What Is The ‘four
In 1983, the Centers for Disease Control in the United States listed the main at-risk groups, including partners of people with AIDS, people who inject drugs, haemophiliacs and people who have recently been to Haiti. At the time that cases of AIDS began to emerge in the USA, the absence of definitive information about HIV and its link to AIDS, inflated the panic and stigma surrounding the epidemic. Before long people began to talk colloquially of a 4-H Club at risk of AIDS: homosexuals, haemophiliacs, heroin addicts and Haitians, contributing to further stigmatisation.21
When And Where Did Hiv Start In Humans
Studies of some of the earliest known samples of HIV provide clues about when it first appeared in humans and how it evolved. The first verified case of HIV is from a blood sample taken in 1959 from a man living in what is now Kinshasa in the Democratic Republic of Congo. The sample was retrospectively analysed and HIV detected. There are numerous earlier cases where patterns of deaths from common opportunistic infections, now known to be AIDS-defining, suggest that HIV was the cause, but this is the earliest incident where a blood sample can verify infection.9
Activism By Aids Patients And Families
Also in 1982, Michael Callen and Richard Berkowitz published How to Have Sex in an Epidemic: One Approach. In this short work, they described ways gay men could be sexual and affectionate while dramatically reducing the risk of contracting or spreading HIV. Both authors were themselves gay men living with AIDS. This booklet was one of the first times men were advised to use condoms when having sexual relations with other men.
At the beginning of the AIDS epidemic in the 1980s, there was very little information about the disease. Also, because AIDS affected stigmatized groups, such as LGBTQ and people of low socioeconomic status, there wasn’t much mass media coverage initially when the epidemic started. However, with the rise of activist groups composed of people suffering from AIDS, either directly or through a loved one, more public attention was brought to the epidemic.
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Origin Of Aids Linked To Colonial Practices In Africa
Monday marks the 25th anniversary of the first report of AIDS. But only recently have scientists come to conclusions about where HIV came from. The current thinking is that the colonial horrors of mid-20th-century Africa allowed the virus to jump from chimpanzees to humans and become established in human populations around 1930. But there is still uncertainty as to why AIDS was first discovered in Los Angeles and New York, and not Cameroon, where scientists say it surely started.
LIANE HANSEN, host:
Twenty-five years ago tomorrow, doctors in Los Angeles first reported cases of what turned out to be the global catastrophe we now know as AIDS. Since then, 55 million people have been infected with the AIDS virus, and it kills around 8,000 people a day.
In the days surrounding the anniversary, NPR is broadcasting a number of stories about AIDS and its effect around the world. Today we examine its origins. Scientists, politicians, and conspiracy theorists have debated for years where AIDS began. Recently, researchers found the missing link: the immediate ancestor of the Human Immunodeficiency Virus.
NPR’s Richard Knox reports that the discovery clarifies the story of how a chimpanzee virus touched off the deadliest pandemic since the Middle Ages.
RICHARD KNOX reporting:
Prof. MOORE: For me, as a comparative primatologist, the more interesting question is why didn’t it happen sooner?
KNOX: With unsterilized syringes.
KNOX: And maybe dozens of others.
Canadian Flight Attendant Theory
A Canadian airline steward named Gaëtan Dugas was referred to as “Case 057” and later “Patient O” with the alphabet letter “O” standing for “outside Southern California”, in an early AIDS study by Dr. William Darrow of the Centers for Disease Control. Because of this, many people had considered Dugas to be responsible for taking HIV to North America. However, HIV reached New York City around 1971 while Dugas did not start work at Air Canada until 1974. In Randy Shilts‘ 1987 book And the Band Played On , Dugas is referred to as AIDS’s Patient Zero instead of “Patient O”, but neither the book nor the movie states that he had been the first to bring the virus to North America. He was incorrectly called “Patient Zero” because at least 40 of the 248 people known to be infected by HIV in 1983 had had sex with him, or with a person who had sexual intercourse with Dugas.
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Aids: Origin Of Pandemic ‘was 1920s Kinshasa’
Health editor, BBC News website
The origin of the Aids pandemic has been traced to the 1920s in the city of Kinshasa, in what is now the Democratic Republic of Congo, scientists say.
An international team of scientists say a “perfect storm” of population growth, sex and railways allowed HIV to spread.
A feat of viral archaeology was used to find the pandemic’s origin, the team report in the journal Science.
They used archived samples of HIV’s genetic code to trace its source, with evidence pointing to 1920s Kinshasa.
Their report says a roaring sex trade, rapid population growth and unsterilised needles used in health clinics probably spread the virus.
Meanwhile Belgium-backed railways had one million people flowing through the city each year, taking the virus to neighbouring regions.
Experts said it was a fascinating insight into the start of the pandemic.
HIV came to global attention in the 1980s and has infected nearly 75 million people.
It has a much longer history in Africa, but where the pandemic started has remained the source of considerable debate.
Are There Other Theories About How The Virus Could Have Gotten Into Humans
There are several competing theories, ranging from implausible conspiracies to arguments grounded in extensive research. The best-known of the latter, the “OPV/AIDS” theory, was exhaustively detailed in the 1999 book The River, by author Edward Hooper. As many as a million Africans were given oral polio vaccines between 1957 and 1960. Hooper says witnesses have told him that a few batches of those vaccines were “grown” in chimp cells at a lab in Kisangani, a city in the Democratic Republic of the Congo — and that the chimp cells, and thus the vaccines, could have contained SIVs that jumped into humans. “There are highly significant correlations between the places where this vaccine was administered and the places where â¦ AIDS first appeared on the planet four to 20 years later,” Hooper says.
The majority of HIV researchers subscribe to the bushmeat theory and raise several arguments against the OPV theory. Hahn’s recent research confirming that HIV-1 M and N arose from Pan troglodytes troglodytes chimps in Cameroon presents one problem: The Kisangani lab is in the Democratic Republic of the Congo, and it’s home to a different subspecies of chimp than the one that was the source of HIV-1 M and N. However, it is possible that the chimps used in the Kisangani experiments were not from the area. In the spring of 2006, Hooper found a paper indicating that at least one of eight chimps at the Kisangani lab was a Pan troglodytes troglodytes.
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Natural History Of Sivcpz Infection
Initially, SIVcpz was thought to be harmless for its natural host. This was because none of the few captive apes that were naturally SIVcpz infected suffered from overt immunodeficiency, although in retrospect this conclusion was based on the immunological and virological analyses of only a single naturally infected chimpanzee . In addition, SIV-infected sooty mangabeys and African green monkeys showed no sign of disease despite high viral loads in blood and lymphatic tissues , leading to the belief that all naturally occurring SIV infections are nonpathogenic. However, the sporadic prevalence of SIVcpz, along with its more recent monkey origin, suggested that its natural history might differ from that of other primate lentiviruses. To address this, a prospective study was initiated in Gombe National Park, Tanzania, the only field site where SIVcpz infected chimpanzees are habituated and so can be observed in their natural habitat.
Where We Are Now: 2000
Since 2000, additional factors have begun contribute to the the global spread of HIV. Heroin addiction in Asia has been on the rise, which brought with it dirty needles and the risk of new infections. India suffered with over 2 million diagnoses alone, in spite of the government’s refusal to admit the epidemic had adversely affected the nation.
The WHO released its comprehensive report examining HIV and AIDS in all of its 25-year history in 2010. This report had good news for developed nations: by 2008, the U.S. domestic HIV infection rate was considered effectively stable, and has remained so to this day. The report also demonstrated that while insistent public awareness campaigns about safe sex and other methods of transmission had slowed the rate of HIV infection in developed countries, there was much to be done elsewhere.
Global Education and Aid Efforts
Under President Bush, the U.S. committed funds to help African countries, but the funds were mismanaged and the spread of HIV continued unabated. Of the 4.1 million cases in sub-Saharan Africa then, only 1% received the available drugs. This led to the WHO’s declaration of the failure to treat the 6 million AIDS patients living in developing nations as a global public health emergency.
HIV Denialism Disrupts Aid
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Impact Across The Country
- Although HIV has been reported in all 50 states, the District of Columbia, and U.S. dependencies, the impact of the epidemic is not uniformly distributed.
- Ten states accounted for about two-thirds of HIV diagnoses among adults and adolescents in 2019 .31 Regionally, the South accounted for more than half of HIV diagnoses in 2019.32
- Rates of HIV diagnoses per 100,000 provide a different measure of the epidemicâs impact, since they reflect the concentration of diagnoses after accounting for differences in population size across states. The District of Columbia has the highest rate in the nation, compared to states, nearly 3 times the national rate and Georgia was the state with highest rate , twice that of the national rate.33,34 Nine of the top 10 states by rate are in the South.35
- New HIV diagnoses are concentrated primarily in large U.S. metropolitan areas , with Miami, Orlando, and Atlanta topping the list of the areas most heavily burdened.36
|Table 1: Top Ten States/Areas by Number and Rate of New HIV Diagnoses , 2019|
|CDC. HIV Surveillance Report, Diagnoses of HIV Infection in the United States and Dependent Areas, 2019 vol. 32. May 2021.|
For Three Decades Newyork
When Drs. Peter Gordon and Samuel Merrick began treating patients at NewYork-Presbyterians first HIV clinics nearly three decades ago, medicines werent effective and people with advanced AIDS were almost certain to die.
The people I cared for in the early 1990s, most of them passed, says Dr. Gordon. Back then, there was little expectation of survival, but you could hopefully improve the quality of the time they had left.
Fast-forward to today. If youre diagnosed with HIV as a 22-year-old and take medicine to control the virus, you can expect to live a near normal life span.
That is a great leap forward in a relatively short time, but HIV still poses a threat around the world. In 2018, 37.9 million people were living with HIV and an estimated 770,000 died of AIDS-related illnesses, according to the Centers for Disease Control and Prevention. And while theres still no vaccine or cure, in just a few decades HIV has gone from a virtual death sentence to a manageable, chronic disease in the United States and most developed countries. Today, New York state is aggressively working to curb new infections, with the number of new HIV diagnoses hitting a record low.
Im optimistic that we can end the epidemic in New York state in the next few years, Dr. Merrick says.
Today, these NewYork-Presbyterian HIV clinics have provided care for three decades, from the earliest days of the AIDS epidemic. And Drs. Gordon and Merrick were there almost from the start.
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The Patient Zero Myth
For decades, a French-Canadian airline employee named Gaetan Dugas, has been known as Patient Zero in the 1980s AIDS epidemic.
Dugas, a man who had sex with men , died in 1984. Since then he has been blamed by some as a primary source for the spread of HIV in North America.
Dugas was one of the primary villains in the 1987 book, And the Band Played On, by San Francisco journalist Randy Shilts.
However, the researchers now say Dugas was falsely accused and unfairly blamed.
Gaetan Dugas is one of the most demonized patients in history, and one of a long line of individuals and groups vilified in the belief that they somehow fueled epidemics with malicious intent, said Richard McKay, D.Phil., a Wellcome Trust Research Fellow in Cambridges Department of History and Philosophy of Science, in a press release.
In fact, McKay says, Dugas actually provided scientists with valuable information before he died.
Dugas told researchers after he contracted HIV that he had 750 sexual partners the previous three years. That wasnt necessarily an unusual number. Researchers said 65 percent of men in a Los Angeles cluster study at the time reported having more than 1,000 sexual partners in their lifetimes.
Much of that sexual connection was with anonymous partners, so many HIV patients couldnt give medical officials any names.
However, McKay says, Dugas provided medical officials with 72 names. That helped scientists track down a wide range of people infected with HIV.
Where Did Aids Come From
Scientists have traced the origin of HIV back to chimpanzees and simian immunodeficiency virus , an HIV-like virus that attacks the immune system of monkeys and apes.
In 1999, researchers identified a strain of chimpanzee SIV called SIVcpz, which was nearly identical to HIV. Chimps, the scientist later discovered, hunt and eat two smaller species of monkeysred-capped mangabeys and greater spot-nosed monkeysthat carry and infect the chimps with two strains of SIV. These two strains likely combined to form SIVcpz, which can spread between chimpanzees and humans.
SIVcpz likely jumped to humans when hunters in Africa ate infected chimps, or the chimps infected blood got into the cuts or wounds of hunters. Researchers believe the first transmission of SIV to HIV in humans that then led to the global pandemic occurred in 1920 in Kinshasa, the capital and largest city in the Democratic Republic of Congo.
The virus spread may have spread from Kinshasa along infrastructure routes via migrants and the sex trade.
In the 1960s, HIV spread from Africa to Haiti and the Caribbean when Haitian professionals in the colonial Democratic Republic of Congo returned home. The virus then moved from the Caribbean to New York City around 1970 and then to San Francisco later in the decade.
International travel from the United States helped the virus spread across the rest of the globe.
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The Development Of Research Treatment And Prevention
Azidothymidine, also known as zidovudine, was introduced in 1987 as the first treatment for HIV. Scientists also developed treatments to reduce mother to child transmission.
In 1997, highly active antiretroviral therapy became the new treatment standard. It caused a 47 percent decline in death rates.
The Food and Drug Administration approved the first rapid HIV diagnostic test kit in November 2002. The test kit allowed hospitals to provide results with 99.6 percent accuracy in 20 minutes.
Also in 2003, the CDC reported that 40,000 new transmissions occurred each year. More than half of those transmissions came from people who didnt know they had contracted the virus. It was later discovered the number was closer to 56,300 people living with HIV. This number remains roughly the same since the late 1990s.
The World Health Organization set a goal to bring treatment to 3 million people by 2005. By 2010, about 5.25 million people had treatment, and 1.2 million people would start treatment.
So Scientists Have Estimated When And Where The Most Deadly Type Of Hiv Started Infecting Humans
Most AIDS researchers believe that the “bushmeat trade” allowed the HIV-1 virus, and separately HIV-2, to enter the human bloodstream several times. Hunters who kill and butcher chimps and monkeys are regularly exposed to animal blood teeming with SIVs. If the hunters have cuts, bites, or scratches — and given the nature of their work they almost always do — they can catch the viruses from their prey. Hunters going after chimps in Cameroon could have caught the first strains of HIV-1. Sooty mangabeys, hunted and kept as pets in West Africa, could have transmitted HIV-2 to humans.
Africans have hunted chimps and monkeys and kept them as pets for centuries they’ve presumably been exposed to SIVs during most of that time. But the conditions needed for HIV to spread widely weren’t in place until after the continent was colonized and urbanized. The first victims would have found it easier to unwittingly spread the virus to sexual partners far and wide as roads and vehicles started connecting previously isolated villages and cities. Hospitals may have played a role, too. Strapped for cash, some of them probably re-used dirty needles, unknowingly infecting patients in the process.
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