More than 40 years ago, the Centers for Disease Control and Prevention (CDC) made its first official report of HIV-related illness in the United States. Now, approximately 1.2 million people in the United States live with HIV.
HIV can suppress a person’s immune system and raise their risk of developing life threatening infections and other illnesses.
Getting treatment is essential for improving survival rates and quality of life for people with HIV. People with HIV who receive early treatment now have similar life expectancies as those without HIV.
Effective treatment can also prevent transmission of HIV from one person to another.
Read on to learn how HIV treatments have changed in recent decades — and how they might improve in the future.
Zidovudine (ZDV), often known as azidothymidine (AZT), was the first treatment that the Food and Drug Administration (FDA) approved for HIV.
AZT is a nucleoside reverse transcriptase inhibitor (NRTI) that can help reduce the amount of the virus in a person’s blood. However, it carries a high risk of drug resistance and tends to become less effective over time.
The FDA approved AZT in 1987 and three more types of NRTIs throughout the early 1990s. These medications also carried a high risk of drug resistance.
The limited treatment options contributed to high rates of HIV-related deaths throughout the 1980s and early 1990s.
By the mid-1990s, researchers had found that combining multiple medications from different drug classes was more effective for treating HIV than using one medication alone.
This combination treatment approach is known as highly active antiretroviral therapy (HAART). It contributed to the first major drop in HIV-related deaths, which declined by
The FDA has now approved more than 30 antiretroviral drugs to treat HIV, including drugs in the following classes:
- non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- protease inhibitors (PIs)
- fusion inhibitors
- CCR5 antagonists
- integrase strand transfer inhibitors (INSTIs)
- post-attachment inhibitors
Newer antiretroviral medications pose a lower risk of drug resistance and side effects than older options.
If you test positive for HIV, your doctor may prescribe medications from two or more drug classes. You may need to try multiple combinations to find what works well for you.
This combination treatment approach can lower the amount of HIV in your blood, which may delay or entirely prevent symptoms of HIV. It also lowers your risk of transmitting the virus to others.
HAART can even reduce HIV to undetectable levels, which makes the virus untransmissible.
If you have an undetectable viral load, you can’t pass HIV to anyone else.
Scientists have also developed medications to help people without HIV lower their risk of contracting the virus. These include preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP).
Your doctor may prescribe PrEP if you test negative for HIV, but you have risk factors that increase your chances of exposure to the virus. For example, they may recommend PrEP if you have a sexual partner with HIV or you share drug injection equipment with other people.
Taking PrEP as prescribed may lower your risk of contracting HIV through sex by
Your doctor may prescribe PEP if you’re not taking PrEP and you’ve had a known or suspected exposure to HIV. For example, they may prescribe PEP after a condom breaks during sex or after a sexual assault.
It’s important to begin taking PEP within 72 hours after possible exposure to HIV.
Your doctor can also help you learn about other strategies to prevent HIV transmission.
Until recently, HAART and PrEP were only available as oral medications that must be taken every day.
But in 2021, the FDA approved the first long-acting injections to treat and prevent HIV.
People with suppressed or undetectable levels of HIV may now receive monthly injections of the combination drug regimen cabotegravir and rilpivirine (Cabenuva) to keep their viral load suppressed or undetectable.
People without HIV may receive monthly injections of cabotegravir (Apretude) as long-acting PrEP.
Some people may find it more convenient to get monthly injections rather than take pills every day.
You can speak with your doctor to learn more about long-acting treatment and prevention options for HIV.
People with HIV must receive treatment to reach and maintain a suppressed or undetectable viral load. Even when the virus is undetectable and untransmissible, small amounts of it remain hidden in the body and may increase to detectable levels if someone stops treatment.
There’s currently no lasting cure for HIV, but scientists are hopeful that a cure may become available in the future.
Researchers are continuing to develop and test new treatments for HIV, including:
- new antiretroviral medications
- stem cell transplants for HIV
- vaccines for HIV
It’s possible that some of these treatments may improve survival or quality of life for people with HIV. Some of them may even provide a permanent cure for HIV. However, more research is needed.
Scientists must study potential treatments in clinical trials to learn how safe and effective they are.
You can learn more about clinical trials for HIV by visiting clinicaltrials.gov.
Recent advancements in treatment are helping people with HIV live longer and healthier lives than ever before.
New treatment and prevention approaches are also helping to lower the rate of new HIV infections.
However, the virus continues to affect many people across the United States. It disproportionately affects historically marginalized groups, men who have sex with men, and people living in the Southern United States.
More work remains to be done to improve access to HIV prevention, diagnosis, and treatment services. An estimated 13% of people with HIV do not know they have it.
Talk with your doctor to learn whether and how often you should get tested for HIV.
Your doctor can also help you learn about the latest PrEP or treatment options for HIV.
Researchers are continuing to develop and test new treatments for HIV, including potential cures.