From our current perspective, it is easy to forget that at the beginning of the AIDS pandemic, scientists did not even know the identity of the infectious agent causing a rare immunodeficiency. Rapid scientific advancement was needed to implement even basic public health measures such as laboratory-based testing to identify infected individuals and screen the blood supply.
In 1984, three years after the first AIDS reports, the human immunodeficiency virus was identified, followed the next year by the first licensed test. Following from these early advances, research has revealed the HIV disease process, developed major new therapies, and designed methods of prevention.
From treatment to combination prevention
Research has enabled scientists to discover two crucial things: key targets for antiretroviral therapies and then highly effective multi-drug regimens. Treatment has transformed the outlook for people living with HIV from almost certain death to a manageable chronic condition.
Critically, the treatment revolution led not only to vast improvement in human lives but also to crucial vehicles for prevention and public health. Beyond the success of preventing perinatal transmission, the two key public health breakthroughs are treatment as prevention, and pre-exposure prophylaxis.