The Modern Epidemic:

AIDS (acquired immunodeficiency syndrome) was first established as a disease when public health officials in New York, Los Angeles, and San Francisco began to see a strange set of symptoms among young, homosexual men; specifically presenting with Pneumocystis carnii pneumonia (PCP) and Kaposi's sarcoma. These two diseases are very, very unusual for young adults who are not known to be immunosuppressed.

The first report, alerting the world to this new syndrome, appeared in June 1981. The article reported on five young homosexual men in Los Angeles, California who have contracted PCP. A few weeks later similar reports came out of both New York and San Francisco of 26 young homosexual men presenting with Kaposi's sarcoma. More reports with similar presenting diseases began to arise in communities of drug users who use syringes.

The CDC then reported in 1982 of 34 cases of Kaposi's sarcoma in Haitians living in several states within the United States, none of whom were homosexual. A week later, more reports of disease among hemophiliacs.

Earliest Evidence of HIV:

After defining the disease, investigation into past cases of unusual syndrome symptoms was undertaken and it is believed that cases of AIDS were actually manifested in the United States as early as the 1950s and 1960s. Tissue samples of a 15 year-old black male who died of Kaposi's sarcoma in 1968 was positive for HIV, appearing to be the first confirmed case of HIV infection in the United States. Because this patient had no history of travel outside of the United States, it is believed that he was actually infected by some other person. The first documented case of AIDS has been established as coming from a Bantu man, who died of an unidentified illness in the Belgian Congo in 1959.

Tracking an Epidemic:

Even before the known cause of AIDS was established, public health departments were tracking the disease by reporting AIDS diagnoses. All fifty states were required to report any case of AIDS from very early on in the epidemic, but initially because of patient privacy and lack of legislation requiring that AIDS cases be reported, many states did not report valuable statistics. This trend changed in the 1990s.

By tracking the number of reported cases of AIDS, 1993 was established as the year with the highest number of newly reported cases. AIDS was a difficult disease to track for a number of reasons, the most crippling is that the incubation period of AIDS appeared to be about ten years.

• • 1981 100 AIDS cases were reported to the CDC.
  • By February 1983, 1000 cases had been reported.
  • By August 1983 (six months later) an additional 1000 cases were reported.
  • By the end of 1983 over 3000 AIDS cases had been reported.
  • By August 1989, 100,000 cases had been reported.
  • November 1991, 200,000 cases.
  • 500,000 cases were reported by October 1995, also the year of the most deaths due to AIDS, over 50,000.

Current data on the AIDS epidemic can be found:

http://www.cdc.gov/hiv/stats.htm

The Changing Face of the Epidemic:

While the initial patients were young homosexual males in 1981, by 1996 the demographics had changed significantly. The epidemic now targeted non-white populations, women, heterosexuals, and IV drug users. By 2001, 26% of all cases were female. The percentage of male homosexuals affected dropped from 71% in 1983 to 44% in 1996.

AIDS Mortality:

By 1993, AIDS was the leading cause of death for young people between the ages of 25 and 44. Over 40,000 people died in the U.S. from AIDS in 1994 and over 50,000 in 1995. This accounted for 23% of all deaths among men and 32% of all deaths among African-American men. These numbers have dropped significantly in more recent years. Only 38,780 died on 1996, and 14,499 in 2000. Such a decrease in AIDS mortality is due to the multi-drug treatment regimens that were initiated in 1996.

Timeline and Risk Factors:

· 1981: The Centers for Disease Control and Prevention (CDC) diagnoses the first cases of AIDS-related diseases among young gay men.

· 1982: "Acquired Immune Deficiency Syndrome (AIDS)" is the term formally established by the CDC and identifies four risk factors associated with AIDS: male homosexuality, IV drug abuse, Haitian origin, and hemophilia A

· 1983: As a fifth risk group, the CDC includes female sexual partners of men with AIDS. Human Immunodeficiency Virus (HIV) is identified as the cause of AIDS.

· 1985: Rock Hudson acknowledges that he has AIDS and dies later that year. Indiana teenager, Ryan White, has been prohibited from attending school and advocates against discrimination of AIDS patients. The FDA (Food and Drug Administration) approves the first HIV antibody test. Screening for HIV in blood donations and blood products begins in the U.S.

· 1987: The World Health Organization (WHO) establishes the Special Programme on AIDS, later called the Global Programme on AIDS, then UNAIDS. The FDA approves the first antiretroviral medication, zidovudine (AZT), as an AIDS treatment. The AIDS Memorial Quilt is displayed on the National Mall in Washington, DC.

Prevention:

There are treatments for AIDS, and such medications can slow the natural course of the disease. However, there currently is no vaccine or cure. The antiretroviral treatments reduce both the mortality and morbidity of an HIV infection. AIDS is difficult to treat, so the best way to control the epidemic is by focusing on ways to prevent infection. Health organizations throughout the world are promoting safe sex practices, needle exchange programs, and blood donation screening programs as ways to control the spread of the AIDS epidemic.

Many health experts believe that only an HIV vaccine will stop the AIDS pandemic because vaccines cost less to produce, are affordable for developing countries eliminating the need for costly daily treatments. Sadly, after thirty years of research, the HIV vaccine remains stubbornly elusive.