AIDS viruses reproduce in CD4 cells and circulate in the blood. In this electron micrograph of a white blood cell, AIDS viruses can be seen as the small white dots covering the cell’s surface.
Credit: Centers for Disease Control and Prevention

Today, December 1, 2022, is World AIDS Day. AIDS is the final, life-threatening stages of infection with the human immunodeficiency virus (HIV). HIV damages the immune system, the human body’s most important defense against disease. AIDS stands for acquired immunodeficiency syndrome or acquired immune deficiency syndrome. On this day, we honor over 40 million people who have lost their lives to AIDS and look ahead to ending the AIDS pandemic through research, healthcare, and community support. The World Health Organization reported that 38.4 million people were living with HIV across the globe at the end of 2021.

AIDS is a relatively new life-threatening disease. HIV is spread through sexual intercourse with an infected person or exposure to blood from an infected person, many times through shared needles used to inject drugs. At first, it mainly affected young adults. In the public imagination, the disease soon became associated with risky sexual behavior and with drug abuse. For all these reasons, efforts to address AIDS or to prevent the spread of HIV have at times faced unique social challenges. An infected pregnant woman can transmit HIV to her unborn child before and during the delivery, even if the woman shows no symptoms. An HIV-infected mother may also pass HIV to her baby through breast-feeding.

Since 1986, the international health community has worked to coordinate the global fight against HIV and AIDS. The World Health Organization’s Global AIDS Programme formed the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 1996. Since that time, UNAIDS has worked with other international partners to coordinate the global fight against HIV and AIDS. UNAIDS reported recently that one obstacle to ending AIDS around the world is gender inequality. Many girls and women live with HIV and AIDS without treatment and education to prevent infection. They report that in countries where girls do not receive an education, the rates of HIV infection are higher. UNAIDS also stated that in countries where same-sex relationships are criminalized the probability of infection is increased.

Many individuals and organizations have worked to increase public awareness of AIDS. The most active organizations include community-based groups and the American Red Cross. They hope that greater awareness will generate more compassion and support for people living with AIDS. They also hope to ensure adequate funding for HIV prevention, treatment, and research. One prominent project bringing attention to the crisis is the AIDS Memorial Quilt. Begun by the NAMES Project Foundation in 1987, the quilt consists of thousands of individually designed panels. The panels memorialize people who died of AIDS. The quilt has been displayed throughout the world.

Poor understanding of HIV has at times stoked public fears, leading many people with the virus to suffer unjustly. Some of the infected have lost or been denied jobs or housing. Others have been denied medical care and health insurance. Many children with AIDS were initially barred from attending school or playing on sports teams. To prevent discrimination, people with HIV and AIDS are often included under laws protecting the rights of people with disabilities. The United States government and some states have also strengthened laws safeguarding the confidentiality of medical records relating to HIV infection and AIDS.

Preventing discrimination against people with HIV is not only just—it also protects public health. When people can live without fear of discrimination, they are more likely to seek counseling and treatment. In many cases, such measures lead to earlier diagnosis and a reduction in risky behavior.

AIDS was first identified as a disease by physicians in California and in New York City, New York, in 1981. Doctors recognized the condition as something new because all the patients were previously healthy, young gay men. They sought medical care because they were suffering from otherwise rare forms of cancer and pneumonia. In 1982, the disease was named AIDS. Scientists soon determined that AIDS occurred when the immune system became damaged. They also learned that the agent that caused the damage was spread through sexual contact, shared drug needles, and infected blood transfusions.

AIDS occurs in every nation. In areas such as Africa south of the Sahara, Southeast Asia, and India, HIV transmission has occurred mostly among heterosexual men and women, particularly young adults and teens. Many developing nations carry enormous burdens of HIV infection. For example, the United Nations reports that in some parts of Africa, the infection rate may reach over 30 percent in some urban areas. The huge number of young adults dying of AIDS in Africa south of the Sahara has decreased overall life expectancy across the continent. A growing number of people have also become infected in countries with increasing drug use, such as Russia, China, and the nations of central Europe.

American activist and playwright Larry Kramer
Credit: David Shankbone (licensed under CC BY 3.0)

The American playwright and AIDS activist Larry Kramer died on Wednesday, May 27, 2020, at the age of 84. (AIDS is the final, life-threatening stages of infection with the human immunodeficiency virus [HIV]). Kramer became known as a fiery advocate (supporter) of public health and gay rights. His advocacy helped not only to further the study and treatment of HIV/AIDS but also to inspire other aggressive public health efforts.

Laurence David Kramer was born on June 25, 1935, in Bridgeport, Connecticut. In 1957, he earned a bachelor of arts degree in English from Yale University. He then entered the motion-picture industry, variously working as screenwriter, story editor, and producer.

In 1981, Kramer cofounded Gay Men’s Health Crisis (GMHC), the first HIV service organization. The organization was created in response to the lack of government action to fight the disease. In 1987, Kramer founded ACT UP (AIDS Coalition to Unleash Power). The organization performed disruptive acts to gain the attention of public officials, scientists, and religious leaders. For instance, the group surrounded St. Patrick’s Cathedral in New York City.

One of the officials with whom Kramer tussled was the American epidemiologist Anthony Fauci. Kramer accused Fauci of having no sense of urgency in studying or treating HIV/AIDS. (In January 2020, Fauci became a lead member of the White House Coronavirus Task Force.) The two later became friends, and Fauci acknowledged the role Kramer had played in drawing attention to the disease.

Kramer is the author of several books, plays, screenplays and essays. His autobiographical play “The Normal Heart” opened in 1985. It explores the rise of the HIV/AIDS crisis in New York City during the early 1980’s. Another autobiographical play, “The Destiny of Me,” was first performed in 1992. The play follows Ned Weeks, the main character of “The Normal Heart.” Kramer wrote a screenplay for the English writer D.H. Lawrence’s novel Women in Love. The film was released in 1969. Kramer received an Academy Award nomination for his screenplay.

American immunologist Anthony Fauci
Photo credit: NIAID

You may have seen Dr. Anthony Fauci featured at press conferences as a member of the White House Coronavirus Task Force, assembled to fight a pandemic (global outbreak) of the coronavirus disease COVID-19. In many ways, Fauci has become the face of efforts to stop the deadly disease in the United States, especially the practice of social distancing. But, how much do you know about Dr. Fauci?

Fauci (pronounced FOW chee), an American immunologist, has served as the director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984. An immunologist is a scientist who studies the body’s defenses against disease. The NIAID is part of the National Institutes of Health (NIH), an agency of the United States government.

Anthony Stephen Fauci was born on Dec. 24, 1940, in the Brooklyn borough (district) of New York City. He earned a bachelor’s degree at the College of the Holy Cross in Worcester, Massachusetts, in 1962. In 1966, Fauci earned a doctor of medicine degree from Cornell University Medical College in New York City. In 1968, Fauci joined the NIAID’s Laboratory of Clinical Investigation. In 1974, he became head of the Clinical Physiology Section, and he was named chief of the Laboratory of Immunoregulation in 1980. Immunoregulation is the control of immune responses.

As director of the NIAID, Fauci has advised multiple U.S. presidents and led efforts to combat such emerging diseases as the human immunodeficiency virus (HIV, the virus that causes AIDS), SARS, the swine flu, MERS, the Ebola virus, and COVID-19. In 2008, President George W. Bush awarded Fauci the Presidential Medal of Freedom for his efforts in fighting HIV and AIDS. The medal is the highest civilian honor awarded by the president of the United States.

February 26, 2013

C. Everett Koop, the most influential surgeon general in United States history, died yesterday at age 96. Among other distinctions, he vehemently preached against smoking when one-third of the nation smoked, and he focused the nation’s attention on the then-emerging disease known as AIDS. The Koop Institute at Dartmouth College confirmed the death, stating that he had died in Hanover, New Hampshire, where he had a home.

C. Everett Koop served as surgeon general from 1981 to 1989. (Office of the Surgeon General)

Koop served as surgeon general for seven years during the administration of President Ronald Reagan. Dr. Koop unquestionably had the highest profile of any person who has served in that position and was often controversial. His claim that smoking was a major health hazard and that cigarettes were as addictive as heroin and cocaine angered politicians from tobacco states, in particular the then-powerful Senator Jesse Helms of North Carolina. Dr. Koop’s antismoking campaign resulted in 40 states restricting smoking in public places; 33 states prohibiting it on public conveyances; 17 banning smoking in offices and other workplaces; and the federal government restricting smoking in 6,800 federal buildings.

Dr. Koop shocked many conservatives by endorsing the use of condoms and sex education to stop the spread of AIDS. In 1988, he roused the ire of the Reagan administration by sending an educational AIDS pamphlet to more than 100 million U.S. households, the largest public health mailing ever carried out. He also angered conservatives by refusing to issue a report, requested by the Reagan administration, claiming that abortions caused physical and psychological harm to women. Although personally opposed to abortion, he refused on the grounds that there was no scientific basis for such claims.

Additional World Book articles:

• Public health 1984 (a Back in Time article)
• Public health 1986 (a Back in Time article)
• Public health 1988 (a Back in Time article)
• AIDS 1988 (a Back in Time article)