Scientists believe that the human immunodeficiency virus (HIV) originated in chimpanzees and gorillas in West Africa. The virus is thought to have been transmitted to humans through the hunting and consumption of these animals, specifically through the transfer of blood. It is believed that the first known cases of HIV occurred in the 1930s in the Democratic Republic of Congo. The virus then spread through Africa and eventually to other parts of the world, leading to the global HIV/AIDS epidemic we know today.
The Beginning of the AIDS Epidemic
In the early 1980s, a cluster of rare illnesses including pneumonia, cancer, and other infections were observed among young gay men in the US. These cases led to the initial name for the disease, Gay-Related Immune Deficiency (GRID). However, cases were also reported among injection drug users by the end of 1981.
1982 was a significant year for the understanding of HIV and AIDS. GRID was officially renamed Acquired Immune Deficiency Syndrome (AIDS), and researchers discovered that it was caused by the human immunodeficiency virus (HIV). It was also understood that HIV could be transmitted through sexual activity. Canada reported its first case of AIDS in March 1982, although later research identified that Canada's first case likely occurred in 1979. Cases of AIDS were also reported among people with hemophilia and blood transfusion recipients. By 1983, it was understood that people of all genders could become infected with HIV.
The Late 1980s
In 1987, Azidothymidine (AZT) was approved as the first treatment for HIV. It is an antiretroviral drug that is used in combination with other anti-HIV medications to slow the progression of the virus but not cure it. AZT works by blocking enzymes that HIV needs to replicate, thereby preventing the virus from getting worse. At the time, AZT was a major breakthrough in the fight against HIV/AIDS, but it also had some severe side effects, particularly with long-term use.
The 1990s
By 1990, it was estimated that 8-10 million people worldwide were living with HIV. AIDS was a leading cause of death, particularly among young men. As the virus mutated and changed over time, the efficacy of AZT as a treatment began to decrease. New drugs such as Saquinavir and Nevirapine were developed, which worked similarly to AZT. The use of multiple drugs to treat HIV is known as Combination Therapy or Highly Active Antiretroviral Therapy (HAART).
HAART was effective in treating HIV, but it also required taking multiple medications and dealing with associated side effects. This can take a toll on a person's physical and mental well-being. To address this issue, drugs such as Combivir were introduced, which combined two antiretroviral drugs in one, making it easier for patients to take their medication.
The 2000s
In 2002, HIV became the leading cause of death worldwide for people between the ages of 15-59. In 2005, point-of-care testing for HIV was approved in Canada. This testing method quickly checks for HIV antibodies, which are present when a person is infected with HIV, and provides accurate results within 2 minutes.
The 2000s also saw the wider acceptance of Post-Exposure Prophylaxis (PEP), a treatment method first developed in the late 1990s. PEP is a set of three medications that can be taken after potential exposure to HIV to lower the risk of infection.
The 2010s
PrEP, which is short for Pre-Exposure Prophylaxis, is approved in 2012. This in an HIV prevention drug that lowers the risk of a person contracting the virus ahead of time. Check out our article on PrEP for more information. Truvada, a generic version of PrEP, is approved in Canada in 2017.
In 2016, the U=U campaign launched, to bring greater awareness to the fact that when someone living with HIV is on effective treatment, it will suppress the virus in their blood to a level that is too low to be measured by lab tests. This is called having an undetectable viral load. When someone living with HIV is on treatment and has an undetectable viral load, they can’t transmit HIV to their sexual partners. Their HIV is untransmittable. Undetectable = Untransmittable.
The 2020s
In 2020, Canada made history by becoming the first country to approve the use of the injectable HIV drug Cabenuva. This combination therapy, which consists of two anti-HIV drugs, can be administered by a medical professional every 1-2 months as part of an individualized treatment plan.
Additionally, in the same year, Health Canada also approved the INSTI HIV Self-Test, which allows individuals to conduct HIV testing in non-clinical settings.
The pharmaceutical industry is currently exploring the use of mRNA-based vaccines for the prevention of HIV, building on the success of mRNA vaccines in the fight against COVID-19.
However, despite these advancements in HIV testing and treatment, many individuals living with HIV still face significant barriers to accessing appropriate healthcare. These obstacles include legal issues, lack of coverage for costly treatments by insurance, and stigma from both community members and healthcare workers.