[Association of Nurses in AIDS Care (ANAC)] ANAC's

HISTORICAL OVERVIEW OF HIV PANDEMIC
1. The acquired immunodeficiency syndrome (AIDS) pandemic was one of the key interna-
tional health and demographic events of the late 20th century.
a. When AIDS first appeared in 1980–1981, few would have predicted the worldwide burden
of disease, death, and orphanhood it would precipitate by the turn of the millennium, particularly in sub-Saharan Africa.
b. By the turn of the century, in some countries, over 30% of adults were living with human
immunodeficiency virus (HIV) infection, a situation that has raised concerns about its potential to destabilize regional and global security.
c. The impact of HIV/AIDS has always been greatest in the poorest countries, where over
95% of new infections currently occur.

2.HIV/AIDS has become a major political issue, both nationally and globally, that challenges
government decision making and the medical establishment’s authority about healthcare research and delivery.
a. Many governments were slow to respond, in large part through failure to recognize themagnitude of the problem and its potential impact, along with, many believe, a lack ofconcern for the disenfranchised groups that were most affected.
i) In the United States, AIDS emerged during a decade of reduced federal funding for numerous government programs, including public health programs, leaving cities with few resources to deal with the growing crisis.
(1) Some U.S. government officials held the view that it was not a broad societal threat and suggested that the public health community and others were exaggerating its magnitude and potential impact to get government spending to fund gay organizations; some opposed using government funds to address sexuality in any way other than extramarital abstinence and heterosexual monogamy.
(2) Fall 1986—Surgeon General’s Report on Acquired Immune Deficiency.
ii) In Africa, HIV’s unique characteristics influenced sociopolitical responses to the epi-
demic (Iliffe, 2006).
(1) Because many AIDS manifestations were already endemic, leaders were slow to grasp the scale of the new problem.
(2) There was reluctance to be identified as the source of a problem that the Western developed world associated with marginalized groups, and the well-publicized