HIV Used to Be a Death Sentence. Here’s What’s Changed in 35 Years

It’s been 35 years since the Centers for Disease Control and Prevention reported the first cases of HIV/AIDS, as the disease is now known. Since then, prognosis for people infected with HIV has improved dramatically; no longer is an HIV diagnosis a death sentence, but some hurdles remain. Here are the 5 biggest changes in the epidemic.

HIV CASES VS. AIDS CASES

THEN

In the early days of the epidemic, most people progressed to AIDS, the advanced form of the disease, and then died of it.

NOW

Anti-HIV drugs have helped many people live with HIV for years, often even decades. At the epidemic’s peak in 1995, 50,000 died; in 2014, around 12,000 people died of late-stage AIDS.

WHO’S AT HIGHEST RISK

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The epidemic began among marginalized populations, including gay men, IV drug users and sex workers.

NOW

While rates among gay men are still high and account for the bulk of new infections, about 25% of Americans living with HIV are women, and most new cases in women happen because they’ve become infected by their partners through sex. 44% of new HIV diagnoses in 2014 were in African-Americans, the racial group most affected by the disease. Transmission is also high among younger men who were born after the height of the epidemic in the 1980s and weren’t exposed to the early public health HIV prevention campaigns.

DRUG TREATMENTS

THEN

For years, AZT was the only drug approved to treat HIV. It was a stop gap, since HIV quickly became resistant to the treatment, but it was the only drug available.

NOW

Dozens of approved mediations exist, each of which blocks HIV from dividing and producing more virus in a different way. Combining the medications has transformed HIV infection into a chronic disease that can be managed with drug treatment.

PREVENTION EFFORTS

THEN

Safe sex campaigns and condom distribution were controversial public health messages, and conservative groups argued that such campaigns would promote promiscuous behavior. Abstinence became a popular message in some parts of the U.S.

NOW

Condoms and clean needles are proven ways to lower spread of the virus; studies consistently show that an abstinence-only approach doesn’t work to reduce spread of HIV.

HIV TESTING

THEN

Only available in labs or HIV clinics, people would have to risk the stigma of being seen at an HIV clinic in order to learn their status.

NOW

Home testing kits allow people to test in their own home; people send the required sample in provided packaging to a lab and can call in for their results. If needed, labs provide counselors to discuss the results.