Howze Exit Disclaimer , director of teenage services at the Urban League of New York, founds the National Black Leadership Commission on AIDS Exit Disclaimer . The organization works to educate, mobilize, and empower black leaders to meet the challenge of fighting HIV/AIDS and other health disparities in their local communities.
• November 13: The American Medical Association declares that doctors have an ethical obligation to care for people with AIDS Exit Disclaimer , as well as for those who have been infected with the virus but show no symptoms.
• March 3: Ryan White , the Indiana teenager who has become a national spokesperson for AIDS education, testifies about the stigma he has endured as a result of having AIDS Exit Disclaimer before the President’s Commission on AIDS .
• May 26: The U.S. Surgeon General, C. Everett Koop , launches the United States’ first coordinated HIV/AIDS education campaign by mailing 107 million copies of an 8-page booklet, Understanding AIDS [PDF, 1.1MB], to all American households. An additional four million copies are printed in Spanish and delivered to Latinx Exit Disclaimer organizations to be distributed locally. The pamphlet is the largest public health mailing in history —and the first time that the federal government provides explicit sex information to the public .
• July 23: The U.S. Food and Drug Administration (FDA) announces that it will allow the importation of small quantities of unapproved drugs for people with life-threatening illnesses Exit Disclaimer , including HIV/AIDS.
• August: The U.S. Health Resources and Services Administration (HRSA) awards $4.4 million in grants to 11 states and Puerto Rico for the first pediatric AIDS service demonstration projects. The projects are expected to demonstrate effective ways to reduce mother-to-child transmission of HIV; develop coordinated, community-based, and family-centered services for infants and children living with HIV; and develop programs to reduce the spread of HIV to vulnerable populations of young people.
• August 9: Drug counselor David Purchase sets up the nation’s first needle-exchange program to combat the spread of HIV Exit Disclaimer on a sidewalk in Tacoma, Washington. Although he has secured support from the mayor and the police chief for his one-man effort, Purchase has to pay for the needles out of pocket. Within five months, he exchanges 13,000 clean needles for contaminated ones. Purchase will go on to form the North American Syringe Exchange Network Exit Disclaimer (NASEN) and become known as the “Godfather of Needle Exchange.”
• October 11: Over 1,000 members and supporters of the activist group ACT UP Exit Disclaimer engage in a massive sit-in that shuts down FDA’s Rockville, MD, offices for the entire day to protest the slow pace of the federal drug-approval process for treatments for HIV/AIDS Exit Disclaimer . There are 176 arrests. Eight days later, FDA announces new regulations to speed up that process Exit Disclaimer .
• October 18: The Abandoned Infants Assistance (AIA) Act [PDF, 262KB] becomes law; it addresses the issue of so-called “boarder babies.” These infants, many of whom have been perinatally exposed to drugs or HIV, have been either been orphaned or left at hospitals indefinitely by their parents. The AIA funds demonstration projects to support moving these children into foster care or other more traditional living arrangements.
• November 4: President Reagan signs the Health Omnibus Programs Extension (HOPE) Act into law. The legislation authorizes the use of federal funds for AIDS prevention, education, and testing. It is the first comprehensive federal AIDS bill, and it establishes the Office of AIDS Research at the National Institutes of Health (NIH) and the AIDS Clinical Trials Group Exit Disclaimer .
• November 7: The New York City Health Department begins a pilot needle-exchange program Exit Disclaimer to address the growing number of HIV infections among people who inject drugs (PWID). The program is opposed by many African American and Latinx leaders in the city Exit Disclaimer , who see it as an abandonment of PWID of color. They demand a more comprehensive approach, including drug-prevention education, treatment and increased law enforcement.
• November 28: Elizabeth Glaser Exit Disclaimer , an HIV-positive mother of two HIV-positive children forms the Pediatric AIDS Foundation (later renamed the Elizabeth Glaser Pediatric AIDS Foundation Exit Disclaimer ). The Foundation funds cutting-edge research that leads to improved treatments for children living with HIV/AIDS and helps to establish protocols to prevent mother-to-child transmission of HIV.
• December 1: World AIDS Day is observed for the first time Exit Disclaimer . The date is designated by the World Health Organization and supported by the United Nations. The theme for the observance is “Join the Worldwide Effort.”
• December 16: Singer Sylvester James, Jr., dies of AIDS-related illness at age 41 Exit Disclaimer . James is an openly gay, African American entertainer who uses only his first name, and who is called “the embodiment of disco.” His legacy is such that, in 2018, the University of Sussex in England will host an interdisciplinary academic conference on disco and Sylvester's contribution to the genre Exit Disclaimer .
• December 20: Pioneering broadcast journalist Max Robinson dies of AIDS-related illness at age 49 Exit Disclaimer . Robinson is the first black network news anchor in the U.S. and a founder of the National Association of Black Journalists Exit Disclaimer .
• December 27: Gay rights activist and writer Joseph Beam dies of an AIDS-related illness three days before his 34th birthday Exit Disclaimer . He is best known for editing In the Life , the first collection of writings by gay black men on the impact HIV/AIDS is having on their community. Today In the Life is widely regarded as a literary and cultural milestone in gay literature Exit Disclaimer .
• Photographer Robert Mapplethorpe dies of AIDS-related illness on March 9.
• On June 16, the U.S. Centers for Disease Control and Prevention (CDC) issue the first guidelines for preventing Pneumocystis carinii pneumonia (PCP), an AIDS-related opportunistic infection, and a major cause of illness and death for people living with AIDS.
• On June 23, CDC releases the Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health-Care and Public-Safety Workers .
• The U.S. Congress creates the National Commission on AIDS. The Commission meets for the first time on September 18.
• Dr. Anthony Fauci, head of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID), endorses giving HIV-positive people who do not qualify for clinical trials access to experimental treatments.
• The U.S. Health Resources and Services Administration (HRSA) grants $20 million for HIV care and treatment through the Home-Based and Community-Based Care State grant program. For many states, this is their first involvement in HIV care and treatment.
• A CDC/HRSA initiative provides $11 million to fund seven community health centers to provide HIV counseling and testing services. This is a precursor to what will be part of the Ryan White CARE Act .
• The number of reported AIDS cases in the United States reaches 100,000 .
• On January 18, the U.S. Centers for Disease Control and Prevention (CDC) report the possible transmission of HIV to a patient through a dental procedure performed by an HIV-positive dentist. This episode provokes much public debate about the safety of common dental and medical procedures.
• On January 26, the U.S. Public Health Service issues a statement on managing occupational exposure to HIV , including considerations regarding post-exposure use of the antiretroviral drug, AZT.
• Pop artist Keith Haring dies of AIDS-related illness on February 16.
• On April 8, Ryan White dies of AIDS-related illness at the age of 18.
• On May 21, ACT UP (AIDS Coalition to Unleash Power) Exit Disclaimer protests at the National Institutes of Health (NIH), demanding more HIV treatments and the expansion of clinical trials to include more women and people of color.
• In June, the 6th International AIDS Conference meets in San Francisco. To protest U.S. immigration policy that bars people with HIV from entering the country, domestic and international nongovernmental groups boycott the conference.
• In July, the U.S. Congress enacts the Americans with Disabilities Act (ADA). The Act prohibits discrimination against individuals with disabilities, including people living with HIV/AIDS.
• In August, the U.S. Congress enacts the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 (PDF 8.3 MB), which provides $220.5 million in Federal funds for HIV community-based care and treatment services in its first year. The U.S. Health Resources and Services Administration (HRSA) manages the program, which is the nation’s largest HIV-specific Federal grant program.
• On October 26, the U.S. Food and Drug Administration (FDA) approves use of zidovudine (AZT) for pediatric AIDS .
• CDC adopts the HIV-prevention counseling model, a “client-centered” approach that focuses on the patient, rather than the disease.
• The Visual AIDS Artists Caucus Exit Disclaimer launches the Red Ribbon Project to create a visual symbol to demonstrate compassion for people living with AIDS and their caregivers. The red ribbon becomes the international symbol of AIDS awareness.
• The U.S. Congress enacts the Housing Opportunities for People with AIDS (HOPWA) Act of 1991. Administered by the U.S. Department of Housing and Urban Development (HUD), HOPWA grants to states and local communities provide housing assistance to people living with AIDS.
• On July 21, the U.S. Centers for Disease Control and Prevention (CDC) recommend restrictions on the practice of HIV-positive healthcare workers and Congress enacts a law requiring states to adopt the CDC restrictions or to develop and adopt their own.
• In August, the U.S. Congress passes the Terry Beirn Community-Based Clinical Trials Program Act (PDF, 56 KB) to establish a network of community-based clinical trials for HIV treatment.
• The National Minority AIDS Council Exit Disclaimer (NMAC), in cooperation with the National Association of People With AIDS (NAPWA) and the National AIDS Interfaith Network, holds the first annual National Skills Building Conference, which will later become the United States Conference on AIDS.
• On November 7, American basketball star Earvin “Magic” Johnson Exit Disclaimer announces that he is HIV-positive.
• On November 24, Freddie Mercury, lead singer/ songwriter of the rock band Queen, dies of bronchial pneumonia resulting from AIDS Exit Disclaimer .
• The 8th International AIDS Conference is originally scheduled to be held in Boston, but is moved to Amsterdam due to U.S. immigration restrictions on people living with HIV/AIDS.
• AIDS becomes the number one cause of death for U.S. men ages 25 to 44 .
• On May 27, the U.S. Food and Drug Administration (FDA) licenses a 10-minute diagnostic test kit which can be used by health professionals to detect the presence of HIV-1.
• On December 1, the U.S. Centers for Disease Control and Prevention (CDC) launch the Business Responds to AIDS program to help large and small businesses meet the challenges of HIV/AIDS in the workplace and the community. (CDC will start the Labor Responds to AIDS program in 1995.)
• Florida teenager Ricky Ray dies of AIDS-related illness on December 13. The 15-year-old hemophiliac and his two younger brothers sparked a national conversation on AIDS after their court battle to attend school led to boycotts by local residents and the torching of their home.
• President Clinton establishes the White House Office of National AIDS Policy (ONAP).
• World-renowned ballet dancer Rudolf Nureyev dies of AIDS-related illness on January 6, and tennis star Arthur Ashe dies on February 3.
• On May 7, the U.S. Food and Drug Administration (FDA) approves the female condom.
• In June, the U.S. Congress enacts the NIH (National Institutes of Health) Revitalization Act, giving the Office of AIDS Research primary oversight of all NIH AIDS research . The Act requires NIH and other research agencies to expand involvement of women and minorities in all research.
• The same act codifies the U.S. HIV immigration exclusion policy into law; President Clinton signs it on June 10.
• In August, the Women’s Interagency HIV Study and HIV Epidemiology Study begin; both are major U.S. Federally funded research studies on women and HIV/AIDS.
• On December 18, the U.S. Centers for Disease Control and Prevention (CDC) expand the case definition of AIDS , declaring those with CD4 counts below 200 to have AIDS.
• In that same MMWR , CDC adds three new conditions—pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer—to the list of clinical indicators of AIDS. These new conditions mean that more women and injection drug users will be diagnosed with AIDS.
• CDC institutes the community-planning process to better target local prevention efforts.
• The National Association of People With AIDS (NAPWA) convenes the first annual “AIDS Watch.” Hundreds of community members from across the U.S. come to Washington, DC to lobby Congress for increased funding.
• The film “Philadelphia” starring Tom Hanks as a lawyer with AIDS, opens in theaters. Based on a true story, it is the first major Hollywood film on AIDS.
• Angels in America , Tony Kushner’s play about AIDS, wins the Tony Award for Best Play and the 1993 Pulitzer Prize for Drama.
• AIDS becomes the leading cause of death for all Americans ages 25 to 44.
• On February 17, Randy Shilts, a U.S. journalist who covered the AIDS epidemic and who authored And the Band Played On: Politics, People and the AIDS Epidemic , dies of AIDS-related illness at age 42.
• On May 20, the U.S. Centers for Disease Control and Prevention (CDC) publishes Guidelines for Preventing Transmission of Human Immunodeficiency Virus Through Transplantation of Human Tissue and Organs .
• On August 5, the U.S. Public Health Service recommends that pregnant women be given the antiretroviral drug AZT to reduce the risk of perinatal transmission of HIV.
• Pedro Zamora, a young gay man living with HIV, appears on the cast of MTV’s popular show, “The Real World.” He dies on November 11 at age 22.
• On December 23, the U.S. Food and Drug Administration (FDA) approves an oral HIV test, the first non-blood-based antibody test for HIV.
• The U.S. Department of Health and Human Services (HHS) issues guidelines requiring applicants for grants from the National Institutes of Health (NIH) to address "the appropriate inclusion of women and minorities in clinical research."
• On February 23, Greg Louganis, Olympic gold medal diver, discloses that he is HIV-positive.
• In June, the U.S. Food and Drug Administration (FDA) approves the first protease inhibitor. This ushers in a new era of highly active antiretroviral therapy (HAART).
• Eric Lynn Wright, a.k.a. rapper Eazy-E, died on March 26 from an AIDS-related illness Exit Disclaimer one month after being diagnosed.
• On June 27, the National Association of People With AIDS (NAPWA) launches the first National HIV Testing Day .
• On July 14, the U.S. Centers for Disease Control and Prevention (CDC) issue the first guidelines to help healthcare providers prevent opportunistic infections in people infected with HIV.
• President Clinton establishes his Presidential Advisory Council on HIV/AIDS (PACHA). The Council meets for the first time on July 28.
• On September 22, CDC reviews Syringe Exchange Programs -- United States, 1994-1995 . The National Academy of Sciences Exit Disclaimer concludes that syringe exchange programs should be regarded as an effective component of a comprehensive strategy to prevent infectious disease.
• President Clinton hosts the first White House Conference on HIV/AIDS on December 6.
• By October 31, 500,000 cases of AIDS have been reported in the US.
• In Vancouver, the 11th International AIDS Conference highlights the effectiveness of highly active antiretroviral therapy (HAART), creating a period of optimism.
• The number of new AIDS cases diagnosed in the U.S. declines for the first time since the beginning of the epidemic.
• AIDS is no longer leading cause of death for all Americans ages 25-44, although it remains the leading cause of death for African Americans in this age group.
• UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer begins operations. It is established to advocate for global action on the epidemic and to coordinate HIV/AIDS efforts across the UN system.
• the first HIV home testing and collection kit (May 14)
• a viral load test, which measures the level of HIV in the blood (June 3)
• the first non-nucleoside reverse transcriptase inhibitor (NNRTI) drug, nevirapine (June 21)
• the first HIV urine test (August 6)
• The U.S. Congress reauthorizes the Ryan White CARE Act on May 20.
• In October, the AIDS Memorial Quilt Exit Disclaimer is displayed in its entirety for the last time. It covers the entire National Mall in Washington, DC.
• HIV/AIDS researcher Dr. David Ho advocates for a new strategy for treating HIV – “hit early, hit hard,” in which patients are placed on new, more aggressive treatment regimes earlier in the course of their infection in hopes of keeping them healthier longer. He is subsequently named TIME Magazine’s “ Man of the Year. ”
• The International AIDS Vaccine Initiative Exit Disclaimer (IAVI) forms to speed the search for an effective HIV vaccine.
• In response to the call to “hit early, hit hard,” highly active antiretroviral therapy (HAART) becomes the new standard of HIV care.
• The U.S. Centers for Disease Control and Prevention (CDC) report the first substantial decline in AIDS deaths in the United States. Due largely to the use of HAART, AIDS-related deaths in the U.S. decline by 47% compared with the previous year.
• On May 18, President Clinton announces that the goal of finding an effective vaccine for HIV in 10 years will be a top national priority, and calls for the creation of an AIDS vaccine research center at the National Institutes of Health (NIH). (He dedicates the Dale and Betty Bumpers Vaccine Research Center on June 9, 1999.)
• On September 26, the U.S. Food and Drug Administration (FDA) approves Combivir, a combination of two antiretroviral drugs in one tablet, which makes it easier for people living with HIV to take their medications.
• On November 21, the U.S. Congress enacts the Food and Drug Administration Modernization Act (FDAMA) of 1997 , codifying an accelerated drug-approval process and allowing dissemination of information about off-label uses of drugs.
• UNAIDS (the Joint United Nations Programme on AIDS) Exit Disclaimer estimates that 30 million adults and children worldwide have HIV, and that, each day, 16,000 people are newly infected with the virus.
• As a greater number of people begin taking protease inhibitors, resistance to the drugs becomes more common, and drug resistance emerges as an area of grave concern within the AIDS community.
• The U.S. Centers for Disease Control and Prevention (CDC) report that African Americans account for 49% of U.S. AIDS-related deaths. AIDS-related mortality for African Americans is almost 10 times that of Whites and three times that of Hispanics.
• In March, African American leaders, including members of the Congressional Black Caucus (CBC), are briefed on the highly disproportionate impact of HIV and AIDS in their communities. They develop a “Call to Action,” requesting that the President and Surgeon General declare HIV/AIDS a “State of Emergency” in the African American community.
• In October, President Clinton declares AIDS to be a “severe and ongoing health crisis” in African American and Hispanic communities in the United States and announces a special package of initiatives aimed at reducing the impact of HIV/AIDS on racial and ethnic minorities.
• With the leadership of the CBC, Congress funds the Minority AIDS Initiative (PDF 126 KB). An unprecedented $156 million is invested to improve the nation’s effectiveness in preventing and treating HIV/AIDS in African American, Hispanic, and other minority communities.
• On April 20, Donna Shalala, Secretary of the U.S. Department of Health and Human Services, determines that needle-exchange programs (NEPs) are effective and do not encourage the use of illegal drugs, but the Clinton Administration does not lift the ban on use of Federal funds for NEPs.
• On April 24, CDC issues the first national treatment guidelines for the use of antiretroviral therapy in adults and adolescents with HIV.
• On June 25, the U.S. Supreme Court rules that the Americans with Disabilities Act (ADA) covers those in earlier stages of HIV disease, not just those who have developed AIDS.
• On November 12, the U.S. Congress enacts the Ricky Ray Hemophilia Relief Fund Act , (PDF 184 KB) honoring the Florida teenager who was infected with HIV through contaminated blood products. The Act authorizes payments to individuals with hemophilia and other blood clotting disorders who were infected with HIV by unscreened blood-clotting agents between 1982 and 1987.
• The Congressional Hispanic Caucus, with the Congressional Hispanic Caucus Institute Exit Disclaimer , convenes Congressional hearings on the impact of HIV/AIDS on the Latino community.
• The World Health Organization Exit Disclaimer (WHO) announces that HIV/AIDS has become the fourth biggest killer worldwide and the number one killer in Africa. WHO estimates that 33 million people are living with HIV worldwide, and that 14 million have died of AIDS.
• February 7: The first National Black HIV/AIDS Awareness Day (NBHAAD) is launched as a grassroots-education effort to raise awareness about HIV and AIDS prevention, care, and treatment in communities of color.
• In March, VaxGen, a San Francisco-based biotechnology company, begins conducting the first human vaccine trials in a developing country—Thailand.
• On July 19, President Clinton announces the formation of the “Leadership and Investment in Fighting an Epidemic” (LIFE) Initiative (PDF 88 KB), which will provide funding to address the global HIV epidemic.
• On December 10, the U.S. Centers for Disease Control and Prevention (CDC) release a new HIV case definition to help state health departments expand their HIV surveillance efforts and more accurately track the changing course of the epidemic.
• On January 10, the United Nations Security Council Exit Disclaimer meets to discuss the impact of AIDS on peace and security in Africa. This marks the first time that the council discusses a health issue as a threat to peace and security.
• In his State of the Union address on January 27, President Clinton announces the launch of the Millennium Vaccine Initiative to create incentives for developing and distributing vaccines against HIV, TB, and malaria.
• On April 30, President Clinton declares that HIV/AIDS is a threat to U.S. national security.
• On May 10, President Clinton issues an Executive Order to assist developing countries in importing and producing generic HIV treatments.
• In July, UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer , the World Health Organization Exit Disclaimer (WHO), and other global health groups announce a joint initiative with five major pharmaceutical manufacturers to negotiate reduced prices for HIV/AIDS drugs in developing countries.
• On July 23, the leaders of the “Group of Eight” (G8) Summit release a statement acknowledging the need for additional HIV/AIDS resources Exit Disclaimer . G8 members make up most of the world’s largest economies, and include: Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States.
• In August, the U.S. Congress enacts the Global AIDS and Tuberculosis Relief Act of 2000 . (PDF 2.1 MB)
• In September, as part of its Millennium Declaration Exit Disclaimer , the United Nations adopts the Millennium Development Goals Exit Disclaimer , which include a specific goal of reversing the spread of HIV/AIDS, malaria, and TB.
• In October, the U.S. Congress reauthorizes the Ryan White CARE Act for the second time.
• May 18 is the first annual observance of HIV Vaccine Awareness Day .
• On June 25-27, the United Nations (UN) General Assembly Exit Disclaimer holds its first Special Session on AIDS Exit Disclaimer (UNGASS) and passes the UNGASS Declaration of Commitment Exit Disclaimer and the ILO (International Labor Organization) Code of Practice on HIV/AIDS in the Workplace Exit Disclaimer (PDF, 127 KB). The meeting also calls for the creation of an international “global fund” to support efforts by countries and organizations to combat the spread of HIV through prevention, care, and treatment, including the purchase of HIV medications.
• Newly appointed U.S. Secretary of State, Colin Powell, reaffirms the U.S. statement that HIV/AIDS is a national security threat.
• After generic drug manufacturers offer to produce discounted, generic forms of HIV/AIDS drugs for developing countries; several major pharmaceutical manufacturers agree to offer further reduced drug prices to those countries.
• On November 14, the World Trade Organization Exit Disclaimer (WTO) announces the Doha Declaration Exit Disclaimer , which affirms the rights of developing countries to buy or manufacture generic medications to meet public health crises such as HIV/AIDS.
• The U.S. Health Resources and Services Administration (HRSA) begins focusing on individuals with HIV disease who know their status and are not receiving HIV-related services. HRSA instructs its grantees to address this population’s “unmet need” for services.
• The U.S. Centers for Disease Control and Prevention (CDC) announce a new HIV Prevention Strategic Plan to cut annual HIV infections in the U.S. by half within five years.
• In January, the Global Fund to Fight AIDS, Tuberculosis and Malaria Exit Disclaimer , a partnership between governments, civil society organizations, the private sector, and affected communities, is established.
• On April 25, the Global Fund approves its first round of grants to governments and private-sector organizations in the developing world. The grants total $600 million for two-year projects.
• On June 25, the United States announces a framework that will allow poor countries unable to produce pharmaceuticals to gain greater access to drugs needed to combat HIV/AIDS, malaria, and other public health crises.
• In July, UNAIDS (the Joint United Nations Programme on AIDS) Exit Disclaimer reports that HIV/AIDS is now by far the leading cause of death in sub-Saharan Africa, and the fourth biggest global killer. Average life expectancy in sub-Saharan Africa falls from 62 years to 47 years as a result of AIDS.
• The 14th International AIDS Conference is held in Barcelona, Spain from July 7-12. Dozens of countries report they are experiencing serious HIV/AIDS epidemics, and many more are on the brink.
• In September, the U.S. National Intelligence Council Exit Disclaimer releases Next Wave of the Epidemic , a report focusing on HIV in India, China, Russia, Nigeria, and Ethiopia.
• On November 7, the U.S. Food and Drug Administration (FDA) approves the first rapid HIV diagnostic test kit for use in the United States that provides results with 99.6 percent accuracy in as little as 20 minutes. Unlike other antibody tests for HIV, this blood test can be stored at room temperature, requires no specialized equipment, and may be used outside of traditional laboratory or clinical settings, allowing more widespread use of HIV testing.
• Worldwide, 10 million young people, aged 15-24, and almost 3 million children under 15 are living with HIV. During this year, approximately 3.5 million new infections will occur in sub-Saharan Africa, and the epidemic will claim the lives of an estimated 2.4 million Africans.
• Side effects and increasing evidence of drug resistance call into question the “hit early, hit hard” strategy.
• The U.S. Centers for Disease Control and Prevention (CDC) calculate that 27,000 of the estimated 40,000 new infections that occur each year in the U.S. result from transmission by individuals who do not know they are infected.
• On January 28, President George W. Bush announces the creation of the United States President’s Emergency Plan For AIDS Relief (PEPFAR) in his State of the Union address . PEPFAR is a $15 billion, 5-year plan to combat AIDS, primarily in countries with a high burden of infections.
• On February 24, VaxGen, a San Francisco-based biotechnology company, announces that its AIDSVAX vaccine trial failed to reduce overall HIV infection rates among those who were vaccinated.
• On March 31, the Bill and Melinda Gates Foundation Exit Disclaimer awards a $60 million grant to the International Partnership for Microbicides Exit Disclaimer to support research and development of microbicides to prevent transmission of HIV.
• On April 18, CDC announces Advancing HIV Prevention: New Strategies for a Changing Epidemic , a new prevention initiative that aims to reduce barriers to early diagnosis and increase access to, and utilization of, quality medical care, treatment, and ongoing prevention services for those living with HIV.
• In early June, the “Group of Eight” (G8) Summit includes a special focus on HIV/AIDS and announcements of new commitments Exit Disclaimer (PDF 854 KB) to the Global Fund. G8 members make up most of the world’s largest economies and include: Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States.
• October 15 marks the first annual National Latino AIDS Awareness Day Exit Disclaimer in the U.S.
• On October 23, the William J. Clinton Foundation Exit Disclaimer secures price reductions for HIV/AIDS drugs from generic manufacturers, to benefit developing nations.
• On December 1, the World Health Organization Exit Disclaimer (WHO) announces the “3 by 5” initiative Exit Disclaimer , to bring treatment to 3 million people by 2005.
• In January, the U.S. Congress authorizes the first $350 million for the United States President’s Emergency Program for AIDS Relief (PEPFAR).
• In February, UNAIDS (the Joint United Nations Programme on AIDS) Exit Disclaimer launches The Global Coalition on Women and AIDS Exit Disclaimer to raise the visibility of the epidemic’s impact on women and girls around the world.
• On March 26, the U.S. Food and Drug Administration (FDA) approves the use of oral fluid samples with a rapid HIV diagnostic test kit that provides the result in approximately 20 minutes.
• On May 17, FDA issues a guidance document for expedited approval of low cost, safe, and effective co-packaged and fixed-dose combination HIV therapies so that high-quality drugs can be made available in Africa and developing countries around the world under PEPFAR.
• On June 10, leaders of the “Group of Eight” (G8) Summit (Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States) call for the creation of a “ Global HIV Vaccine Enterprise Exit Disclaimer ,” a consortium of government and private-sector groups designed to coordinate and accelerate research efforts to find an effective HIV vaccine.
• During its annual meeting in January, the World Economic Forum Exit Disclaimer approves a set of new priorities, including one with a focus on addressing HIV/AIDS in Africa and other hard-hit regions.
• On January 26, the World Health Organization Exit Disclaimer (WHO), UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer , the U.S. Government, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria Exit Disclaimer announce results of joint efforts to increase the availability of antiretroviral drugs in developing countries. An estimated 700,000 people have been reached by the end of 2004.
• Also on January 26, the U.S. Food and Drug Administration (FDA) grants tentative approval to a generic copackaged antiretroviral drug regimen for use under the United States President’s Emergency Plan for AIDS Relief (PEPFAR).
• May 19 is the first annual National Asian and Pacific Islander HIV/AIDS Awareness Day in the U.S.
• On June 2, the United Nations (U.N.) General Assembly High-Level Meeting on HIV/AIDS meets to review progress on targets set at the 2001 U.N. General Assembly Special Session on HIV/AIDS Exit Disclaimer (UNGASS).
• On July 6-8, the “Group of Eight” (G8) Summit focuses on development in Africa, including HIV/AIDS Exit Disclaimer (PDF, 372KB). G8 members make up most of the world’s largest economies and include: Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States.
• June 5 marks 25 years since the first AIDS cases were reported.
• March 10 is the first annual National Women and Girls HIV/AIDS Awareness Day in the U.S.
• March 20 is the first annual observance of National Native HIV/AIDS Awareness Day Exit Disclaimer in the U.S.
• On May 3-6, the Office of AIDS Research , in the National Institutes of Health (NIH), sponsors Embracing Our Traditions, Values, and Teachings: Native Peoples of North America HIV/AIDS Conference , in Anchorage, Alaska. The conference involves nearly 1,000 participants from the American Indian, Alaska Native, Native Hawaiian, First Nations, and U.S. Territorial Pacific Islander communities.
• On May 31, the United Nations convenes a follow-up meeting and issues a progress report on the implementation of the Declaration of Commitment on HIV/AIDS Exit Disclaimer .
• On September 22, the U.S. Centers for Disease Control and Prevention (CDC) release revised HIV testing recommendations for healthcare settings, recommending routine HIV screening for all adults, aged 13-64, and yearly screening for those at high risk.
• In December, a University of Illinois at Chicago study indicates that medical circumcision of men reduces their risk of acquiring HIV during heterosexual intercourse by 53 percent. The clinical trial of Kenyan men is supported by the U.S. National Institute for Allergy and Infectious Diseases and the Canadian Institute of Health Research Exit Disclaimer .
• On December 19, the U.S. Congress reauthorizes the Ryan White CARE Act for the third time.
• In an attempt to increase the number of people taking HIV tests, on May 30, the World Health Organization Exit Disclaimer (WHO) and UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer issue new guidance recommending “provider-initiated” HIV testing Exit Disclaimer in healthcare settings.
• In June, the Rwandan Government hosts the International HIV/AIDS Implementers Meeting Exit Disclaimer (PDF). Over 1,500 delegates share lessons on HIV prevention, treatment, and care. Cosponsors include WHO, UNAIDS, the United States President’s Emergency Plan for AIDS Relief (PEPFAR), The Global Fund to Fight AIDS, Tuberculosis, and Malaria Exit Disclaimer , the United Nations Children’s Fund Exit Disclaimer (UNICEF), the World Bank Exit Disclaimer , and GNP+ (the Global Network of People Living with HIV) Exit Disclaimer .
• In October, the U.S. Centers for Disease Control and Prevention (CDC) launch Prevention IS Care (PIC) , a social marketing campaign designed for healthcare providers who deliver care to people living with HIV.
• CDC reports over 565,000 people have died of AIDS in the U.S. since 1981.
• In June, the International HIV/AIDS Implementers Meeting is hosted by the Ugandan Government. Cosponsors include the United States President’s Emergency Plan for AIDS Relief (PEPFAR), The Global Fund to Fight AIDS, Tuberculosis, and Malaria Exit Disclaimer , UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer , the World Health Organization Exit Disclaimer (WHO), the United Nations Children’s Fund Exit Disclaimer (UNICEF), the World Bank Exit Disclaimer , and GNP+ (the Global Network of People Living with HIV) Exit Disclaimer .
• On July 31, President Bush signs legislation reauthorizing PEPFAR for an additional five years for up to $48 billion. The bill contains a rider that lifts the blanket ban on HIV-positive travelers to the U.S., and gives the U.S. Department of Health and Human Services the authority to admit people living with HIV/AIDS on a case-by-case basis.
• On August 6, the U.S. Centers for Disease Control and Prevention (CDC) release new domestic HIV incidence estimates that are substantially higher than previous estimates (56,300 new infections per year vs. 40,000). The new estimates do not represent an actual increase in the numbers of HIV infections, but reflect a more accurate way of measuring new infections. A separate analysis suggests that the annual number of new infections was never as low as 40,000 and that it has been roughly stable since the late 1990s.
• September 18 is the first observance of National HIV/AIDS and Aging Awareness Day Exit Disclaimer .
• National Gay Men’s HIV/AIDS Awareness Day is first recognized on September 27.
• Newly elected President Barack Obama calls for the development of the first National HIV/AIDS Strategy for the United States.
• In February, the District of Columbia Health Department’s HIV/AIDS, Hepatitis, STD, and TB Administration reports that Washington, DC has a higher rate of HIV (3% prevalence) than West Africa– enough to describe it as a “severe and generalized epidemic.”
• On April 7, the White House and the U.S. Centers for Disease Control and Prevention (CDC) launch the Act Against AIDS campaign , a multiyear, multifaceted communication campaign designed to reduce HIV incidence in the United States. CDC also launches the Act Against AIDS Leadership Initiative (AAALI) , to harness the collective strength and reach of traditional, longstanding African American institutions to increase HIV-related awareness, knowledge, and action within Black communities across the U.S.
• On May 5, President Obama launches the Global Health Initiative (GHI), a six-year, U.S. $63 billion effort to develop a comprehensive approach to addressing global health in low- and middle-income countries. The United States President’s Emergency Plan for AIDS Relief (PEPFAR) will serve as a core component.
• June 8 marks the first annual recognition of Caribbean American HIV/AIDS Awareness Day Exit Disclaimer .
• On August 17, the Department of Veterans Affairs (VA) moves to increase the number of veterans getting HIV tests by dropping the requirement for written consent (verbal consent is still required).
• On October 6, the U.S. Food and Drug Administration (FDA), in association with the PEPFAR program, approves the 100 th antiretroviral drug Exit Disclaimer .
• On October 30, President Obama announces that his administration will officially lift the HIV travel and immigration ban in January 2010 by removing the final regulatory barriers to entry. The lifting of the travel ban occurs in conjunction with the announcement that the International AIDS Conference Exit Disclaimer will return to the United States for the first time in more than 20 years. The conference will be held in Washington, DC in 2012.
• On November 24, UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer reports that there has been a significant decline (-17%) in new HIV infections in the past decade. East Asia, however, has seen a dramatic 25% increase in infections over the same period.
• In December, President Obama signs the Consolidated Appropriations Act, 2010 (PDF, 1.08 MB), modifying the ban on the use of Federal funds for needle exchange programs. When applicable, Federal funds may be used for personnel, equipment, syringe disposal services, educational materials, communication and marketing activities and evaluation activities, and evaluation. Some HHS programs may still contain partial or complete bans on the use of funds for needle exchange programs.
• On January 4, the U.S. Government officially lifts the HIV travel and immigration ban.
• On March 23, President Obama signs the Patient Protection and Affordable Care Act , which expands access to care and prevention for all Americans—but offers special protections for those living with chronic illnesses, like HIV , that make it difficult for them to access or afford healthcare.
• On July 13, the Obama Administration releases the first comprehensive National HIV/AIDS Strategy for the United States .
• The 18th International AIDS Conference Exit Disclaimer takes place in Vienna, Austria from July 18-23. The biggest outcomes from the conference include:
• The results of the Centre for the AIDS Programme of Research in South Africa’s (CAPRISA) 004 study Exit Disclaimer of antiretroviral-based vaginal microbicides are released on July 19. The study shows the microbicides to be safe and effective in reducing risks of new HIV infections among women by 39%. Women who use the microbicides as directed have even higher rates of protection (54%) against HIV infection.
• The National Institutes of Health (NIH) announce the results of the iPrEx study, showing that a daily dose of HIV drugs reduced the risk of HIV infection among HIV-negative men who have sex with men by 44%, supporting the concept of pre-exposure prophylaxis (PrEP) in a targeted population.
• On September 20-22, the United Nations Exit Disclaimer (UN) convenes a summit to accelerate progress toward the 2015 Millennium Development Goals Exit Disclaimer .
• Also in September, the World Health Organization Exit Disclaimer (WHO), UNAIDS (the Joint United Nations Programme on HIV/AIDS) Exit Disclaimer , and the United Nations Children’s Fund Exit Disclaimer (UNICEF) publish their annual Universal Access report Exit Disclaimer for low- and middle-income countries. The report shows an estimated 5.25 million people were receiving antiretroviral therapy in 2009, and an estimated 1.2 million people started treatment that same year – the largest annual increase yet recorded.
• AIDS Action merges with the National AIDS Fund to form AIDS United Exit Disclaimer .
• Public debate begins on whether the longstanding ban on transplants of HIV-infected organs should be dropped Exit Disclaimer .
• Lead Federal agencies release implementation plans in support of the U.S. National HIV/AIDS Strategy .
• The U.S. Department of Health and Human Services (HHS) launches the 12 Cities Project (PDF, 427 KB), an HHS-wide project that supports and accelerates comprehensive HIV/AIDS planning and cross-agency response in the 12 U.S. jurisdictions that bear the highest AIDS burden in the country.
• AIDS activist and award-winning actress Elizabeth Taylor dies on March 23. One of the first celebrities to advocate on behalf of people living with HIV and AIDS, Taylor was the founding national chairman of amfAR (American Foundation for AIDS Research) Exit Disclaimer , a nonprofit organization that supports AIDS research, HIV prevention, treatment education, and advocates for AIDS-related public policy.
• On June 8, HHS Secretary Sebelius hosted “ Commemorating 30 Years of Leadership in the Fight Against HIV/AIDS ”. Watch Exit Disclaimer the Secretary's speech.
• Over 3,000 people participate in the United Nation’s (UN) High-Level Meeting on HIV/AIDS in New York from June 8–10. The session recognizes critical milestones, including three decades of the pandemic and the 10-year anniversary of the 2001 UN General Assembly Special Session on HIV/AIDS and the resulting Declaration of Commitment Exit Disclaimer . At the Meeting, the U.S. joined with other partners in launching a global plan to eliminate mother-to-child transmission of HIV and keep mothers alive.
• July 13 marks the one-year anniversary of the White House National HIV/AIDS Strategy . The White House release a video: “ President Obama’s National HIV/AIDS Strategy Exit Disclaimer “ and the “ National HIV/AIDS Strategy: Implementation Plan Update “ (PDF, 387 KB).
• On July 13, a new CDC study ( TDF2 Exit Disclaimer (PDF 130 KB)) and a separate trial (the Partners PrEP study ) provide the first evidence that a daily oral dose of antiretroviral drugs used to treat HIV infection can also reduce HIV acquisition among uninfected individuals exposed to the virus through heterosexual sex.
• At the International AIDS Society’s Exit Disclaimer Conference on HIV Pathogenesis, Treatment, and Prevention Exit Disclaimer in Rome (July 17-20), scientists announce that two studies have confirmed that individuals taking daily antiretroviral drugs experienced infection rates more than 60 percent lower than those on a placebo.
• In September, the Office of National AIDS Policy begins to convene a series of five regional dialogues to focus attention on critical implementation issues for the National HIV/AIDS Strategy .
• On September 30, the first Road to AIDS 2012 Exit Disclaimer Town Hall meeting kicks off in San Francisco. This is the first of 15 meetings to be held across the country, leading up to the XIX International AIDS Conference (AIDS 2012) Exit Disclaimer , to be held July 22-27, 2012, in Washington, DC.
• On November 8, Secretary of State Hillary Rodham Clinton shares the U.S. Government’s bold new vision of creating an AIDS-free generation, and speaks about the remarkable progress made in 30 years of fighting AIDS.
• On December 1 (World AIDS Day), at the ONE Campaign and (RED) event in Washington, DC, President Obama announces accelerated efforts to increase the availability of treatment to people living with HIV/AIDS in the United States . He challenges the global community to deliver funds to The Global Fund to Fight AIDS, Tuberculosis and Malaria Exit Disclaimer , and calls on Congress to keep its past commitments intact. He calls on all Americans to keep fighting to end the epidemic.
• On December 23, the journal Science announces that it has chosen the HPTN 052 study as its 2011 Breakthrough of the Year.
• March 13: Researchers from the University of New South Wales in Australia find that people living with HIV who are taking antiretroviral therapy (ART) have an increased risk of cardiovascular disease Exit Disclaimer .
• March 27: The U.S. Department of Health and Human Services issues new HIV treatment guidelines recommending treatment for all HIV-infected adults and adolescents, regardless of CD4 count or viral load.
• July 1: The Kaiser Family Foundation Exit Disclaimer and the Washington Post release a joint survey Exit Disclaimer of the American public’s attitudes, awareness, and experiences related to HIV and AIDS. The survey finds that roughly a quarter of Americans do not know that HIV cannot be transmitted by sharing a drinking glass—almost exactly the same share as in 1987.
• July 3: The FDA approves the first at-home HIV test that will let users learn their HIV status right away.
• July 16: The FDA approves the use of Truvada® for pre-exposure prophylaxis (PrEP). Adults who do not have HIV, but who are at risk for infection, can now take this medication to reduce their risk of getting the virus through sexual activity.
• July 22-27: The XIX International AIDS Conference ( AIDS 2012 Exit Disclaimer ) is held in Washington, DC—the first time since 1990 that the conference has been held in the United States. Conference organizers had refused to convene the event in the U.S. until the Federal government lifted the ban on HIV-positive travelers entering the country.
• During AIDS 2012, the AIDS Memorial Quilt Exit Disclaimer is displayed in its entirety in Washington, DC, for the first time since 1996. Volunteers have to rotate nearly 50,000 panels to ensure that the entire work is displayed. Microsoft Research, the University of Southern California, the NAMES Project Foundation Exit Disclaimer , and a handful of other institutions collaborate to create a zoomable “map” of the Quilt Exit Disclaimer .
• The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) celebrates its 10th anniversary.
• March 4: NIH-funded scientists announce the first well-documented case of an HIV-infected child, designated as “the Mississippi Baby,” who appears to have been functionally cured of HIV infection (i.e., no detectable levels of virus or signs of disease, even without antiretroviral therapy.
• June 2: The New York Times runs two articles which focus on middle-aged people living with HIV: The Faces of H.I.V. in New York in 2013 Exit Disclaimer and ‘People Think It’s Over’: Spared Death, Aging People With H.I.V. Struggle to Live Exit Disclaimer .
• June 5: The National Minority AIDS Council (NMAC) releases RISE Proud: Combating HIV Among Black Gay and Bisexual Men Exit Disclaimer (PDF 1.4 MB), an action plan to mitigate the impact of HIV on black gay and bisexual men.
• June 18: Secretary of State John Kerry announces that, thanks to direct PEPFAR support, more than 1 million infants have been born HIV-free since 2003.
• July 3: Researchers report Exit Disclaimer that two HIV-positive patients in Boston who had bone-marrow transplants for blood cancers have apparently been virus-free for weeks since their antiretroviral drugs were stopped.
• July 13: President Obama issues an Executive Order directing Federal agencies to prioritize supporting the HIV care continuum as a means of implementing the National HIV/AIDS Strategy. The HIV Care Continuum Initiative Exit Disclaimer aims to accelerate efforts to improve the percentage of people living with HIV who move from testing to treatment and—ultimately—to viral suppression.
• October: The National Latino AIDS Action Network Exit Disclaimer (NLAAN)—a diverse coalition of community-based organizations, national organizations, state and local health departments, researchers and concerned individuals—publishes the National Latino/Hispanic HIV/AIDS Action Agenda Exit Disclaimer (PDF 4.1 MB) to raise awareness, identify priorities, and issue specific recommendations to address the impact of the epidemic in Hispanic/Latino communities.
• November 21: President Obama signs the HIV Organ Policy Equity (HOPE) Act , which will allow people living with HIV to receive organs from other infected donors. The HOPE Act has the potential to save the lives of about 1,000 HIV-infected patients with liver and kidney failure annually.
• December 5: Nelson Mandela Exit Disclaimer —South African anti-apartheid leader, political prisoner, and national President from 1994 to 1999—dies at the age of 95. After his son, Makgatho, died of AIDS-related causes in 2005, Mandela spent the remainder of his post presidential career working to address the AIDS epidemic in South Africa, which is home to the largest number of people living with HIV (~6.8 million) in the world.
• At the end of 2012, UNAIDS estimates Exit Disclaimer that, worldwide, 2.3 million people were newly infected with HIV during the year, and 1.6 million people died of AIDS. Approximately 35.3 million people around the world are now living with HIV, including more than 1.2 million Americans (PDF 477 KB).
• UNAIDS also announces that new HIV infections have dropped Exit Disclaimer more than 50% in 25 low- and middle-income countries, and the number of people getting antiretroviral treatment has increased 63% in the past two years.
• January 1: Major provisions of the Affordable Care Act (ACA) designed to protect consumers go into effect Exit Disclaimer . Insurers are now barred from discriminating against customers with pre-existing conditions, and they can no longer impose annual limits on coverage—both key advances for people living with HIV/AIDS.
• January 2: News sources report that the two Boston patients believed to have been cured of HIV after undergoing treatment for cancer have relapsed Exit Disclaimer .
• February 3: amfAR announces the launch of Countdown to a Cure for AIDS Exit Disclaimer , a $100 million research initiative aimed at finding a broadly applicable cure for HIV by 2020.
• March 4: European researchers announce the results of the first phase of the PARTNER Study Exit Disclaimer , an observational study focusing on the risk of sexual HIV transmission when an HIV-positive person is on treatment. The study found that no HIV-positive partner who was undergoing antiretroviral therapy and had an undetectable viral load had transmitted HIV.
• March—The United Nations Commission on the Status of Women releases a report Exit Disclaimer (PDF 563 KB) on the challenges and achievements of implementing the MDGs for women and girls. The Commission concludes that progress on MDG6 (Combating HIV/AIDS, Malaria, and Other Diseases) has been limited, given that the number of women living with HIV globally continues to increase. The report notes several key challenges: adolescent/young women’s particular vulnerability to HIV; the need to increase access to healthcare services; and the challenges of structural gender inequalities, stigma, discrimination, and violence.
• March 24—Douglas Brooks is appointed as the new Director of the White House Office of National AIDS Policy (ONAP). He is the first African American and the first HIV-positive person to hold the position.
• April 4: Dr. Deborah Birx is sworn in as Ambassador at Large and U.S. Global AIDS Coordinator to oversee the President’s Emergency Plan for AIDS Relief (PEPFAR). She replaces Dr. Eric Goosby.
• July 10: The National Institutes of Health announce that the “Mississippi baby” now has detectable levels of HIV after more than two years of showing no evidence of the virus.
• July 17: Flight MH17, en route from Amsterdam to Kuala Lumpur, is shot down over conflict-ridden Ukraine Exit Disclaimer , killing all 298 people aboard, including six prominent scientists and AIDS activists on their way to the 20th International AIDS Conference ( AIDS 2014 Exit Disclaimer ) in Melbourne, Australia.
• July 20-25: AIDS 2014 draws nearly 14,000 delegates from over 200 nations. One key message of the conference is that a one-size-fits-all approach may not be suitable for all settings Exit Disclaimer (PDF 4.6 MB), especially given the diversity of the epidemic’s geographical hotspots and key populations. Interventions and policies will require target-based strategies and greater support of key populations, especially in countries where discriminatory policies and legislation are hindering prevention and treatment efforts.
• September 9: The Pew Charitable Trust publishes Southern States Are Now Epicenter of HIV/AIDS in the U.S. Exit Disclaimer
• October 9: CDC releases a new report that finds gaps in care and treatment among Latinos diagnosed with HIV.
• November 25: CDC announces that only 30% of Americans with HIV had the virus under control in 2011 , and approximately two-thirds of those whose virus was out of control had been diagnosed but were no longer in care.
• December 23: FDA announces it will recommend changing the blood donor deferral guidelines for men who have sex with men from permanent deferral to one year since the last sexual contact. In 1983, the agency imposed a lifetime ban on donating blood for all men who have ever had sex with another man.
• January 8: A review of multiple studies Exit Disclaimer of South African women indicates that using Depo Provera, an injectable contraceptive, may increase women’s chances of contracting HIV by 40 percent.
• February 5: HHS announces the launch of a new, 4-year demonstration project to address HIV disparities among MSM of color. The cross-agency project, “Developing Comprehensive Models of HIV Prevention and Care Services for MSM of Color,” will support community-based models for HIV prevention and treatment.
• February 23: CDC’s annual HIV Surveillance Report , indicates that HIV diagnosis rates in the U.S. remained stable between 2009-2013, but men who have sex with men, young adults, racial/ethnic minorities, and individuals living in the South continue to bear a disproportionate burden of HIV.
• February 23: CDC announces that more than 90% of new HIV infections in the United States could be prevented by diagnosing people living with HIV and ensuring they receive prompt, ongoing care and treatment.
• February 25: Indiana state health officials announce an HIV outbreak linked to injection drug use (PDF 59 KB) in the southeastern portion of the state. By the end of the year, Indiana will confirm 184 new cases of HIV linked to the outbreak.
• April 15: NIH launches a large, multicenter, international clinical trial to study heart disease in people living with HIV, who are up to twice as likely as HIV-negative individuals to have heart attacks and other forms of cardiovascular disease.
• May 8: The U.S. Department of Health and Human Services announces on May 8 that it will amend the Federal rules covering organ transplants to allow the recovery of transplantable organs from HIV-positive donors. The new regulations will provide a framework for clinical studies on transplanting organs from HIV-positive donors to HIV-positive recipients.
• May 27: Results from the Strategic Timing of AntiRetroviral Treatment (START) study indicate that HIV-positive individuals who start taking antiretroviral drugs before their CD4+ cell counts decrease have a considerably lower risk of developing AIDS or other serious illnesses. Subsequent data releases show that early therapy for people living with HIV also prevents the onset of cancer, cardiovascular disease, and other non-AIDS-related diseases.
• June 30: The World Health Organization certifies that Cuba is the first nation to eliminate mother-to-child transmission Exit Disclaimer of both HIV and syphilis.
• July 14: UNAIDS announces that the targets for Millennium Development Goal #6 Exit Disclaimer —halting and reversing the spread of HIV—have been achieved and exceeded 9 months ahead of the schedule set in 2000.
• July 20: Researchers report that antiretroviral therapy is highly effective at preventing sexual transmission of HIV from a person living with HIV to an uninfected heterosexual partner, when the HIV-positive partner is virally suppressed. The finding comes from the decade-long HPTN 052 clinical trial.
• July 23: The U.S. Food and Drug Administration approves the first diagnostic test that differentiates between different types of HIV infections (HIV-1 and HIV-2). The test can also differentiate between acute and established HIV infections.
• July 30: The White House launches the National HIV/AIDS Strategy: Updated to 2020 (PDF 2.2 MB). The updated Strategy retains the vision and goals of the original, but reflects scientific advances, transformations in healthcare access as a result of the Affordable Care Act, and a renewed emphasis on key populations, geographic areas, and practices necessary to end the domestic HIV epidemic.
• September 18: The U.S. Departments of Housing and Urban Development and Justice announce they will collaborate on a demonstration project to provide housing assistance and supportive services to low-income persons living with HIV/AIDS who are victims of sexual assault, domestic violence, dating violence, or stalking.
• September 26: At a United Nations summit on the Sustainable Development Goals Exit Disclaimer , the United States announces new PEPFAR prevention and treatment targets (PDF 640 KB) for 2016–2017. By the end of 2017, the U.S. will commit sufficient resources to support antiretroviral therapy for 12.9 million people, provide 13 million male circumcisions for HIV prevention, and reduce HIV incidence by 40% among adolescent girls and young women within the highest burdened areas of 10 sub-Saharan African countries.
• September 30: The World Health Organization announces new treatment recommendations Exit Disclaimer that call for all people living with HIV to begin antiretroviral therapy as soon after diagnosis as possible. WHO also recommends daily oral PrEP as an additional prevention choice for those at substantial risk for contracting HIV. WHO estimates the new policies could help avert more than 21 million deaths and 28 million new infections by 2030.
• October 20: Greater Than AIDS launches a new campaign, Empowered: Women, HIV and Intimate Partner Violence Exit Disclaimer , to bring more attention to issues of relationship violence and provide resources for women who may be at risk of, or dealing with, abuse and HIV.
• November 17: Actor Charlie Sheen announces his HIV-positive status Exit Disclaimer in a nationally televised interview. Significant public conversation about HIV follows his disclosure. Earlier in the year, rapper, performance artist, and poet Mykki Blanco took to Facebook to disclose his HIV status, and former child TV star Danny Pintauro told Oprah that he is living with HIV.
• November 24: UNAIDS releases its 2015 World AIDS Day report Exit Disclaimer (PDF 27 MB), which finds that 15.8 million people were accessing antiretroviral treatment as of June 2015—more than doubling the number of people who were on treatment in 2010.
• November 30: amfAR, The Foundation for AIDS Research, announces its plan to establish the amfAR Institute for HIV Cure Research Exit Disclaimer at the University of California, San Francisco. As the cornerstone of amfAR’s $100 million investment in cure research, the Institute will work to develop the scientific basis for an HIV cure by the end of 2020.
• December 1: The White House releases a Federal Action Plan (PDF 772 KB) to accompany the updated National HIV/AIDS Strategy. The plan was developed by 10 Federal agencies and the Equal Employment Opportunity Commission and contains 170 action items that the agencies will undertake to achieve the goals of the Strategy.
• December 6: CDC announces that annual HIV diagnoses in the U.S. fell by 19% from 2005 to 2014. There were steep declines among heterosexuals, people who inject drugs, and African Americans (especially black women), but trends for gay/bisexual men varied by race/ethnicity. Diagnoses among white gay/bisexual men decreased by 18%, but they continued to rise among Latino gay/bisexual men and were up 24%. Diagnoses among black gay/bisexual men also increased (22%), but the increase has leveled off since 2010.
• December 19: Partly in response to the HIV outbreak in Indiana, which is linked to people injecting drugs, Congress lifts restrictions that prevented states and localities from spending Federal funds for needle exchange programs.
• December 21: The U.S. Food and Drug Administration announces it will lift its 30-year-old ban on all blood donations by men who have sex with men and institute a policy that allows them to donate blood if they have not had sexual contact with another man in the previous 12 months.
• January 19: The U.S. Centers for Disease Control and Prevention report Exit Disclaimer that only 1 in 5 sexually active high school students has been tested for HIV. An estimated 50% of young Americans who are living with HIV do not know they are infected.
• January 28: Researchers announce Exit Disclaimer that an international study of over 1,900 patients with HIV who failed to respond to the antiretroviral drug tenofovir—a key HIV treatment medication—indicates that HIV resistance to the medication is becoming increasingly common.
• February 25: At the annual Conference on Retroviruses and Opportunistic Infections (CROI), researchers report Exit Disclaimer that a man taking the HIV-prevention pill Truvada® has contracted HIV—marking the first reported infection of someone regularly taking the drug.
• March 3: The White House Office of National AIDS Policy, the NIH Office of AIDS Research, and the National Institute of Mental Health cohost a meeting to address the issue of HIV stigma: Translating Research to Action: Reducing HIV Stigma to Optimize HIV Outcomes . Participants include researchers, policymakers, legal scholars, faith leaders, advocates, and people living with HIV.
• March 3: Pharmacy researchers report finding that women need daily doses Exit Disclaimer of the antiviral medication Truvada® to prevent HIV infection, while men only need two doses per week due to differences in the way the drug accumulates in vaginal, cervical and rectal tissue.
• March 29: The U.S. Department of Health and Human Services releases new guidance [PDF, 960 KB] for state, local, tribal, and territorial health departments that will allow them to request permission to use federal funds to support syringe-services programs (SSPs). The funds can now be used to support a comprehensive set of services, but they cannot be used to purchase sterile needles or syringes for illegal drug injection.
• May 24: The National Institutes of Health and partners announce they will launch a large HIV vaccine trial in South Africa in November 2016, pending regulatory approval. This represents the first time since 2009 that the scientific community has embarked on an HIV vaccine clinical trial of this size.
• June 8-10: The United Nations Exit Disclaimer holds its 2016 High-Level Meeting on Ending AIDS Exit Disclaimer . UN member states pledge to end the AIDS epidemic by 2030, but the meeting is marked by controversy after more than 50 nations block the participation of groups representing LGBT people from the meeting. The final resolution Exit Disclaimer barely mentions those most at risk for contracting HIV/AIDS: men who have sex with men, sex workers, transgender people and people who inject drugs.
• January 4: The Bill and Melinda Gates Foundation Exit Disclaimer announces that it will invest $140 million in a new HIV-prevention tool Exit Disclaimer . The funds will go to develop implants that can deliver HIV-prevention medication continuously over a long period of time—eliminating the need for people to take daily preexposure prophylaxis (PrEP).
• May 2: The U.S. Centers for Disease Control and Prevention (CDC) reports significant declines in HIV/AIDS death rates for black/African Americans between 1999-2015 . Among those aged 18-34, HIV-related deaths drop 80%, and among those aged 35, deaths drop by 79%.
• June 6: The New York Times reports Exit Disclaimer that, as a group, America’s black gay and bisexual men have a higher HIV prevalence rate than any nation in the world Exit Disclaimer .
• August 27: Muslim-American organization RAHMA Exit Disclaimer (Arabic for “mercy”) launches the first national Faith HIV & AIDS Awareness Day . The goal is to rally U.S. faith communities (including Muslim, Christian, Jewish, Buddhist, Sikh, Hindu and Baha’i) to take a public stand against stigma in their congregations and raise awareness of HIV and AIDS.
• September 9: Broadway composer and lyricist Michael Friedman Exit Disclaimer dies of AIDS-related illness at age 41. He is best known for his work on the play Bloody, Bloody Andrew Jackson . His death is a shocking reminder to many that HIV continues to be deadly—even for well-to-do, white men with good health insurance.
• October 6: With the support of the public health community, California governor Jerry Brown signs a bill decreasing the penalty for knowingly exposing a sexual partner to HIV Exit Disclaimer or donating blood without disclosing the infection from a felony to a misdemeanor. These laws discouraged people from getting tested and into treatment. The new law takes a public health approach and recognizes the current understanding that with treatment with HIV medicine, people with HIV have effectively no risk of sexually transmitting HIV to others.
• November 6: Harvard University awards singer and HIV activist Elton John its Humanitarian of the Year Award Exit Disclaimer . Since 1992, the Elton John AIDS Foundation has raised more than $385 million to support HIV/AIDS-related programming around the world.
• November 12: Atlanta performance artist, writer, and HIV educator Antron-Reshaud Olukayode Exit Disclaimer dies of AIDS-related illness at age 33. Olukayode had participated in CDC’s Let’s Stop HIV Together campaign .
• December 4: Gilead Sciences announces the launch of the COMmitment to Partnership in Addressing HIV/AIDS in Southern States (COMPASS) Initiative Exit Disclaimer , a 10-year, $100 million commitment to support organizations working to address the HIV/AIDS epidemic in the Southern United States.
• January 15: Dr. Mathilde Krim dies at age 91 Exit Disclaimer . Dr. Krim, a geneticist and virologist who turned from studying cancer to studying AIDS, started the AIDS Medical Foundation in 1983, and then became the founding chairwoman of the Foundation for AIDS Research Exit Disclaimer (amfAR) in 1985. She raised hundreds of millions of dollars for AIDS research, prevention, treatment, and advocacy. In announcing her passing, the New York Times calls her “ America’s foremost warrior in the battle against superstitions, fears and prejudices that have stigmatized many people with AIDS Exit Disclaimer .”
• January 24: The National Institutes of Health launches a large international study to compare the safety and efficacy of antiretroviral treatment regimens for pregnant women living with HIV and their infants . It will provide data on the use of newer HIV medications during pregnancy, helping to ensure that women living with HIV and their infants receive the best available treatments.
• January 28: PEPFAR (the President’s Emergency Plan for AIDS Relief) celebrates its 15th anniversary . When PEPFAR began in 2003, only 50,000 people in Africa were on lifesaving HIV treatment. PEPFAR now supports over 14 million people on treatment globally.
• April 16: After a former boyfriend threatens to blackmail her over her HIV status, Austrian singer and Eurovision winner Conchita tells her fans that she is HIV-positive Exit Disclaimer . In a press statement, she notes that she has been in treatment and virally suppressed for many years, and says “I hope to show courage and take another step against the stigmatization of people with HIV.” Exit Disclaimer
• May 3: An international research team finds that early antiretroviral therapy (ART) is key to avoiding brain atrophy for people living with HIV Exit Disclaimer . Using magnetic resonance imaging (MRI) data, researchers found that the longer people living with HIV went without treatment, the greater the atrophy in several brain regions. Once patients began ART, the atrophy stopped and some brain volume and was restored—demonstrating the importance of early screening and ART initiation.
• June 11: In the first study to focus specifically on the effect of sustained viral suppression on overall cancer risk, researchers find that early, sustained antiretroviral therapy resulting in long-term viral suppression helps to prevent AIDS-defining cancers and—to a lesser degree—other cancers Exit Disclaimer for people living with HIV. But the long-term study (1999-2015), which followed nearly 150,000 veterans, also found that patients with long-term viral suppression still had excess cancer risk compared to HIV-negative patients.
• June 28: In a Northwestern University study, “Keep It Up!”, a novel online HIV-prevention program that targets young men who have sex with men (MSM), between the ages of 18-29, reduces sexually transmitted infections by 40%. Exit Disclaimer The program, which offers video clips, soap operas, and interactive games is the first online HIV-prevention program to show effects on a biological outcome.
• July 18: A global analysis finds that people living with HIV are twice as likely as their HIV-negative counterparts to suffer from heart disease Exit Disclaimer . Based on a review of studies with almost 800,000 people from 153 countries, an international team of experts finds that HIV-associated cardiovascular disease has more than tripled in the past 20 years as more people live longer with the virus.
• August 1: Researchers at Los Alamos National Laboratory demonstrate that computer simulations can accurately predict the transmission of HIV across populations Exit Disclaimer . The simulations are consistent with 840,000 actual HIV DNA sequences contained in a global public HIV database. The simulations could allow state health departments to track the spread of HIV and provide a powerful new tool to help prevent new HIV infections.
• September 7: The Office of HIV/AIDS and Infectious Disease Policy , in the U.S. Department of Health and Human Services (HHS), hosts the first in a series of listening sessions to begin updating the National HIV/AIDS Strategy and the National Viral Hepatitis Action Plan . The session is held as part of activities at the U.S. Conference on AIDS in Orlando, Florida, and is attended by HIV community leaders, frontline workers, individuals living with and at risk for infection, and other stakeholders from across the nation.
• September 28: A study of MSM in Thailand finds that having a sexually transmitted infection does not affect the ability of people living with HIV to achieve and maintain an undetectable viral load Exit Disclaimer . The results confirm the generalizability of the “Undetectable = Untransmittable” ( U=U Exit Disclaimer ) message.
• October 17: An new study reports that targeted, high-coverage roll-out of pre-exposure prophylaxis (PrEP) was associated with a 25% reduction in new HIV diagnoses in one year Exit Disclaimer . The study followed 3,700 MSM in New South Wales, Australia, who were taking PrEP with high levels of adherence. It is the first empirical study to test PrEP's population-level effectiveness.
• November 20: The U.S. Preventive Services Task Force Exit Disclaimer , an independent, volunteer panel of national experts in prevention and evidence-based medicine, issues a draft recommendation that clinicians should offer PrEP to individuals at high risk for HIV infection Exit Disclaimer . The Task Force gives its “A” recommendation—the strongest endorsement it can give—to PrEP, stating that, when taken as prescribed, PrEP is highly effective at preventing HIV among those at high risk, and concluding with "high certainty" that there is a substantial benefit to the target population.
• December 1: The date marks the 30th anniversary of the observance of World AIDS Day .
• January 30: Scientists funded by the National Institutes of Health (NIH) announce they have developed a new tool to measure the success of HIV cure strategies . The tool accurately and easily counts the cells that make up the HIV reservoir , the stubborn obstacle to an HIV cure. This advance will enable researchers who are trying to eliminate the HIV reservoir to clearly understand whether their strategies are working.
• February 5: In his State of the Union address, President Donald J. Trump announces his administration’s goal to end the HIV epidemic in the United States in 10 years. The proposed Ending the HIV Epidemic: A Plan for America will leverage new biomedical prevention and treatment options and powerful data to reduce the number of new HIV infections in the United States by 75% in five years and by 90% by 2030. This will prevent an estimated 400,000 new HIV cases over those 10 years, while protecting and preserving the health of people currently living with HIV.
• February 7: In a bid to expand the HIV prevention choices available to adolescent girls and young women, NIH announces the launch of a Phase 2 clinical trial to examine the safety and use of two HIV prevention tools—oral pre-exposure prophylaxis (PrEP) and a vaginal ring—in that population in southern Africa. The REACH (Reversing the Epidemic in Africa with Choices in HIV prevention) trial Exit Disclaimer will enroll 300 girls and young women ages 16–21 at five sites in Kenya, South Africa, Uganda and Zimbabwe.
• March 4: At the 2019 Conference on Retroviruses and Opportunistic Infections (CROI), researchers announce the second cure of a person with HIV Exit Disclaimer . Like the 2007 case of the “ Berlin Patient Exit Disclaimer ” (the first person to be cured of HIV), the “London Patient” has no detectable HIV infection three years after he received a bone marrow transplant from a donor who is genetically immune to HIV, despite having been off antiretroviral therapy (ART) for 18 months. Both patients received bone marrow transplants to treat cancer. While the treatment is too dangerous and costly for widespread use, researchers hail the news as further proof that HIV can be cured.
• March 25: Surgeons at Johns Hopkins Medical Center in Baltimore, Maryland, perform the first living donor HIV-to-HIV kidney transplant in the United States Exit Disclaimer .
• May 9: NIH announces the launch of a clinical trial to evaluate long-acting ART for maintaining HIV suppression in people who find it a challenge to take daily ART in pill form. The study, called Long-Acting Therapy to Improve Treatment Success in Daily Life, or LATITUDE , will help determine whether a combination of two experimental injectable formulations of ART are better than conventional daily medications in managing HIV infection in this population.
• June 11: The U.S. Preventive Services Task Force (Task Force) gives A-level recommendations for HIV screening and prevention , stating that clinicians should screen for HIV in adolescents, adults, and pregnant people and offer PrEP to people at high risk for HIV .
• December 3: A new CDC Vital Signs report shows that progress in reducing new HIV infections in the United States has stalled in recent years and highlights the need for increased HIV testing, treatment, and prevention to end the HIV epidemic in the U.S.
• December 11: HRSA’s HIV/AIDS Bureau releases a new report showing that clients receiving Ryan White HIV/AIDS Program (RWHAP) medical care were virally suppressed at a record level – 87.1 percent – in 2018. More than half of people with diagnosed HIV in the U.S. received RWHAP services in 2018.
• August 17: HHS launches AHEAD: America’s HIV Epidemic Analysis Dashboard , a tool that provides national and jurisdictional data on the six Ending the HIV Epidemic (EHE) initiative indicators, allowing national, state, and local stakeholders to track progress towards meeting EHE goals.
• November 19: CDC publishes a new study showing that the age-adjusted rate of HIV-related deaths among people with HIV in the U.S. fell by nearly half from 2010 to 2017. Much of the reduction was likely the result of early testing and diagnoses of people with HIV and helping them to get – and stay on – lifesaving treatment, underscoring the need to sustain and scale up the EHE initiative.
• December 7: HRSA’s HIV/AIDS Bureau releases åthe 2019 Ryan White HIV/AIDS Program (RWHAP) Client-Level Data Report , showing that clients receiving RWHAP medical care were virally suppressed at a record level – 88.1 percent – in 2019. This success emphasizes the importance of continuing and expanding the HIV diagnosis, care, and treatment work of the EHE initiative.
• January 15: HHS releases the HIV National Strategic Plan for the United States: A Roadmap to End the Epidemic 2021-2025 (HIV Plan), with a 10-year goal of reducing new HIV infections by 90% by 2030. It details four goals with objectives and strategies for use by all partners and stakeholders. The HIV Plan and the EHE initiative are closely aligned and complementary. The EHE initiative serves as a leading component of the work by the U.S. Department of Health and Human Services to implement the HIV Plan.
• January 21: The FDA approves Cabenuva (cabotegravir and rilpivirine, injectable formulation) the first injectable, extended release, complete HIV treatment regimen that is administered once a month, offering the first alternative to a daily oral treatment regimen.
• March 17: HRSA’s Bureau of Primary Health Care announces that 195 health centers across the nation achieved significant results in HIV testing, linkage to care, and PrEP starts in the first several months of their work as EHE grantees. Within the first eight months of award (March-November 2020), 93% of the health centers hired dedicated staff to work on HIV outreach, testing, linkage to care and treatment, and PrEP services; over 573,000 individuals were tested for HIV; 2,260 individuals tested positive for HIV and received follow-up within 30 days; and nearly 50,000 individuals at health centers were prescribed PrEP.
• June 5: The world marks 40 years since the first five cases of what later became known as AIDS were officially reported. President Biden , HHS Secretary Xavier Becerra , and Secretary of State Antony J. Blinken release messages recognizing the 40th anniversary. Other events and activities are held across the country to remember the lives that were cut short by this terrible disease and celebrate the resilience and dignity of the more than 38 million people with HIV worldwide.
• December 1: The White House publishes the National HIV/AIDS Strategy (2022-2025) . The Strategy reflects President Biden’s commitment to re-energize and strengthen a whole-of-society response to the epidemic while supporting people with HIV and reducing HIV-associated morbidity and mortality. The Strategy sets bold targets for ending the HIV epidemic in the United States by 2030. To guide the nation toward realizing the vision, the Strategy focuses on four goals and details 21 objectives and 78 strategies for federal and nonfederal stakeholders. The Strategy replaces the HIV National Strategic Plan.
• December 1: CDC publishes updated HIV PrEP guidelines to increase PrEP use among all people who could benefit.
• December 16: HRSA releases a letter encouraging Ryan White HIV/AIDS Program (RWHAP) service providers to leverage their infrastructure to provide access to gender-affirming care and treatment services for transgender and gender-diverse people with HIV. Of the more than half-million people served by RWHAP, 2.1 percent are transgender. Gender-affirming care is an important strategy to effectively address the health and medical needs of transgender people with HIV.
• December 21: The FDA approves the first long-acting injectable form of HIV pre-exposure prophylaxis (PrEP), Apretude (cabotegravir extended-release injectable suspension), for use in adults and adolescents. The approval of long-acting cabotegravir injected once every two months expands biomedical HIV prevention options available to people in the United States, providing an alternative to daily oral pills.
• December 21: HRSA releases the 2020 Ryan White HIV/AIDS Program Client-Level Data Report, showing that clients receiving HIV/AIDS medical care were virally suppressed at a record level – 89.4 percent – in 2020, demonstrating that clients receiving medical care through the RWHAP are reaching and maintaining viral suppression at high rates despite the ongoing COVID-19 pandemic.
• January 7: The National Institutes of Health’s Office on AIDS Research issues its five-year NIH Strategic Plan for HIV and HIV-Related Research , which serves as the guiding framework to allocate funds that advance the NIH-wide HIV research agenda and ensures investment of resources in the highest priority areas of scientific opportunity.
• June 6: The Department of Defense updates its policies on HIV-positive personnel serving within the military in light of significant advances in HIV diagnosis, prevention, and treatment. Service members with HIV can no longer be discharged or separated solely on the basis of their HIV-positive status and no restrictions can applied to their deployability or to their ability to commission solely on the basis of their HIV-positive status.
• June 15: HHS’ Office of HIV/AIDS and Infectious Disease Policy (OIDP) launched a national awareness campaign called “I am a Work of ART,” to encourage people with HIV who are not in care to seek and stay in care and achieve viral suppression through antiretroviral therapy (ART).
• June 30: The White House Office of National AIDS Policy (ONAP) brings prosecutors, public health officials, and legal and infectious disease experts to the White House to discuss the need to modernize state’s HIV-specific criminal laws and their prosecution, ensuring they are supported by the latest scientific evidence about HIV transmission risk.
• July 29: At the 2022 International AIDS Conference, the Biden-Harris Administration joins global partners in affirming Exit Disclaimer the evidence-based message that “undetectable=untransmittable” (U=U), meaning that people with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load will not transmit HIV to their HIV-negative partners through sex.
• August 26: ONAP releases the National HIV/AIDS Strategy (NHAS) Federal Implementation Plan , detailing more than 380 programs, policies, research, and activities that dozens of federal agencies will take during fiscal years 2022–2025 to meet NHAS goals, pursuant to their respective missions, funding, and resources.
• September 29 : IHS announces $1.2 million in three-year cooperative agreements to seven tribes, tribal organizations, and urban Indian organizations to support their work toward eliminating HIV, hepatitis C, and sexually transmitted infections in Indian Country.
• October 1: CDC introduces the new Division of HIV Prevention organizational structure removing “AIDS” from its title to more accurately reflect CDC’s focus on high-impact HIV prevention.
• October 9: At the U.S. Conference on HIV/AIDS (USCHA), OIDP launched Exit Disclaimer "Celebro mi salud," the Spanish-language version of the I am a Work of ART national viral suppression campaign.
• November 17: HRSA issues the Fiscal Year (FY) 2023 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) Notice of Funding Opportunity . HRSA will invest $50 million through this competitive funding opportunity for health centers located in EHE’s priority jurisdictions to expand HIV prevention services in underserved communities.
• December 1: The U.S. Public Health Service Commissioned Corps, a uniformed service of HHS, announces that it is changing its medical standards to accept future applicants living with chronic hepatitis B and Human Immunodeficiency Virus (HIV).
• December 2: The Indian Health Service observes World AIDS Day 2022 with the release of the Indigenous HIV/AIDS Syndemic Strategy: Weaving Together the National HIV, STI, and Viral Hepatitis Plans, referred to as the Indigi-HAS Exit Disclaimer . It was developed in consultation with every part of Indian Country, complements the existing NHAS, and contains additional content specific to Indigenous communities.
• December 2: IHS releases the Indigenous HIV/AIDS Syndemic Strategy:  Weaving Together the National HIV, STI, and Viral Hepatitis Plans Exit Disclaimer , referred to as the Indigi-HAS. Developed in consultation with every part of Indian Country, the Indigi-HAS weaves together the National HIV/AIDS Strategy, the Viral Hepatitis National Strategic Plan: A Roadmap to Elimination 2021-2025, and the Sexually Transmitted Infections National Strategic Plan, along with important content specific to Indigenous populations.
• December 16: HRSA releases the 2021 Ryan White HIV/AIDS Program (RWHAP) Client-Level Data Report , showing that more than 576,000 clients received services through the RWHAP in 2021. Of these, a record 89.7% were virally suppressed, highlighting the key role of the RWHAP in providing high-quality care and treatment services to people with HIV.
• February 1: HHS updates the HIV clinical practice guidelines to clarify breastfeeding/chestfeeding options for people with HIV and support shared decision-making between them and their healthcare providers.
• February 21: An NIH-supported clinical study demonstrates that long-acting injectable antiretroviral therapy may improve viral suppression outcomes for people experiencing challenges taking a daily HIV treatment pill.
• March 31: The Biden-Harris Administration announces new steps to support transgender communities, including issuing a landmark report on ways to support and affirm LGBTQI+ youth, especially transgender youth, and guidance on gender inclusion in the workforce. Transgender women are an NHAS priority population.
• April 24: SAMHSA publishes a Draft Harm Reduction Framework , the first document to comprehensively outline harm reduction and its role within HHS. The Framework calls for health hubs that offer integrated HIV, viral hepatitis, and healthcare services for people who use drugs.
• May 11: FDA updates its blood donor eligibility guidance, ending longstanding discriminatory policies that excluded gay and bisexual people from donating blood while maintaining appropriate safeguards to protect recipients of blood products.
• May 18: In response to the ongoing mpox public health emergency, HHS distributes mpox prevention resources targeting LGBTQI+ communities and focuses on expanding mpox vaccination for at-risk individuals, including people with HIV.
• June 8: The Biden-Harris Administration announces new actions to protect LGBTQI+ communities from attacks on their rights and safety, including launching a new LGBTQI+ Community Safety Partnership and strengthening resources for LGBTQI+ youth. Youth ages 13-24 are an NHAS priority population.
• June 13: HHS announces phase 1 winners of two national HIV and aging challenges . With funding from the Minority HIV/AIDS Fund, these challenges support innovative efforts to improve health outcomes for people aging with HIV and long-term survivors, particularly among racial and ethnic minority and LGBTQI+ populations.
• July 28: An NIH-supported study shows that statins may offset the elevated risk of cardiovascular disease experienced by people with HIV by more than a third, potentially preventing one in five major cardiovascular events or premature deaths in this population.
• September 20: An NIH-supported trial of a preventive HIV vaccine candidate begins enrollment at six sites in the U.S. and South Africa. The Phase 1 trial will evaluate a novel vaccine known as VIR-1388 for its safety and ability to induce an HIV-specific immune response in people.
• October 2: CDC develops draft guidelines on using STI post-exposure prophylaxis with doxycycline (Doxy PEP) to prevent some bacterial STIs. STIs are increasing rapidly in the U.S. and can increase a person’s risk of getting or transmitting HIV.
• October 18: CDC publishes preliminary data on PrEP coverage showing that in 2022, for the first time, more than one-third of people in the U.S. who could benefit from PrEP had been prescribed it. Increasing PrEP coverage is one of the key prevention strategies outlined in the Ending the HIV Epidemic in the U.S. (EHE) initiative.
• December: The White House releases the National HIV/AIDS Strategy 2023 Interim Action Report , detailing federal partners’ commitments to policies, research, and activities during fiscal years (FY) 2022–2025 to meet the Strategy’s goals. The report shows that thanks to the efforts of community, state, and federal partners, our nation is making important progress toward the Strategy’s goals.

Disclaimer and Acknowledgements

The information contained in this timeline has been drawn from numerous sources, including (but not limited to): ACT UP Exit Disclaimer , the Albion Center Exit Disclaimer (Australia— PDF, 613KB), AVERT Exit Disclaimer (United Kingdom), TheBody.com Exit Disclaimer , FRONTLINE Exit Disclaimer , GMHC Exit Disclaimer , the Kaiser Family Foundation Exit Disclaimer , the New School’s United States of AIDS project Exit Disclaimer , UNAIDS Exit Disclaimer , and the University of California, San Francisco Exit Disclaimer .

We have also relied on material provided by the U.S. Centers for Disease Control and Prevention (CDC), including the National Prevention Information Network (NPIN) , the National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA), and the U.S. Health Resources and Services Administration (HRSA).

The timeline is presented for informational purposes only. HIV.gov does not endorse any organization or viewpoint represented in entries drawn from non-federal sources.

Where possible, specific dates have been provided and events have been listed in chronological order. Entries without specific dates occurred in the year in which they are listed, but the order of those entries may not reflect the actual chronology of events.

Every attempt has been made to ensure that the information contained in the timeline is accurate, but some inaccuracies may exist due to competing source materials. In cases where our information differs from other timelines (including HIV.gov’s earlier versions) we add or update information only with the backing of independent, reliable sources. Please send any corrections to [email protected] .

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HIV and AIDS

• HIV remains a major global public health issue, having claimed an estimated 42.3 million lives to date.  Transmission is ongoing in all countries globally.
• There were an estimated 39.9 million people living with HIV at the end of 2023, 65% of whom are in the WHO African Region.
• In 2023, an estimated 630 000 people died from HIV-related causes and an estimated 1.3 million people acquired HIV.
• There is no cure for HIV infection. However, with access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.
• WHO, the Global Fund and UNAIDS all have global HIV strategies that are aligned with the SDG target 3.3 of ending the HIV epidemic by 2030.
• By 2025, 95% of all people living with HIV should have a diagnosis, 95% of whom should be taking lifesaving antiretroviral treatment, and 95% of people living with HIV on treatment should achieve a suppressed viral load for the benefit of the person’s health and for reducing onward HIV transmission. In 2023, these percentages were 86%, 89%, and 93% respectively.
• In 2023, of all people living with HIV, 86% knew their status, 77% were receiving antiretroviral therapy and 72% had suppressed viral loads.

Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system. Acquired immunodeficiency syndrome (AIDS) occurs at the most advanced stage of infection.

HIV targets the body’s white blood cells, weakening the immune system. This makes it easier to get sick with diseases like tuberculosis, infections and some cancers.

HIV is spread from the body fluids of an infected person, including blood, breast milk, semen and vaginal fluids. It is not spread by kisses, hugs or sharing food. It can also spread from a mother to her baby.

HIV can be prevented and treated with antiretroviral therapy (ART). Untreated HIV can progress to AIDS, often after many years.

WHO now defines Advanced HIV Disease (AHD) as CD4 cell count less than 200 cells/mm3 or WHO stage 3 or 4 in adults and adolescents. All children younger than 5 years of age living with HIV are considered to have advanced HIV disease.

Signs and symptoms

The symptoms of HIV vary depending on the stage of infection.

HIV spreads more easily in the first few months after a person is infected, but many are unaware of their status until the later stages. In the first few weeks after being infected people may not experience symptoms. Others may have an influenza-like illness including:

• sore throat.

The infection progressively weakens the immune system. This can cause other signs and symptoms:

• swollen lymph nodes
• weight loss

Without treatment, people living with HIV infection can also develop severe illnesses:

• tuberculosis (TB)
• cryptococcal meningitis
• severe bacterial infections
• cancers such as lymphomas and Kaposi's sarcoma.

HIV causes other infections to get worse, such as hepatitis C, hepatitis B and mpox.

Transmission

HIV can be transmitted via the exchange of body fluids from people living with HIV, including blood, breast milk, semen, and vaginal secretions. HIV can also be transmitted to a child during pregnancy and delivery.  People cannot become infected with HIV through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water.

People living with HIV who are taking ART and have an undetectable viral load will not transmit HIV to their sexual partners. Early access to ART and support to remain on treatment is therefore critical not only to improve the health of people living with HIV but also to prevent HIV transmission.

Risk factors

Behaviours and conditions that put people at greater risk of contracting HIV include:

• having anal or vaginal sex without a condom;
• having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhoea and bacterial vaginosis;
• harmful use of alcohol or drugs in the context of sexual behaviour;
• sharing contaminated needles, syringes and other injecting equipment, or drug solutions when injecting drugs;
• receiving unsafe injections, blood transfusions, or tissue transplantation; and
• medical procedures that involve unsterile cutting or piercing; or accidental needle stick injuries, including among health workers.

HIV can be diagnosed through rapid diagnostic tests that provide same-day results. This greatly facilitates early diagnosis and linkage with treatment and prevention. People can also use HIV self-tests to test themselves. However, no single test can provide a full HIV positive diagnosis; confirmatory testing is required, conducted by a qualified and trained health worker or community worker. HIV infection can be detected with great accuracy using WHO prequalified tests within a nationally approved testing strategy and algorithm.

Most widely used HIV diagnostic tests detect antibodies produced by a person as part of their immune response to fight HIV. In most cases, people develop antibodies to HIV within 28 days of infection. During this time, people are in the so-called “window period” when they have low levels of antibodies which cannot be detected by many rapid tests, but they may still transmit HIV to others. People who have had a recent high-risk exposure and test negative can have a further test after 28 days.

Following a positive diagnosis, people should be retested before they are enrolled in treatment and care to rule out any potential testing or reporting error. While testing for adolescents and adults has been made simple and efficient, this is not the case for babies born to HIV-positive mothers. For children less than 18 months of age, rapid antibody testing is not sufficient to identify HIV infection – virological testing must be provided as early as birth or at 6 weeks of age. New technologies are now available to perform this test at the point of care and enable same-day results, which will accelerate appropriate linkage with treatment and care.

HIV is a preventable disease.  Reduce the risk of HIV infection by:

• using a male or female condom during sex
• being tested for HIV and sexually transmitted infections
• having a voluntary medical male circumcision
• using harm reduction services for people who inject and use drugs.

Doctors may suggest medicines and medical devices to help prevent HIV infection, including:

• antiretroviral drugs (ARVs), including oral Pre-Exposure Prophylaxis (PrEP) and long acting products
• dapivirine vaginal rings
• injectable long acting cabotegravir.

ARVs can also be used to prevent mothers from passing HIV to their children.

People taking antiretroviral therapy (ART) and who have no evidence of virus in the blood will not pass HIV to their sexual partners. Access to testing and ART is an important part of preventing HIV.

Antiretroviral drugs given to people without HIV can prevent infection

When given before possible exposures to HIV it is called pre-exposure prophylaxis (PrEP) and when given after an exposure it is called post-exposure prophylaxis (PEP).  People can use PrEP or PEP when the risk of contracting HIV is high; people should seek advice from a clinician when thinking about using PrEP or PEP.

There is no cure for HIV infection. It is treated with antiretroviral drugs, which stop the virus from replicating in the body.

Current antiretroviral therapy (ART) does not cure HIV infection but allows a person’s immune system to get stronger. This helps them to fight other infections.

Currently, ART must be taken every day for the rest of a person’s life.

ART lowers the amount of the virus in a person’s body. This stops symptoms and allows people to live full and healthy lives. People living with HIV who are taking ART and who have no evidence of virus in the blood will not spread the virus to their sexual partners.

Pregnant women with HIV should have access to, and take, ART as soon as possible. This protects the health of the mother and will help prevent HIV transmission to the fetus before birth, or through breast milk.

Advanced HIV disease remains a persistent problem in the HIV response. WHO is supporting countries to implement the advanced HIV disease package of care to reduce illness and death. Newer HIV medicines and short course treatments for opportunistic infections like cryptococcal meningitis are being developed that may change the way people take ART and prevention medicines, including access to injectable formulations, in the future.

More information on HIV treatments

WHO response

Global health sector strategies on HIV, viral hepatitis, and sexually transmitted infections for the period 2022–2030 ( GHSSs ) guide strategic responses to achieve the goals of ending AIDS, viral hepatitis B and C, and sexually transmitted infections by 2030.

WHO’s Global HIV, Hepatitis and STIs Programmes recommend shared and disease-specific country actions supported by WHO and partners. They consider the epidemiological, technological, and contextual shifts of previous years, foster learning, and create opportunities to leverage innovation and new knowledge.

WHO’s programmes call to reach the people most affected and most at risk for each disease, and to address inequities.  Under a framework of universal health coverage and primary health care, WHO’s programmes contribute to achieving the goals of the 2030 Agenda for Sustainable Development.

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• Global Health Sector Strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030 (GHSS)
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History of AIDS

By: History.com Editors

Updated: February 21, 2021 | Original: July 13, 2017

In the 1980s and early 1990s, the outbreak of HIV and AIDS swept across the United States and rest of the world, though the disease originated decades earlier. Today, more than 70 million people have been infected with HIV and about 35 million have died from AIDS since the start of the pandemic, according to the World Health Organization  (WHO).

READ MORE: AIDS Crisis Timeline

What is HIV?

The human immunodeficiency virus, or HIV, is a virus that attacks the immune system, specifically CD4 cells (or T cells).

The virus is transmitted through bodily fluids such as blood, semen, vaginal fluids, anal fluids, and breast milk. Historically, HIV has most often been spread through unprotected sex, the sharing of needles for drug use, and through birth.

Over time, HIV can destroy so many CD4 cells that the body can’t fight infections and diseases, eventually leading to the most severe form of an HIV infection: acquired immunodeficiency syndrome, or AIDS. A person with AIDS is very vulnerable to cancer and to life-threatening infections, such as pneumonia.

Though there is no cure for HIV or AIDS, a person with HIV who receives treatment early can live nearly as long as someone without the virus. And a study in 2019 in the medical journal, Lancet , showed that an anti-viral treatment effectively halted the spread of HIV.

Where Did AIDS Come From?

Scientists have traced the origin of HIV back to chimpanzees and simian immunodeficiency virus (SIV), an HIV-like virus that attacks the immune system of monkeys and apes.

In 1999, researchers identified a strain of chimpanzee SIV called SIVcpz, which was nearly identical to HIV. Chimps, the scientist later discovered, hunt and eat two smaller species of monkeys—red-capped mangabeys and greater spot-nosed monkeys—that carry and infect the chimps with two strains of SIV. These two strains likely combined to form SIVcpz, which can spread between chimpanzees and humans.

SIVcpz likely jumped to humans when hunters in Africa ate infected chimps, or the chimps’ infected blood got into the cuts or wounds of hunters. Researchers believe the first transmission of SIV to HIV in humans that then led to the global pandemic occurred in 1920 in Kinshasa, the capital and largest city in the Democratic Republic of Congo.

The virus spread may have spread from Kinshasa along infrastructure routes (roads, railways, and rivers) via migrants and the sex trade.

In the 1960s, HIV spread from Africa to Haiti and the Caribbean when Haitian professionals in the colonial Democratic Republic of Congo returned home. The virus then moved from the Caribbean to New York City around 1970 and then to San Francisco later in the decade.

International travel from the United States helped the virus spread across the rest of the globe.

READ MORE: Pandemics That Changed History: A Timeline

The AIDS Epidemic Arises

Though HIV arrived in the United States around 1970, it didn’t come to the public’s attention until the early 1980s.

In 1981, the Centers for Disease Control and Prevention (CDC) published a report about five previously healthy homosexual men becoming infected with Pneumocystis pneumonia , which is caused by the normally harmless fungus Pneumocystis jirovecii. This type of pneumonia, the CDC noted, almost never affects people with uncompromised immune systems.

The following year, The New York Times published an alarming article about the new immune system disorder, which, by that time, had affected 335 people, killing 136 of them. Because the disease appeared to affect mostly homosexual men, officials initially called it gay-related immune deficiency, or GRID.

Though the CDC discovered all major routes of the disease’s transmission—as well as that female partners of AIDS-positive men could be infected—in 1983, the public considered AIDS a gay disease. It was even called the “gay plague” for many years after.

In September of 1982, the CDC used the term AIDS to describe the disease for the first time. By the end of the year, AIDS cases were also reported in a number of European countries.

READ MORE: Pandemics that Changed History

The HIV Test Arrives

In 1984, researchers finally identified the cause of AIDS—the HIV virus—and the Food and Drug Administration (FDA) licensed the first commercial blood test for HIV in 1985.

Today, numerous tests can detect HIV, most of which work by detecting HIV antibodies. The tests can be done on blood, saliva, or urine, though the blood tests detect HIV sooner after exposure due to higher levels of antibodies.

In 1985, actor Rock Hudson became the first high-profile fatality from AIDS. In fear of HIV making it into blood banks, the FDA also enacted regulations that ban gay men from donating blood. The FDA would revise its rules in 2015 to allow gay men to give blood if they’ve been celibate for a year, though blood banks routinely test blood for HIV.

By the end of 1985, there were more than 20,000 reported cases of AIDS, with at least one case in every region of the world.

AZT is Developed

In 1987, the first antiretroviral medication for HIV, azidothymidine (AZT), became available.

Numerous other medications for HIV are now available, and are typically used together in what’s known as antiretroviral therapy (ART) or highly active antiretroviral treatment (HAART).

The regimes work by preventing the virus from multiplying, giving the immune system a chance to recover and fight off infections and HIV-related cancers. The therapy also helps reduce the risk of HIV transmission, including between an infected mother and her unborn child.

The World Health Organization (WHO), in 1988, declared December 1st to be World AIDS Day. By the end of the decade, there were at least 100,000 reported cases of AIDS in the United States and WHO estimated 400,000 AIDS cases worldwide.

HIV/AIDS in the 1990s and 2000s

In 1991, the red ribbon became an international symbol of AIDS awareness.

In that year, basketball player Magic Johnson announced he had HIV, helping to further bring awareness to the issue and dispel the stereotype of it being a gay disease. Soon after, Freddie Mercury —lead singer of the band Queen—announced he had AIDS and died a day later.

In 1994, the FDA approved the first oral (and non-blood) HIV test. Two years later, it approved the first home testing kit and the first urine test.

AIDS-related deaths and hospitalizations in developed countries began to decline sharply in 1995 thanks to new medications and the introduction of HAART. Still, by 1999, AIDS was the fourth biggest cause of death in the world and the leading cause of death in Africa.

HIV Treatment Progresses

WATCH: 30 Years of AIDs Research

In 2001, generic drug manufacturers began selling discounted copies of patented HIV drugs to developing countries, leading to several major pharmaceutical manufacturers slashing prices on their HIV drugs. The following year, the Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that AIDS was by far the leading cause of death in sub-Saharan Africa.

In 2009, President Barack Obama lifted a 1987 U.S. ban that prevented HIV-positive people from entering the country.

The FDA approved pre-exposure prophylaxis, or PrEP, for HIV-negative people in 2012. When taken daily, PrEP can reduce the risk of HIV from sex by more than 90 percent and from intravenous drug use by 70 percent, according to the CDC. A major study completed in 2019 showed that over 750 gay men on an anti-viral treatment did not transmit the virus to their partners. "Our findings provide conclusive evidence that the risk of HIV transmission through anal sex when HIV viral load is suppressed is effectively zero," the paper, published in Lancet, stated .

At the end of 2019, some 38 million people were living with HIV/AIDS worldwide, and 940,000 people died from AIDS-related illnesses that year, according to WHO . Sub-Saharan Africa remains the most severely affected region, accounting for nearly two-thirds of the world’s current HIV cases.

Origin of HIV and AIDS: AVERT . HIV Originated With Monkeys, Not Chimps, Study Finds: National Geographic . HIV pandemic originated in Kinshasa in the 1920s, say scientists: The Guardian . America’s HIV outbreak started in this city, 10 years before anyone noticed: PBS . HIV Testing: CDC . About HIV/AIDS: CDC . How HIV spread across the West: CNN . Obama Lifts a Ban on Entry Into U.S. by H.I.V.-Positive People: The New York Times . Global Health Observatory (GHO) data: World Health Organization .

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AIDS and AIDS Activism

By Dan Royles | Reader-Nominated Topic

Doctors in Philadelphia diagnosed the first local case of what would later become known as AIDS (Acquired Immune Deficiency Syndrome) in September 1981, just months after the Centers for Disease Control first reported mysterious outbreaks of pneumocystis pneumonia and Kaposi’s sarcoma among gay men in New York and Los Angeles that marked the beginning of the recognized AIDS epidemic in the United States. Since pneumocystis pneumonia is rarely seen in healthy patients but common to those with weakened immune systems, and Kaposi’s sarcoma is a skin cancer otherwise seen among elderly Mediterranean men, the presence of these diseases in otherwise healthy young men signaled the potential for a serious public health crisis. Researchers  later discovered the cause of AIDS to be the Human Immunodeficiency Virus (HIV), which replicates in the human body by killing cells that are vital to immune function, over time depressing the ability of the host body to fight off infections.

Although the number of new cases in New York City, Los Angeles, and San Francisco multiplied quickly over the first two years of the epidemic, at first the number of people with AIDS in Philadelphia rose slowly. Within the first year, only seven cases were reported locally, but by early 1983 trends in Philadelphia seemed to be catching up to the rapidly growing epidemic witnessed in New York and California. The disease also appeared in New Jersey, particularly in the urban corridors between Philadelphia and New York and between Philadelphia and Atlantic City, and in Delaware.

As gay men watched their friends and lovers die in increasing numbers, they organized in response. Philadelphia Community Health Alternatives (PCHA, later known as the Mazzoni Center ), a health clinic founded in 1979 to serve the local lesbian and gay community, formed the Philadelphia AIDS Task Force to provide social services to those affected and offer information about AIDS and other sexually transmitted diseases through a local hotline. Meanwhile, social clubs like the Gay Men’s Chorus and Girlfriends Motorcycle Club joined forces to raise funds for PCHA’s education and prevention efforts.

Spread of AIDS

By the middle 1980s public health authorities recognized that the AIDS epidemic had grown beyond the communities of gay men in which doctors first identified the disease. Researchers in the United States and France had identified HIV as the cause of AIDS in 1983, and thus definitively determined that the disease could be transmitted through blood-to-blood contact, including needle-sharing among intravenous drug users, blood transfusions, and from an infected mother to her unborn child. At the same time, in cities around the country, reports showed the growing incidence of HIV and AIDS among African Americans and Latinos, particularly within networks of intravenous drug users and among their sexual partners and young children. Although those in this “second wave” of new cases had likely been infected for some time, their low access to medical care combined with the long latency period of HIV, during which time the virus spreads throughout a patient’s system but does not produce symptoms, to initially mask the prevalence of AIDS within communities of color.

In Philadelphia, by 1985 African Americans made up almost half of all reported AIDS cases, and the majority of cases among people under twenty five years old. David Fair, a longtime local gay activist and secretary-treasurer of a local predominantly Black health care workers’ union, and Rashidah Hassan, a nurse who had worked with PCHA and its AIDS Task Force, became dissatisfied with the groups’ failure to effectively reach out to African Americans at risk of contracting HIV. To stem the rising tide of new infections in Philadelphia’s Black community, in 1986 they founded Blacks Educating Blacks About Sexual Health Issues (BEBASHI) , one of the nation’s first Black AIDS service organizations. Perceiving that the AIDS Task Force’s efforts to reach out to the Black community had been undercut by its reputation as an all-white organization, BEBASHI representatives worked through existing social institutions like African American churches so that their education and prevention messages that would resonate with Black audiences.  In New Jersey, Project IMPACT (Intensive Mobilization to Promote AIDS Awareness through Community-based Technologies) also reached out to African American leaders in urban areas.

In 1987, as the AIDS community nationwide became frustrated with the dearth of effective treatments and President Ronald Reagan’s reticence on the epidemic, grassroots AIDS politics took a radical turn. In March, a group of New York activists founded the inaugural chapter of the AIDS Coalition to Unleash Power (ACT UP) , an organization whose protest actions became the public face of AIDS advocacy in the United States during the late 1980s and early 1990s. The group quickly spawned a network of chapters in cities across the country and abroad, including Philadelphia , South Jersey, and Delaware.

Dramatic Demonstrations

Members of the Philadelphia branch of ACT UP began staging theatrical “die-ins” and other dramatic demonstrations to highlight the human cost of high prescription drug prices and inadequate public health policy. To protest the Catholic Church’s opposition to condom use, in May 1991 around one hundred ACT UP Philadelphia members interrupted a prayer service for people with AIDS conducted by  Archbishop Anthony Bevilacqua and tried to place wrapped condoms near his hands and feet, shouting, “These will save lives–your morals won’t.” In addition to public protests, ACT UP became well known for creating memorable visual messages to both educate people about AIDS and mobilize those affected by the epidemic. In this vein, during one holiday season the Philadelphia chapter circulated stickers featuring an HIV-positive Santa Claus with the tagline, “If only Reagan and Bush had told the truth, Santa wouldn’t have to die from AIDS.”

During the mid-1990s, ACT UP declined in national prominence as the white gay men who filled much of the organization’s ranks passed away, grew tired of activism, or gained access to the highly effective (but expensive) class of new antiretroviral drugs that became available due to advances in HIV treatment research. The Philadelphia chapter, however, remained vital due to the recruiting efforts of a core group of members, who reached out to lower-income people of color, among whom the nationwide AIDS epidemic continued to grow fastest. The changing membership in turn shaped the direction of the group’s activism, as it increasingly focused on affordable housing, HIV prevention in prisons, and access to medications for impoverished people in the United States and throughout the developing world. Working with Health GAP (Global Access Project) , a coalition of AIDS activists and allied organizations, Philadelphia ACT UP members pressured the White House to move forward with a coordinated response to the worldwide AIDS pandemic.  This effort, supported by numerous AIDS action groups in Philadelphia and the Cooper Early Intervention Program in Camden, culminated in 2003 with President George W. Bush’s announcement of the President’s Emergency Program for AIDS Relief (PEPFAR), a five-year, $15 billion commitment funding HIV prevention and drug access programs in Africa. In 2008, Congress reauthorized the program through 2013, and expanded its funding to almost $48 billion.

Four Decades

As the epidemic entered its fourth decade, the Philadelphia Department of Public Health estimated that 1.3% of the city’s population was living with HIV or AIDS, about three times the national average. Center City and the surrounding area had the greatest prevalence of cases in Philadelphia County, with additional areas of high concentration in the Northeast, West Philadelphia, and around Germantown. Despite the city’s relatively large percentage of people living with HIV and AIDS, local trends reflected patterns of infection for the United States as a whole, inasmuch as the epidemic in Philadelphia disproportionately affected African Americans, and in particular men who had sex with men and women, among whom the disease was growing fastest.

Regionally, statistics collected by the Centers for Disease Control from the beginning of the epidemic through 2008 showed New Jersey ranking fifth-highest in number AIDS diagnoses among the fifty states; Pennsylvania ranking seventh; and Delaware ranking thirty-third (although in rate of cases per thousand population, Delaware ranked eighth-highest in the nation). By 2010 Philadelphia accounted for the highest proportion of AIDS cases in Pennsylvania, surpassing other counties by far (20,411 diagnosed cases from 1980 to 2010, compared with 1,098 in Montgomery County, 1,743 in Delaware County, 802 in Bucks County, and 603 in Chester County).  In South Jersey, by 2010 the disease was most prevalent in Atlantic County.

In light of these realities, activists reignited the search for an AIDS cure. In 2009 a group of veteran Philadelphia activists, many of whom had been part of ACT UP chapters around the country during the organization’s heyday, founded the AIDS Policy Project to advocate for funding and scientific research on treatments to not only slow the spread of HIV within a patient’s system, but eliminate it altogether.  In this way, Philadelphians sought to lead the way to the end of the AIDS epidemic once and for all.

Dan Royles is a Ph.D. Candidate at Temple University.  This essay is derived from his dissertation research on the political culture of African American AIDS activism. (Author information current at time of publication.)

Copyright 2012, University of Pennsylvania Press

ACT UP Demonstration Poster

John J. Wilcox LGBT Archives of Philadelphia

Philadelphians joined in the global movement to call attention to the AIDS crisis.

City Avenue, 1988

Demonstrators on the City Avenue boundary between Philadelphia and the western suburbs join in the radical turn of HIV/AIDS politics in the late 1980s.

ACT UP on Broad Street, 1991

n March 1987, a group of New York activists founded the inaugural chapter of the AIDS Coalition to Unleash Power (ACT UP), an organization whose protest actions became the public face of AIDS advocacy in the United States during the late 1980s and early 1990s. The group quickly spawned a network of chapters in cities across the country and abroad, including Philadelphia, South Jersey, and Delaware. This demonstration on Broad Street occurred during a visit to Philadelphia by President George H.W. Bush in 1991.

Related Topics

• City of Medicine
• Greater Philadelphia
• Philadelphia and the Nation

Time Periods

• Twentieth Century after 1945
• Twenty-First Century
• Center City Philadelphia
• Board of Health (Philadelphia)
• Civil Rights (LGBT)
• Infectious Diseases and Epidemics
• Philadelphia (Film)
• Public Health

Related Reading

Brier, Jennifer. Infectious Ideas: U.S. Political Responses to the AIDS Crisis . Chapel Hill: University of North Carolina Press, 2009.

Chambré, Susan M. Fighting for Our Lives: New York’s AIDS Community and the Politics of Disease . New Brunswick: Rutgers University Press, 2006.

Levenson, Jacob. The Secret Epidemic: the Story of AIDS and Black America . New York: Pantheon, 2004.

Smith, Raymond A. and Patricia D. Siplon. Drugs into Bodies: Global AIDS Treatment Activism. Westport, CT: Praeger, 2006.

City of Philadelphia, Department of Public Health, AIDS Activities Coordinating Office. Data and Research.   http://www.phila.gov/health/aaco/aacodataresearch.html

Related Collections

• The AIDS Library and the Scott Wilds Papers Special Collections Research Center, Temple University, Charles Library 1900 N. Thirteenth Street, Philadelphia.
• ACT-UP Philadelphia Collection and BEBASHI newsletter collection John J. Wilcox LGBT Archives of Philadelphia, William Way Community Center 1315 Spruce Street, Philadelphia.

Backgrounders

Connecting Headlines with History

• Two decades ago, Tom Hanks and 'Philadelphia' prompted changing attitudes toward HIV-AIDS (WHYY, December 20, 2013)
• Philly on front lines of HIV prevention with guidelines for pre-exposure drug (WHYY, May 16, 2014)
• Temple scientists edit out HIV from cultured cells (WHYY, July 23, 2014)
• City of Philadelphia AIDS Research and Data (Phila.gov)
• 2010 Delaware HIV/AIDS Report (Delaware Health and Social Services) (pdf)
• Striving for Equality: LGBT Activism in Philadelphia (Greater Philadelphia Roundtable discussion program, March 10, 2010, William Way Community Center)
• ACT UP and the AIDS Crisis Primary Source Set (Digital Public Library of America)

Connecting the Past with the Present, Building Community, Creating a Legacy

How HIV/AIDS got its name − the words Americans used for the crisis were steeped in science, stigma and religious language

Associate Professor of Religion and of Women's, Gender, and Sexuality Studies, Boston University

Disclosure statement

Anthony Petro does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Boston University provides funding as a founding partner of The Conversation US.

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The Centers for Disease Control and Prevention first used the term “AIDS ” on Sept. 24, 1982, more than a year after the first cases appeared in medical records. Those early years of the crisis were marked by a great deal of confusion over what caused the disease, who it affected and how it spread.

But the naming itself – acquired immunodeficiency syndrome, which we now know is caused by the human immunodeficiency virus, or HIV – was a milestone. How people talked about and named the AIDS crisis shaped how it was viewed and either fostered or countered a culture of stigma.

Throughout the 1980s and 1990s, for instance, conservative Christian leaders such as Rev. Jerry Falwell described AIDS as “ God’s punishment ” for sexual immorality. Many AIDS activists , on the other hand, also took up the importance of naming. Instead of being called “AIDS victims,” they preferred phrases like “people with AIDS” and “people living with HIV” to affirm their status as people rather than merely patients or victims.

As a historian of religion, sexuality and public health , I became interested in how moral and religious rhetoric shaped this global pandemic from the start. In my book “ After the Wrath of God ,” I trace how the AIDS crisis could not be separated from the broader cultural contexts in which it emerged, including the histories of LGBTQ+ people and the Christian right.

In other words, from the start, this medical epidemic was also a moral epidemic.

Before ‘AIDS’

The naming of AIDS in 1982 came more than a year after the CDC first reported cases of young, otherwise healthy men diagnosed with rare forms of cancer, pneumonia and other infections that occur in people with weakened immune systems.

CDC researchers searched for a connection and found that these men were “ all active homosexuals .” This confirmed what many gay and bisexual men living in places such as New York City and San Francisco already knew: There was a mysterious illness affecting their community.

Early news coverage described a new “gay cancer” or “gay pneumonia.” Some medical researchers called it GRID – gay-related immune deficiency – or acquired community immune deficiency. When CDC leaders settled on AIDS instead, they wanted to acknowledge the prevalence of cases among many other groups, including heterosexuals.

Despite these efforts, however, this early association with homosexuality would stick.

In fact, the history of homosexuality was crucial to the very discovery of AIDS. Scientists have now shown that HIV circulated well before 1981 , especially among intravenous drug users, many of whom were homeless. But unusual illnesses and deaths within this population largely went unnoticed.

Meanwhile, the modern LGBTQ+ rights movement had been picking up steam since 1969, when a police raid at the Stonewall Inn , a gay bar in New York City, set off a series of riots that prompted a new wave of LGBTQ+ activism. By the 1980s, queer and trans people asserted greater political and cultural influence.

This visibility and increasing cultural influence were crucial to the detection of this new disease.

Stirring ‘God’s wrath’

The early association of AIDS with homosexuality also ensured that this public health crisis would stir moral and religious debate.

In the 1970s, conservative Christian leaders had already warned the broader public about what they considered to be an epidemic of homosexuality . They argued that social acceptance of LGBTQ+ people was a sign of moral decline , and warned that if the United States did not stamp out this “moral disease,” the country would face the same fate as Sodom and Gomorrah, biblical cities destroyed by God.

In other words, the Christian right already had its own way to talk about homosexuality as an epidemic, as a threat to society itself. The AIDS crisis seemed to only confirm their belief in God’s wrath.

Medical and public health officials were not immune to this rhetoric. In the 1980s, at hospitals across New York, people readily referred to WOGS – the wrath of God syndrome . A physician at the Medical College of Georgia penned an editorial for Southern Medical Journal that asked whether AIDS fulfilled a biblical pronouncement about “the due penalty” for sexual sins and recommended conversion therapy for homosexuals.

In the White House, as historian Jennifer Brier has shown , President Ronald Reagan’s conservative advisers Gary Bauer and William Bennett formulated a strategy to fight AIDS that emphasized the moral righteousness of heterosexuality and abstinence outside of marriage.

They were frustrated to get pushback from the Reagan-appointed Surgeon General C. Everett Koop , a pediatric surgeon who had also become one of the leaders of the evangelical pro-life movement. He insisted that national AIDS policy focus on comprehensive sex education.

In 1988, Koop sent a mailer called Understanding AIDS to virtually every household in America. Conservatives balked at Koop’s approach, although he still prioritized abstinence for people who were unmarried as the best form of protection.

Bauer and Bennett complained that the flyer included information about condoms and described the risks of contagion through oral and anal sex. Phyllis Schlafly, the conservative Catholic crusader against feminism, abortion and gay rights, accused the surgeon general of trying to teach “ safe sodomy ” to third graders.

Beyond the Christian right

Not all conservative Christians understood AIDS to be God’s punishment for sexual sin. Many evangelical groups and Catholic leaders even pushed against that notion – yet still spoke of it in religious and moral terms.

Cardinal John O’Connor, the archbishop of New York, drew the ire of many AIDS activists when he spoke about AIDS at the Vatican in 1989. “Good morality,” he proclaimed, “is good medicine.”

Many Christians took more progressive positions. Southern Baptist ethicist Earl Shelp and chaplain Ronald Sunderland worked as research fellows at Texas Medical Center, where they first encountered people with AIDS. Together, they started one of the earliest AIDS ministry programs, which focused on helping gay men with AIDS without judgment.

And many queer and feminist Christian and Jewish leaders, including Jim Mitulski , Yvette Flunder and Yoel Kahn , forged queer-affirming and justice-oriented responses to the stigma of AIDS. They countered the idea that AIDS was a “gay disease,” but they also focused on how AIDS harmed populations that were often sidelined, including people of color, women and drug users.

What’s in a name?

Today, when I teach about the history of the HIV/AIDS crisis, my students tend to be confused by this early association with homosexuality. They associate AIDS with sub-Saharan Africa, which had become the epicenter of the pandemic by the 1990s.

Nevertheless, my students have grown up in a world where AIDS is far better understood. Thanks to the work of activists and scientists , far more people now know that HIV can be blocked by using condoms and sterile needles. Antiretroviral therapy has proven very effective in treating people able to obtain and tolerate the medicines.

Yet no matter how scientific or objective people hope to be, epidemics are shaped by culture. And studying that history helps us understand more about ourselves.

• Public health
• Science and religion
• Moral panic
• Medical history
• Centers for Disease Control and Prevention (CDC)
• Christian right
• LGBTQ history
• Religion and society

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Home — Essay Samples — Nursing & Health — AIDS — And The Band Played On: The Implications of The AIDS Epidemic

And The Band Played On: The Implications of The AIDS Epidemic

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Essay on AIDS for Students and Children

500+ words essay on aids.

Acquired Immune Deficiency Syndrome or better known as AIDS is a life-threatening disease. It is one of the most dreaded diseases of the 20 th century. AIDS is caused by HIV or Human Immunodeficiency Virus, which attacks the immune system of the human body. It has, so far, ended more than twenty-nine million lives all over the world. Since its discovery, AIDS has spread around the world like a wildfire. It is due to the continuous efforts of the Government and non-government organizations; AIDS awareness has been spread to the masses.

AIDS – Causes and Spread

The cause of AIDS is primarily HIV or the Human Immunodeficiency Virus. This virus replicates itself into the human body by inserting a copy of its DNA into the human host cells. Due to such property and capability of the virus, it is also known as a retrovirus. The host cells in which the HIV resides are the WBCs (White Blood Cells) that are the part of the Human Immune system.

HIV destroys the WBCs and weakens the human immune system. The weakening of the immune system affects an individual’s ability to fight diseases in time. For example, a cut or a wound takes much more time to heal or the blood to clot. In some cases, the wound never heals.

HIV majorly transmits in one of the three ways – Blood, Pre-natal and Sexual transmission. Transfusion of HIV through blood has been very common during the initial time of its spread. But nowadays all the developed and developing countries have stringent measures to check the blood for infection before transfusing. Usage of shared needles also transmits HIV from an infected person to a healthy individual.

As part of sexual transmission, HIV transfers through body fluids while performing sexual activity. HIV can easily be spread from an infected person to a healthy person if they perform unprotective sexual intercourse through oral, genital or rectal parts.

Pre-natal transmission implies that an HIV infected mother can easily pass the virus to her child during pregnancy, breastfeeding or even during delivery of the baby.

AIDS – Symptoms

Since HIV attacks and infects the WBCs of the human body, it lowers the overall immune system of the human body and resulting in the infected individual, vulnerable to any other disease or minor infection. The incubation period for AIDS is much longer as compared to other diseases. It takes around 0-12 years for the symptoms to appear promptly.

Few of the common symptoms of AIDS include fever , fatigue, loss of weight, dysentery, swollen nodes, yeast infection, and herpes zoster. Due to weakened immunity, the infectious person falls prey to some of the uncommon infections namely persistent fever, night sweating, skin rashes, lesions in mouth and more.

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AIDS – Treatment, and Prevention

Till date, no treatment or cure is available for curing AIDS, and as a result, it is a life-threatening disease. As a practice by medical practitioners, the best way to curb its spread is antiretroviral therapy or ART. It is a drug therapy which prevents HIV from replicating and hence slows down its progress. It is always advisable to start the treatment at the earliest to minimize the damage to the immune system. But again, it is just a measure and doesn’t guarantee the cure of AIDS.

AIDS prevention lies in the process of curbing its spread. One should regularly and routinely get tested for HIV. It is important for an individual to know his/her own and partner’s HIV status, before performing any sexual intercourse activity. One should always practice safe sex. Use of condoms by males during sexual intercourse is a must and also one should restrict oneself on the number of partners he/she is having sex with.

One should not addict himself/herself to banned substances and drugs. One should keep away from the non-sterilized needles or razors.  Multiple awareness drives by the UN, local government bodies and various nonprofit organizations have reduced the risk of spread by making the people aware of the AIDS – spread and prevention.

Life for an individual becomes hell after being tested positive for AIDS. It is not only the disease but also the social stigma and discrimination, felling of being not loved and being hated acts as a slow poison. We need to instill the belief among them, through our love and care, that the HIV positive patients can still lead a long and healthy life.

Though AIDS is a disease, which cannot be cured or eradicated from society, the only solution to AIDS lies in its prevention and awareness. We must have our regular and periodical health checkup so that we don’t fall prey to such deadly diseases. We must also encourage and educate others to do the same. With the widespread awareness about the disease, much fewer adults and children are dying of AIDS. The only way to fight the AIDS disease is through creating awareness.

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HIV and AIDS

HIV stands for human immunodeficiency virus. It weakens a person’s immune system by destroying important cells that fight disease and infection. There is currently no effective cure for HIV. But with proper medical care, HIV can be controlled.

If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).

Psychologists help people dealing with the myriad psychological and social issues associated with HIV/AIDS, including stigma and anxiety.

Adapted from the Centers for Disease Control and Prevention

Resources from APA

Spotlight: HIV in Psychotherapy

The guest editors of the March 2020 special issue of Psychotherapy discuss the practical implications of featured articles.

The Trump administration has a plan to end the U.S. HIV epidemic by 2030, but psychologists say it won’t succeed without addressing the psychosocial issues driving the epidemic

Advocacy on HIV prevention

Additional resources need to go to dealing with mental health and substance use disorders, which are linked to HIV transmission and adherence.

Implementing motivational interviewing to end the youth HIV epidemic

Motivational interviewing can improve HIV care cascade outcomes among youth.

More resources about HIV and AIDS

What APA is doing

HIV/AIDS programs

APA’s HIV/AIDS programs in the Health Disparities Office provide information, training, and technical assistance on HIV/AIDS-related topics associated with coping, mental health services, prevention, technology transfer, community collaboration, public policy, and ethics.

APA publications

Lesbian, Gay, and Bisexual Racial and Ethnic Minority Individuals

Addressing HIV in Psychotherapy

Dynamics in Couples and Families Coping With HIV Risk and Infection

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What Lessons Does the AIDS Crisis Offer for the Coronavirus Pandemic?

Over the past month, those of us who lived through the AIDS epidemic have searched for ways in which that experience can inform the COVID -19 crisis . Do we know something that can be useful now? Can this knowledge help us survive? Do we have things to teach people who have not known this grief and anger before? (A meme started circulating in March: “Straights: I can’t believe the government would just ignore an epidemic that threatens thousands of lives. Gays: You don’t say.” It was illustrated with a picture of the AIDS Memorial Quilt.) Writing in BuzzFeed , the journalist Mark Schoofs summoned the grief and fear that was our daily companion during the AIDS crisis, and offered a set of lessons from it: act as if you are infected; the government will not save you; everyone is at risk—and this is our best hope. In the Guardian , the novelist Edmund White enumerated the many differences between AIDS and COVID -19, but also the haunting similarities: the rumor, misinformation, and parascientific folklore surrounding both. White, who is eighty, also wondered if he would survive the coronavirus, after living with H.I.V. since 1985. In LGBTQ Nation, Mark S. King objected to drawing any parallels between the viruses. “No one cared about people dying of AIDS in the early years of the pandemic,” he wrote. “The stock market didn’t budge. The president didn’t hold news conferences. Billions of dollars were not spent. . . . There is no comparison.”

But, of course, we continue to compare, because AIDS was a global pandemic that killed millions of people, and because of that mixture of grief and fear that feels so familiar. “The main feeling I have when I wake up each morning is palpable, physical,” Gregg Gonsalves, who was an AIDS activist before he was an epidemiologist, tweeted . “It’s a weight behind the eyes for tears that never come. I am so fearful and sad right now, because while I think there is a way out of this that minimizes the pain and suffering ahead, the President and his party have no interest in it, no conception of how to move forward. It means all this will go on longer than it should, be more cruel than it needed to be. This is one of the most shameful episodes in American history and it’s happening in real time.”

So I keep searching my memory for lessons of my own that could be useful. One lesson from AIDS was about the power of communities coming together to take care of one another, to touch one another, to act, using bodies—often frail bodies, always endangered bodies, sometimes even dead bodies—to fight. This lesson is difficult to apply in the era of social distancing, though some ACT UP veterans are managing to stage direct actions even now, standing six feet apart. Maybe the most important lesson I learned from the AIDS epidemic was that it would end. The world would reconstitute itself. Now, when I look at pictures of the deserted streets of Paris or empty central Moscow, I think of all the violence, tragedy, and history that those buildings have witnessed. The cities will still be there when this pandemic is over. Many of us will still be there, too. “ We will meet again ,” as the Queen of England said, in her address to her nation.

There was a time, when I was very young, when everyone in my world was sick and dying. In my early twenties, some weeks, I would go to several funerals. My roommate died. My other roommate died. All my mentors died. I edited a gay magazine that featured a column on living with AIDS . The columnist died; I had to find a replacement, who would also die. I could not imagine that any of this was happening, I could not imagine that the government and so many others didn’t realize that it was happening, and I couldn’t imagine that it would ever end, especially because the science told us that there would never be a cure or a vaccine.

Then, for many people, it ended, as suddenly as it had begun. My younger friends have little idea of what living through the AIDS epidemic was like, and neither do my straight friends, or friends who were straight at the time. Last year, when I was collecting remembrances for the fiftieth anniversary of Stonewall, I was struck by how little space AIDS seemed to occupy in the recollections even of people who had lived through it. Writing in the Boston Review , Amy Hoffman suggested that, because AIDS was so traumatic, so outside our understanding of life, it cannot be made a part of any narrative; one is speaking either about AIDS or about other stories that make up a lifetime, but not about both at the same time.

There may be another reason why it would be very hard to carry the memory of the AIDS era wholly intact. Meeting a medical professional of a certain age, one would have to wonder, Were you one of those who refused to enter the room of a person with AIDS ? Meeting some nice lady who long ago lost a son to AIDS , one would have to wonder, Were you one of those mothers who refused to let her child come home? Did his friends take care of him as he died, while you stayed away? Reading an obituary or biography of Ronald Reagan or George H. W. Bush, one would have to wonder , Did the people who died of AIDS matter so little that the writer could ignore the inaction of both of these Presidents?

Crises bring out the worst in us, and we forget this at our peril. In 1985, the people of Kokomo, Indiana, blocked Ryan White, a boy living with AIDS , from going to school; now, a co-op building in Manhattan has expelled a doctor who came to the city to help save New Yorkers. In 2015, also in Indiana, Mike Pence , who was then the state’s governor, willfully mishandled an H.I.V. outbreak; now he is the Vice-President, in charge of the coronavirus task force. Nations have closed their borders. States want to close their borders. Cape Cod wants to close bridges (an online petition has accumulated thirteen thousand signatures). Rhode Island, where a golf course has posted “Course open to RI residents only” signs, has arrested three men from Massachusetts for golfing. (No, they should not have been golfing, but neither should Rhode Islanders.) There is just enough overlap between sane and sound policy—such as social distancing and minimizing travel—and xenophobic behavior that we hardly question the absurd assumption that national or state borders are meaningful obstacles to the virus. Trump may not have succeeded in forcing all the world to call COVID -19 the “Chinese virus,” but people everywhere are talking about it as the disease of other people. The fear of the invisible virus is replaced with the fear and blame of people from other places.

When we talk about public health, we somehow envision that the epidemic will be thwarted by everyone fending for themselves. The President’s son-in-law, Jared Kushner, said that the national strategic stockpile is not for the states to use. The states bid against one another for ventilators. The government tells all of us to find or make our own masks. “This assumption that you can issue an order from above, and a highly heterogeneous population under conditions of stress and scarcity can suddenly comply without the government supplying the necessities—that is astonishing,” Sheila Jasanoff, a professor of science and technology studies at Harvard’s Kennedy School of Government, told The Nation . It hardly occurs to us that the common good is not simply a matter of everyone’s personal responsibility.

Even in the middle of a nearly nationwide lockdown, at no level do we think of the pandemic as our problem . That allows the Supreme Court to rule that Wisconsin cannot extend its deadline for absentee ballots, deciding, in effect, that it’s the voters’ problem if they would not risk their health to go to the polls and the state didn’t have enough ballots for them. This is a problem not only on the right of the political spectrum—back in March, Joe Biden ’s campaign was encouraging voters to go to the polls, when he should have been imploring them to self-isolate.

Before it’s over, the pandemic will get much worse, and so will we. Then it will end. And, unless we start the work of noticing and remembering now, we will forget how low we went. We will assimilate the ways in which the virus has changed our perceptions. We will romanticize the heroism and ingenuity of people who were betrayed by their government, rather than confront the people responsible for the betrayal.

A Guide to the Coronavirus

• How to practice social distancing , from responding to a sick housemate to the pros and cons of ordering food.
• How the coronavirus behaves inside of a patient .
• Can survivors help cure the disease and rescue the economy ?
• What it means to contain and mitigate the coronavirus outbreak.
• The success of Hong Kong and Singapore in stemming the spread holds lessons for how to contain it in the United States .
• The coronavirus is likely to spread for more than a year before a vaccine is widely available.
• With each new virus, we've scrambled for a new treatment. Can we prepare antivirals to combat the next global crisis ?
• How pandemics have propelled public-health innovations, prefigured revolutions, and redrawn maps .
• What to read, watch, cook, and listen to under coronavirus quarantine .

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An overview of global epidemics and the challenges faced

Nizam uddin.

1 Department of Nutrition and Food Engineering, Faculty of Allied Health Science, Daffodil International University, Dhaka, Bangladesh

Thamina Acter

2 Department of Mathematical and Physical Sciences, East West University, Dhaka, Bangladesh

In this chapter, the global epidemiological events causing infections that ravaged humanity throughout its existence by bringing hardship to rich and poor nations alike are aggregated and presented. Among these, the largest known epidemics including the recent COVID-19 pandemic will be highlighted along with the analysis of the actual and common reason behind the occurring of all the epidemic scenarios. The epidemiological and nonepidemiological impacts of the most fatal pandemics recorded in history are also discussed. The vulnerable countries’ readiness for coping with epidemics is assessed in terms of different indices. Furthermore, the current and future challenges in fighting epidemiological events are on the frontline and a number of preparative measures and strategies have been suggested.

• • Global epidemic events, that is, plague, influenza, coronaviruses have been evolving from deadly human pathogens.
• • Most of the emerging pathogens are of “zoonotic” or animal origin.
• • Practicing nonpharmacological interventions is an effective weapon in fighting against an epidemic.
• • The 2019 Global Health Security Index indicated the weakness of global preparedness.
• • The next global pandemic is not so far away.
• • A number of preparative measures should be undertaken for tackling future epidemics.

1.1. Introduction to global epidemics

The disease of a living system is a mechanism of dysfunction that includes specific symptoms and signs that hinder the body’s normal homeostatic processes ( Wikipedia, 2020b ). Many external and internal factors may be responsible for a disease. Usually, there are four main types of diseases: infectious diseases, deficiency diseases, hereditary diseases, and physiological diseases. In terms of the transmission chance of any disease, it can either be communicable or noncommunicable. Communicable diseases are mostly infectious diseases, which introduced the epidemic phenomenon into the world a long time ago. A very rare disease that does not occur randomly in a population is usually categorized as an epidemic. The term epidemic originates from the two Greek words “epi,” meaning “upon,” and “demos,” meaning “population”. According to WHO, a regional outbreak of an illness that spreads unexpectedly is known as an epidemic ( Jha, 2020 ). The broad definition of epidemic disease delivered by the Centers for Disease Control and Prevention (CDC) is “the occurrence of large number cases of disease, injury, or other health condition than expected in a given community or region or among a specific group of persons during a particular period.”

There are three major components of an epidemiologic triad: external agent, susceptible host, and environment. The agent means an infectious pathogen such as a virus, bacterium, parasite, or other microbes that can attack the host in a favorable and balanced environment. All these three components work together to cause disease and other health events. The assessment of the interactions among these three components is required for developing effective interventions to control an epidemic ( CDC, 2006 ).

There are four phases of an epidemic: the emergence of a disease in a community, outbreak of the disease with localized transmission, sustained outbreak of the disease in the community, and reduced transmission by controlling the disease or acquiring immunity. The epidemic concept is different from the other related infectious disease terms like “endemic”, “outbreak,” and “pandemic” in terms of the spreading of the disease. Knowing the difference among these terms is important for understanding the baseline rate of incidence and public health updates and thus implementing appropriate health responses ( CDC, 2006 ). An endemic disease belongs to a particular geographic area. For example, malaria was an endemic disease in parts of Africa. An outbreak deals with an increase in the number of endemic cases and becomes an epidemic if not controlled quickly. The terms “epidemic” and “outbreak” are sometimes used interchangeably. While a disease-causing agent is different from current strains and much more infectious, the epidemic disease spreads over multiple countries by affecting a substantial number of people, and thus a situation, named a pandemic, arises ( CDC, 2006 ). In general, pandemics affect far more people than an epidemic in wider geographical areas in the entire world and cause impaired health and many more deaths than epidemics, which often creates enormous social disruption, economic loss, and hardship ( CDC, 2006 ).

1.2. List of epidemics

Until the 21 st century the world has faced several global pandemic and epidemic diseases including COVID-19, ( Fig. 1–1 and Table 1–1 ) ranging from asymptomatic to lethal and caused by different viruses and bacteria ( Wikipedia, 2020c ). All these pandemics posed a major challenge across the world and ultimately led to the death of thousands of people and the destruction of civilization as well as the economy.

Burden of epidemics: illustrations: epidemic events* globally, 2011–17**: a total of 1307 epidemic events in 172 countries.

Table 1–1

List of epidemics that occurred worldwide until the 21st century.

1.3. Origin of epidemics hitting the globe

Usually, most of the epidemics may have a common origin ( CDC, 2006 ). Despite the fact that the etiology of the multitude of shimmered pandemics is at first dark, the origin of the continuously evolving epidemics hitting the globe seems to be natural and comprises a diverse species of bacteria, viruses, fungi, and parasites.

Since the ancient age of human ecology, any novel microbe or pathogen, either newly emerging or reemerging, has been considered an independent variable to which the immunologically susceptible population lacks significant degrees of procured invulnerability to avert the disease ( Morse, 2009 ). Until the 21st century, 70% of more than 1500 emerging human pathogens have been proven to be “zoonotic” or of animal origin, which indicates that the next pandemic would be a zoonosis. The major sources of zoonotic transmission are farmed animals (such as poultry), livestock production systems, wildlife reservoirs, unsafe storage of farmed animals in commercial places, consumption of wild species, and contact with wildlife such as wild animal trade ( Morse et al., 2012 ). Besides, certain animal disease vectors are responsible for animal-to-human transmission. Other nonanimal disease vectors contributing to the diffusion of epidemics in a region are contaminated drinking water, food, air, and surfaces, and human touch ( WHO, 2018 ).

Pandemic risk mainly depends on the survival and adaptation behavior of zoonotic pathogens. The adaptation behavior of pathogens can be spanned into five stages ( Table 1–2 ), ranging from animal reservoir transmission (stage 1) to human-to-human transmission (stage 5). In the case of stages 2–3, the geographical spread of pathogens is restricted by the territorial scope of an animal reservoir, and thus pathogens cannot adapt well to humans, causing only localized outbreaks. These stages subsequently increase the adaptability of pathogens within a human population. Over stage 3, the pathogens adapt well to humans, increasing the risk of pandemic ( Madhav et al., 2017 ).

Table 1–2

Pathogen adaptation and pandemic risk.

For example, the origin of human plague may be the wild rodent fleas found in rural areas such as Southwestern United States ( Gage et al., 1995 ); infected animals such as guinea pigs in Peru and Ecuador ( Gabastou et al., 2000 ); infected camels in Central Asia and the Middle East ( Fedorov, 1960 ); or the handling of infected cats and the consumption of plague-infected rodents in Africa ( Isaäcson et al., 1973 ) or the United States ( Gage et al., 2000 ).

Fig. 1–2 represents the possible transmission pathways for the plague foci through rodent hosts and their associated fleas. When a commensal rodent consumes an infected flea, the cycle continues ( Fig. 1–2B ) until the commensal rodents die, and then their fleas move to alternative hosts, for example, humans. Finally, human-to-human transmission may occur depending on the favorable conditions if humans are infected by pneumonic plague through the transmission of respiratory droplets as well as the handling of infected animals such as rodents, cats, camels, mammal predators, and birds ( Fig. 1–2C ). The most likely sources of the Ebola virus are bats transmitting the virus to other animals, that is monkeys, apes, duikers, and humans ( WHO, 2016a ). A major reservoir host of the MERS-CoV infection is dromedary camels transmitted by bats. Since 1986, acquired immunodeficiency syndrome (AIDS) has emerged from different primate species and generated new pathogens through cross-species infections with lentiviruses named simian immunodeficiency viruses (SIVs). The species of human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), and SIVs may have originated from the zoonotic transfers of viruses, ( Fig. 1–3 ) which infected mostly different primates such as African green monkeys, sooty mangabeys, mandrills, and chimpanzees found in sub-Saharan Africa ( Sharp and Hahn, 2011 ).

Possible transmission pathways for the plague agent Yersinia pestis .

Origins of human AIDS viruses.

The main causes behind triggering an epidemic are the recent introduction of a new strain of an infectious agent to a host population that is unknown to the hosts’ immune systems, sudden reduction of the host immunity to the agent below the endemic equilibrium, and the increment of virulence of the agent due to its exceeding threshold that leads to an enhanced mode of transmission. A number of strains of multidrug-resistant microorganisms can evolve due to the inappropriate use of antibiotics for treating viral infections. There are also some seasonal epidemics such as whooping cough, influenza, and measles ( Marcovitch, 2005 ).

The number of cases and usual frequency of disease during an epidemic can vary according to the time and place of occurrence and the size and type of population exposed to the disease in an area ( Cliff et al., 1998 ). The possible diverse epidemic drivers speeding up the pathogenic proliferation on a global scale are trade-induced pathogenic diffusion such as increased speed of trade and migration, advances in transportation technologies, qualitative changes in globalization processes, knowledge and fear diffusion via telecommunications media, burgeoning human population, increased speed of travel, and accelerated genetic mixing ( Morse, 2009 ).

1.4. Comparison of the magnitude of all epidemics

1.4.1. the plague epidemic.

One of the most ancient scourges in human history is the plague, which is an acute infectious disease caused by the bacillus Yersinia pestis ( Stenseth et al., 2008 , Gage and Kosoy, 2005 ). Different Y. pestis strains that have different phenotypic properties are of four types of biovars or geographic origins, namely Antiqua, Mediaevalis, Orientalis, and Microtus ( Zhou et al., 2004 ). Different biovars of Y. pestis caused three major world pandemics having different paths of spread, which resulted in devastating mortality among people. The first pandemic, occurring in the 6th century CE (i.e., 541), was called the Justinian Plague, which evolved in central Africa following spreading around the Mediterranean Sea. The second pandemic, occurring in the 14th century (i.e., 1347), was known as the Black Death, which started in Asia following spreading to Europe, and mainly affected the social, economic, cultural, religious, and political progression of the continents ( Twigg, 1984 ). The third pandemic, occurring in the middle of the 19th century (i.e., 1894), known as the pneumonic plague, evolved in Yunnan, China following spreading to Hong Kong and India, and then finally throughout the world as well ( Stenseth et al., 2008 ). Most of the plague epidemics were bubonic plague caused by the infection of lymph nodes. The other plague epidemics were of septicemic or pneumonic type ( Gage and Kosoy, 2005 ).

All the recorded plague pandemics greatly affected the social and economic statuses of various nations and continents. Fig. 1–4 represents the global epidemiology of plagues all over the world since 1954, where the increased number of cases reported in recent years indicates the plague as a reemerging as well as an endemic disease ( Schrag and Wiener, 1995 ) that presently exists in some parts of South and North America, Africa, and Central Asia ( Fig. 1–4A ). Ultimately, the bubonic and pneumonic plague disease has shifted from Asia to Africa since the 19th century, where most cases and deaths occur in the Democratic Republic of the Congo (DRC), Madagascar, Mozambique, Malawi, Tanzania, and Uganda ( Fig. 1–4B ). Between 1900 and 2015, the number of infected plague cases in the United States was 1036 with an average of 9 cases/year. Furthermore, the number of plague cases in the United States including rural California, northern Arizona, northern New Mexico, southern Colorado, southern Oregon, and far western Nevada in 2015 was 16 ( CDC, 2019b ).

Plague distribution worldwide: (A) Map showing countries with known presence of plague in wild reservoir species (red), (B) Annual number of human plague cases over different continents, reported to the WHO in the period of 1954–2005, (C) Cumulative number of countries that have reported plague to the WHO since 1954.

The total number of plague cases and deaths in the world was 3248 and 584, respectively, within the period of 2010–15, while the most affected countries were the DRC, Madagascar, and Peru ( Stenseth et al., 2008 ). The DRC was the most affected country for over a decade since 2001. In the DRC, the large pneumonic plague outbreak occurred in October and November, 2006 ( WHO, 2006 ). The host of regular plague epidemics has been Madagascar since 2012. In Madagascar, the major pneumonic and bubonic plague disease outbreak occurred in 2017, which led to more than 2417 infected plague cases and 209 deaths. As a result, the plague preparedness alert was imposed in nine countries and territories connected to Madagascar for trade and travel. As of July 2020, a bubonic plague case was reported in Bayannur, Inner Mongolia of China and Mongolia due to which a plague-prevention system has been activated throughout the year ( Stenseth et al., 2008 ).

1.4.2. Influenza pandemic (H1N1 virus)

In the last 140 years, there have been five severe epidemics of influenza A virus that have emerged as different variants such as the bird flu, dog flu, H1N1 flu, H3N2 flu, horse flu, human flu, and swine flu ( Fig. 1–5 ) ( CDC, 2019a ). Among these, the most deadly flu pandemic (category 5 influenza) was the 1918 flu (Spanish flu) caused by the H1N1-type influenza A virus that spread to the Arctic and remote Pacific islands ( Potter, 2001 ). The death toll of the 1918 influenza pandemic was more than 50 million worldwide, similar to that of the Black Death, due to the extremely high infection rate caused by cytokine storms and lung infection ( Patterson Kd Fau et al., 1991 ). As a result, the 1918 pandemic caused mental harm to numerous individuals, social disruption, and a sense of fear in the affected regions ( NationalAcademiesPress, 2005 ).

Types of influenza viruses evolved in humans causing recurring influenza pandemics since 1889.

The next influenza pandemic was the category 2 flu pandemic named the Asian flu, which emerged in Guizhou, China in 1956 and then spread to Singapore, Hong Kong, and the United States in 1957 ( Mittal and Medhi, 2007 ). The death toll of the Asian flu worldwide was in the range of 1 million to 4 million. In the period between 1968 and 1969, a strain of the H3N2 influenza virus caused the category 2 Hong Kong flu pandemic, killing 1 million people worldwide ( AssociatedPress, 2009 ).

The latest pandemic of the 21st century of the influenza A virus named swine flu was caused by a strain of H1N1 in 2009 ( CDC, 2019a ). According to the WHO, the number of infected cases and deaths during the influenza H1N1 pandemic were 482,300 and 18,000, respectively, in 199 countries. During the 2009 influenza pandemic, the main comorbidities were acute myocardial infarction and stroke, which significantly increased the number of deaths.

1.4.3. AIDS

One of the most annihilating diseases that has evolved in recent history is AIDS, an infection caused by a member of retroviruses called the human immunodeficiency virus (HIV) ( Sepkowitz, 2001 ). According to the CDC, AIDS is defined as a disease at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease. The symptoms of AIDS are degrading immune function and unintended weight loss along with developing opportunistic infections. The major routes of transmission of the virus are contaminated blood transfusions, contaminated and used needles, unprotected sex, and pregnant and breastfeeding mothers ( Cohen et al., 2011 ).

In 1981, the first five AIDS cases were reported in homosexual men due to a rare fungal infection caused by Pneumocystis carinii pneumonia, which was recognized by the CDC ( Sharp and Hahn, 2011 , Gallo, 2006 ). Since the first identification of AIDS cases in 1981, the number of HIV infections and the number of deaths has tremendiously increased worldwide ( Merson et al., 2008 ). Higher HIV/AIDS morbidity and mortality were observed in developing countries, while the highest prevalence rates were observed in sub-Saharan Africa ( UNAIDS, 2020 ). As of 2019, the number of infected HIV cases was 38 million with 690,000 deaths, among which 20.6 million were from eastern and southern Africa. Thus HIV/AIDS is still actively spreading and is considered a pandemic ( Kallings, 2008 ). The disease outbreak has caused large economic impacts, many controversies involving religion, and discrimination in society ( UNAIDS, 2006 ).

1.4.4. Coronavirus epidemics

1.4.4.1. severe acute respiratory syndrome coronavirus.

The first coronavirus causing disease was severe acute respiratory syndrome (SARS), which is a relatively rare viral respiratory infection ( CDC, 2017 ). The sign of SARS infection is similar to that of atypical pneumonia, and its symptoms are mainly breathing difficulties along with dry cough, fever, and headache. The SARS virus is readily transmissible and thus can spread directly through air like the influenza virus and indirectly via surfaces touched by infected persons.

The SARS outbreak first emerged in Guangdong province, southeastern China on 16 November, 2002, and then spread to 29 countries in North America, South America, Europe, and Asia within about 8 months, from November 2002 to July 2003 ( Routledge, 2003 ). According to the WHO, the total number of SARS infections was reported to be 8098, including 29 cases from the United States, while the total number of deaths was 774 ( Fig. 1–6 ) ( Routledge, 2003 ). The case fatality rate (CFR) of the SARS epidemic was 11% ( Chan-Yeung and Xu, 2003 ) and it depends on the patient’s age and gender ( Routledge, 2003 ). Patients that were 65 years old and male were most likely to die ( NationalAcademiesPress, 2004 ). The SARS outbreak mainly caused hospital-based as well as healthcare worker infections. Furthermore, the outbreak raised fear and economic instability across the world.

2003 Probable cases of SARS worldwide.

After the 2002–03 SARS outbreak, a few SARS infections were reported until May 2004 ( WHO, 2004 ). Since May 2004, there have not been any known cases of SARS reported worldwide. In December 2019, the SARS-related virus strain called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected, which caused the coronavirus disease 2019 (COVID-19) pandemic ( Morens and Fauci, 2020 ).

1.4.4.2. Middle East respiratory syndrome coronavirus

Another coronavirus that appeared in Saudi Arabia in the Middle East region in 2012 was responsible for causing an epidemic called Middle East respiratory syndrome (MERS) ( Parry, 2015 ). MERS is also a viral respiratory disease like SARS. The MERS coronavirus (MERS-CoV) originated from bats and then was transmitted to humans via infected camels ( Zumla et al., 2015 ).

The first MERS case was identified in June 2012 in Jeddah, Saudi Arabia, and Saudi Arabia was the most affected place in the Arabian Peninsula.” ( Zumla et al., 2015 ). In the period of 2012–13, the largest MERS epidemic spread fatally into Saudi Arabia, United Arab Emirates, and the Republic of Korea, while Saudi Arabia (approximately 80% of human cases) was the most affected country ( Fig. 1–7 ) ( Zumla et al., 2015 ). Since 2012, the countries that have reported MERS cases have been Algeria, Austria, Bahrain, China, Egypt, France, Germany, Greece, Islamic Republic of Iran, Italy, Jordan, Kuwait, Lebanon, Malaysia, Netherlands, Oman, Philippines, Qatar, Republic of Korea, Kingdom of Saudi Arabia, Thailand, Tunisia, Turkey, United Arab Emirates, United Kingdom, United States, and Yemen. Larger MERS outbreaks have been seen in South Korea and Saudi Arabia in 2015 and 2018, respectively ( WHO, 2017 ).

Confirmed cases of MERS-CoV worldwide in the period of 2012–15.

According to the WHO, the number of MERS cases as of January 2020 was about 2500, while the death rate was 35% of the reported cases ( Carmona et al., 2012 ). The spread of MERS-CoV mainly occurred in healthcare facilities among family members, patients, and healthcare workers before MERS-CoV was diagnosed and where infection prevention practices were inadequate. The patients with chronic lung disease, diabetes, immunodeficiency, and renal failure were at high risk of MERS severity. The impact of the MERS epidemic has been observed in the Republic of Korea in different aspects of life, such as travel, trade, and economies.( Al-Osail and Al-Wazzah, 2017 )

1.4.4.3. Severe acute respiratory syndrome coronavirus-2

The most recent outbreak of coronavirus disease 2019 (currently known as COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been a potential threat to human health ( Acter et al., 2020 ). The origin of the disease was Huanan Seafood Wholesale Market, located in Wuhan, Hubei, China, and then it subsequently spread to Thailand, Japan, and then other regions in Asia, Europe, North America, South America, Africa, and Oceania, developing into the global 2019–20 coronavirus pandemic by March. WHO declared this massive global outbreak as the sixth Public Health Emergency of International Concern on January 30 and a pandemic on March 11, 2020 as the disease spread worldwide.

According to figures compiled by US-based Johns Hopkins University, as of January 04, 2021, there are 85,603,740 confirmed cases, 23,188,005 active cases, 60,562,667 recoveries, and 1,853,068 deaths in about 191 countries/territories and 26 cruise/naval ships. The current scenario of the ten most affected countries in the world is presented in Table 1–3 . As the number of confirmed COVID-19 infections is higher than the total number of suspected SARS cases, the SARS-CoV-2 virus is assumed to be more contagious than other coronaviruses, that is, SARS, MERS, and influenza. The natural reservoir of the SARS-CoV-2 virus is assumed to be bats. The human-to-human transmission of the virus mainly occurs via respiratory droplets produced from the coughs or sneezes of an infected person. The pandemic has caused global health impacts; social, economic, educational, and agricultural disruption; panic buying; widespread supply and food shortages; and postponement or cancellation of events ( Cave and May, 2020 , Horowitz, 2020 , Larson, 2020 , Litvinova et al., 2019 , Maxmen, 2020 ).

Table 1–3

COVID-19 pandemic by location for ten most affected countries.

1.4.4.4. The ebola epidemic

One of the most severe, deadliest, and most fatal viral diseases is Ebola virus disease (EVD) or Ebola hemorrhagic fever caused by a group of ebolaviruses such as Ebola virus (species Zaire ebolavirus ), Sudan virus (species Sudan ebolavirus ), Taï Forest virus (species Taï Forest ebolavirus ), Bundibugyo virus (species Bundibugyo ebolavirus ), Reston virus (species Reston ebolavirus ), and Bombali virus (species Bombali ebolavirus ) in human and nonhuman primates (such as monkeys, gorillas, and chimpanzees), among which the human disease-causing ebolaviruses are Ebola, Sudan, Taï Forest, and Bundibugyo viruses ( WHO, 2016a ).

The most likely sources of the ebolavirus are infected wild animals such as fruit bats; porcupines; and nonhuman primates such as chimpanzees, apes, and monkeys. The spreading of the virus may take place through direct contact with the infected blood, body fluids, or secretions of infected people; mucous membranes in the eyes, nose, or mouth; tissues of infected animals; and contaminated objects or surfaces ( WHO, 2016a ). Besides, the virus may exist in the semen or breast milk of an EVD-recovered person ( WHO, 2015a ). The incubation period of the disease is from 2 days to 3 weeks, while its major signs and symptoms are fever, sore throat, muscular pain, headaches, vomiting, diarrhea, decreased liver and kidney functions, sometimes internal and external bleeding, and low blood pressure from fluid loss ( WHO, 2016a , Singh and Ruzek, 2013 ). The Ebola epidemic overwhelmed the healthcare systems and caused a lack of routine diagnosis and treatment for endemic diseases such as malaria, HIV/AIDS, and tuberculosis. As a result, the nonebola diseases contributed to an estimated 10,600 additional deaths during the Ebola epidemic in Guinea, Liberia, and Sierra Leone of West Africa ( Parpia et al., 2016 ). Besides, understaffing and fear of contracting the disease caused the closure of facilities that led to decreasing routine childhood immunization rates and routine healthcare in affected countries.

The Ebola virus first emerged with two simultaneous outbreaks in two tropical regions of sub-Saharan Africa named Sudan (in a village near Ebola river) and the DRC (formerly Zaire) in 1976, while the number of infections was 284 (with a mortality rate of 53%) and 318 (with a mortality rate of 88%) in the first and second outbreaks, respectively ( WHO, 2016a ). In the last 40 years, the Ebola virus has been mostly affecting several African countries with occasional outbreaks as well as a sparking alarm worldwide due to more than 25 deadly outbreaks ( Table 1–4 ). The most severe EVD epidemic since 1976 that caused a large number of deaths occurred in West Africa (Guinea, Liberia, and Sierra Leone) from December 2013 to January 2016, with 28,646 cases and 11,323 deaths ( WHO, 2016a ). According to the WHO, the numbers of confirmed Ebola cases and deaths due to this disease were 2387 and 1590, respectively, from 1976 through 2020. The emergency alert for EVD was withdrawn on 29 March 2016. Recently, EVD has been reemerged in the DRC, Africa from May 2017 ( K, 2017 ). The average CFR of EVD is about 50%, which indicates that the disease has a high risk of death ( WHO, 2016a ).

Table 1–4

Chronology of previous ebola virus disease outbreaks.

1.5. Assessing countries’ readiness for coping with epidemics

In order to cope with an epidemic, five crucial stages are required to be followed: prediction of the novel pathogen; faster pathogen detection in animal reservoirs and human populations; disease containment at the beginning phases of transmission; control of the epidemic during its amplification; and elimination of the outbreak risk ( CDC, 2006 ). Effective readiness of a country during an epidemic involves a disease surveillance system; early mitigation efforts; actual response measures such as case and contact tracing; identifying infected cases; and preventive measures in healthcare facilities and public health measures, such as clean water and handwashing etiquette ( Gates, 2015 ).

In order to flatten the epidemic curve, nonpharmacological interventions such as using personal protective equipment (PPE; i.e., masks, gloves, etc.) and social distancing have been exercised in the affected countries ( Stawicki et al., 2020 ). Vaccine production, as well as the purchasing capability, is variable from country to country. For example, according to the WHO, 19 countries manufactured the influenza vaccine, while only the United States and France were the suppliers of the H1N1 vaccine in 2009 ( CDC, 2019c ).

Until now, different effective ways have been followed in the countries for coping with the epidemics, resulting in various impacts in the affected regions. The indices for measuring and identifying countries’ preparedness and responses against the threats of epidemics worldwide are the Global Health Security (GHS) Index and the COVID-19 Safety, Risk and Treatment Efficiency framework and indices. There is a relationship between global health security and its ability to cope with pandemics. In this context, the GHS Index is an assessment index projected by the Nuclear Threat Initiative and the Johns Hopkins Center for Health Security (CHS) and developed with the Economist Intelligence Unit that benchmarks the capabilities of the health security of any nation affected by infectious disease outbreaks and thus encourages to upgrade the health facilities of the respective country. The GHS index usually is calculated based on 140 questions organized into six categories, namely the prevention of emerging diseases, the detection and reporting of confirmed cases and deaths, rapid response to the epidemic, the health system, the compliance with global norms, and the risk environment.

The 2019 GHS Index reported the rankings of 195 countries and territories, which finds that the average score is 40.2 out of 100, indicating the fundamental weakness of global healthcare systems and preparedness to face epidemics ( LePan, 2020 ). The pre-COVID-19 GHS report highlights the global health security problems of the current world due to the following reasons:

• • Worldwide weak national health security required for facing epidemic response
• • Few efforts taken by countries for testing the capacities of health securities
• • Inadequate funding for filling up the preparedness gaps of the countries
• • Inadequate coordination and training among health professionals.

As shown in Fig. 1–8 , 81% of the countries had a low score pertaining to the health security system in 2019, while 85% of countries did not exercise biological threat-focused simulation efforts along with the WHO. According to GHS, the score of the United States (98.2) was higher than that of Germany (84.6) and South Korea (92.1) in the case of detection, reporting, and infection control practices and availability of equipment, while the private sector of South Korea had sufficient protective equipment such as masks and developed and implemented test kits faster. Along with sufficient protective equipment, Germany had greater healthcare facilities such as hospital beds, intensive care beds, and ventilators ( Lafortune, 2020 ). One of the limitations of GHS methodology in testing and the adaptability of health systems is that the index may over or underestimate the preparedness level of certain countries. One of the effective measures to flatten the epidemic curve is imposing lockdowns of nonessential economic activities, especially implemented by most Asian countries, including South Korea, and some European countries, including France and Germany. However, these shutdown approaches are responsible for the economic impacts of the affected regions.

Global Health Security Index of countries with population of more than 5 million. ( GHSI, 2019 ).

Table 1–5 shows the ranking of the GSH index of the top ten countries that have adequate healthcare systems, which are best prepared to deal with a pandemic although there are still some gaps in their preparedness. Overall, the top 2019 GHS-ranked countries globally are the United States, the United Kingdom, and the Netherlands. In addition, Fig. 1–9 shows that numerous medical service frameworks have had their security tested with the episode of COVID-19 ( Lafortune, 2020 ). The highest number of deaths per capita was reported in countries like Belgium, France, Italy, Spain, United States, and United Kingdom during the COVID-19 pandemic. The countries near the origin of the COVID-19 outbreak, such as South Korea, have started to release the lockdown measures due to effective management of the disease outbreak.

Table 1–5

The top 10 highest-ranking countries in the Global Health Security index ( GHSI, 2019 ).

Confirmed COVID-19 cases versus Global Health Security score. ( GHSI, 2019 ).

The COVID-19 Safety, Risk and Treatment Efficiency framework and indices have been released by the Deep Knowledge Group (a consortium of profit and nonprofit organizations) in March 2020, which cover 150 countries. This “Safety” index was calculated based on 72 metrics grouped into 3 indices, namely Safety, Risk and Treatment Efficiency, and 12 underlying quadrants. The data was collected from the WHO, Johns Hopkins University, Worldometer, and the CDC. Overall, the top COVID-19 Safety Indexed countries of 2020 are Israel, Germany, and South Korea.

Countries like Australia and South Korea performed well on both the November 2019 GHS Index and COVID-19 Safety Index. The top-ranked GHS Indexed countries such as the United Kingdom and the United States and Other OECD (Organisation for Economic Co-operation and Development) countries such as France, Spain, and Sweden were not in the list of the top 40 COVID-19 Safety Indexed countries. On the other hand, better ranked COVID-19 Safety countries were observed to be Austria, China, Hungary, Israel, Japan, New Zealand, Singapore, and the United Arab Emirates according to their GHS ranks. Besides, Germany ranked 2 nd and 14 th on the COVID-19 Safety Index and GHS Index, respectively. Asian countries performed well in the effective management of the COVID-19 crisis, such as massive testing, intense reconnaissance frameworks, and quick detachment of tainted patients and the subsequent leveling of the epidemic curve ( Lafortune, 2020 ).

1.6. Challenges in battling with epidemics

Epidemics of any disease put the resources of the health systems of the affected countries under pressure due to the admission of a large number of patients to hospitals. The most recent COVID-19 pandemic shows that the health and nonhealth impacts of a pandemic could be devastating even with good public health surveillance systems ( Acter et al., 2020 ). All attention given to the emergency of medical supplies and supports may often be responsible for neglecting other regular health facilities. As a result, people with other diseases may not get healthcare services on time during an epidemic, and thus mortality rates get higher. The situation is worsening in poorer communities around the world and low-income countries, and countries facing severe epidemics faced mainly this type of difficulty. For example, the Ebola virus in West Africa spread rapidly in more than 2 months before diagnosis and thus caused the Ebola epidemics. Besides, the epidemic caused by any novel virus may generate fear among certain at-risk populations, which leads to the generation of inadequate decisions or inappropriate behaviors.

The rapidly evolving nature of known epidemic diseases, such as cholera, HIV infection, influenza, meningitis, malaria, and tuberculosis still remains a threat for the globe. It is sometimes difficult to effectively access public health measures even in cases of known epidemics. The major limitations of access to vaccines are inadequate production capacity for diseases, for example yellow fever and influenza; vaccines out of stock during explosive outbreaks (e.g., meningitis); and the absence of markets during emergencies (e.g., oral cholera vaccine). Unprepared health systems could be challenged during epidemics of infectious diseases. In the case of inadequately undertaken preventive measures such as triage and isolation, the hospitals could be a source of transmission for unknown and emerging pathogens (for instance, MERS) from infected patients. Healthcare workers are usually at high risk of infection, which results in shortages of them during emergencies of epidemics and thus further weakens the health workforce. Therefore training new healthcare workers is time consuming. The traditional containment measures like home quarantine are sometimes unacceptable, which should be reevaluated in the perception of people’s freedom of movement. The term “infodemics” is a new health risk among the population in the era of epidemics, which includes the rapid spreading of unauthentic, misleading, and unreliable information through social media nationally and internationally.

1.7. Concerns about future pandemics

The 21st century has been vigorously attacked by so many major epidemics ( Gates, 2015 ). People will always remember the West African Ebola outbreak in 2014. The coronaviruses, that is, MERS, are still active, and the recent COVID-19 pandemic is still ongoing. Viral hemorrhagic fevers, that is, Ebola and Marburg viruses, causing disease could become pandemics. The history of pandemics occurring every decade tells us that the recurrences between pandemics become more limited as seen with SARS in 2003, influenza A H1N5 (bird flu) in 2007, H1N1 (swine flu) in 2009, MERS in 2012, and Ebola in 2014 ( Morse and Schluederberg, 1990 , Jones et al., 2008 ).

Multidrug-resistant strains of tuberculosis (MDR-TB) are a major concern. Without dynamic reconnaissance and regulation measures, the possibility of avian influenza (H5N1) infection joining with human seasonal infections is a concern to researchers. The emergence and spread of multidrug-resistant strains of the plague virus would pose a major concern to human health ( Inglesby et al. ). As plague can originate in wildlife rodent reservoirs, it could not be eradicated. Africa is particularly at risk due to possibly favorable contact between plague reservoirs and peridomestic rodents in poor rural communities ( Stenseth et al., 2008 ). The plague is known to be affected by various environmental conditions such as hotter springs and wetter summers that may turn out to be more normal in the future ( Parmenter et al. , Enscore et al. ). Furthermore, plague bacillus may adapt to new ecological niches due to its genomic rearrangement capacity and antibiotic resistivity ( Parkhill et al. , Galimand et al., 1997 ).

As the current world remains vulnerable to epidemic events, the possibility of the next global pandemic could not be ignored. Although the advancement of medical science has been progressing rapidly in recent years, the natural immunity of humans to a newly mutated disease would not develop, and thus there are still concerns about global, sustained, and threatening public health emergencies in the future ( Ross et al., 2015 ). As diseases very rarely disappear, there is always space for new ones. There are some reasons behind emerging and reemerging new pathogens and the increasing transmissibility and severity of infectious diseases. The major potential factors that serve as the breeding grounds for concerns of the future transmission of respiratory and fecal-oral pathogens are overpopulation ( Alirol et al. ); weak populations along with malnourishment in low-to-middle-income countries (LMICs); quick and extreme mobility of individuals, with expanded vehicle offices; greater interconnectivity between megacities; poverty; globalization; relentless urbanization ( Alirol et al. ); swelling populations of city dwellers; global warming; environmental degradation; ecological changes; habitat destruction; close and rehashed interaction among individuals, animals, and livestock; domestic animals; drug resistance to entering pathogens and the existence of viral pathogens with high nucleotide substitution rate, poor mutation error-correction rate ability, and quick adaptation capacity to human hosts ( Jones et al., 2008 ). Given the abovementioned contributing factors, it is almost certain that the following arising infection will likewise spread quickly and far.

1.8. Preparative measures for tackling future pandemics

It is impossible to create a pandemic-free world. But meticulous preparation and rapid response can be helpful to prevent, detect, and respond effectively and rapidly to most episodes from gaining out of power at the very start of a disease outbreak that represents potential international threats. In order to make the world safer, the following pandemic preparation methods should be undertaken:

• • Addressing the root cause of health insecurity and strengthening health systems with a strong focus on surveillance systems.
• • Providing protected, compelling, and subjective wellbeing administrations prior to, during, and after scourges by long-term substantial investments.
• • Building and sustaining versatile limits at public, local, and worldwide levels.
• • Ensuring, improving, and implementing rapid accessibility of essential life-saving health services and interventions including medicines and vaccines and other countermeasures worldwide during crises.
• • Early recognition of a new microbe and the beginning of human-to-human transmission during emergence by detecting unusual clusters of severe cases.
• • Raising clinicians’ awareness by training them effectively as detectors and first-line responders.
• • Flexibility of preparedness to adapt to any novel agent.
• • Employing risk communication and sophisticated skills among health specialists, offices, doctors, and health experts to limit the social, political, and monetary effects of a scourge.
• • Permitting innovative work exercises in any event during pandemics to quickly track the accessibility of powerful tests, immunizations, and drugs.
• • Empowering and engaging anthropologist communities for better understanding human ecology as well as addressing fear and trust issues.
• • Empowering and engaging the health workforce community in creating and executing strong arrangements and techniques toward widespread health coverage.
• • Adequate clinical management and better supportive care for patients by involving skilled, qualified, and dedicated health personnel.
• • Recently, computational or artificial intelligence (AI) techniques have been playing a significant role in coping with global epidemics and addressing public health surveillance ( Zeng et al., 2021 , Dananjayan and Raj, 2020 , Bansal et al., 2020 ). AI can help researchers in predicting the magnitude and impact of future epidemics. However, there are still some challenges regarding AI techniques, that is, unawareness, data sparsity, lack of skilled operating manpower, high cost, software malfunction, noninvincibility, algorithm bias, data breach, etc. ( Harkut and Kasat, 2019 ). In order to explore AI techniques widely in the areas of global epidemics, some developments in AI techniques such as research on collaborative systems, fine-tuning of networks of neural network algorithms, generation of innovative ways to explore human intelligence, deep learning, development of neural biological networks, advent of reinforcement learning, limitations in the cost of high computational capacity, and wide availability of labeled data should be performed ( Harkut and Kasat, 2019 ).

Furthermore, a number of hygiene measures are recommended in order to maintain health and prevent the spread of disease outbreaks in the future.

• • Medical hygiene: The standard infection control precautions, that is, frequent handwashing; use and disinfection of PPE including masks, gowns, caps, eyewear, and gloves; prevention of sharp injury; disinfection of surgical equipment and environment; airborne and contact precautions; droplet precautions; isolation of infected patients; and safe removal of clinical waste, etc. should be practiced in medical care settings ( WHO 2007 ).
• • Home hygiene: Home hygiene may include frequent handwashing with soap and water, using hand sanitizer, food hygiene, water hygiene, cleaning common surfaces, care of domestic animals, using tissues or covering mouth during coughing, and disposal of used tissues after coughing ( Bloomfield et al., 2009 ).
• • Social hygiene: Social hygiene may include social distancing in public transport, educational institutions, workplaces, and markets; installment of handwashing set-ups; and frequent use of disinfectants in public places.

1.9. Review questions

• 1. What is the common origin of the continuously evolving epidemics hitting the globe and how does the transmission of any infectious disease take place?
• 2. How does a pathogen adapt to the human population?
• 3. How many times did the influenza viruses reemerge as variants until the 21st century?
• 4. Which coronavirus is the deadliest virus in history and why?
• 5. How many stages are essential for coping with an epidemic?
• 6. What are the popular nonpharmaceutical interventions that should be followed during an epidemic?
• 7. What is the relationship between countries’ preparedness measuring index and its ability to cope with pandemics?
• 8. How can the Global Health Security (GHS) index be calculated for measuring the preparedness of a vulnerable country?
• 9. Write about the current health security problems worldwide.
• 10. Why are the health systems of any country the most affected part during any epidemic?
• 11. What are the major challenges faced during an epidemic?
• 12. Which factors contribute most to evolving novel pathogens in the human population?
• 13. How can an epidemic be responded to in a short time?
• 14. How can the challenges of computational or artificial intelligence (AI) techniques be overcome?
• 15. How can different hygiene practices be maintained?

1.10. Problem statements for young researchers

• 1. The countries with a good 2019 GHS Index score and COVID-19 Safety Index score performed effective management of epidemics. The top-ranked GHS Indexed countries are not always the top-ranked COVID-19 Index countries. What is the reason behind this dissimilarity?
• 2. The number of cases and the usual frequency of any disease during an epidemic can vary according to the time and place of occurrence and the size and type of population exposed to the disease in an area. How is this statement true in terms of epidemic events that have occurred in history?

1.11. Discussion questions

• 1. All the epidemic events show the devastating health and nonhealth impacts even with good public health surveillance systems. The poorer communities are the main victims of this scenario. Besides, healthcare workers are at high infection risk even in developed countries. How can the resources of the health system be enriched in order to cope with an epidemic and reduce the infection risk of healthcare providers?
• 2. There have been many major epidemics since the early age of human evolution. The recent epidemics include the West African 2014 Ebola outbreak, 2012 MERS, and COVID-19. The history of pandemics occurring is a reflection of concern for future epidemics. What kind of key issues can be raised regarding the growing concerns of the future transmission of human pathogens?
• 3. Any novel microbe or pathogen, either newly emerging or reemerging, is considered an independent variable that causes disease in the susceptible human population. While most of the emerging human pathogens are of animal origin, discuss the main causes behind the triggering of an epidemic.
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