HIV/AIDS Pandemic: Light At the End of the Tunnel

“The HIV field has seen its share of ups and downs, but rarely has something arrived with as much hope as lenacapavir.”

Kai Kupferschmidt, contributing correspondent, Science Magazine

“Recent advances have made a cure possible for the first time in the history of HIV research.”Barbara Zenz, Medscape Medical News, October 15, 2025

In 1981, the HIV/AIDS pandemic first reared its god-awful head in America debuting in gay men in San Francisco, California. I remember vividly the very first HIV-infected patient I met in 1984 at the clinic at Hennepin County Medical Center in Minneapolis. He was a gay musician who recently returned from San Francisco to be at home with his parents in Minnesota where he sought care and fought to stay alive. At that time, there was no effective treatment for HIV/AIDS; it was a death sentence.

Now, some four decades and over 40 million lost lives later, it appears that the World Health Organization’s (WHO) goal to end the HIV/AIDS pandemic by 2030 is within reach. In this week’s Germ Gems post, I discuss the reasons behind this optimistic opinion and the formidable challenges that remain.

HIV/AIDS pandemic (recap). In 1959, scientists discovered the first case of HIV infection in blood samples from individuals in Kinshasa, Democratic Republic of the Congo. Scientists believe the virus was transmitted to humans from chimpanzees, meaning it is one of many emerging zoonotic infections. In 1981, the infection was clinically recognized in the U.S. as a new disease cluster.

By 1983, teams of scientists at the Institut Pasteur and the National Institutes of Health officially determined that a retrovirus was the cause of the then uniformly fatal disease AIDS. In 1986, the virus was officially named HIV (Human Immunodeficiency Virus).

Since the beginning of the HIV/AIDS pandemic, around 91.4 million people have contracted HIV and approximately 44.1 million have died from HIV and HIV-related causes. One of the major bottlenecks in stopping the relentless spread of the virus (either by unprotected sex or intravenous drug use) has been the lack of an effective vaccine. (Since 1987, over 300 HIV vaccine trials have been conducted.) Nonetheless, due to the dedicated work of many clinicians and scientists, a number of breakthroughs in the management of HIV infection have occurred over the past four decades, and AIDS is no longer a uniformly fatal disease. In fact, with proper treatment HIV-infected people can live a normal life span.

The main thrust of HIV management has been the use of antiretroviral drugs. The Federal Drug Administration (FDA) has approved over 50 different medicines for treating HIV infection. These drugs are typically given in combination and taken for life.

One of the most recent and remarkable developments in HIV management/treatment is Gilead Sciences’ introduction of the HIV capsid disrupter lenacapavir (Yeztugo). Approved by the FDA on July 1, 2025, this drug is injected twice-a-year to prevent HIV infection. (I reviewed this drug in my January 8, 2025 Germ Gems post,  “Can the HIV Pandemic Be Stopped? All Eyes Are on Lenacapavir.”)

Soon after the FDA approved lenacapavir for HIV prevention, Gilead Sciences announced its intention to make the agent cost-effective—a deal that was roundly welcomed by the HIV community. (See, e.g., Baeten, J.M., “Lenacapavir for HIV Prevention: A Commitment to Equitable Access and Partnership by Gilead Sciences,” Clinical Infectious Diseases,September 15, 2025; Cousins, S., “HIV community welcomes lenacapavir deal,” Lancet, October 4, 2025).

What else is new in the management of HIV? Rolling out lenacapavir is a transformative Pre-Exposure Prophylaxis (PrEP) strategy; it is the next best thing to a vaccine in prevention of HIV infection. Nonetheless, HIV vaccine trials are ongoing with a major focus on new technologies like mRNA, building on the success seen with COVID-19.

At the same time as breakthroughs in prevention are occurring, recent advances in treatment suggest that curing HIV infection is a realistic goal. (Zenz, B., “Will HIV Soon Be Curable? New Therapies Offer Hope,” Medscape Medical News, October 15, 2025). New studies  demonstrate that patients can be freed of the need for sustained anti-HIV drugs by providing combination immunotherapy and passive transfer of broadly neutralizing antibodies (bNAbs). (Peluso, M. J., et al., “Correlates of HIV-1 control after combination immunotherapy,” Nature, December 1, 2025; Teagle, A., “New Trials Hint that a  ‘Functional Cure’ for HIV May Be in Reach, Helping Some Patients Achieve Lasting Remission,” Knowable Magazine,  December 1, 2025). (Although not applicable to widespread treatment, on December 1, 2025, a man became the seventh person to become HIV-free after receiving a stem cell transplant to treat blood cancer.) (Wong, C., “Man unexpectedly cured of HIV after stem cell transplant,” New Scientist, December 1, 2025).

My assessment. Given the recent advances in prevention and treatment, I believe achieving the WHO’s goal to end the AIDS pandemic as a public health threat by 2030 is realistic. If met, it will be cause for great celebration. But it can only be accomplished if every country commits sufficient resources toward this goal.

In the U.S., the current administration has made drastic cuts in infrastructure support of HIV-related programs. This administration has eliminated HIV programs totaling more than $1.5 billion from its 2026 budget. It has cut back funding for HIV-related research grants, HIV prevention and surveillance programs through the Centers for Disease Control and Prevention, and curtailed global HIV efforts. Ironically. the U.S. may now be the country that poses the biggest threat to the WHO’s achieving its goal of eliminating the public health threat of the HIV/AIDS pandemic by 2030. And that, in my opinion, would be a tragedy.