Since HIV was first found in 1983, medical experts and scientists have struggled with how to best manage the condition. In the 40 years since, there have been significant advancements in treatment that have extended lifespans, made identification of the virus easier, and improved the quality of life for those living with HIV and subsequent AIDS diagnoses if patients do not remain in care.
Over the past four decades, a diagnosis of HIV has evolved from essentially a death sentence to what is considered a manageable chronic condition. From the first identification of the virus that causes AIDS, it would take four years to develop and gain FDA approval for the first medication treatment, called AZT.
AZT had been originally developed to treat cancer but was found to be effective in interrupting the HIV-infected cells’ ability to make new viruses and was hailed as a game changer, proving that HIV was treatable. However, it would take many more advancements to loosen the death grip that HIV/AIDS had on the world in the 1980s and through the 1990s.
Challenges and limitations
While initial HIV treatments brought about hope for those who acquired the virus, they also presented a host of challenges and certain limitations. Traditional antiretroviral regimens were complex, requiring a cocktail of drugs taken simultaneously, and each drug within the cocktail had its own dosing schedule and side effects, ranging from vomiting and diarrhea to insomnia and bone marrow suppression.
The complex nature of early treatments led to human error in dosing and non-adherence to the regimen. Those who were living with HIV and in areas with limited resources, such as rural areas or those facing homelessness, were more likely to lack adherence to the regimen and suffer the consequences of dosing errors — if they were able to access antiretroviral medications at all.
The side effects of early HIV/AIDS treatments significantly reduced the quality of life for patients. Although AZT was hailed as the “light at the end of the tunnel” by the company responsible for its production, it was also fast-tracked through the approval system. Additionally, AZT was still costly and out of reach for many.
Over time, HIV mutated and began to resist AZT. By 1992, AIDS had become the number one cause of death for men ages 25 to 44. It became evident that scientists and experts had to go back to the drawing board to find out how to better combat this stronger strain of the virus.
Advancements in HIV treatment and prevention
As the Centers for Disease Control (CDC) and other experts on HIV and AIDS learned more about how the virus was contracted, spread, and progressed once someone acquired the virus, they began to develop stronger, more effective treatments and prevention methods.
In 1990, the CDC developed a patient-centered counseling model for the prevention of HIV. This model focused on the important aspects of consent, confidentiality, counseling, correct test results, and a connection to prevention, treatment, and care. This approach wildly changed how the medical community faced the virus and those who carried it, focusing on the human aspect of care instead of a virus-centered model.
Trials for HIV treatments continued through the 1990s, testing different ways to see which were most effective in making the virus undetectable, while topics such as safe sex and improved HIV tests gained attention. protease inhibitor was approved by the FDA in 1995, leading to renewed optimism and the introduction of “highly active antiretroviral therapy” (HAART).
By the end of the 1990s, medical experts promoted a “hit early, hit hard” approach to HIV infections, a method still widely used today to keep HIV undetectable through early, aggressive intervention. Dr. David Hocoined the “hit early, hit hard” approach and advocated for the early introduction of antiretroviral treatment.
Implications of advancements for people living with HIV
In the past 20 years, there have been significant strides in HIV and AIDS treatment, including the development of preventive medication, highly effective antiretroviral therapy (ART), and even the start of clinical trials for an HIV vaccine. While it may be too early to tell if we can eliminate HIV for good, these substantial steps forward have brought hope to communities most affected by HIV and AIDS. Our clinic, Hope & Help in Winter Park, Florida, provides free HIV testing, primary care for those with HIV, and prevention education, following in the footsteps of groups such as the renowned
Friends in Deed who supported a population feeling abandoned during the early days of the AIDS epidemic, offering both medical care and emotional assistance. Although new HIV infections have decreased, the issue persists. Real change requires ongoing scientific study, support, fundraising, and education.
While statistics Lisa Barr is the Executive Director at
Hope and Help Center of Central Florida, Inc. d/b/a Hope & Help. With a background in business development, marketing, and grant writing, Barr is dedicated to enhancing the organization's impact and fulfilling its vision of a world without HIV/AIDS. In the past, AIDS was the main reason men aged 25-44 died. Although it's no longer always fatal, there is still a significant amount of progress needed.
