We have come vast distances in 30 years. From desperate speculation as to the cause of once rare cancers that killed so many gay men in San Francisco and New York, to the discovery of the HIV virus in 1983/84, to effective anti-retroviral therapy (ART) available from 1996. Someone diagnosed in good time can now, with effective treatment, expect a normal lifespan.

It has not all been good news, of course. Stigma and discrimination was one of the main ways society responded to the epidemic and it has not gone away even if, in some parts of the world, it has diminished.


Looking forward

Going forward, we must continue what we know works and look towards further innovation. For example, it is extremely unlikely that HIV can be passed on from someone who is on effective and established ART. This is known as ‘Treatment as Prevention’ and will greatly impact how we respond to the epidemic.

In addition, clinical trials show how effective the taking of ART drugs is in preventing HIV acquisition. This use of ART for HIV negative people is called ‘PrEP’ (‘Pre-exposure prophylaxis’). An exciting area of research is the prospect of long-acting ART, which you would not need to take daily. There is even real research into a functional cure for HIV, though this still seems a long way off.

There is still, however, a need for progress in attitudes both in the UK and around the world. Without progress here, there is a risk that deterioration in attitudes and the revival of a moralistic response can undo all of the good previously achieved.