According to the World Health Organization, in 2017 nearly 1 million people worldwide died of HIV related illness and about 37 million people have HIV/AIDS. There were about 1.8 million new infections in 2017. Since the beginning of the HIV/AIDS epidemic in the early 1980s, 35 million people worldwide have died of the disease.

However, amazing progress has been made since the early 1990s. According to the Gates Foundation, “In the past decade, the world has made significant progress in the fight against HIV due to large-scale treatment programs and efforts to prevent infection among infants born to mothers with HIV. The global incidence of HIV has declined by nearly 40 percent since 2001, and 17 million people worldwide are receiving antiretroviral treatment.”

What is HIV?

HIV stands for “Human Immunodeficiency Virus.” The virus attacks the body’s immune system, specifically “T Cells” which are important immune cells that fight off disease and infection. As HIV kills more and more T Cells, the body’s ability to fight off various diseases and infections is compromised. Currently, there is no vaccine or cure for HIV. Once a person has HIV they have it for life.

HIV is transmitted through bodily fluids which come in contact with a mucous membrane or damaged tissue or be injected directly into the bloodstream.

What is AIDS?

AIDS stands for “Acquired Immunodeficiency Syndrome.” It is the final stage of an HIV infection where the body’s immune system is so damaged that they are susceptible to “Opportunistic Infections.” Not everyone with HIV advances to the AIDS stage of the disease.

Common Opportunistic Infections that people with AIDS battle include
Kaposi’s sarcoma which is a type of cancer that results in pink and purple spots on the skin, Pneumonia, Toxoplasmosis, and Tuberculosis. Here’s a list from the CDC of the most common Opportunistic Infections.

Treatment and Life Expectancy

While there is no cure for HIV infection, it can be controlled. Prior to 1987, there was no effective drug to slow the progression of HIV into full-blown AIDS. Contracting HIV was usually a death sentence. In 1987 AZT became the first drug approved for treatment of HIV infection and since then more than 30 drugs have been approved. These drugs are known as antiretroviral therapy drugs or ART. According to the CDC, “if people with HIV take ART as prescribed, their viral load (amount of HIV in their blood) can become undetectable. If it stays undetectable, they can live long, healthy lives and have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS (the last stage of HIV infection) in a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.”

So Why Are 1 Million People a Year Dying of HIV/AIDS?

Over 70% of people with HIV are living in sub-Saharan Africa. There are three main issues relating to the AIDS epidemic in Africa:

First, According to the Bill and Melinda Gates Foundation, a major challenge is that nearly half of the people with HIV are not aware that they have HIV. Thus, there must be a greater push for testing of at-risk populations. WIthout knowledge of HIV status, treatment with ART drugs is not possible and use of preventative measures to avoid spreading the infection is not possible.

Second, according to the Kaiser Family Foundation, many people living with HIV or at risk for HIV infection do not have access to prevention, treatment, and care. Treatment with ART drugs is expensive and inflexible.

Finally, more can be done in terms of preventative measures such as increased condom use.

Note that ending the AIDS epidemic is a top UN Sustainable Development Goal. The Global community is committed to ending “the AIDS epidemic by 2030, and under the UNAIDS ’90-90-90′ targets, countries work toward achieving, by 2020, 90% of people living with HIV knowing their HIV status; 90% of people who know their HIV-positive status on treatment; and 90% of people on treatment with suppressed viral loads.” Quote from the Kaiser Family Foundation.

Pedro Zamora and the Real World San Francisco

Because many of the HIV infections occurred in the gay population and to intravenous drug users, HIV/AIDS was demonized.

In her excellent book Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them, Jennifer Wright links together plagues over the centuries and notes that a commonality is that the victim is often blamed or viewed as having done something wrong to have gotten the disease (examples being leprosy, syphilis, AIDS, etc) . In addition to being really mean-spirited and horrible, victim blaming can be an impediment to treatment and prevention of the disease. Ms. Wright expounds as follows: “I believe there will be a day when we will see diseases as what they are — an enemy of all humanity. Not of perceived sinners, not of people who are poor or have a different sexual orientation, not of those who we somehow decided ‘have it coming’ because they’re ‘not like us.’ When we fight plagues, not each other, we will not only defeat diseases but preserve our humanity in the process.”

In the U.S., for many of us of a certain age, our view into the life of someone with AIDS was Pedro Zamora, a young AIDS activist living with the disease. He was on one of the first seasons of the MTV hit show The Real World in 1994. For many people, he added a face to the disease and changed AIDS from a disease that happened “to other people” to a disease that happens to someone we cared about. According to this article, through “that experiment in living on camera, he would become — for a generation of young people — the first person living with AIDS with whom they were able to feel truly connected.” Pedro died not long after the airing of The Real World San Francisco.