Top Developments in HIV/AIDS: 1981-2009 By Wendi Williams, Editor & HIV/AIDS Prevention Educator

Instead of the usual doom and gloom article about HIV/AIDS, I thought I would highlight what I consider to be the top seven major developments that have occurred in the AIDS arena since 1981 when the epidemic first began in the United States. Although they are not in any order of importance, these factors have played a major role in helping to change the course of history in what is now a global pandemic.

#1: One of the most significant changes in regard to HIV/AIDS is the development of new antiretroviral drugs. When AIDS first hit the United States (US) in 1981, the mortality rate was 100 percent and people on average lived only a year after being diagnosed. Today, individuals are living for two decades or longer under the care of a physician. AZT was the first HIV antiretroviral drug approved by the Food and Drug Administration (FDA) on March 19, 1987. However, it is the Highly Active Antiretroviral Therapy, also known as HAART with its drug "cocktails," that is responsible for slowing down the spread of HIV in the human body. Today, more than 30 antiretroviral drugs have been approved by the FDA for use in the US.

#2: When the history books are written, President George W. Bush may not be remembered as one of our most favourable presidents, but he will be remembered for his AIDS efforts in Africa and other countries. In 2003, when the President's Emergency Plan for AIDS Relief (PEPFAR) was first introduced to the global community approximately 50,000 people were documented as receiving HIV/AIDS treatment. In a five-year span, 40 times that number or more than 1.7 million people in sub-Saharan Africa alone now receive care for HIV/AIDS. In addition, more than 240,000 babies are HIV-negative as a result of PEPFAR efforts. Funding from PEPFAR is expected to increase from $15 billion to $48 billion over the next five years (PEPFAR, 2008).

In December 2008, President Bush was awarded the Global Peace Coalition's first "International Medal of PEACE" for his AIDS efforts.

#3: No longer do you have to wait days or weeks before knowing your HIV status. Rapid HIV tests allow you to get your results in just 3-5 minutes. When I underwent my first HIV test, I had to wait a period of three days for my results. Timing is significant because people generally did not return for their results that may have been HIV-positive. Timing is significant because people will know their status and hopefully will act responsibly. Timing is significant because people can enter treatment earlier, and early treatment helps to prolong and to improve their quality of life. For more information about rapid HIV screening, visit www.cdc.gov/hiv/topics/testing.

#4: HIV/AIDS prevention education like other programmatic education has evolved over the years. Not only is it important to educate people about HIV/AIDS, but it's important to try and change negative behavior that puts people at risk for HIV. Therefore, the thrust of prevention education in the past five years has been to develop and implement effective scientific-based programs for culturally-specific audiences regardless of race, sexual orientation, age, and HIV status. There is scientific proof from random controlled trials that individual, small-group, and community-level interventions do work to change behavior. The goals of any health prevention or intervention program are to reduce the number of cases and to prolong or improve the quality of life through treatment and education.

#5: When I think about prevention education, I must also mention increased media coverage. I'm not just referring to the daily news that is broadcasted over our television sets, radios, or other electronic gadgets, but rather every single form of electronic and print media from movies to weekly magazines and drug ads. There was a time when we rarely talked or heard anything about HIV/AIDS, but not a day goes by when I don't receive some developing news about this pandemic.

On January 15, 2004, former United Nations Secretary-General Kofi Annan urged media executives from around the world to educate consumers about HIV/AIDS. He stated, "If there is one thing we have learned in the two decades of this epidemic, it is that in the world of AIDS, silence is death."

What we have witnessed since 2004 is an explosion of information filtering out to households around the world from CNN reports to Black Entertainment Television's Rap-it-Up campaign. People are now talking about HIV and AIDS in their homes, on their jobs, and even at their religious places of worship.

#6: According to a report issued by the Kaiser Family Foundation, the US spent roughly $150 billion dollars on fighting the AIDS epidemic from 1981 to 2004. In 1981, only a few thousand dollars was spent on AIDS research. However, in 2009, an estimated $24.1 billion has been requested for domestic ($18.2 billion) and global ($5.9 billion) HIV/AIDS efforts. More than half of these proposed funds are going for care and treatment programs in the US, while the rest will go to housing, domestic HIV prevention and research, and global efforts.

One of the most significant changes in regard to funding is certainly the reauthorization of the Ryan White Care Act. In 2006, the reauthorization redefined "Eligible Metropolitan Areas" as cities with a population greater than 50,000 versus 500,000. This allowed more funding to go to cities that have witnessed an escalation in HIV/AIDS cases rather than just to larger metropolitan areas like New York, Los Angeles, and Chicago. The Ryan White Care Act funds the AIDS Drugs Assistance Program that provides HIV antiretroviral drugs to low-income people. Without this program many US citizens would not be able to afford the medications that help to prolong their lives.

#7: Research is critical when it comes to HIV/AIDS, particularly since there is no cure. How we respond to this epidemic is certainly driven by research. It is research that gives us the tools we need to combat HIV/AIDS at the grassroots level and the medications physicians prescribe to patients. Because of research we now know that certain blood types may be more susceptible to HIV (Clark, 2009). Because of research we also know that HIV may have been evolving since the early 1900s (Avasthi, 2008). It is also research that will take us one step closer to finding that elusive cure.

Visit our Extension site www.aces.edu and www.cdc.gov/hiv for other HIV/AIDS resources.

Centers for Disease Control and Prevention. (2008, February 4). FDA-approved rapid HIV antibody screening tests ­ purchasing details. Retrieved January 15, 2009.

Clark, T. (2009, January 13). Potential new weapon in battle against HIV infection identified by researchers. Medical News Today. Retrieved January 13, 2009.

Ryan White Care Act. (2008, August 17). In: Wikipedia: the free encyclopedia. Retrieved January 9, 2009.

Summers, T. and Kates, J. (2004, March). Issue brief: Trends in U.S. government funding for HIV/AIDS--fiscal years 1981 to 2004. The Henry J. Kaiser Family Foundation. Retrieved January 15, 2009.

The Henry J. Kaiser Family Foundation. (2008, April). U.S. federal funding for HIV/AIDS: The FY 2009 budget Request. HIV/AIDS Policy Fact Sheet. Retrieved January 15, 2009.

The Henry J. Kaiser Family Foundation. (2008, August). Behavior change for HIV prevention: (Re) considerations for the 21st century. Global HIV Prevention Working Group. Retrieved January 15, 2009.

The United States President's Emergency Plan for AIDS Relief. (2008, August). Reauthorizing PEPFAR. Retrieved January 15, 2008.

United States Food and Drug Administration. (2008, January). Drugs used to treat complications of HIV/AIDS. Retrieved January 12, 2008.

United Nations Information Center. (2004, January 17). Secretary-general urges media leaders to use influence to spread information in AIDS fight. UN Weekly Newsletter. Retrieved January 15, 2008.

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