INTRODUCTION
A timeline of the HIV epidemic in the United States June 2021 marks the 40th anniversary of the first recognition and first official report of the HIV/AIDS epidemic in the US and around the world. 1 The historic Centers for Disease Control and Prevention (CDC) report published on June 5, 1981 described biopsy-confirmed Pneumocystis carinii pneumonia in 5 previously healthy gay men aged 29 to 36-years- old at 3 different Los Angeles hospitals. 2 Since then, the US has passed through numerous important, and groundbreaking, milestones in the ongoing epidemic (Table 1). 3 Although substantial progress has been in the past 40 years towards the goal of ending the HIV epidemic through advancements in prevention and treatment, 5 many challenges remain. The world’s attention has moved away from HIV/AIDS as an acute, immediately life-threatening disease with almost certain death to a chronic, manageable and treatable health condition. In addition, the COVID-19 pandemic has resulted in declines in HIV testing and prevention services. 1
Ending the HIV epidemic: A Plan for America In response to the remaining challenges presented by the HIV/AIDS epidemic, the US Department of Health and Human Services (HHS) launched “Ending the HIV Epidemic: A Plan for American” 4 in 2019. This cross-agency initiative leverages scientific advances in HIV prevention, diagnosis, treatment, and outbreak response by coordinating highly successful programs, resources, and infrastructure of many HHS agencies (CDC, NIH, HRSA, IHS). The goal of this initiative is to reach a 75% reduction in new HIV diagnoses by 2025 and at least a 90% reduction by 2030. HHS is working with both urban and rural communities to establish local teams to tailor and implement strategies to test all persons and diagnose those with HIV as early as possible after infection, initiate treatment rapidly and effectively to achieve sustained viral suppression, prevent new transmissions using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs, and respond quickly to potential HIV outbreaks to begin prevention and treatment services to people who need them. 5 The initiative is initially focusing resources on areas where HIV transmission occurs most frequently.
Table 1: Major Milestones in the HIV/AIDS Epidemic 3,4 Year Milestone 1981
CDC reports first cases of rare pneumonia and persistent HSV in previously healthy young gay men. Viral cause proposed (CMV). French researchers publish first paper describing the new retrovirus as cause of AIDS. Two American researchers confirm their discovery. FDA licenses first commercial blood test, ELISA, to detect HIV in blood. Blood banks begin screening US blood supply. HHS and WHO host the first International AIDS Conference in Atlanta, GA.
1983
1985
1987 1989
FDA approves the first antiretroviral drug, zidovudine (AZT).
CDC reports that the number of reported AIDS cases in the US has reached 100,000. 1990 Congress enacts the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990. 1992 AIDS becomes the number one cause of death for American men aged 25 to 44. 1993 Two large RCTs from US and Europe confirm that AZT monotherapy’s effect on the virus is not durable. 1994 AIDS becomes the leading cause of death for all Americans aged 25 to 44 years old. 1995 Polymerase chain reaction (PCR) is used to accurately detect and quantitate HIV in blood (viral load). Untreated HIV is never quiescent or latent. FDA approves the first protease inhibitor. This ushers in a new era of highly active antiretroviral therapy (HAART) 1996 The number of new AIDS cases diagnosed in the U.S. precipitously declines for the first time since the beginning of the epidemic. Prophylaxis for opportunistic infections and HAART are major factors. 1998 CDC reports 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.
Book Code: CT24CME
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