HIV/AIDS
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HIV (Human Immunodeficiency Virus) is a virus that attacks the body’s immune system, specifically targeting CD4 cells (T cells), which, when healthy, help fight off infections. If left untreated, HIV can lead to AIDS (Acquired Immunodeficiency Syndrome), the final stage of HIV infection, where the immunity is severely damaged, leaving the body vulnerable to opportunistic infections and certain cancers. There are two species of the virus, HIV-1 and HIV-2. The first evolved from a simian immunodeficiency virus (SIV) found in chimpanzees, while the second originated from an SIV in a type of monkey known as the sooty mangabey. HIV-1, which is responsible for the vast majority of AIDS cases worldwide, is divided into three groups: the "major" group M, the much rarer group O, and group N, which have diverged over years of mutation and evolution. Within the M group, which makes up 90 percent of all infections worldwide, there are at least nine strains, known as "clades," of HIV-1 that are constantly mutating and merging, creating yet more new varieties. Stage 1 HIV disease is asymptomatic and not categorized as AIDS. Stage II includes minor mucocutaneous manifestations and recurrent upper respiratory tract infections. Stage III includes unexplained chronic diarrhea for longer than a month, severe bacterial infections, and pulmonary tuberculosis, or Stage IV, which includes toxoplasmosis of the brain, candidiasis of the oesophagus, trachea, bronchi, or lungs, and Kaposi’s sarcoma. The time between infection with HIV and becoming ill with AIDS can be 10–15 years. HIV can be transmitted through penetrative sex, with anal sex reported to be 10 times higher than vaginal sex, use of an unsterilized object, such as a razor or knife, re-using or sharing needles or syringes, during pregnancy, labour, delivery, and breastfeeding, and through blood transfusion. Quality-assured condoms are the only products currently available to protect against sexual infection by HIV and other sexually transmitted infections. As of 2024, 91.4 million people have become infected with HIV, and 44.1 million have died from AIDS-related illnesses since the start of the epidemic in 1981. There is no cure for HIV; however, there is effective treatment, which, if started promptly and taken regularly, results in a quality and length of life for someone living with HIV that is similar to that expected in the absence of infection.
Approximately one century ago in southeastern Cameroon, cross-species transmission of SIVcpz from chimpanzees gave rise to HIV-1 group M, the principal cause of the AIDS pandemic in humans. How humans acquired the precursors of HIV-1 is still not definitively known, but it's thought that it must have occurred through cutaneous or mucous membrane exposure to infected ape blood and/or body fluids. Such exposures occur most commonly in the context of bushmeat hunting, which has resulted in cross-species transmission between 1890 and 1920. HIV 1 was spreading at a low level in the Congo Basin between 1920 and 1970. Still, several factors seem to have created an environment in which HIV could spread more easily, such as the more frequent use of injectable arsenic-based treatments of syphilis. A clinic used by the city’s sex workers gave up to 300 injections a day during the 1950s, many of them with reused, unsterilised needles and syringes. Cases of hepatitis after injectable treatments were documented at this clinic in 1953, suggesting HIV could have been transmitted in the same way.
A blood sample that was taken in 1959 from a man living in Leopoldville, Belgian Congo, was stored away in a freezer and tested and confirmed as positive for HIV in 1998.
A Norwegian sailor who had traveled throughout the world, including a long trip through West Africa in 1961, as well as a two-day stay in Kenya in 1964, died of an immune deficiency in 1966, followed by his wife and their daughter, who was born in 1967. Blood tests later revealed that the family all tested positive for the group O subtype of HIV, which is primarily found in West Africa, indicating that the man had likely been infected during his 1961 voyage.
Between June 1979 and November 1981, doctors in Haiti diagnosed 12 cases of Kaposi's sarcoma (KS), a rare skin cancer usually found in older Eastern European men.
But it wasn’t until the early 1980s that HIV began to capture medical and public attention on a global scale. In 1981, AIDS was detected in California and New York. The first cases were among gay men and injection drug users. Subsequent investigations have found probable cases in adults and children dating back to 1978, supporting the view that HIV began to circulate in the United States in the 1970s.
On May 18, 1981, Lawrence Mass became the first journalist in the world, and later one of the co-founders of GMHC, to write about the epidemic in the New York Native, a gay newspaper. A gay tipster overheard his physician mention that some gay men were being treated in intensive-care units in New York City for a strange pneumonia. "Disease Rumors Largely Unfounded" was the headline of Mass's article. Mass repeated a New York City public health official's claims that there was no wave of disease sweeping through the gay community. At this point, however, the Centers for Disease Control (CDC) had been gathering information for about a month on the outbreak that Mass's source had dismissed.
The first published document of what would ultimately become known as HIV and AIDS appeared in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report in June 1981. When these initial cases emerged, very little was known about the disease; it did not have an agreed-upon name, researchers had not yet determined what caused it, there were no tests or recognized treatments, and by the time most patients presented with symptoms, they had only months to live. The virus was first referred to as gay-related immune deficiency (GRID). On top of believing it was a type of cancer that only affected gay men, some labeled it the “gay plague.”
One of the most significant indicators of the progression of the first patients’ conditions was an aggressive form of the AIDS-related Kaposi’s sarcoma, which occurs in individuals with severely weakened immune systems. This type of cancer manifests as red or purple patches on the skin, mouth, lungs, liver, or digestive system. It was considered a rare and relatively harmless disease until the onset of the AIDS epidemic.
In September 1982, the CDC labeled the condition acquired immunodeficiency syndrome (AIDS), and by 1984, researchers had identified the cause as a virus they named human immunodeficiency virus (HIV). Additional advances in knowledge included identifying how it spreads and its effects on the immune system.
By 1983, AIDS cases had been reported in 33 countries. The global conversation around the disease expanded as the U.S. Department of Health and Human Services and the World Health Organization co-hosted the first International AIDS Conference in Atlanta in April 1985. That same month, the CDC removed Haitians from its list of high-risk groups, correcting an earlier stigmatizing classification. Meanwhile, public discourse shifted thanks to the debut of two landmark plays: The Normal Heart and As Is, both of which brought the emotional reality of the epidemic to a broader audience.
Public awareness reached new heights in July 1985, when Hollywood star Rock Hudson announced he had AIDS. As the first major U.S. celebrity to do so, his revelation shattered stereotypes and fueled a surge in media coverage.
Youth entered the narrative in August when teenager Ryan White, who contracted HIV through contaminated blood products, was banned from attending school in Indiana. His story brought worldwide attention to the discrimination faced by people with AIDS, and made him an early advocate for AIDS education and compassion.
By the end of 1985, AIDS had been reported in every region of the world. The U.S. Congress significantly increased funding for AIDS research, and the CDC issued new guidelines to reduce the risk of mother-to-child transmission. Though stigma remained high, the year had sparked a broader public conversation and set in motion the policies, funding, and activism that would shape the global AIDS response for decades to come.
In 1986, The New York Times reported that one million Americans had already been infected with the virus, and this number would jump to at least 2 or 3 million within 5 to 10 years.
In the United States, the emergence of the AIDS epidemic in the early years significantly impacted marginalized groups, including men who have sex with men (MSM), individuals who inject drugs, and sex workers. The response from policymakers lacked the urgency the situation desperately required. There were not enough resources allotted for crucial AIDS research, prevention, and treatment initiatives. At the time, there was a feeling among some that the Centers for Disease Control and Prevention (CDC) did not need additional funding, and efforts in Congress to secure more support for the federal government’s response to this critical health crisis faced resistance.
In 1987, after years of limited resources, the U.S. Congress held a hearing where dedicated doctors and researchers, who were at the forefront of combating the epidemic, shared their experiences and insights. This hearing highlighted the hesitance of the administration to fully acknowledge the scale of the crisis or to advocate for a well-financed federal response to AIDS.
The political climate during the Reagan administration influenced many Republican attitudes toward social issues. The administration’s use of homophobic rhetoric helped foster support among far-right factions, particularly the Religious Right. In 1984, President Reagan asserted that he would resist efforts to have the government endorse homosexuality. It wasn’t until September 1985 that he first addressed the AIDS epidemic publicly, responding to reporters' questions.
During this period, he claimed that AIDS had been a “top priority” since 1981, and promoted its “vital contributions” while maintaining strict budgetary constraints. Reagan sought to present the federal response as an achievement of his economic philosophy while not affirming homosexuality. To navigate the sensitivities of the Religious Right, his comments on AIDS were minimal. It wasn’t until 1987, during a significant presentation to the College of Physicians of Philadelphia, that he made an impactful speech, attributing the AIDS crisis to a perceived abandonment of traditional values and suggesting a return to those morals as a means to address the epidemic.
In 1988, the Health Omnibus Programs Extension (HOPE) Act was passed, establishing the Office of AIDS Research (OAR) at the National Institutes of Health (NIH) and providing funding for AIDS research, education, prevention, and testing.
In 1990, the U.S. Congress enacted the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act.
In June 1993, President Bill Clinton established the White House Office of National AIDS Policy (ONAP), demonstrating a significant commitment to addressing the HIV/AIDS crisis in the United States. ONAP, which operates within the White House Domestic Policy Council, is responsible for coordinating ongoing government efforts to reduce the number of HIV infections nationwide. The Office emphasizes prevention through comprehensive education initiatives and plays a vital role in coordinating care and treatment for individuals living with HIV/AIDS. Additionally, ONAP collaborates with the National Security Council and the Office of the Global AIDS Coordinator, working alongside international organizations to ensure a unified response to the global HIV/AIDS pandemic while aligning prevention, care, and treatment strategies worldwide.
In 1996, the Joint United Nations Programme on HIV/AIDS (UNAIDS) was established to coordinate a united response to the HIV/AIDS epidemic among its six founding cosponsoring organizations: UNDP, UNICEF, UNFPA, WHO, UNESCO, and the World Bank.
During his State of the Union address in 2003, President George W. Bush announced his Emergency Plan for AIDS Relief (PEPFAR), a five-year initiative with a budget of $15 billion aimed at combating HIV/AIDS, primarily in Africa and the Caribbean.
A decade later, President Obama issued an Executive Order directing federal agencies to prioritize support for the HIV care continuum as a way to implement the National HIV/AIDS Strategy. The HIV Care Continuum Initiative aims to enhance efforts to increase the percentage of people living with HIV who transition from testing to treatment and eventually achieve viral suppression.
Additionally, he signed the HIV Organ Policy Equity (HOPE) Act, which permitted individuals living with HIV to receive organs from other HIV-positive donors, expanded health coverage for people with HIV by prohibiting discrimination based on pre-existing conditions and mandating that preventative services, such as HIV testing, be provided at no cost, under the Affordable Care Act (ACA), and, in 2010, ended the country's 22-year ban on HIV-positive travelers and immigrants.
President Trump announced the EHE initiative in 2019, a plan to reduce new HIV infections in the U.S. by 90% by 2030 through a focus on diagnosis, treatment, prevention, and response. However, despite the launch, his administration was also noted for proposing cuts to domestic HIV prevention programs and disrupting global efforts.
Under President Biden's administration, the EHE initiative has continued and released a new National HIV/AIDS Strategy (NHAS) to guide efforts through 2030. Biden also reaffirmed the U.S. commitment to global efforts through PEPFAR and the Global Fund, leading a replenishment effort that raised billions for the Global Fund. There was expanded access to preventive measures, such as PrEP, for uninsured and underinsured individuals.
1998
1985
1990
⛬ Ryan White dies of AIDS
⛬ RWHAP is established
⛬ Artist Keith Haring dies from AIDS-related complications1981
1987
1991
⛬ AIDS becomes the number one cause of death for American men 25-44 years of age
⛬ The FDA implemented an Accelerated Approval Program to expedite the availability of drugs for severe conditions like HIV/AIDS
⛬ The red ribbon became the symbol of HIV/AIDS support and awareness.⛬ Basketball player Magic Johnson told the public he had HIV. ⛬ Queen's Fred Mercury dies of AIDS.
1995
2008
2017
From the very beginning of the HIV/AIDS epidemic, activism has been vital in confronting stigma, advocating for research funding, and pushing for compassionate care. Grassroots organizations like ACT UP and GMHC emerged as powerful advocates, calling for government accountability and quicker access to treatments. Their protests and direct actions have raised public awareness and influenced policies, ultimately saving countless lives.
The official foundation of the movement for individuals with AIDS was established during a conference in Denver, Colorado, in 1983, where a manifesto called the Denver Principles was created. Often regarded as the “Magna Carta of AIDS activism,” the Principles advocated for a new relationship between people with AIDS, their healthcare providers, and society. Nurse Bobbi Campbell, an AIDS patient from San Francisco, and musician Michael Callen from New York, both diagnosed with the disease, led the small group of gay men at the conference who wrote the document.
The involvement of celebrities has significantly humanized the epidemic, as many have used their platforms to fight prejudice and promote awareness. A pivotal moment occurred in 1985 when Hollywood icon Rock Hudson publicly revealed his AIDS diagnosis. This announcement broke the silence surrounding the disease and sparked increased media attention and public concern.
In 1987, Princess Diana further highlighted the issue when she was photographed shaking hands with an HIV-positive patient without gloves. At a time when fear and misinformation about casual contact were widespread, her compassionate gesture challenged stigma and changed public perceptions around the world. She went on to become a passionate advocate for those living with HIV/AIDS, using her global platform to address discrimination and foster understanding.
Elton John is another prominent figure in the fight against HIV/AIDS, and his commitment to activism has spanned many years. The death of Ryan White significantly affected him and inspired the creation of the Elton John AIDS Foundation.
In 1994, actor Tom Hanks won an Oscar for his role in "Philadelphia," which was America’s first mainstream film focused on HIV/AIDS.
Many contemporary artists and public figures continue to promote awareness of HIV/AIDS. Beyoncé, Lady Gaga, and Billie Eilish are just a few who have used their influence to advocate for education and fight stigma, often collaborating with organizations to support prevention initiatives aimed at youth. Actor and musician Billy Porter has also been a strong advocate for LGBTQ+ rights and HIV awareness, sharing his personal experiences to inspire and educate others.
The continued engagement of celebrities keeps HIV/AIDS in the public spotlight, helps combat misinformation, and raises crucial funds for research and support services. Their visibility assists in breaking down stereotypes and serves as a reminder that HIV can impact anyone, promoting compassion, prevention, and solidarity.
Despite decades of research, activism, and treatment advances, HIV/AIDS remains a significant global health challenge, with close to $40 million people worldwide living with HIV, 53% being women and girls. Approximately 88.4 million people have acquired HIV since the start of the epidemic, and 42.3 million have died from AIDS-related illnesses. Stigma and discrimination still create barriers to testing, treatment, and support for many affected communities; however, global organizations and governments continue to work on expanding access to healthcare, combating misinformation, and addressing social inequalities that fuel the epidemic. Prevention strategies, such as Pre-Exposure Prophylaxis (PrEP) and widespread education, have helped reduce new infections in many regions.
In 2021, 40 years after the first AIDS cases were detected, researchers continued the search for a vaccine.
In 2023, the CDC published 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.
The unfortunate news is that by the end of 2024, only $18.7 billion was available for the AIDS response in low- and middle-income countries. This amount is 17% lower than the $21.9 billion needed annually by 2030 to remain on track to end AIDS as a public health threat. In 2025, there were even more significant cuts to U.S. foreign aid, which jeopardized critical HIV/AIDS programs worldwide. Countries like South Africa and Eswatini, which heavily depend on American funding through PEPFAR and USAID, faced immediate funding shortfalls. This led to the closure of treatment centers and a reduction in prevention efforts. Global health leaders, including UNAIDS, have warned that without urgent action, these funding cuts could lead to over 6 million new HIV infections and an additional 1.6 million AIDS-related deaths by 2030, threatening decades of progress in the global fight against HIV/AIDS.