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History of HIV/AIDS in the U.S.

Director of IHV

Between 1976 and 1982, Dr. Robert C. Gallo (now Director of the Institute of Human Virology) and his co-workers discovered the world’s first two known human retroviruses, HTLV-1 and HTLV-2, and developed the techniques that provided the intellectual framework for understanding these retroviruses. The Human Immunodeficiency Virus (HIV) would later be known as the world’s third known human retrovirus.

In early 1980 through 1981 there were 26 cases of a rare form of cancer called Kaposi Sarcoma – 20 from New York and 6 from California. By May of 1981 there were 5 cases of Pneumocystis Carinii Pneumonia. Both of these diseases are considered very rare. An extensive review of two hospitals in New York was only able to locate three known previous cases of Kaposi Sarcoma from 1961 to 1979. The majority of these cases were found in young gay men.

As such, many in the beginning of the early epidemic referred to the disease as GRID (Gay-Related Immune Deficiency). It was identified later as Acquired Immune Deficiency Syndrome (or AIDS) due to its non-discriminatory, infectious spread around the world. By the beginning of July 1982 a total of 452 cases, from 23 states, had been reported to the U.S. Center for Disease Control (CDC). In hindsight, we now know these early AIDS patients had HIV for years prior to 1981 (as we know a person without treatment can have HIV for five to ten years before AIDS is imminent).

In December 1982, a 20-month old child who previously received multiple transfusions of blood died from infections related to this newly identified disease, AIDS. This particular case provided clearer evidence that AIDS was caused by an infectious agent through sex, mother’s milk and blood, which caused increasing concerns about the safety of the United States’ blood supply. As a result, by the end of 1982 many more people were taking notice of this newly recognized disease, as it became clearer that many more people than originally anticipated would be affected by HIV and AIDS. This wide group of affected people also included those seemingly contracting the disease through heterosexual relations, which was later proven in 1985 by IHV’s Director of Clinical Care and Research, Dr. Robert Redfield. By 1984, Dr. Gallo and Dr. Luc Montagnier (in addition to their colleagues) discovered the HIV retrovirus and illustrated it as the cause of AIDS. Also in the monumental year of 1984, Dr. Gallo along with Dr. William Blattner (now IHV Director of Epidemiology and Prevention), published the first report of the high sensitivity of the HIV blood test developed by Gallo and coworkers. By this time, already more than 5,500 had died in the U.S. from AIDS.

"In 1985, 13-year old Ryan White became a symbol of the intolerance that is inflicted on AIDS victims. Once it became known that White, a hemophiliac, had contracted the disease from a tainted blood transfusion, school officials banned him from classes" (Time Magazine). The actor Rock Hudson died of AIDS on October 3, 1985. He was the first major public figure known to have died of AIDS. By the end of 1985, 15,948 cases of AIDS had been reported in the USA.

Thankfully, also by 1985, the development of Dr. Gallo’s HIV blood test meant health care workers in most industrialized nations had the ability for the first time to screen for the AIDS virus — leading to a more rapid HIV diagnosis and, simultaneously, the protection of patients receiving blood transfusions. The tissue culture techniques developed by Dr. Mika Popovic (currently an IHV Senior Researcher) and Dr. Gallo opened the door to the blood test as well as a system for testing drugs against HIV.

From 1986-1987, there was dramatic progress in the provision of medical treatment for AIDS, when early results of clinical tests based on studies by Dr. Samuel Broder, working in collaboration with Dr. Gallo, showed that a drug called Zidovudine (AZT) slowed down the attack of HIV. AZT became the first anti-HIV therapeutic drug approved by the Food and Drug Administration (FDA). On April 8, 1990 Ryan White died in the United States – one of an astonishing 100,000 who had died from AIDS at that time in the virus' history. As mentioned, White was a hemophiliac who had been infected with HIV through the use of infected blood products. He had become well-known as a result of his fight to be allowed to attend public school. His social cause for patients with AIDS and for more AIDS research, led, a few months after his death, to the legislation of the Ryan White CARE Act, which was passed by the United States Congress in 1990. The Act, to this day, provides grants to programs such as the JACQUES Initiative to improve the quality and availability of care for individuals and families with HIV.

In 1991, the United States’ Earvin (Magic) Johnson announced that he had tested HIV positive and was therefore retiring from professional basketball, on the advice of his doctors. Famous tennis great Arthur Ashe also announced his HIV positive status. A couple of weeks later in the United Kingdom, Freddie Mercury, lead singer of the rock group Queen, confirmed that he had AIDS. Just one day later it was announced that he had died. By then, according to the World Health Organization, more than 10 million worldwide were infected with HIV, and one million were infected in the U.S.

In 1995 the FDA approved the first of a potent new family of anti-AIDS medications. The drug saquinavir belonged to a class of drugs called protease inhibitors. By this time, more than 300,000 had died in the U.S. from AIDS.

In June 1996 the FDA approved the drug Viramune (nevirapine), the first in a new class of drugs known as non-nucleoside reverse transcriptase inhibitors. Another treatment development included the introduction of the viral load test, which provided information about the risk of disease progression.

Early in 1997 it was reported that, for the first time since the AIDS epidemic became visible in 1981, the number of deaths from AIDS had dropped substantially across the USA.

However, in 1998 the first case of a patient being infected with an HIV resistant strain to the most powerful new antiretroviral drugs was reported in San Francisco in July. The newly drug resistant HIV was seemingly impervious to protease inhibitors and older drugs.

In January 2000, the CDC reported that, for the first time, the rate of AIDS diagnoses among black and Hispanic gay men had overtaken that among white gay men in the U.S. Statistics showed that African Americans comprised 57% of all new HIV infections, even though they made up just 13% of the U.S. population. In order to publicize the importance of HIV testing for African Americans, Reverend Jesse Jackson publicly took an oral HIV test.

It was also at this turn of the millennium, that clear evidence showed the dramatic increase of HIV infection through heterosexual transmission. In Baltimore in particular, heterosexual transmission represents the predominant mode of infection. For those who needed more proof, this fact solidified (if there were any misconceptions left from the 1980’s) that HIV was not confined to particular demographic or social-economic groupings, but rather affects all races, income classes, educational status, and other modifiers that previously made for false insecurity because HIV was a “those people disease.”

Also during the turn of this century, the Clinton Administration formally declared HIV/AIDS to be a threat to U.S national security. The United States government believed the global spread of AIDS was reaching catastrophic dimensions that could topple foreign governments, spark ethnic wars and undo decades of efforts building free-market democracies abroad. It was the first time the U.S. National Security Council was involved in fighting an infectious disease.

2004 brought the start of President Bush's $15 billion initiative to combat the global AIDS pandemic, which is widely known now as PEPFAR (President's Emergency Plan For AIDS Relief). Full implementation of PEPFAR commenced in June of that year, having received its first funding in January. PEPFAR concentrates on fifteen “focus” countries, all of them in Africa except Guyana, Haiti and Vietnam (which was a late addition to the list). The initiative set a goal of providing AIDS treatment to 200,000 people living in the focus countries by June 2005.

In 2006, the CDC issued new guidelines recommending routine HIV testing for all adults and adolescents acquiring health care services. Routine testing had already proved highly successful in identifying HIV among pregnant women.

In March 2009 a report from the Washington, DC Health Department revealed that Washington DC had a higher rate of HIV than many areas in West Africa with 3% prevalence – enough to describe it as a “severe and generalized epidemic.”

Currently, HIV care providers - which include members from diverse sectors of society including, medical, civic, faith, arts and entertainment, and business - continually look to an evolving model program to provide comprehensive and holistic care for communities affected by this illness. The JACQUES Initiative, as part of the Institute of Human Virology, is one such model that is pursuing this plan. Learn about our story of engagement in the About Us section of this website.

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