Evolving Testing and Treatment

The understanding and prognosis of individuals with HIV have come a long way since AIDS first appeared on the public radar in 1981. In more than 30 years, scientists and doctors have found and named the virus that leads to Acquired Immunodeficiency Syndrome (AIDS) as well as rapid testing methods, effective retroviral treatments and prevention strategies.

A Look Back to the Early Years of AIDS

The disease now known as AIDS was first called by a number of names, most of them descriptions of opportunistic infections, such as Pneumocystis carinii pneumonia (PCP) and Kaposi’s Sarcoma (KS). Because these diseases were identified among gay men, mostly in San Francisco, Los Angeles and New York, they were often collectively dubbed “gay cancer.”

As more cases were diagnosed and more funding provided for research, some details about the disease came to light. By the mid-1980s, we knew:

  • AIDS (term first used in 1982) was caused by a virus, discovered by both French and American scientists. (The virus would be named the Human Immunodeficiency Virus (HIV) in 1986.)
  • HIV/AIDS was transmitted through sexual contact, blood and blood products. It was not transmitted by casual contact, sharing food, air, water or other surfaces.
  • A blood test for antibodies to the retrovirus that caused AIDS could diagnose new cases (before symptoms presented).

Throughout the 1980s, national and global initiatives, policies and summits would make AIDS research and treatment a priority. Still, challenges remained. In the late 1980s:

  • AIDS patients and advocates widely complained about the lengthy FDA approval process that kept promising new drugs off the market.
  • The first attempt at vaccines were unsuccessful—one trial being sanctioned for human trials.
  • Many high-risk populations, including infants, women and minorities, were disproportionately being infected and excluded from many research programs and drug trials.

However, in fewer than 10 years from the first case, one treatment method had been developed; AZT, the first antiretroviral was released in 1987.

AIDS in the 1990s

The 90s brought increasing awareness of the AIDS epidemic both in the US and abroad. Unfortunately, the life expectancy of those with HIV/AIDS was significantly cut short. Most people with the virus would succumb to the disease and/or opportunistic infections in their 30s and 40s, earlier for those who contracted the virus as children or teens (common among hemophiliacs who received regular blood transfusions).

With growing awareness came increased pressure for better treatment and access to care. As a result, the ADA was passed, which included AIDS as a disability, protecting those with a positive diagnosis from discrimination in hiring and housing. (The ADA was later expanded in 1998 to include those with HIV, so the full-blown disease was not required for protection against discrimination).

AZT was deemed safe for use in pediatric AIDS cases and for pregnant women, and HAART—highly active retroviral therapy—was FDA-approved and quickly became the new standard of care. With the expansion of treatment and new drugs slowly making their way to clinical trials and market, 1996 was the first year that new AIDS cases declined for the first time since 1981.

AIDS in the 21st Century

Advances in testing, treatment and policies in the 2000s have led to the most sweeping changes in how HIV is detected, prevented and treated. While early years of the new millennia were focused on finding a vaccine, financial and political support for research has led to some amazing developments, including:

  • Rapid HIV testing that provides results in 20 minutes and requires no specialized equipment or even a blood sample
  • Home testing kits
  • Combination antiretroviral drugs that simplify medication regimens
  • Pre-exposure prophylaxis (PrEP) that significantly reduce the risk of infection for homosexual and heterosexual individuals with HIV+ partners

By 2008, medical experts agreed that people diagnosed with HIV could expect to live into their 60s. Life expectancy and quality of life continue to improve with early diagnosis and early treatment, which now involves antiretroviral therapy regardless of CD4 count (the standard of care since 2012).

A Look to the Future

The development of an effective HIV vaccine seems on the horizon, and with the first “functionally cured” HIV+ infant in 2013, there seems hope for those living with HIV/AIDS that they may one day be infection-free. But the scientific and medical communities are not the only ones who need to work to secure a better future.

Today, there are still a number marginalized and stigmatized populations who experience a disproportionate risk for HIV, including:

  • African American gay and bisexual men
  • Latino gay and bisexual men
  • Minority women

HIV risk is also increased for incarcerated populations and is rising among senior citizens.

While the means to detect, diagnose and treat the virus exist, awareness and access to these resources needs to expand. UNM Truman Health Services strives to stay on the cutting edge of HIV/AIDS medicine and promote social awareness in the greater Albuquerque community. Contact us for information about community events and other resources to improve HIV/AIDS prevention, education and access to care in your community.