Chronological Evolution

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The Chronological Evolution of the HIV/AIDS Epidemic and Theories of Origin. (Discussion)

Discussion
Chronological Evolution
1981: The Discovery
The CDC reported the onset of PCP in June 1981 (De Cock et al., 2012). Five young gays had been diagnosed with this condition in Los Angeles. According to the CDC, all five patients manifested unusual infections, which denoted a dysfunctional immune system. Therefore, the CDC reported what later came to be termed the AIDS epidemic. On the same day, Dr. Alvin Friedman, a dermatologist from New York, also informed the CDC of “Kaposi’s Sarcoma (KS),” an unusual and rare form of aggressive cancer. Similar to PCP, the disease was prevalent among those with a compromised immune system. A day after the CDC publication, the organization received countrywide cases of a KS, PCP, and other opportunistic conditions in this population. On June 8, CDC formed a task force to investigate these opportunistic infections spreading across the US. This task force’s objective was to create a case definition and identify the risk factors contributing to these infections.
1982. First Case Definition of AIDS
In September, CDC coined the term “AIDS.” In the same publication, CDC provided its first case definition. According to this definition, “AIDS is a disease at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease” (“A timeline of HIV and AIDS,” 2020).
1983. Infection among Women
CDC held released another publication reporting the first AIDS cases among women (“History of HIV/AIDS,” 2017). According to this report, women with HIV positive men had exhibited immunodeficiency. Another CDC report released on March 4 indicated that most of the AIDS cases were reported among gays with multiple partners. Besides, the cases were also present among drug users who share needs, Hemophilia patients, and Haitians. The report further suggested that AIDS transmission occurred primarily through blood transfusion and sexual intercourse.
1986. Public Awareness
According to the CDC publication on January 16, there was an 89% increase in AIDS cases in 1985 compared to the previous year. The Institute of Medicine (IOM), on October 29, published a report on AIDS confrontation. The report called for mass public health, educational, and media campaign to deter the spread of HIV in populations. According to IOM estimates, this initiative would cost the government 2 billion dollars in patient care and research (“A timeline of HIV and AIDS,” 2020).
1987. The Approval of AZT, an Antiretroviral Drug
On March 19, the FDA approved zidovudine (AZT) for AIDS treatment. Scientists initially developed AZT for cancer treatment. Significantly, the FDA issued regulations for expanding access to this new medication. Thus, this regulation accelerated drug approval by three years (“A timeline of HIV and AIDS,” 2020).
1988. Worlds AIDS Day
Due to the global burden of this epidemic, the WHO marked December 1 as “World AIDS Day” (“A timeline of HIV and AIDS,” 2020). The United Nations also supported this initiative. The theme was to promote joint efforts in fighting the epidemic.
The 1990s Epidemic
The Red Ribbon Project, became the official global symbol of HIV/AIDS awareness in 1991. Moreover, estimates showed that more than 700,000 individuals in the Pacific and Asia had contracted the infection. As 1993 came to an end, official reports showed that there were 2.5 million HIV/AIDS cases globally (“A timeline of HIV and AIDS,” 2020). The Public Health Service, in August 1994, recommended the prevention of the transmission from mother-to-infant using AZT. The FDA, in December, licensed oral HIV testing. Therefore, this was the first non-invasive test.
In 1996, the UN adopted the “Joint United Nations Program on AIDS (UNAIDS)”. UNAIDS aimed at coordinating HIV/AIDS response and prompting a worldwide action on this epidemic. The FDA licensed Combivir for HIV treatment in 1997. UNAIDS revealed that more than 30 million people had the virus with daily infections amounting to 16,000. In 1999, the WHO stated that this infection was the top killer in Africa and the fourth leading cause of mortality. Approximately 33 million people had the disease, while 14 million had passed away since the onset of this epidemic (“History of HIV and AIDS overview,” 2019).
The Epidemic in the 2000s
UNAIDS engaged five pharmaceutical firms in July 2000 to decrease antiretroviral drugs’ prices to increase access in developing nations. The UN also came up with the Millennium Development Goals (MDGs) with a provision to avert the spread of TB, malaria, and HIV in September 2000 (“History of HIV and AIDS overview,” 2019). New studies indicated that male circumcision aided in reducing HIV transmission by 60% in 2006. Since this finding, UNAIDS and the WHO recommended and emphasized male circumcision in to prevent this infection (“History of HIV and AIDS overview,” 2019).
The Epidemic in the 2010s
Scientists noted success in the “CAPRISA 004 microbicide trial.” The treatment was fundamental in diminishing HIV risk among women by 40% in July 2010. The FDA licensed the use of PrEP for those without the virus to curb transmission through sexual intercourse in July 2012. In 2013, UNAIDS revealed a 30% decline in AIDS-related deaths. However, 35 million were infected. The UNAIDS, in September 2014, recommended a scale-up in treatment and prevention interventions to prevent 28 million new cases.
In September 2015, the WHO developed new guidelines that declared mandatory antiretroviral treatment irrespective of the CD4 count. UNAIDS revealed that 18.2 million people were on antiretroviral therapy in 2016. The figure comprised 0.9 million children. In 2017, more than 50% of those with the virus had access to antiretroviral therapy. Thus, this implied that 19.5 million people had access to this treatment (“History of HIV and AIDS overview,” 2019).
Theories of Origin
The Contaminated OPV Theory
Although scientists have refuted this theory, it is provocative and highly controversial. Edward Hooper coined this theory, having lived in Africa for five years since 1981 (Katrak, 2006). While working in Uganda, Hooper experienced an unusual infection where patients exhibited constant diarrhea, sores, ulcers, fever, and cough (Katrak, 2006). Hooper reviewed thousands of interviews, government documents, scientific papers, and medical records to prove his theory (Katrak, 2006). In his book called “The River,” Hooper reveals that the polio vaccine’s contamination led to the AIDS epidemic. Hooper provides evidence of OPV vaccination sites where the first cases of this virus were reported. Hooper’s book stirred controversy in the scientific community. Although the scientific community refuted Hooper’s theory, it persists.
The Contaminated Needle Theory
Preston Marx, a primate research virologist, had advanced this theory initially (Katrak, 2006). Marx gathered blood samples from primates and the village hunters. Based on a sample analysis of the blood, Marx found out that the primate samples were SIV positive. Similarly, some of the villagers had traces of SIV and HIV genes (Katrak, 2006).
Marx was convinced that retroviral zoonosis occurred for centuries in this region of Sierra Leone. However, Marx did not understand the reason for the sporadic spread of this epidemic since 1980 until he met Professor Ernest Drucker. Drucker informed Marx about his research on the use of unsterile needs before the AIDS epidemic in West Africa, South America, and Asia (Katrak, 2006). Based on this finding, Marx concluded that the spread of SIV and HIV from primates to humans, added to the reuse of unsterilized needs, which was a common practice in Africa, contributed to this epidemic (Katrak, 2006).
The Cut Hunter Theory
The theory focuses on zoonosis as the pathway for transferring SIV from primates to humans (Harindra, 2008). Researchers widely acknowledge that SIV contributed to the development of HIV because different SIV strains have HIV-1 and HIV-2 homology (Katrak, 2006). Bushmeat hunting has been a common trend in African communities across centuries. Therefore, some scholars contend that communities that killed and fed on primates with SIVs could have contracted these viruses (Harindra, 2008). While butchering these primates, their blood came into contact with the wounds and cuts of the hunters. Over time, the SIVs adapted to the hunters’ bodies and transformed into HIV over time (Harindra, 2008).

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