This past week marked the 30th anniversary of AIDS in America. The CDC reported the first cases of Pneumocystis Pneumonia in an MMWR on June 5, 1981. This marked the beginning of the most documented, studied and advocated epidemic in human history. We started knowing so little and now we know so, so much – as that original MMWR stated: “Pneumocystis pneumonia in the United States is almost exclusively limited to severely immunosuppressed patients. The occurrence of pneumocystosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual.”
Unusual. That is how AIDS began – out of the ordinary, affecting people then on the fringes of society, seemingly out of nowhere. In my lifetime, HIV/AIDS in many parts of the world has moved from being unusual to being a fact of life. We have learned that HIV/AIDS can not be fought with medicine alone, that the social make-up of the disease means that all sectors of society impact its prevention and spread.
Of all the new science and sociocultural interventions, the recent release of the “treatment as prevention” study is of great interest and excitement to me. Finding a significant reduction in transmission from a positive partner to a negative partner when the positive partner is put on ARVs immediately, these results can and should drastically shift our thinking on prevention. This doesn’t mean other interventions won’t be needed; community-based structural changes and access to treatment will now be significant elements to reducing rates of transmission.
AIDS has entered an era of optimism, but we need to remember that in many parts of the World it is still a haunting demon. The research and outreach are not over, but perhaps in another 30 years they will be.
If you are interested in what the U.S. is currently doing to combat HIV/AIDS domestically, take a look at the National HIV/AIDS Strategy.
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