The Incredible Trajectory of HIV Treatment

December 1 is World AIDS Day, an opportunity for people worldwide to unite in the fight against human immunodeficiency virus (HIV), to show support for people living with HIV, and to commemorate those who have died from an acquired immune deficiency syndrome (AIDS)-related illness. 

Tez Anderson can still remember the moment when doctors told him he was HIV-positive. It was the 1980s, and the AIDS crisis was in full swing. 

“Life felt like a war zone,” Anderson said. “You’d meet someone perfectly healthy one week, and a few weeks later, you’d read their obituary. Leaving the health clinic with a positive diagnosis was like walking back out into Oz. I was certain I was going to die.”

Tez’s reaction is representative of the time. When scientists first isolated and identified the virus that causes AIDS in 1983, a diagnosis could carry a life expectancy of months. It wasn’t for another four years that the U.S. Food and Drug Administration (FDA) approved the first treatment, an antiretroviral medicine initially developed to treat cancer that was found to slow the progression of AIDS in advanced cases. When the FDA approved it for use in 1987, the medicine marked the first significant step in the mission to tackle the rapidly expanding epidemic, which affected 100,000 patients in the United States by 1989. 

But it was far from a permanent solution to the crisis. By 1994, AIDS became the leading cause of death for all Americans ages 25 to 44. The death toll had risen every single year since 1981, and a cumulative total of 270,000 people in America had died from the disease or its complications. The disease had also spurred an international health crisis, as countries around the world had few options to combat its devastating impact.

Finally, in 1995, after more than a decade of research, biopharmaceutical researchers developed the first successful protease inhibitor, which halted the growth of HIV by preventing infected cells from replicating and spreading the virus. This discovery marked the beginning of highly active antiretroviral therapy (HAART), which quickly revolutionized the fight against AIDS. Death rates began declining rapidly, and for the first time, people living with HIV could think about the future.

Continued Innovation 

Since 1995, dozens of treatments for HIV have been approved in the United States, helping slow the replication of the virus or preventing it from entering cells altogether. Within the last decade, the fight against HIV/AIDS made another significant leap forward, with the development of medicines that can prevent the transmission of HIV, called pre-exposure prophylaxis medicines (PrEP). Intended for populations at an increased risk of HIV infection, when taken daily, PrEP regimens have been shown to reduce risk of HIV infection by between 74% and 99%, depending on the population. 

The treatment process has changed dramatically as well, dropping in complexity to once-daily, single-tablet regimens. Today, more than 50 new medicines designed to treat HIV are in development by biopharmaceutical companies, including potential vaccines that could stop the spread of HIV entirely. Further innovations under study include once-monthly, long-acting regimen which could reduce the need for daily medicine intake for HIV positive patients. This research continues to offer broad benefit, laying the foundation for some potential COVID-19 treatments and vaccines. 

Even so, the fight is not over. The vast majority of people with HIV live in low- or middle-income countries, where they face the disease’s substantial impact on households, communities and economic growth. Although the number of HIV infections has declined in recent years due to a global effort to fight the disease, the need for an effective vaccine or antiviral cure remains high. 

Not Just Surviving, But Thriving

In the 35 years since his diagnosis, Anderson witnessed tremendous progress first-hand. 

“Aging with HIV has been the hardest thing I’ve ever done, but it’s given me a sense of depth and empathy I couldn’t have gotten otherwise,” Anderson said. “It’s my hope that America will keep investing in future breakthroughs so that my story—of having lost hope only to regain it—can repeat itself hundreds, if not millions, of times.”

Learn more about the incredible progress we’ve made in addressing HIV/AIDS.