AIDS was first identified in the United States in 1981. However, HIV was propagating in the country before that.

HIV, which is the virus that may lead to AIDS, remains a global epidemic today.

In 1984, three years after scientists identified AIDS (acquired immunodeficiency syndrome), they discovered its cause: HIV.

Researchers estimate that about 100,000 to 300,000 people worldwide lived with HIV pre-1980.

It’s believed that HIV-1, the most common form of the virus, spread from chimpanzees to humans no later than 1930, most likely during bushmeat trading. Hunters would have come into contact with animal blood while hunting chimpanzees, probably in and around Cameroon.

Researchers have retrospectively discovered HIV in old blood samples. One sample was drawn as far back as 1959 from a man living in what’s now known as the Democratic Republic of the Congo.

Genetic tracing has shown that HIV has propagated in the United States since the 1970s, if not earlier.

When the first few cases of AIDS emerged, people believed it was only contracted by men who had sex with men. Early on, the Centers for Disease Control and Prevention (CDC) called the condition “GRID,” or gay-related immunodeficiency.

In 1982, the CDC published a case definition calling the condition AIDS.

In March 1983, the CDC declared that certain groups were at increased risk for HIV. The media later dubbed these groups the “4-H club.” They included:

  • people with hemophilia, who received contaminated blood through transfusions
  • homosexual men, who reported higher incidences of the condition
  • heroin users and other people who used injectable drugs
  • Haitians or people of Haitian origin, as many cases of AIDS were reported in Haiti

Later, however, researchers learned more about how HIV was transmitted.

By the end of 1983, researchers had determined the following:

The number of cases continued to grow as the CDC refined their case definition, and scientists learned more about the condition.

Public response was negative in the early years of the epidemic.

In 1983, Dr. Joseph Sonnabend in New York was threatened with eviction for treating people with HIV, leading to the first AIDS discrimination lawsuit.

Bathhouses across the country closed due to sexual activity and the associated risk. Some schools also barred children with HIV from attending.

U.S. blood banks started screening for HIV in 1985, and men who had sex with men were banned from donating blood. (The Food and Drug Administration (FDA) first lifted some of its restrictions in December 2015. The FDA loosened its restrictions again in 2020, motivated by the blood shortage caused by COVID-19.)

In 1987, the United States placed a travel ban on visitors and immigrants with HIV. (President Barack Obama later lifted this ban in 2010.)

The United States government resisted funding needle exchange programs (NEPs) due to the War on Drugs. NEPs were shown to be effective at reducing HIV transmission.

In 1997, researchers calculated that this resistance accounted for 4,394 to 9,666 avoidable transmissions.

The number of avoidable transmissions may be even higher.

A 2005 study looked at people in New York City who used injectable drugs and had been admitted to a drug detoxification program. The researchers concluded that the legalization of syringe exchange programs helped reduce HIV prevalence among this group from 50 percent in 1990 to 17 percent in 2002.

Pop culture opens up conversations

In 1985, actor Rock Hudson became the first major public figure to announce he had AIDS. Before he died that same year, he donated $250,000 to help establish the organization later known as amfAR, the Foundation for AIDS Research. Friend and actress Elizabeth Taylor was the national chairperson until her death in 2011.

In 1987, Princess Diana also made international headlines after she shook hands with an HIV-positive man.

Pop culture icon Freddie Mercury, singer for the band Queen, passed away from AIDS-related illness in 1991. Since then, many other public figures have revealed that they’re HIV-positive, including:

  • tennis star Arthur Ashe
  • former basketball star and entrepreneur Magic Johnson
  • Pedro Zamora, a cast member on MTV’s “The Real World: San Francisco”
  • actor Charlie Sheen, who announced his status on national television in 2015
  • hairstylist and television personality Jonathan Van Ness
  • actor and singer Billy Porter

In September 1985, President Ronald Reagan called AIDS research “a top priority” for his administration. This came amidst criticism that government funding was inadequate and not enough had been done to find a treatment or cure. This was Reagan’s first public statement about AIDS.

Zidovudine, commonly known as AZT, was introduced in 1987 as the first treatment for HIV. Scientists also developed treatments to reduce transmission during pregnancy.

In 1995, President Bill Clinton hosted the first White House Conference on HIV and AIDS, and called for a vaccine research center. This center later opened in 1999.

Throughout the years, the government has continued to fund HIV- and AIDS-related:

  • systems of care
  • counseling
  • testing services
  • treatment
  • studies and research

In 1996, in Vancouver, researchers at the 11th International Conference on AIDS introduced the concept of highly active antiretroviral therapy (HAART). This regimen requires people with HIV to take a combination of at least three medications daily. HAART, which is commonly known as antiretroviral therapy, became the new treatment standard in 1997.

Between 1996 and 1997, deaths from HIV decreased by 47 percent in the United States, largely as a result of HAART.

Also in 1997, the FDA approved Combivir. Combivir combines the drugs zidovudine and lamivudine into a single medication, making HIV medications easier to take.

The FDA approved the first rapid HIV diagnostic test kit in November 2002. It allows hospitals to provide results with 99.6 percent accuracy within 20 minutes. OraQuick, the test manufacturer, later created a version that’s appropriate for in-home use.

The FDA continues to approve HIV medical products, regulating:

  • product approval
  • warnings
  • safety regulations
  • label updates

In 1995, AIDS reached its peak in the United States. Complications from AIDS were the leading cause of death for adults 25 to 44 years old. Over 49,000 people in the country died of AIDS-related causes.

In 1996, for the first time, the CDC reported that African Americans accounted for a larger percentage of AIDS cases than white Americans. The disparity is fueled by broader inequities in healthcare access.

In 2003, the CDC reported that 40,000 new transmissions had occurred each year since the early 1990s. More than two-thirds of those transmissions came from people who didn’t know they’d contracted HIV. In 2008, with the help of more accurate tracking, experts discovered that the number of new transmissions was actually closer to 56,300 a year.

In 2019, there were 36,801 new cases in the United States and its territories. HIV continues to have a disproportionate effect on African Americans and Hispanic Americans. Discover more HIV stats, numbers, and facts here.

Researchers continue to create new formulations and combinations to improve treatment outcomes.

The FDA approved cabotegravir (Vocabria) and cabotegravir/rilpivirine (Cabenuva) as recently as January 2021. Cabenuva, which is taken monthly, is the first FDA-approved injectable medication for HIV.

By August 2021, the FDA had approved nearly 50 brand-name treatment options for HIV. HIV medications are effective but expensive. A few generic versions, which help lower costs, are also available.

Preexposure prophylaxis (PrEP)

In July 2012, the FDA approved emtricitabine/tenofovir disoproxil fumarate (Truvada) for preexposure prophylaxis (PrEP). PrEP is shown to lower the risk of contracting HIV from sexual activity or needle use. This prevention method requires taking the medication on a daily basis.

Healthcare professionals recommend PrEP for people who are in a relationship with someone who has HIV. The U.S. Preventive Services Task Force recommends it for all people with known risk factors for HIV. PrEP is shown to reduce the risk for HIV from sex by greater than 90 percent.

Who benefits from preexposure prophylaxis (PrEP)?

People who may benefit from preexposure prophylaxis (PrEP) include anyone who:

  • is in a relationship with an HIV-positive person who has a detectable viral load
  • has sex with men and women
  • regularly has sexual partners of unknown HIV status, especially if they inject drugs
  • has had anal sex without a condom or barrier method in the past 6 months
  • has contracted a sexually transmitted infection (STI) in the past 6 months
  • has injected drugs, been in drug treatment, or shared needles in the past 6 months
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Postexposure prophylaxis (PEP)

In 2005, the CDC released guidelines for the use of postexposure prophylaxis (PEP) in the general public. People on PEP must begin a combination of antiretroviral medications within 72 hours of possible exposure. Treatment lasts for 28 to 30 days.

PEP may reduce the risk of HIV by 80 percent.

“Undetectable” = “Untransmittable”

In 2017, the CDC declared that an HIV-positive person who’s on regular antiretroviral therapy that reduces the virus to undetectable levels in their blood is unable to transmit HIV to a partner during sex.

The consensus among medical professionals is that “Undetectable = Untransmittable” (“U=U”), which became the name of a campaign by the Prevention Access Campaign.

In 2007, Timothy Ray Brown became the first person to be cured of HIV after he received a stem cell transplant to help treat his leukemia. Brown’s viral load remained undetectable until his death from leukemia in 2020.

Brown, a Seattle native living in Berlin at the time of his treatment, was the only person who’d been successfully cured of HIV until a similar case was revealed in 2019. Adam Castillejo, originally identified as “the London patient,” had also received a stem cell transplant to help treat cancer.

Only a handful of people around the world have been deemed cured of HIV, but HAART has led to HIV-positive people living longer overall. Between 2010 and 2018, HIV-related deaths among people 13 years old and up fell by 36.6 percent, according to a CDC report.

The number of new HIV cases each year has declined from its peak and largely plateaued as of late. Treatment cost and access to preventive care remain a barrier for many, however.

In 2019, the Department of Health and Human Services launched Ending the HIV Epidemic. The goals are a 75 percent reduction in new infections by 2025 and at least a 90 percent reduction in new infections by 2030.

In December 2019, the Ready, Set, PrEP program expanded access to PrEP for uninsured people. In July 2021, as part of the Affordable Care Act (ACA), the federal government announced that almost all health insurers were required to cover PrEP.

According to a 2021 report, around 23 percent of people who would benefit from PrEP were prescribed the medication in 2019.

In 2021, 40 years after the first AIDS cases were detected, researchers also continued the search for a vaccine.

Pharmaceutical companies such as Moderna and Johnson & Johnson created vaccines using the same technology as their successful COVID-19 vaccines. The Johnson & Johnson HIV vaccine failed in phase 2 clinical trials in September, but hope continues.