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HIV/AIDS
HIV/AIDS
HIV is a virus that attacks the immune system, and AIDS is the most advanced stage of the infection it causes. First recognized in 1981, the epidemic reshaped medicine, activism and public health, and today treatment lets people with HIV live long, healthy lives.
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Beyond the Timeline
HIV, the human immunodeficiency virus, attacks the body's immune system, in particular the CD4 cells that help it fight infection. Without treatment, HIV can lead to AIDS, acquired immunodeficiency syndrome, the most advanced stage of infection, when the immune system is so damaged that rare infections and cancers can take hold. The virus spreads through certain body fluids, including blood, semen and breast milk. In September 1983 the CDC ruled out transmission through casual contact, food, water, air or surfaces. The virus received its name, HIV, on May 1, 1986.
There are two types of the virus. HIV-1 causes the global pandemic. Its four groups each crossed into people separately: groups M and N from chimpanzees and groups O and P from western lowland gorillas, all in southern Cameroon, as described in Cross Species Origin. Group M accounts for nearly all infections worldwide. HIV-2, which is less easily transmitted and remains concentrated in West Africa, came from sooty mangabey monkeys.
According to UNAIDS, 40.8 million people were living with HIV in 2024, 53 percent of them women and girls. That year 1.3 million people acquired HIV, 40 percent fewer than in 2010, and about 630,000 died of AIDS related illnesses, a 70 percent drop from the peak in 2004. Since the start of the epidemic, an estimated 91.4 million people have become infected with HIV and 44.1 million have died of AIDS related illnesses.
There is no cure that can be offered to most people, although two men were cured after stem cell transplants for cancer, as described in Berlin Patient and London Patient. Treatment, however, now allows people with HIV to live long and healthy lives, and at the end of 2024, 77 percent of people living with HIV were receiving it. Since the combination therapy that arrived in 1996, described in Dr. Ho, daily treatment has kept the virus under control, and a person whose viral load stays undetectable does not transmit HIV to sexual partners, as shown in the HPTN 052 trial in 2011 and summed up in the message Undetectable equals Untransmittable, U=U. People without HIV can protect themselves with medication, described in PrEP, along with condoms and, for men in some high prevalence countries, medical circumcision, which three trials in South Africa, Kenya and Uganda showed in 2005 and 2006 cuts the risk of acquiring HIV by 50 to 60 percent.
HIV-1 group M, the virus behind the pandemic, began as a simian immunodeficiency virus carried by chimpanzees in southeastern Cameroon. Researchers believe it entered people through contact with infected blood when chimpanzees were hunted or butchered for bushmeat, and genetic studies date the common ancestor of group M to about 1908, as described in Cross Species Origin.
The virus found its foothold in Léopoldville, today Kinshasa, the capital of the Democratic Republic of the Congo. A 2014 study traced the common ancestor of group M to the city around 1920 and showed how it traveled along the colony's railways and rivers to Brazzaville, Lubumbashi, Mbuji-Mayi and Kisangani, as described in Cross Species Origin. Researcher Jacques Pépin found circumstantial evidence that the virus's rapid growth in the city in the 1950s may have been driven by a clinic for sexually transmitted diseases, where up to 500 injections were given each day with syringes and needles that were only rinsed between patients. An outbreak of hepatitis spread by injections was reported among its patients in 1951 and 1952. After the Congo's independence in 1960, changes in sex work allowed the virus to spread further through sex.
The oldest confirmed evidence of the virus comes from that city. A blood sample taken in 1959 from a man in Léopoldville was confirmed in 1998 to contain HIV, as described in 1959 Blood Sample, and a 1960 biopsy from a woman in the same city showed that the virus had already diversified widely.
The virus traveled with people. A Norwegian sailor who worked on ships calling at West African ports in the early 1960s became infected with group O, and he, his wife and their young daughter all died in 1976. Stored samples later tested positive for HIV, and in 1997 researchers in Oslo identified the strain as group O, making the family the earliest documented cluster of AIDS cases. Genetic studies show that one lineage of group M, subtype B, moved from central Africa to Haiti around 1966 and then to the United States around 1969, where it circulated unrecognized for about twelve years. In Port-au-Prince, doctors later counted 61 previously healthy Haitians diagnosed with Kaposi's sarcoma, opportunistic infections or both between June 1979 and October 1982. In May 1982 Jean William Pape, Bernard Liautaud and colleagues founded GHESKIO, the Haitian study group that in 1983 published the first comprehensive description of AIDS in a resource poor country.
The first press report came from the gay press. On May 18, 1981, the New York Native published an article by physician Lawrence Mass, after a friend who worked in an emergency room told him gay men were being treated in intensive care units in New York; health officials told him the rumors were unfounded. On June 5, 1981, the CDC's Morbidity and Mortality Weekly Report described five young gay men in Los Angeles with a rare pneumonia, as described in First Reports. On July 3, The New York Times published "Rare Cancer Seen in 41 Homosexuals," and the phrase "gay cancer" entered public use. By the end of 1981, 337 cases had been reported in the United States, and 130 of those patients had died.
The illness was first labeled GRID, for Gay Related Immune Deficiency, a term first used in The New York Times on May 11, 1982. Cases soon appeared among people with hemophilia, people who injected drugs and Haitian immigrants, and on September 24, 1982, the CDC named the syndrome and published its first case definition. In January 1983 the CDC reported the first cases in women, and that September it ruled out transmission through casual contact. In November 1983 the World Health Organization held its first meeting on AIDS and began international surveillance.
The cause was identified as a virus, first reported by a team at the Pasteur Institute in Paris on May 20, 1983, as described in HIV Discovered. On March 2, 1985, the first test to screen blood for it was licensed, as described in Blood Screening Test. On April 10, 1985, the CDC removed Haitians from its list of groups at increased risk, and that month the first International AIDS Conference met in Atlanta. On April 22, Larry Kramer's play The Normal Heart opened Off Broadway, and on May 1 As Is became the first play about AIDS on Broadway.
On July 25, 1985, Rock Hudson announced that he had AIDS, and coverage of the epidemic in the major print media more than tripled in the following six months. On August 27, Indiana teenager Ryan White, infected through a hemophilia treatment, was refused entry to his middle school. By the end of 1985 the United Nations reported at least one HIV case in every region of the world, and in December the CDC issued its first recommendations on preventing transmission from mother to child.
In January 1986 the CDC reported that more people had been diagnosed with AIDS in 1985 than in all earlier years combined, and that patients lived on average about 15 months after diagnosis. That October the Surgeon General issued the report described in Surgeon General Report, and the Institute of Medicine called for a national commission on AIDS and an investment of $2 billion by the end of the decade.
The federal response was slow to begin. In May 1983 Congress passed the first bill with money specifically for AIDS research and treatment, $12 million. President Ronald Reagan mentioned AIDS publicly for the first time on September 17, 1985, calling it a top priority and defending his administration's spending, and on October 2 Congress allocated nearly $190 million for AIDS research, about $70 million more than the administration had requested. Reagan gave his first public speech on AIDS on May 31, 1987, at a dinner for the American Foundation for AIDS Research. His Surgeon General, C. Everett Koop, released a report on AIDS in October 1986 and in 1988 mailed an AIDS brochure to every household in the country, as described in Surgeon General Report.
The federal scientific response was led by Anthony Fauci, who became director of the National Institute of Allergy and Infectious Diseases in 1984. On June 24, 1987, Reagan created a presidential commission on the epidemic, chaired from that October by retired Admiral James D. Watkins. Its final report, in June 1988, made nearly 600 recommendations, and Reagan rejected most of them in favor of a scaled down plan of his own. That May, the government added HIV to the list of diseases that barred travelers and immigrants from entering the United States, a ban not lifted until January 4, 2010. On November 4, 1988, Reagan signed the Health Omnibus Programs Extension Act, the first comprehensive federal AIDS law, which funded prevention, education and testing and established the Office of AIDS Research and the AIDS Clinical Trials Group at the National Institutes of Health.
In 1990 Congress passed the Americans with Disabilities Act, which protected people with HIV from discrimination, and the CARE Act, which provided $220.5 million for HIV care in its first year. In 1993 President Bill Clinton created the Office of National AIDS Policy, ONAP, and in 1995 he established the Presidential Advisory Council on HIV/AIDS.
The international response took shape in the same years. On February 1, 1987, the World Health Organization launched its Special Programme on AIDS, renamed the Global Programme on AIDS in 1988, and on October 22, 1987, AIDS became the first disease ever debated on the floor of the UN General Assembly. The first World AIDS Day was observed on December 1, 1988, and UNAIDS began operating in 1996. On January 10, 2000, the UN Security Council discussed a health issue as a threat to peace and security for the first time. In 2001 a UN special session called for what became the Global Fund to Fight AIDS, Tuberculosis and Malaria, established in Geneva in January 2002, and the World Trade Organization adopted the Doha Declaration. On January 28, 2003, President George W. Bush announced PEPFAR.
Later administrations built on that foundation. In July 2010 President Barack Obama released the first National HIV/AIDS Strategy, and on July 15, 2013, he signed an executive order creating the HIV Care Continuum Initiative, overseen by ONAP. That November he signed the HIV Organ Policy Equity Act, lifting the ban on research into organ transplants between people with HIV, and from 2014 the Affordable Care Act required insurers to cover HIV testing without extra cost and prohibited discrimination based on HIV status. In 2019 the federal government launched the Ending the HIV Epidemic in the U.S. initiative, a plan to end the epidemic in the United States by 2030. PEPFAR's authorization lapsed on March 25, 2025, though the program continues as long as Congress funds it.
President Ronald Reagan did not speak publicly about AIDS in the first four years of the epidemic. In October 1982, when a reporter asked about the disease at a White House press briefing, the White House spokesman answered by asking the reporter whether he had it himself, and on February 4, 1985, administration officials rejected the CDC's first national AIDS prevention plan. That July, Rock Hudson's publicist asked the White House for help getting the actor into a French military hospital. Documents released in 2015 show the request was referred to the US Embassy in Paris, and Hudson was admitted after the French defense minister intervened.
Under President Bill Clinton the federal response gained a coordinator. On June 25, 1993, he named Kristine Gebbie, formerly the top public health official in Oregon and then in Washington state, as the first National AIDS Policy Coordinator, heading the new Office of National AIDS Policy, which the press called the office of the AIDS czar. At the time AIDS had killed about 200,000 Americans and was the leading cause of death among people aged 25 to 44. Gebbie left after about a year, and the office continued under later presidents. In July 2010 President Barack Obama released the National HIV/AIDS Strategy, the first comprehensive plan for a coordinated national response.
In the first years of the epidemic there was no treatment for HIV itself. Doctors could only treat the opportunistic infections that killed most patients, and in June 1989 the CDC issued the first guidelines for preventing Pneumocystis carinii pneumonia, a major cause of death among people with AIDS.
The first drug against the virus, AZT, was approved on March 19, 1987, and that day the Food and Drug Administration also issued rules expanding access to promising drugs that had not yet been approved. In 1990 AZT was approved for children, and in 1994 the trial described in ACTG 076 showed that it could cut transmission from mother to child by about two thirds; that August the Public Health Service recommended it for pregnant women with HIV.
The turning point came with combination therapy. The first protease inhibitor was approved in December 1995, and at the International AIDS Conference in Vancouver in July 1996, studies showed that three drug combinations could suppress the virus and keep it suppressed, as described in Dr. Ho. Researcher David Ho argued for treating HIV early and hard, and in 1997 AIDS deaths in the United States fell 47 percent. That year Combivir combined two HIV drugs in a single tablet, and on April 24, 1998, the CDC issued the first national guidelines for antiretroviral treatment of adults and adolescents.
Treatment also became simpler. Tenofovir, developed by Gilead Sciences from antiviral research at the Institute of Organic Chemistry and Biochemistry in Prague, was approved by the Food and Drug Administration on October 26, 2001, as a single tablet taken once a day. In August 2004 Gilead combined it with emtricitabine in one tablet, Truvada, and on July 12, 2006, the FDA approved Atripla, the first complete HIV regimen in a single tablet taken once a day.
Cost kept the new drugs from most of the world. By 2000 a year of HIV treatment cost more than the yearly income per person in many of the poorest countries. In February 2001 the Indian generic maker Cipla offered a three drug combination for $350 per person per year, against about $15,000 three years earlier, and that April the 39 drug companies suing South Africa over its medicines law dropped the case. On November 14, 2001, the World Trade Organization adopted the Doha Declaration on the TRIPS Agreement and Public Health, which affirmed that patent rules should be read in a way that supports public health and confirmed governments' right to issue compulsory licenses for medicines. By April 2002 the cheapest generic combination offered to developing countries cost a little over $200 a year.
Lower prices made wider programs possible. On World AIDS Day, December 1, 2003, the World Health Organization and UNAIDS launched 3 by 5, a plan to put three million people in developing countries on treatment by the end of 2005. The target was missed, but by the end of 2005, 1.3 million people in low and middle income countries were on treatment, more than three times as many as in 2003, and by 2007 the number reached three million. Much of that growth was paid for by the Global Fund, which approved its first grants in April 2002, and by PEPFAR.
Treatment also became prevention. The HPTN 052 trial showed in 2011 that it protects partners from infection, and PrEP gave people without HIV a way to protect themselves. On January 21, 2021, the FDA approved Cabenuva, the first complete long acting HIV treatment, given by monthly injection to people whose virus was already suppressed on other drugs, and in 2022 its label was expanded to injections every two months. Long acting prevention followed, culminating in the twice yearly injection approved in June 2025. A cure remains limited to rare cases, described in Berlin Patient and London Patient. Since 2022 more people have been reported in long term remission after stem cell transplants for cancer, among them a woman in New York who received cord blood cells carrying the protective CCR5 mutation, a man in Düsseldorf whose case was confirmed in February 2023, and a man in Geneva reported in July 2023 whose donor cells did not carry the mutation. By August 2026 amfAR listed ten such transplant cases after the London Patient, and transplants are used only for people who need them to treat cancer.
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Communities most affected by AIDS organized before governments acted. On August 11, 1981, more than 80 gay men met in Larry Kramer's New York apartment and raised $6,635 for research, at the time almost the only new money raised to fight the epidemic that year; the following January six of them founded GMHC. In San Francisco, a group formed in 1982 to provide information on Kaposi's sarcoma later became the San Francisco AIDS Foundation. On May 3, 1983, the first AIDS candlelight vigils in San Francisco and New York brought people with AIDS together in a public demonstration for the first time.
People with AIDS also claimed a voice of their own. Nurse Bobbi Campbell became the first person to go public with his diagnosis in 1981, and in June 1983 he and Michael Callen led the eleven men who wrote the Denver Principles, the founding charter of the National Association of People with AIDS. In 1987 activists in New York formed ACT UP, which shut down the Food and Drug Administration's offices in Rockville, Maryland, for a day on October 11, 1988, with 176 arrests; eight days later the FDA announced new rules to speed drug approvals. On May 21, 1990, ACT UP protested at the National Institutes of Health to demand more treatments and more women and people of color in clinical trials.
Communities of color built their own organizations. The National Minority AIDS Council grew out of a 1986 meeting with the Surgeon General, the National Black Leadership Commission on AIDS was founded in 1987, and the first National Black HIV/AIDS Awareness Day was held on February 7, 1999. Memorials and symbols helped the public grieve and remember: the AIDS Memorial Quilt, described in Names Project, was first displayed in 1987 and covered the entire National Mall in 1996, and the Red Ribbon appeared in 1991.
Public figures changed public attitudes. Rock Hudson's 1985 announcement led to a surge in coverage, and his friend Elizabeth Taylor became founding national chairman of amfAR. In April 1987 Princess Diana was photographed shaking hands with a man with AIDS without gloves, as described in Diana's Handshake, and in 1991 basketball star Magic Johnson announced that he had HIV. Elton John, who was with Ryan White in his last days in 1990, founded the Elton John AIDS Foundation in 1992. Queen singer Freddie Mercury died of AIDS on November 24, 1991. In 1993 Philadelphia, starring Tom Hanks as a lawyer with AIDS, became the first major Hollywood film about the epidemic and won Hanks an Oscar, and Tony Kushner's Angels in America won the Tony Award for Best Play and the Pulitzer Prize for Drama. In 2016 activists launched the campaign Undetectable equals Untransmittable, U=U, to spread the science that people with an undetectable viral load cannot transmit HIV sexually.
By the end of 2024 the global response had reached its strongest point. According to UNAIDS, new infections had fallen 40 percent since 2010 and deaths from AIDS related illnesses 54 percent; 31.6 million of the 40.8 million people living with HIV, 77 percent, were receiving treatment, and 73 percent had suppressed viral loads. Gaps remained: more than nine million people living with HIV were not on treatment, children made up 3 percent of people with HIV but 12 percent of deaths, and PrEP reached 3.9 million people, far below the target of 21.2 million for 2025.
Funding was already short. At the end of 2024, $18.7 billion was available for the AIDS response in low and middle income countries, 17 percent below the $21.9 billion UNAIDS estimates is needed each year through 2030. In early 2025 the United States, the largest donor to the global HIV response, paused most foreign aid for review, closed USAID and moved PEPFAR to the State Department. The law that authorized PEPFAR expired on March 25, 2025, but the program continued under permanent authorities as long as Congress funded it.
In September 2025 the State Department released the America First Global Health Strategy. It kept paying for HIV medicines, tests and frontline health workers, about $1.3 billion and $827 million a year, through agreements signed with each country, which would then take on a growing share of the costs, set by its income, on a path to self reliance. The department presented the plan as a way to stop outbreaks before they reach the United States, to end reliance on international contractors and to make aid serve American interests. By March 2026 it had signed agreements with 27 countries worth $20.2 billion for 2026 to 2030. Critics, including researchers and HIV advocacy groups, warned that many countries could not yet afford their share and that separate deals could weaken coordination with partners such as the Global Fund. In February 2026 Congress passed a $9.42 billion global health budget for fiscal year 2026, with $4.6 billion for PEPFAR and $1.25 billion for the Global Fund, $400 million less than the year before.
The two sides read the results differently. In April 2026 the State Department reported that about 20 million people were on HIV treatment through its programs as of September 2025, about the same as a year earlier, and said its programs had proved resilient. Outside experts, including researchers at amfAR, pointed instead to drops in HIV testing and in people starting treatment after about a quarter of frontline health workers lost their jobs or support. In July 2026 UNAIDS reported that international HIV funding fell 18 percent in 2025, from $8.8 billion to $7.3 billion, its lowest level in nearly two decades. That year 1.2 million people acquired HIV and 570,000 died of AIDS related illnesses, and new infections rose in three regions and 21 countries. Many governments increased their own spending, and 54 countries pledged to raise their HIV budgets in 2026.
Science continued to advance. In June 2025 the Food and Drug Administration approved lenacapavir, sold as Yeztugo, the first PrEP option given by injection only twice a year; in its main trial, none of the 2,134 young women in Africa who received it became infected. Its US price of $14,109 per injection raised concerns about access, and by mid 2026 it reached only a few thousand people in lower income countries, with a goal of 3 million by 2028. In the United States, preliminary CDC data showed that in 2022 only 36 percent of people who could benefit from PrEP had been prescribed it, with wide gaps by race and sex, as described in PrEP.
More than four decades after the first reports, no vaccine has yet been approved, and a cure has been achieved only in rare transplant cases. The tools to end AIDS as a public health threat exist, in treatment that keeps the virus undetectable and in prevention that keeps people from acquiring it, but in 2025 about nine million people living with HIV were still not on treatment.
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Beyond the Timeline
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 immune system is severely damaged, leaving the body vulnerable to opportunistic infections and certain cancers.
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 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 found in sooty mangabeys. 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; Stage IV includes toxoplasmosis of the brain, candidiasis of the esophagus, 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, labor, 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.
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, unsterilized 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.
In the early years of the HIV/AIDS epidemic, treatment options were virtually nonexistent. A diagnosis in the 1980s was often considered a death sentence. Doctors could only offer palliative care, managing symptoms and opportunistic infections as best as possible. The urgency for medical breakthroughs intensified as the virus continued to spread and claim lives globally.
A significant turning point came in 1987, when the U.S. Food and Drug Administration (FDA) approved AZT (zidovudine), the first antiretroviral drug for treating HIV. Though its effects were limited and side effects severe, it represented the beginning of pharmaceutical intervention against the virus.
Over the next few years, additional drugs were developed, but they were often used in isolation, which allowed the virus to develop resistance.
In 1996, a new era in treatment began with the introduction of Highly Active Antiretroviral Therapy (HAART). Its success was showcased at the 11th International AIDS Conference in Vancouver, marking a welcomed milestone in the global fight against the epidemic.
Since then, HIV treatment has evolved rapidly. Newer drug regimens are more effective, easier to tolerate, and require fewer pills. The development of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) also brought new tools for prevention. For people living with HIV, consistent treatment can reduce the viral load to undetectable levels, effectively eliminating the risk of sexual transmission, a concept now known as “Undetectable = Untransmittable” (U=U).
However, access to treatment remains unequal. While some countries have made significant strides in providing free or low-cost antiretroviral therapy, others, particularly in low-income regions, still face barriers due to infrastructure, stigma, and economic challenges. Closing this treatment gap remains one of the central goals of global HIV/AIDS strategies.
The Food and Drug Administration approved the first injectable regimen, Cabenuva (cabotegravir plus rilpivirine), in 2021, but it is only indicated for people with an undetectable viral load who wish to switch to a long-acting regimen. However, around 2024-2025, a pilot study showed that it may also be a viable option for people who are unable to achieve and maintain viral suppression due to challenges with treatment adherence.
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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.
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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.
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TAYLOR SWIFT
Taylor Swift, named after singer James Taylor, was raised in Wyomissing, Pennsylvania. Her father worked as a stockbroker, and her mother was a former marketing executive. She has one younger brother who pursued a career in acting. Swift developed an early passion for storytelling and music, particularly country, inspired by artists like Shania Twain and the Dixie Chicks. She began performing locally at fairs, festivals, and karaoke contests, and started writing songs as a child. Recognizing her potential, her family supported her musical aspirations. In 2003, the Swifts made the pivotal decision to relocate to Nashville, Tennessee, aiming to immerse Taylor in the heart of the country music industry. During this time, she worked with Dan Dymtrow, a talent manager who helped her secure early meetings with labels and industry professionals before her first major deal.
Taylor Alison Swift
Born: Dec 13, 1989, West Reading, PA
Parents: Andrea and Scott Swift
Sibling: Austin Swift
Fiancé: Travis Kelce
Pets: 🐱
Awards: 300+
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