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Up until the 1980s, we do not know how many people were infected with HIV or developed AIDS.
HIV was unknown and transmission was not accompanied by noticeable signs or symptoms.
Regions defined by the US Census Bureau and used in CDC’s National HIV Surveillance System: Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY People are considered retained in care if they get two viral load or CD4 tests at least 3 months apart in a year.
(CD4 cells are the cells in the body’s immune system that are destroyed by HIV.) Viral suppression (having less than 200 copies of HIV per milliliter of blood) is based on the most recent viral load test.
By region these were; Africa 2,323, Americas 31,741, Asia 84, Europe 3,858, and Oceania 395.35 In February 1987, the WHO launched The Global Program on AIDS to raise awareness; generate evidence-based policies; provide technical and financial support to countries; conduct research; promote participation by NGOs; and promote the rights of people living with HIV.36 In March, the FDA approved the first antiretroviral drug, zidovudine (AZT), as treatment for HIV.37 In April, the FDA approved the western blot blood test kit, a more specific HIV antibody test.38 In July, the WHO confirmed that HIV could be passed from mother to child during breastfeeding.39 In October, AIDS became the first illness debated in the United Nations (UN) General Assembly.40 By December, 71,751 cases of AIDS had been reported to the WHO, with 47,022 of these in the USA.
The WHO estimated that 5-10 million people were living with HIV worldwide.41 In 1988, the WHO declared 1st December as the first World AIDS Day.42 The groundwork was laid for a nationwide HIV and AIDS care system in the USA that was later funded by the Ryan White CARE Act.43 In March 1989, 145 countries had reported 142,000 AIDS cases.
NGOs boycotted the conference.47 In July, the USA enacted the Americans with Disabilities Act (ADA) which prohibits discrimination against those with disabilities including people living with HIV.48 In October, the FDA approved the use of zidovudine (AZT) to treat children with AIDS.49 By the end of 1990, over 307,000 AIDS cases had been officially reported with the actual number estimated to be closer to a million.
Between 8-10 million people were thought to be living with HIV worldwide.50 In 1991, the Visual AIDS Artists Caucus launched the Red Ribbon Project to create a symbol of compassion for people living with HIV and their carers.
This aimed to widen knowledge of HIV status and greatly increase access to HIV treatment and prevention.83 In January 2010, the travel ban preventing HIV-positive people from entering the USA was lifted.84 In July, the CAPRISA 004 microbicide trial was hailed a success after results showed that the microbicide gel reduces the risk of HIV infection in women by 40%.85 Results from the i Pr Ex trial showed a reduction in HIV acquisition of 44% among men who have sex with men who took pre-exposure prophylaxis (Pr EP).86 In 2011, results from the HPTN 052 trial showed that early initiation of antiretroviral treatment reduced the risk of HIV transmission by 96% among serodiscordant couples.87 In August, the FDA approved Complera, the second all-in-one fixed dose combination tablet, expanding the treatment options available for people living with HIV.88 In July 2012, the FDA approved Pr EP for HIV-negative people to prevent the sexual transmission of HIV.89 For the first time, the majority of people eligible for treatment were receiving it (54%).90 In 2013, UNAIDS reported that AIDS-related deaths had fallen 30% since their peak in 2005.91 An estimated 35 million people were living with HIV.92 In September 2014, new UNAIDS “Fast Track” targets called for the dramatic scaling-up of HIV prevention and treatment programmes to avert 28 million new infections and end the epidemic as a public health issue by 2030.93 UNAIDS also launched the ambitious 90-90-90 targets which aim for 90% of people living with HIV to be diagnosed, 90% of those diagnosed to be accessing antiretroviral treatment and 90% of those accessing treatment to achieve viral suppression by 2020.94 In July 2015, UNAIDS announced that the Millennium Development Goal (MDG) relating to HIV and AIDS had been reached six months ahead of schedule.The annual number of new HIV diagnoses remained stable between 20.Subpopulations representing 2% or less of all people who received an HIV diagnosis in 2017 are not represented in this chart. Diagnoses of HIV infection in the United States and dependent areas, 2017.In June 1995, the FDA approved the first protease inhibitor beginning a new era of highly active antiretroviral treatment (HAART).Once incorporated into clinical practice HAART brought about an immediate decline of between 60% and 80% in rates of AIDS-related deaths and hospitalisation in those countries which could afford it.62 By the end of the year, there were an estimated 4.7 million new HIV infections - 2.5 million in southeast Asia and 1.9 million in sub-Saharan Africa.63 In 1996, the Joint United Nations Programme on AIDS (UNAIDS) was established to advocate for global action on the epidemic and coordinate the response to HIV and AIDS across the UN.64 The 11th International AIDS Conference in Vancouver highlighted the effectiveness of HAART leading to a period of optimism.65 The FDA approved the first home testing kit; a viral load test to measure the level of HIV in the blood; the first non-nucleoside transcriptase inhibitor (NNRTI) drug (nevirapine); and the first HIV urine test.66 New HIV outbreaks were detected in Eastern Europe, the former Soviet Union, India, Vietnam, Cambodia and China among others.
The target of MDG 6 – halting and reversing the spread of HIV – saw 15 million people receive treatment.95 In September, the WHO launched new treatment guidelines recommending that all people living with HIV should receive antiretroviral treatment, regardless of their CD4 count, and as soon as possible after their diagnosis.96 In October, UNAIDS released their 2016-2021 strategy in line with the new Sustainable Development Goals (SDGs), that called for an acceleration in the global HIV response to reach critical HIV prevention and treatment targets and achieve zero discrimination.97 The number of people in Russia living with HIV reached one million.