40 Years and Counting: A Timeline of the AIDS Epidemic

40 Years and Counting: A Timeline of the AIDS Epidemic

April 22, 2022

Over the course of its epic six-hour run time, Matthew López’s The Inheritance examines all of gay life — the past, the present, and the future. However, the conversations that this play seeks to have are inextricably linked to the HIV/AIDS crisis that began in 1981 and still affects millions globally today. Compiled by Production Dramaturgs Dennis Corsi and  Rulas A. Muñoz, this timeline follows the unfolding of the HIV/AIDS crisis from the first cases to widespread epidemic, and the queer community’s battle to fight for their lives in the face of an uncaring government.

1981

  • June 5: The CDC reports first cases of rare pneumonia in five young gay men in LA. Doctors noticed that all the men have other unusual infections as well, indicating that their immune systems are not working. The same day, a New York dermatologist reported a cluster of cases of a rare and unusually aggressive cancer— Kaposi’s Sarcoma (KS) —among gay men in New York and California.
  • Talk emerges of “Gay Men’s Pneumonia” and “Gay cancer.”
  • Larry Kramer holds a meeting of over 80 gay men in his New York City apartment to discuss the burgeoning epidemic. He asks the group to contribute money to support his research. The plea raises $6,635—essentially the only new money, public or private, that will be raised to fight the epidemic this year.
  • By year’s end, there is a cumulative total of 337 reported cases of individuals with severe immune deficiency in the United States. Of those cases, 130 are already dead by December 31.

1982

  • The disease is officially labeled acquired immune deficiency syndrome (AIDS).
  • Legislature is introduced to allocate funding for AIDS research. The resolution dies in committee. Congress will not approve the first dedicated funding for AIDS research and treatment until July 1983 (two years after the first cases).
  • At year’s end, number of cumulative deaths in the US: 1,080

1983

  • Larry Kramer, gay playwright and author, publishes a blistering assessment of the impact of AIDS on the gay community in the New York Native. The essay, 1,121 and Counting, is a frantic plea for that community to get angry at the lack of government support for sick and dying gay men and the slow pace of scientific progress in finding a cause for AIDS.
  • Richard Berkowitz and Michael Callen—both men living with AIDS—publish a booklet on “safer sex” titled How to Have Sex in an Epidemic: One Approach. It advocates condom use for gay men and focuses on self-empowerment for those living with AIDS.
  • The U.S. Congress passes the first bill that includes funding specifically targeted for AIDS research and treatment.
  • At year’s end, number of cumulative deaths in the US: 3,420

1984

  • The HIV virus is identified and studied. There is hope of a vaccine within two years.
  • The CDC announces that the virus cannot be transmitted through casual contact, food, water, air or environmental surfaces.
  • The New York Times reports that new scientific evidence has raised the possibility that AIDS may be transmissible through saliva. (It will be another two years before proof emerges that this is not the case.)
  • San Francisco and NYC close their bath houses.
  • At year’s end, number of cumulative deaths in the US: 7,670

1985

  • The first blood screening test for HIV antibodies is approved by the FDA.
  • The Normal Heart opens Off-Broadway at The Public. As Is opens on Broadway. Both are plays about AIDS.
  • Rock Hudson is the first public figure to announce he has AIDS.
  • President Reagan mentions AIDS publicly for the first time. (At this time he had been president for 4 years and and over 13,000 people have died of AIDS in the US.)
  • This year is a turning point in public awareness of the epidemic. AIDS stories in major print media triples.
  • A Los Angeles Times polls finds that a majority of Americans favor quarantining people who have AIDS.
  • At year’s end, number of cumulative deaths in the US: 13,300

1986

  • Of all AIDS cases to date, 51% have died. At this time, on average, AIDS patients die about 15 months after diagnosis.
  • The CDC reports that AIDS is disproportionately affecting Black and Latino people.
  • The first clinical trials of the antiviral drug AZT begin.
  • At year’s end, number of cumulative deaths in the US: 16,300

1987

  • Larry Kramer founds the AIDS Coalition to Unleash Power (ACT UP). TIME Magazine calls it “the most effective health activist group in history.”
  • The FDA approves AZT. The effectiveness of the drug was controversial, but it had the potential of at least buying the patient a bit more time, in hopes that a more effective treatment would be found in time. AZT often came with intense side effects like chronic headaches and nausea, and debilitating muscle fatigue.
  • The FDA approves a more effective test for HIV antibodies.
  • The US mandates HIV testing for immigrants and bans immigrants who are HIV+. (This ban isn’t lifted until 23 years later.)
  • In a 94-2 vote, the U.S. Senate adopts the Helms Amendment, which requires federally financed educational materials about AIDS to stress sexual abstinence and forbids any material that “promotes” homosexuality. This hindered organizations like Gay Men’s Health Crisis from publishing materials on safe sex practices.

1988

  • The government mails an educational booklet Understanding AIDS to all households. This was the largest public health mailing in history.
  • President Reagan signs the Health Omnibus Programs Extension (HOPE) Act into law. The legislation authorizes the use of federal funds for AIDS prevention, education, and testing. It is the first comprehensive federal AIDS bill.

1989

  • Dr. Anthony Fauci endorses giving HIV-positive people access to experimental treatments.

1990

  • U.S. Congress enacts the Americans with Disabilities Act (ADA). The Act prohibits discrimination against individuals with disabilities, including people living with HIV/AIDS.
  • 10 million people have HIV worldwide. More than a million are in the US.

1992

  • AIDS becomes the number one cause of death for U.S. men ages 25 to 44.

1993

  • The film Philadelphia, starring Tom Hanks as a lawyer with AIDS, opens in theaters. Based on a true story, it is the first major Hollywood film on AIDS.
  • Angels in America, Tony Kushner’s play about AIDS, wins the Tony Award for Best Play and the Pulitzer Prize for Drama.
  • The “female condom” is approved, which is a pouch inserted into the vagina to prevent pregnancy and STIs. The FDA refused to allow testing this condom for anal sex, saying sodomy is illegal in too many states. (Around 20 states at this time still had anti- sodomy laws. For example, in Idaho a person convicted of sodomy could earn a life sentence in prison.)

1994

  • AIDS becomes leading cause of death for all Americans ages 25 to 44.

1995

  • The FDA approves highly active antiretroviral therapy (HAART). This is a daily regimen of several medications. With the advent of HAART, the number of HIV-related deaths in the United States and Europe plummeted by more than 50% within the span of three short years. For the first time in the 14 years of the epidemic, a drug was able to afford people with HIV near-normal life expectancy and prolonged, disease-free health. It also lowered the transmission rate of the virus to sexual partners.
  • By October, half a million cases of AIDS have been reported in the US.

1996

  • The number of new AIDS cases diagnosed in the U.S. declines for the first time since the beginning of the epidemic.
  • AIDS is no longer leading cause of death for all Americans ages 25-44, although it remains the leading cause of death for African Americans in this age group.

1997

  • First substantial delicate in AIDS-related deaths, largely attributed to HAART.
  • However, resistance to the drugs becomes more common, and drug resistance emerges as an area of grave concern within the AIDS community.
  • President Bill Clinton announces goal of finding a vaccine in 10 years.
  • Approximate number of HIV-positive people worldwide—22 million. To put this number in perspective, it was larger than the total population of the continent of Australia.

1998

  • The CDC reports that African Americans account for 49% of U.S. AIDS-related deaths. AIDS-related mortality for African Americans is almost 10 times that of white people.
  • Congress funds the Minority AIDS Initiative. An unprecedented $156 million is invested to improve the nation’s effectiveness in preventing and treating HIV/AIDS in African American, Hispanic, and other minority communities.
  • The U.S. Supreme Court rules that the Americans with Disabilities Act (ADA) covers those in earlier stages of HIV disease, not just those who have developed AIDS.

1999

  • The WHO announces that HIV/AIDS has become the fourth biggest killer worldwide and the number one killer in Africa.
  • WHO estimates that 33 million people are living with HIV worldwide, and that 14 million have died of AIDS.

2001

  • Manufacturers of generic drugs offer to produce discounted forms of HIV/AIDS drugs for developing countries.
  • The CDC announce a new HIV Prevention Strategic Plan to cut annual HIV infections in the U.S. by half within five years.

2002

  • Although mortality rates have greatly improved in the US, HIV is leading cause of death worldwide among those aged 15 to 59.
  • Worldwide, 10 million young people, aged 15-24, are living with HIV.

2003

  • The CDC calculates that almost 70% of new infections that occur each year in the U.S. result from transmission by individuals who do not know they are infected. There are major pushes to increase testing.

2006

  • June 5 marks 25 years since the first AIDS cases were reported.

2007

  • In an attempt to increase the number of people taking HIV tests, WHO issues new guidance recommending “provider- initiated” HIV testing in healthcare settings.

2010

  • President Obama lifts the travel and immigration ban on HIV+ people.
  • The National Institutes of Health (NIH) announce the results of the iPrEx study, showing that a daily dose of HIV drugs reduced the risk of HIV infection among HIV-negative men who have sex with men by 44%, supporting the concept of pre-exposure prophylaxis (PrEP) in a targeted population.

2011

  • Treatment of HIV is shown to reduce transmission by 96 percent, demonstrating the concept “treatment as prevention.”

2012

  • The Washington Post release a survey of the American public’s attitudes, awareness, and experiences related to HIV and AIDS. The survey finds that roughly a quarter of Americans do not know that HIV cannot be transmitted by sharing a drinking glass— almost exactly the same share as in 1987.
  • The FDA approves the use of Truvada for pre-exposure prophylaxis (PrEP). Adults who do not have HIV, but who are at risk for infection, can now take this medication to reduce their risk of getting the virus through sexual activity.

2014

  • Major provisions of the Affordable Care Act designed to protect consumers go into effect. Insurers are now barred from discriminating against customers with pre-existing conditions, and they can no longer impose annual limits on coverage — both key advances for people living with HIV/AIDS.
  • A European study found that no HIV-positive partner who was undergoing antiretroviral therapy and had an undetectable viral load had transmitted HIV.

2015

  • WHO recommends daily oral PrEP as an additional prevention choice for those at substantial risk for contracting HIV.
  • The U.S. Food and Drug Administration announces it will lift its 30-year-old ban on all blood donations by men who have sex with men and institute a policy that allows them to donate blood if they have not had sexual contact with another man in the previous 12 months.

2016

  • The Undetectable=Untransmissable (U=U) slogan is launched. This was part of an awareness campaign to ensure people that a person with an undetectable viral load is unable to pass the virus to an HIV- partner.
  • The CDC reports that only 1 in 5 sexually active high school students has been tested for HIV. An estimated 50% of young Americans who are living with HIV do not know they are infected.
  • Researchers announce that an international study of over 1,900 patients with HIV who failed to respond to the antiretroviral drug tenofovir—a key HIV treatment medication—indicates that HIV resistance to the medication is becoming increasingly common.
  • At the annual Conference on Retroviruses and Opportunistic Infections, researchers report that a man taking Truvada has contracted HIV—marking the first reported infection of someone regularly taking the drug.

2017

  • The CDC officially announces that people living with HIV who are on treatment and have undetectable viral loads have effectively no risk of transmitting the virus to sexual partners.
  • The Bill and Melinda Gates Foundation announces that it will invest $140 million in a new HIV-prevention tool. The funds will go to develop implants that can deliver HIV-prevention medication continuously over a long period of time—eliminating the need for people to take daily PrEP.
  • The CDC reports significant declines in HIV/AIDS death rates for Black Americans between 1999-2015. Among those aged 18-34, HIV-related deaths drop 80%, and among those aged 35, deaths drop by 79%.
  • Broadway composer and lyricist Michael Friedman dies of AIDS-related illness at age 41. He is best known for his work on the musical Bloody, Bloody Andrew Jackson. His death is a shocking reminder to many that HIV continues to be deadly.

2019

  • President Trump announces his administration’s goal to end the HIV epidemic in the United States in 10 years.
  • A new CDC report shows that progress in reducing new HIV infections in the United States has stalled in recent years and highlights the need for increased HIV testing, treatment, and prevention to end the HIV epidemic in the U.S.

2020

  • The CDC publishes a new study showing that the rate of HIV-related deaths among people with HIV in the U.S. fell by nearly half from 2010 to 2017.

2021

  • June 5 marks 40 years since the first cases of AIDS.
  • The FDA approves Cabenuva, the first injectable, extended release, complete HIV treatment regimen that is administered once a month, offering the first alternative to a daily oral treatment regimen.
  • The FDA later approves the first long-acting injectable form of HIV pre-exposure prophylaxis (PrEP), Apretude, for use in adults and adolescents. It is injected once every two months, providing an alternative to daily oral pills.

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