Timeline of HIV/AIDS Epidemic (Source: Kaiser Family Foundation, unless otherwise noted)

Transcription

1 Timeline of HIV/AIDS Epidemic (Source: Kaiser Family Foundation, unless otherwise noted) 1980: A Los Angeles doctor examined a young man with a severe yeast infection in his throat. A count of the T4-Helper cells in the man's immune system revealed there were none. 1981: A baby in New York City who was given a series of blood transfusions, sickened quickly and died. Report from the U.S. Centers for Disease Control and Prevention (CDC) stated that from Oct 1980-May 1981: Five young, previously healthy homosexual men in Southern California were treated for pneumocystis carinii pneumonia (PCP), a protozoan-produced condition that occurs almost exclusively in persons with severely suppressed or defective immune systems. Federal officials noted that rarely prescribed drugs (Bactrim and Septra) for the treatment of PCP were being dispensed more often. (Morbidity and Mortality Weekly Report (MMWR) 1-2) Reports from New York City and San Francisco stated that from : Twenty six young to middle aged homosexual men had been diagnosed with Kaposi's sarcoma (KS), a rare cancer in this country occurring primarily in elderly men and immunosuppressed transplant recipients. (MMWR, 2-4) The first heterosexual immunosuppressed patients, including the first woman, were reported by the CDC. (MMWR, 5) 1982: Some researchers designated this new disease with the acronym GRID (Gay Related Immune Deficiency) despite the fact that the CDC reported there were known cases of heterosexual transmission. Doctors concluded that a hemophiliac patient who died of PCP became immune suppressed because of infection derived from Factor VIII, the clotting factor. Hemophiliacs were identified as a "high risk group." CDC adopted AIDS (Acquired Immune Deficiency Syndrome) as the official name of the new disease.

2 Gay Men s Health Crisis, the first community-based AIDS service provider in the U.S., established in New York City. 1983: A Public Health Service interagency report indicated that homosexual men with multiple sexual partners, users of intravenous drugs, Haitians who had recently immigrated to the U.S. and hemophiliacs were at increased risk of getting AIDS. It also stated that unexplained immune deficiency and opportunistic infections were being seen in the female sexual partners of bisexual men and of men who used intravenous drugs. Children born to these women were also experiencing serious immune related illness. This report hypothesized for the first time that the cases shared exposure to an unknown transmissible agent (perhaps similar to that of hepatitis B infection), a sexually transmitted and blood-borne microbe. Following birth of a baby girl with HIV infection, the CDC confirmed that perinatal HIV transmission was possible from infected mother to child. 1984: Thirty cases of AIDS were confirmed as having been caused by HIV infected blood transfusions. Dr. Robert Gallo of the United States identifies HIV as the cause of AIDS. CDC states that abstention from intravenous drug use and reduction of needle-sharing should also be effective in prevention transmission of the virus. Blood testing procedures were developed for the detection of HIV antibodies. The first HIV infection was detected in Thailand which eventually would have one of the world's worst infection rates attributable to its thriving international sex industry. 1985: The American Red Cross acknowledged that about one in 500 blood donors is infected with HIV, suggesting there could be thousands of people who received HIV infected blood. In the US, all donated blood began to be screened for antibodies to the virus. Two laboratory procedures, the ELISA (Enzyme-Linked Immunosorbent Assay) Test and the Western Blot Test, began to be used to detect HIV antibodies.

3 Another new retrovirus causing AIDS-like symptoms was isolated. It was called HIV-2 and was found specifically in West Africa. HIV-2 is similar in structure to HIV, the agent thought to cause most of the AIDS cases in Central Africa and other regions of the world. Cases thought to be caused by HIV-2 had a substantially lower risk of developing lethal symptoms of AIDS. First International AIDS Conference held in Atlanta. Hosted by U.S. Department of Health and Human Services (DHHS) and the World Health Organization (WHO). 1986: Ryan White, a 13 year old hemophiliac with AIDS who had been barred from attending school since September 1985, was allowed to return to classes. Opposition to his attendance slowly ended. Data suggested that the human response to the virus was broader than previously thought. Stages of HIV disease are identified: viral infection without clinical symptoms (HIV+ asymptomatic), some AIDS-related symptoms (HIV+ symptomatic), and diagnosis of one or more life-threatening, opportunistic infections such as KS or PCP, resulting in a clinical diagnosis of AIDS (Diagnosed AIDS). New studies showed that in adults, a clinical diagnosis of AIDS usually occurred more than two years after the initial infection and could develop more than five years later. 1987: The United Church Board for Homeland Ministries (UCBHM), the UCC Office for Church in Society (OCIS) and the UCC Council for Health and Human Service Ministries (CHHSM) collaborated with one another to form UCAN, a loosely formed network within the UCC. Azidothymidine (AZT), trade-named "Retrovir," was approved by the Federal Drug Administration despite limited evidence of its safety and efficacy. Its manufacturer, Burroughs Wellcome, set the price at $10, per year, making AZT the most expensive drug in history and the only drug approved for treatment of AIDS. By Executive Order, President Ronald Reagan established the Presidential Commission on the Human Immunodeficiency Virus Epidemic and named to it 13 individuals who, by their own admission, knew nothing about AIDS. A year later, they presented the President with a report containing nearly 600 recommendations. The Names Project AIDS Memorial Quilt, comprised of 1,900 panels, each memorializing a person who died from AIDS, was displayed for the first time on the mall in Washington, DC.

4 U.S. FDA adds HIV prevention as a new indication for male condoms. 1988: A rise in drug-resistant tuberculosis among AIDS patients was reported for the first time. The U.S. Surgeon General's Report on AIDS was sent to every American household. The World Health Organization estimated 5 to 10 million people worldwide had HIV infection. Nearly 1100 cases of pediatric AIDS (AIDS diagnosis in children under 13 years of age) had been reported in the U.S. Intravenous drug use in the U.S. was identified as the major cause of HIV transmission among heterosexual women and men and of perinatal HIV transmission as well. The National Academy of Sciences and the Institute of Medicine estimated that the direct annual cost of caring for AIDS patients would rise to more than $10 billion by Congress adopted legislation creating the National Commission on Acquired Immune Deficiency Syndrome, comprised of 15 members -- 5 appointed by the President (three were administration officials who were non-voting members), 5 each appointed by the leadership of the U.S. House of Representatives and the U.S. Senate. The Commission's life was extended until September 1993, at which time it issued a final report, supplementing interim reports it had issued on a variety of topics. It made a cumulative total of 30 comprehensive recommendations. 1989: In January 1989, the United Church Board for Homeland Ministries (UCBHM), the UCC Office for Church in Society (OCIS) and the UCC Council for Health and Human Service Ministries (CHHSM) co-sponsored a UCC AIDS Ministry Consultation attended by 33 UCC clergy and lay members with extensive, firsthand experience in HIV and AIDS ministry. The group included persons with HIV and AIDS, family members, pastors, counselors, AIDS service providers, educators and chaplains with rural, suburban and urban perspectives. The Consultation was initiated under the inspired leadership of the Rev. Dr. William R. "Bill" Johnson, UCBHM Secretary for AIDS Programs and Ministries Coordination. A Consultation report entitled, AIDS, Where We Live, set forth the Consultation's recommendations to the whole church and was sent to UCC Executives and Conference Ministers. One thousand copies of the report were also distributed at the UCC's 17th General Synod meeting in Fort Worth, Texas (June 1989).

5 The other important outcome from the Consultation was the creation of the United Church of Christ AIDS/HIV Network (UCAN), which participants in the Consultation had covenanted together to do. An Ad Hoc Leadership Team was formed whose primary task was to review the report of the Consultation and oversee UCAN preparations for GS17, including preparation of two General Synod resolutions called for by the Consultation. The CDC reported that although the number of new AIDS cases continued to rise, the rate of increase had slowed. The new finding was attributed to the effectiveness of AZT in delaying the onset of opportunistic infections that resulted in an AIDS diagnosis. AZT was approved for use by children with AIDS. 1990: Ryan White died of AIDS. His death spurred a U.S. Congressional movement to provide increased funds to cities hardest hit by AIDS through the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. In the first year, it is funded at $220.5 million. Among teenagers who applied for military service between 1985 and 1989, three out of every 10,000 tested positive for HIV. Among African-American teens, the infection rate was one in 1,000. U.S. House of Representatives passes the Americans With Disabilities Act to protect the civil liberties of persons with disabilities, including people living with HIV/AIDS. David Acer, a dentist who infected several of his patients with HIV, died of AIDS. Over several years, this aberrant case provokes irrational demands for widespread HIV antibody testing of health-care workers. 1991: The CDC reported that more than 20% of persons reported with AIDS were in their 20s, suggesting that, given a period of 10 years or more between infection and the onset of symptoms, the majority of these people were probably infected with HIV during their teenage years. The CDC announced revision of its definition of AIDS, effective January 1, The new definition allowed doctors to make an AIDS diagnosis for any HIV+ person whose T-cell level dropped to 200 or fewer T-cells per cubic millimeter of blood. The Federal Drug Administration approved a second anti-aids drug, Dideoxyinosine (DDI).

6 Professional basketball superstar, Magic Johnson, announces that he is HIV-positive. The World Health Organization announces that 60% of the world's estimated AIDS cases are in Africa, which has 12% of the world's population. According to WHO, there are 92,457 AIDS cases in Africa and an estimated 7 million Africans are infected with HIV. Up to 10 million African children could be orphaned by AIDS by the year : Wisconsin Pharmacal Co. sought approval from the U.S. Food and Drug Administration to market a condom for females. The pouch-shaped, 7 inch long device made of lubricated polyurethane contains two flexible rings, one of which fits inside the vagina like a diaphragm, anchoring the sheath, while the other remains outside the body. A third anti-aids drug, Dideoxycytidine (DDC), was approved by the FDA for use against AIDS in combination with AZT. AIDS becomes number one cause of death for U.S. men ages FDA licenses first rapid HIV test, which provides results in as little as ten minutes. 1993: Affirming Persons, Saving Lives (APSL) was created, a groundbreaking curriculum for AIDS awareness and prevention education. In that same year, UCAN received the National AIDS Interfaith Network's Special Award for Outstanding Curriculum Development for APSL. At the Ninth International Conference on AIDS, held in Berlin, Dr. Michael H. Merson, director of the World Health Organization AIDS Programme, announced 14 million people are infected with HIV. President Clinton signs HIV immigration exclusion policy into law. The Social Security Administration issued new guidelines regarding disability benefits for persons living with HIV infection. The new regulations contained an updated listing of HIV-related illnesses, including those unique to HIV infected women and children, and new procedures to ensure presumptive disability payments for persons living with HIV infection. President Clinton establishes White House Office of National AIDS Policy (ONAP). 1994: AIDS becomes leading cause of death for all Americans ages 24 to 44; remains so through 1995.

7 U.S. FDA approves an oral HIV test, the first non-blood based antibody test for HIV. 1995: President Clinton establishes Presidential Advisory Council on HIV/AIDS (PACHA). First protease inhibitor, saquinavir, approved in record time by the U.S. FDA, ushering in new era of highly active antiretroviral therapy (HAART). First National HIV Testing Day created by the National Association of People with AIDS. 1996: Joint United Nations Programme on HIV/AIDS (UNAIDS) begins operations; established to advocate for global action on the epidemic, and to coordinate HIV/AIDS efforts across the UN system. The number of new AIDS cases diagnosed in the U.S. declines for first time in history of epidemic, though experience varies by sex, race and ethnicity. U.S. Congress reauthorized the Ryan White CARE Act. HIV no longer leading cause of death for all Americans ages 25-44; remains leading cause of death for African Americans in this age group. 1997: AIDS-related deaths in the U.S. decline by more than 40 percent compared to the prior year, largely due to HAART. 1998: Minority AIDS Initiative created in U.S., after African American leaders declare a state of emergency and Congressional Black Caucus (CBC) calls on the Department of Health and Human Services to do the same. U.S. Department of Health and Human Services Secretary Shalala determines that needle exchange programs are effective and do not encourage the use of illegal drugs, but Clinton Administration does not lift the ban on use of federal funds for such purposes. First large scale human trials (Phase III) for an HIV vaccine begin. 2000: U.S. Congress reauthorized the Ryan White CARE Act for the second time.

8 U.S. CDC reports that, among men who have sex with men in the U.S., African American and Latino cases exceed those among whites. 2001: At General Synod 23 (Kansas City, MO), a resolution entitled, "The Epidemic of Acquired Immune Deficiency Syndrome on the Continent of Africa," was passed. This resolution recommended information-sharing with local churches, Associations, and Conferences on how the United Church of Christ is responding to the AIDS crisis in Africa and how these groups may further assist this response. It also encouraged advocacy and support for those affected by HIV and AIDS in Africa, and called for meaningful and prayerful dialogue concerning HIV and AIDS with our partner churches on the African continent. United Nations General Assembly convenes first ever special session on AIDS, UNGASS June 5 marks 20 years since first AIDS case reported. Newly appointed U.S. Secretary of State, Colin Powell, reaffirms U.S. statement that HIV/AIDS is a national security threat. 2002: HIV is leading cause of death worldwide, among those aged Approval of OraQuick Rapid HIV-1 Antibody Test, by U.S. FDA; first rapid test to use finger prick. OraQuick granted a Clinical Laboratory Improvement Amendments (CLIA) waiver in 2003, enabling the test to be performed outside of the laboratory, allowing more widespread use. 2003: President Bush announces PEPFAR, the President s Emergency Plan for AIDS Relief, during the State of the Union Address; PEPFAR is a five-year, $15 billion initiative to address HIV/AIDS, tuberculosis, and malaria primarily in hard hit countries. 3 by 5 Initiative announced by World Health Organization, to bring treatment to 3 million people by : Leaders of the Group of Eight (G8) nations call for creation of Global HIV Vaccine Enterprise, a consortium of government and private sector groups designed to coordinate and accelerate research efforts to find an effective HIV vaccine.

9 OraQuick Rapid HIV-1 Antibody Test approved for use with oral fluid by U.S. FDA. Oral fluid rapid test is granted a CLIA waiver. 2005: UCAN recommitted itself to promote awareness and offer technical assistance to racial/ethnic minority constituencies throughout the country, who are now among the highest risk group for HIV transmission. 2006: June 5 marks a quarter century since first AIDS case reported. U.S. Congress reauthorizes the Ryan White CARE Act for the third time. U.S. Centers for Disease Control and Prevention releases revised HIV testing recommendations for health-care settings, recommending routine HIV screening for all adults, aged 13-64, and yearly screening for those at high risk. 2007: President Bush calls on Congress to reauthorize PEPFAR at $30 billion over 5 years (White House Press Release) In order to continue to increase UCAN s capacity in the most effective ways, the Wider Church Ministries Board of Directors approved a proposal to create a new 501(c)(3) for UCAN. 2008: UCAN Inc. acquired its own IRS 501(c)(3) status, in order to more effectively and efficiently carry out its mission, yet also maintain strong service ties to UCC's global community. In June 2008, UCAN demonstrated their commitment to the use of culturally/linguistically appropriate resources by publishing a Spanish language version of their HIV education cards, "Why Use Condoms". 2009: At the 27th General Synod, a Resolution Calling for Comprehensive HIV Prevention in Church and Society was overwhelmingly passed. President Obama signed the Ryan White HIV/AIDS Treatment Extension Act of 2009, which is the fourth reauthorization of the Ryan White CARE Act.

10 President Obama also announced that he would be lifting the ban which prohibits HIVpositive people from entering the United States without a waiver. The policy change took effect January 4, 2010.