UPDATE COMING We’re currently working to update this article. Studies have shown that a person living with HIV who is on regular antiretroviral therapy that reduces the virus to undetectable levels in the blood is NOT able to transmit HIV to a partner during sex. This page will be updated soon to reflect the medical consensus that “Undetectable = Untransmittable.”
Researchers found the earliest case of HIV in a blood sample of a man from the Democratic Republic of Congo. It’s said that the virus spread from chimpanzees to humans sometime before 1931, most likely during “bush meat trading.” While hunting chimpanzees, hunters would come in contact with animal blood.
Before the 1980s, researchers estimate that about 100,000 to 300,000 people were infected with HIV. The earliest case was confirmed in 1968, in Robert Rayford, a 16-year-old teenager, who never left the Midwest or received a blood transfusion. This suggests that HIV and AIDS may have been present in the United States before 1966.
But before AIDS was identified, the disease appeared as other immunodeficiency conditions like Pneumocystic carinii pneumonia (PCP) and Kaposi sarcoma (KS). A year after scientists identified AIDS they discovered the cause: HIV.
The start of the epidemic
Originally people believed that only certain people were at risk for AIDS. Media named them the “four-H club:”
- hemophiliacs, who received contaminated blood transfusions
- homosexual men, who reported higher incidences of the disease
- heroin users, and people who used drugs via injection
- Haitian origin, many cases of AIDS were reported in Haiti
But then researchers studied how the disease spread and by 1984:
- They found that females could get HIV through sex.
- There were 3,064 diagnosed cases of AIDS in the United States.
- Of those cases, 1,292 people died.
The National Cancer Institute identified HIV as the cause of AIDS.
The number of cases continued to grow as the CDC refined their case definition and scientists learned more about the virus.
By 1995, AIDS was the leading cause of death for adults 25 to 44 years old. About 50,000 Americans died of AIDS-related causes. African-Americans made up 49 percent of AIDS-related deaths.
But death rates began to decline after multidrug therapy became widely available. The number of deaths has since dropped from 38,780 in 1996 to 14,499 in 2000.
The development of research, treatment, and prevention
Azidothymidine, also known as zidovudine, was introduced in 1987 as the first treatment for AIDS. Scientists also developed treatments to reduce mother to child transmission.
In 1997, highly active antiretroviral therapy (HAART) became the new treatment standard. It caused a 47 percent decline in death rates.
The Food and Drug Administration (FDA) approved the first rapid HIV diagnostic test kit in 2003. The test kit allowed hospitals to provide results with 99.6 percent accuracy in 20 minutes.
Also in 2003, the CDC reported that 40,000 new infections occurred each year. More than half of those transmissions came from people who didn’t know they were infected. It was later discovered the number was closer to 56,300 infections. This number remains roughly the same since the late 1990s.
The FDA approved Combivir in 1997. Combivir combines two drugs into a single medication, making HIV medications easier to take.
Researchers continued to create new formulations and combinations to improve treatment outcome. By 2010, there were up to 20 different treatment options and generic drugs, which helped lower costs. The FDA continues to approve HIV and AIDS medical products, including:
- product approval
- safety regulations
- label updates
The cultural response to HIV
Stigma in the early years
When the first few cases of AIDS emerged, people believed they were only among men who had sex with men. The CDC called this infection GRIDS, or gay-related immunodeficiency syndrome. Shortly after, the CDC published a case definition calling the infection AIDS.
Public response was negative in the early years of the epidemic. In 1983, a doctor in New York was threatened with eviction, leading to the first AIDS discrimination lawsuit.
Bathhouses across the country closed due to high-risk sexual activity. Some schools also barred children with HIV from attending.
In 1987, the United States placed a travel ban visitors and immigrants with HIV. President Obama lifted this ban in 2010.
Throughout the years, the government continues to fund HIV- and AIDS-related:
- systems of care
- testing services
- studies and research
In 1985, President Ronald Reagan called research for AIDS “a top priority” for his administration. And President Clinton hosted the first White House Conference on HIV and AIDS and called for a vaccine research center. This center later opened in 1999.
Pop culture opens up conversations about HIV
Actor Rock Hudson was the first major public figure to acknowledge he had AIDS. After he died in 1985, he left $250,000 to set up an AIDS foundation. Elizabeth Taylor was the national chairperson until her death in 2011. Princess Diana also made international headlines after she shook hands with someone with HIV.
Pop culture icon Freddie Mercury, singer for the band Queen, also passed away from AIDS-related illnesses in 1991. Since then many other celebrities have revealed that they’re HIV-positive. More recently, Charlie Sheen announced his status on national television.
In 1995, the National Association of People with AIDS founded National HIV Testing Day. Organizations, conventions, and communities continue to fight the stigmas attached to this infection.
Following the politics of blood bans
Prior to the epidemic, U.S. blood banks did not screen for HIV. When they started doing so in 1985, men who had sex with men were banned from donating blood. In December 2015, the FDA lifted some of its restrictions. Current policy says that donors can give blood if they have not had sexual contact with another man for at least one year.
Recent drug development for HIV prevention
In July 2012, the FDA approved pre-exposure prophylaxis (PrEP). PrEP is a medication shown to prevent HIV from sexual activity or needle use. The treatment requires taking the medication on a daily basis.
Doctors recommend PrEP for people who are in a relationship with someone who has HIV.
Other people who may benefit from PrEP include:
- people in a nonmonogamous relationship with a partner who is HIV-negative (to reduce the risk you or your partner will get HIV)
- people who have had anal sex without a condom or contracted a sexually transmitted disease (STD) in the past six months
- people who have sex with men and women
- people who have injected drugs, have been in drug treatment, or shared needles in the past six months
- people who regularly have different sexual partners of unknown HIV status, especially if they inject drugs
PrEP is shown to reduce the risk for HIV infection by greater than 90 percent.