Is the HIV pandemic over

The first case of AIDS was described in 1981 when the U.S. Centres for Disease Control and Prevention reported unusual clusters of Pneumocystis pneumonia (PCP) among homosexual men in Los Angeles. During the early years there was no effective treatment. In 1983, scientists at the Pasteur Institute in Paris discovered a retrovirus, later named Human Immunodeficiency Virus (HIV), as the causative agent of AIDS. This discovery led to the introduction of diagnostic tests and paved the way for drug discoveries. The first antiretroviral drug, zidovudine (Azidothymidine or AZT) was approved in 1987. The introduction of combination antiretroviral therapy (cART) in the mid 1990s, using three antiretroviral drugs in combination effectively suppressed the virus, improving the quality of life and extending survival for many individuals. HIV-related mortality rates climbed steadily through the 1980s and peaked in 1995, but have dropped gradually due to the introduction of ART. Today, individuals living with HIV who adhere to ART can achieve an undetectable viral load, meaning the level of HIV in the blood being so low it cannot be detected by standard tests. This not only improves health outcomes and long term survival but also means the virus cannot be sexually transmitted – a concept known as “undetectable equals untransmissible or U = U.” Despite many advances HIV pandemic is not over. In 2023, the global number of people living with HIV was 39.9 million compared to 27.2 million in 2000. There is still a need to increase public awareness, healthcare inequalities exist, stigma and social barriers are still present in many places, and there are also economic and political factors in some parts of the world. To end the HIV pandemic, a multi-pronged approach is required.