The 1980’s HIV and AIDS Epidemic

By: Christian Porcu, PharmD Candidate c/o 2024 and John Ortiz, PharmD Candidate c/o 2025

Human immunodeficiency virus (HIV) impairs immune cells, leaving patients with an increased susceptibility to opportunistic infections and other illnesses. HIV is transmitted through an exchange of bodily fluids, most often through unprotected sex or sharing drug injection equipment.¹ The first stage of HIV infection is known as acute HIV infection. This first stage persists anywhere from a few days to several weeks. Two-thirds of people with acute HIV infection experience flu-like symptoms, such as swollen lymph nodes, ulcers, and fever. In the second stage of infection, known as clinical latency, HIV can multiply at low levels, present asymptomatic, and remain dormant for 10 to 15 years. If not treated, the virus will progress to the third and most advanced stage of HIV infection, acquired immunodeficiency syndrome (AIDS). Some presentable symptoms include rapid weight loss, diarrhea, and memory loss. Those with AIDS have an average life expectancy of about three years and a high viral load of HIV ribonucleic acid (RNA), making them highly contagious.^1,2 Although the body is unable to eliminate HIV on its own, patients can take antiretroviral therapy (ART) to decrease the viral load of HIV RNA to undetectable levels, virtually nullifying the transmission of HIV.¹

ART was not always accessible to all patient populations. However, thanks to the efforts of activists, access to therapy was accelerated and became more available to those in need. The AIDS Coalition to Unleash Power (ACT UP) was a prominent activist organization  founded by Larry Kramer on March 12, 1987. It served as the forefront of advocacy for the HIV and AIDS epidemic and was primarily composed of young LGBTQ+ and/or HIV-infected members.^3,4 True to their name, ACT UP was a radical and passionate organization that effectively raised awareness through confrontational demonstrations.³ Their presence pressured drug companies, government agencies, and others to prioritize the treatment of AIDS. Zidovudine (AZT) became the first drug indicated for AIDS with approval from the Food and Drug Administration on March 19, 1987, just a week after ACT UP’s foundation. In the same year, Ronald Reagan signed an Executive Order for the first Presidential Commission on AIDS and publicly addressed AIDS after years of silence. The American Medical Association even declared that the medical care of patients with AIDS is an ethical obligation of healthcare professionals.⁴  

However, these staggering developments were not without pitfalls. According to a 2018 study on the effects of AIDS activism on ACT UP members active during its peak years, 17% of respondents were consistent with an approximate diagnosis of post-traumatic stress disorder (PTSD), with depression prevalent among those with consistent PTSD symptoms. Those with depression and PTSD also experienced a higher incidence of AIDS survivor syndrome, manifesting as anger, anxiety, and hopelessness. The respondents credit the movement for giving them a sense of community and camaraderie. Along with personal growth, they recounted how the experience gave them a network that empowered them to exercise their agency and regain control in a situation they felt powerless in.³

Although the HIV and AIDS epidemic had a slow start in establishing appropriate healthcare, the efforts and sacrifices made by activists, alongside the progress made in drug development, expedited the public’s access to treatment, sufficiently suppressing the virus and preventing increasing rates of death from HIV infection. Rather than yielding for the consequences of HIV, young people afflicted with this life-threatening disease mobilized to fight for change, and their impact still resonates to this day.

References

1. What are HIV and AIDS? HIV.gov. https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids. Published June 15, 2020. Last Updated January 13, 2023.
2. About HIV/AIDS. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/whatishiv.html. Published June 1, 2021.
3. Rabkin JG, McElhiney MC, Harrington M, Horn T. Trauma and Growth: Impact of AIDS Activism. AIDS Research and Treatment. 2018;2018:1-11. doi:10.1155/2018/9696725.
4. A Timeline of HIV and AIDS. HIV.gov. https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline#year-1987.