HIV/AIDS Warning: You are not logged in. Your IP address will be publicly visible if you make any edits. If you log in or create an account, your edits will be attributed to your username, along with other benefits.Anti-spam check. Do not fill this in! == History == {{Main|History of HIV/AIDS}} {{For timeline}} {{Further|Category:HIV/AIDS by country}} === Discovery === <!-- This section is the same as the equivalent section at HIV. (https://en.wikipedia.org/wiki/HIV) Thus, if you update one please update the other as well --> [[File:Mmwr-aids-July1981-report-101.png|thumb|right|alt=text of the Morbidity and Mortality Weekly Report newsletter|The ''[[Morbidity and Mortality Weekly Report]]'' reported in 1981 on what was later to be called "AIDS".]]<!-- note that this was not the first report, per CDC; see discussion [[Talk:HIV/AIDS#I've uploaded the original MMWR piece.. but...|here]] --> The first news story on the disease appeared on May 18, 1981, in the gay newspaper ''[[New York Native]]''.<ref>{{cite news|title=On this day|work=[[News & Record]]|date=May 18, 2020|page=2A}}</ref><ref>{{cite web |last=Cloutier |first=Bill |title=Today in History, May 18 |url=https://www.rep-am.com/news/today_in_history/2020/05/17/today-in-history-may-18-2/ |website=Republican-American |access-date=May 19, 2020 |date=May 17, 2020 |archive-date=June 1, 2020 |archive-url=https://web.archive.org/web/20200601141613/https://www.rep-am.com/news/today_in_history/2020/05/17/today-in-history-may-18-2/ |url-status=dead }}</ref> AIDS was first clinically reported on June 5, 1981, with five cases in the United States.<ref name=M169/><ref>{{cite news |title=How I told the world about Aids |url=http://news.bbc.co.uk/2/hi/health/5041928.stm |access-date=February 12, 2019 |work=BBC News |date=June 5, 2006 |archive-url=https://web.archive.org/web/20190212190640/http://news.bbc.co.uk/2/hi/health/5041928.stm |archive-date=February 12, 2019 |url-status=live }}</ref> The initial cases were a cluster of injecting drug users and gay men with no known cause of impaired immunity who showed symptoms of ''[[Pneumocystis carinii]]'' pneumonia (PCP), a rare opportunistic infection that was known to occur in people with very compromised immune systems.<ref name=MMWR2>{{cite journal |vauthors=Gottlieb MS |title=Pneumocystis pneumonia – Los Angeles. 1981 |journal=[[American Journal of Public Health]] |volume=96 |issue=6 |pages=980–81; discussion 982–83 |date=June 2006 |pmid=16714472 |pmc=1470612 |doi=10.2105/AJPH.96.6.980 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm |archive-url=https://web.archive.org/web/20090422042240/http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm |url-status=live |archive-date=April 22, 2009}}</ref> Soon thereafter, a large number of homosexual men developed a generally rare skin cancer called [[Kaposi's sarcoma]] (KS).<ref name="pmid7287964">{{cite journal |vauthors=Friedman-Kien AE |title=Disseminated Kaposi's sarcoma syndrome in young homosexual men |journal=[[Journal of the American Academy of Dermatology]] |volume=5 |issue=4 |pages=468–71 |date=October 1981 |pmid=7287964 |doi=10.1016/S0190-9622(81)80010-2}}</ref><ref name="pmid6116083">{{cite journal |vauthors=Hymes KB, Cheung T, Greene JB, Prose NS, Marcus A, Ballard H, William DC, Laubenstein LJ |title=Kaposi's sarcoma in homosexual men-a report of eight cases |journal=The Lancet |volume=2 |issue=8247 |pages=598–600 |date=September 1981 |pmid=6116083 |doi=10.1016/S0140-6736(81)92740-9|s2cid=43529542 }}</ref> Many more cases of PCP and KS emerged, alerting U.S. Centers for Disease Control and Prevention (CDC) and a CDC task force was formed to monitor the outbreak.<ref name="Basavapathruni_2007">{{cite journal |vauthors=Basavapathruni A, Anderson KS |title=Reverse transcription of the HIV-1 pandemic |journal=FASEB Journal |volume=21 |issue=14 |pages=3795–808 |date=December 2007 |pmid=17639073 |doi=10.1096/fj.07-8697rev|doi-access=free |s2cid=24960391 }}</ref> In the early days, the CDC did not have an official name for the disease, often referring to it by way of diseases associated with it, such as [[lymphadenopathy]], the disease after which the discoverers of HIV originally named the virus.<ref name=MMWR1982a>{{cite journal |author=Centers for Disease Control (CDC) |title=Persistent, generalized lymphadenopathy among homosexual males |journal=Morbidity and Mortality Weekly Report |volume=31 |issue=19 |pages=249–51 |date=May 1982 |pmid=6808340 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/00001096.htm |archive-url=https://web.archive.org/web/20111018015418/http://cdc.gov/mmwr/preview/mmwrhtml/00001096.htm |url-status=live |archive-date=October 18, 2011}}</ref><ref name="Montagnier">{{cite journal |vauthors=Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vézinet-Brun F, Rouzioux C, Rozenbaum W, Montagnier L |title=Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) |journal=Science |volume=220 |issue=4599 |pages=868–71 |date=May 1983 |pmid=6189183 |doi=10.1126/science.6189183 |bibcode=1983Sci...220..868B|s2cid=390173 }}</ref> They also used ''Kaposi's sarcoma and opportunistic infections'', the name by which a task force had been set up in 1981.<ref name=MMWR1982b>{{cite journal |author=Centers for Disease Control (CDC) |title=Opportunistic infections and Kaposi's sarcoma among Haitians in the United States |journal=Morbidity and Mortality Weekly Report |volume=31 |issue=26 |pages=353–54, 360–61 |date=July 1982 |pmid=6811853 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/00001123.htm |archive-url=https://web.archive.org/web/20110920181924/http://www.cdc.gov/mmwr/preview/mmwrhtml/00001123.htm |url-status=live |archive-date=September 20, 2011}}</ref> At one point the CDC referred to it as the "4H disease", as the syndrome seemed to affect heroin users, homosexuals, [[haemophilia]]cs, and [[Haiti]]ans.<ref>{{cite journal |title=AIDS and Syphilis: The Iconography of Disease |journal=October |volume=43 |pages=87–107 |editor-last=Gilman |editor-first=Sander L. |year=1987 |jstor=3397566 |last=Gilman |first=Sander L. |doi=10.2307/3397566}}</ref><ref name=SciRep470b>{{cite web |publisher=[[American Association for the Advancement of Science]] |date=July 28, 2006 |url=http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf |title=Making Headway Under Hellacious Circumstances |access-date=June 23, 2008 |url-status=live |archive-url=https://web.archive.org/web/20080624235131/http://www.scienceonline.org/cgi/reprint/313/5786/470b.pdf |archive-date=June 24, 2008 }}</ref> The term ''GRID'', which stood for [[gay-related immune deficiency]], had also been coined.<ref name=Altman>{{cite news |last=Altman |first=Lawrence K. |url=https://www.nytimes.com/1982/05/11/science/new-homosexual-disorder-worries-health-officials.html |title=New homosexual disorder worries health officials |work=[[The New York Times]] |date=May 11, 1982 |access-date=August 31, 2011 |url-status=live |archive-url=https://web.archive.org/web/20130430231803/http://www.nytimes.com/1982/05/11/science/new-homosexual-disorder-worries-health-officials.html |archive-date=April 30, 2013 }}</ref> However, after determining that AIDS was not isolated to the [[gay community]],<ref name=MMWR1982b/> it was realized that the term ''GRID'' was misleading, and the term ''AIDS'' was introduced at a meeting in July 1982.<ref name=Kher>{{cite magazine |last=Kher |first=Unmesh |title=A Name for the Plague |magazine=Time |date=July 27, 1982 |url=http://www.time.com/time/80days/820727.html |access-date=March 10, 2008 |archive-url=https://web.archive.org/web/20080307015307/http://www.time.com/time/80days/820727.html |archive-date=March 7, 2008 |url-status=dead}}</ref> By September 1982 the CDC started referring to the disease as AIDS.<ref name=MMWR1982c>{{cite journal |author=Centers for Disease Control (CDC) |title=Update on acquired immune deficiency syndrome (AIDS) – United States |journal=Morbidity and Mortality Weekly Report |volume=31 |issue=37 |pages=507–08, 513–14 |date=September 1982 |pmid=6815471}}</ref> In 1983, two separate research groups led by [[Robert Gallo]] and [[Luc Montagnier]] declared that a novel retrovirus may have been infecting people with AIDS, and published their findings in the same issue of the journal ''[[Science (journal)|Science]]''.<ref name=Gallo>{{cite journal |vauthors=Gallo RC, Sarin PS, Gelmann EP, Robert-Guroff M, Richardson E, Kalyanaraman VS, Mann D, Sidhu GD, Stahl RE, Zolla-Pazner S, Leibowitch J, Popovic M |title=Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS) |journal=Science |volume=220 |issue=4599 |pages=865–67 |date=May 1983 |pmid=6601823 |doi=10.1126/science.6601823 |bibcode=1983Sci...220..865G}}</ref><ref name=Montagnier/> Gallo claimed a virus which his group had isolated from a person with AIDS was strikingly similar in [[Virus structure|shape]] to other [[human T-lymphotropic virus]]es (HTLVs) that his group had been the first to isolate. Gallo's group called their newly isolated virus HTLV-III. At the same time, Montagnier's group isolated a virus from a person presenting with swelling of the [[lymph node]]s of the neck and [[Asthenia|physical weakness]], two characteristic symptoms of AIDS. Contradicting the report from Gallo's group, Montagnier and his colleagues showed that core proteins of this virus were immunologically different from those of HTLV-I. Montagnier's group named their isolated virus lymphadenopathy-associated virus (LAV).<ref name="Basavapathruni_2007"/> As these two viruses turned out to be the same, in 1986, LAV and HTLV-III were renamed HIV.<ref>{{cite book |veditors=Aldrich R, Wotherspoon G |title=Who's who in gay and lesbian history |year=2001 |publisher=Routledge |location=London |isbn=978-0-415-22974-6 |page=154 |url=https://books.google.com/books?id=9KA7_1s6w-QC&pg=PA154 |access-date=June 27, 2015 |archive-url=https://web.archive.org/web/20150911044550/https://books.google.com/books?id=9KA7_1s6w-QC&pg=PA154 |archive-date=September 11, 2015 |url-status=live }}</ref> ===Origins=== [[File:SIV primates.jpg|right|upright=1.35|thumb|alt=three primates possible sources of HIV|Left to right: the [[African green monkey]] source of [[Simian immunodeficiency virus|SIV]], the [[sooty mangabey]] source of [[HIV-2]], and the [[Common chimpanzee|chimpanzee]] source of [[HIV-1]]]] The origin of HIV / AIDS and the circumstances that led to its emergence remain unsolved.<ref name="Thomas_Gilbert"/> Both HIV-1 and HIV-2 are believed to have originated in non-human [[primate]]s in West-central Africa and were [[zoonosis|transferred to humans]] in the early 20th century.<ref name=Orgin2011/> HIV-1 appears to have originated in southern [[Cameroon]] through the evolution of SIV(cpz), a [[simian immunodeficiency virus]] (SIV) that infects wild [[Common chimpanzee|chimpanzee]]s (HIV-1 descends from the SIVcpz endemic in the chimpanzee subspecies ''Pan troglodytes troglodytes'').<ref name="pmid9989410">{{cite journal |vauthors=Gao F, Bailes E, Robertson DL, Chen Y, Rodenburg CM, Michael SF, Cummins LB, Arthur LO, Peeters M, Shaw GM, Sharp PM, Hahn BH |title=Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes |journal=Nature |volume=397 |issue=6718 |pages=436–41 |date=February 1999 |pmid=9989410 |doi=10.1038/17130 |bibcode=1999Natur.397..436G|s2cid=4432185 |doi-access=free }}</ref><ref name=Keele>{{cite journal |vauthors=Keele BF, Van Heuverswyn F, Li Y, Bailes E, Takehisa J, Santiago ML, Bibollet-Ruche F, Chen Y, Wain LV, Liegeois F, Loul S, Ngole EM, Bienvenue Y, Delaporte E, Brookfield JF, Sharp PM, Shaw GM, Peeters M, Hahn BH |title=Chimpanzee reservoirs of pandemic and nonpandemic HIV-1 |journal=Science |volume=313 |issue=5786 |pages=523–26 |date=July 2006 |pmid=16728595 |pmc=2442710 |doi=10.1126/science.1126531 |bibcode=2006Sci...313..523K}}</ref> The closest relative of HIV-2 is SIV (smm), a virus of the [[sooty mangabey]] (''Cercocebus atys atys''), an [[Old World monkey]] living in coastal West Africa (from southern [[Senegal]] to western [[Ivory Coast]]).<ref name="Reeves"/> [[New World monkey]]s such as the [[Night monkey|owl monkey]] are resistant to [[Subtypes of HIV|HIV-1]] infection, possibly because of a genomic [[fusion gene|fusion]] of two viral resistance genes.<ref name=Goodier>{{cite journal |vauthors=Goodier JL, Kazazian HH |title=Retrotransposons revisited: the restraint and rehabilitation of parasites |journal=Cell |volume=135 |issue=1 |pages=23–35 |date=October 2008 |pmid=18854152 |doi=10.1016/j.cell.2008.09.022|s2cid=3093360 |doi-access=free }}(subscription required)</ref> HIV-1 is thought to have jumped the species barrier on at least three separate occasions, giving rise to the three groups of the virus, M, N, and O.<ref name=Sharp2001>{{cite journal |vauthors=Sharp PM, Bailes E, Chaudhuri RR, Rodenburg CM, Santiago MO, Hahn BH |title=The origins of acquired immune deficiency syndrome viruses: where and when? |journal=Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences |volume=356 |issue=1410 |pages=867–76 |date=June 2001 |pmid=11405934 |pmc=1088480 |doi=10.1098/rstb.2001.0863 }}</ref> There is evidence that humans who participate in [[bushmeat]] activities, either as hunters or as bushmeat vendors, commonly acquire SIV.<ref name=Kalish2005>{{cite journal |vauthors=Kalish ML, Wolfe ND, Ndongmo CB, McNicholl J, Robbins KE, Aidoo M, Fonjungo PN, Alemnji G, Zeh C, Djoko CF, Mpoudi-Ngole E, Burke DS, Folks TM |title=Central African hunters exposed to simian immunodeficiency virus |journal=Emerging Infectious Diseases |volume=11 |issue=12 |pages=1928–30 |date=December 2005 |pmid=16485481 |pmc=3367631 |doi=10.3201/eid1112.050394 |first8=George |last9=Zeh |last8=Alemnji |first9=Clement |last7=Fonjungo |last6=Aidoo |first6=Michael |first7=Peter N.}}</ref> However, SIV is a weak virus which is typically suppressed by the human immune system within weeks of infection. It is thought that several transmissions of the virus from individual to individual in quick succession are necessary to allow it enough time to mutate into HIV.<ref name=Marx2001>{{cite journal |vauthors=Marx PA, Alcabes PG, Drucker E |title=Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa |journal=Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences |volume=356 |issue=1410 |pages=911–20 |date=June 2001 |pmid=11405938 |pmc=1088484 |doi=10.1098/rstb.2001.0867 }}</ref> Furthermore, due to its relatively low person-to-person transmission rate, SIV can only spread throughout the population in the presence of one or more high-risk transmission channels, which are thought to have been absent in Africa before the 20th century.<ref>{{cite journal |last1=Sharp |first1=Paul M. |last2=Hahn |first2=Beatrice H. |date=September 2011 |title=Origins of HIV and the AIDS Pandemic |journal=Cold Spring Harbor Perspectives in Medicine |volume=1 |issue=1 |pages=a006841 |doi=10.1101/cshperspect.a006841 |issn=2157-1422 |pmc=3234451 |pmid=22229120}}</ref> Specific proposed high-risk transmission channels, allowing the virus to adapt to humans and spread throughout society, depend on the proposed timing of the animal-to-human crossing. Genetic studies of the virus suggest that the most recent common ancestor of the HIV-1 M group dates back to {{circa}} 1910.<ref name=Worobey2008>{{cite journal |vauthors=Worobey M, Gemmel M, Teuwen DE, Haselkorn T, Kunstman K, Bunce M, Muyembe JJ, Kabongo JM, Kalengayi RM, Van Marck E, Gilbert MT, Wolinsky SM |title=Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960 |journal=[[Nature (journal)|Nature]] |volume=455 |issue=7213 |pages=661–64 |date=October 2008 |pmid=18833279 |pmc=3682493 |doi=10.1038/nature07390 |bibcode=2008Natur.455..661W}} (subscription required)</ref> Proponents of this dating link the HIV epidemic with the emergence of [[colonialism]] and growth of large colonial African cities, leading to social changes, including a higher degree of sexual promiscuity, the spread of prostitution, and the accompanying high frequency of [[genital ulcer disease]]s (such as [[syphilis]]) in nascent colonial cities.<ref name=Sousa2010>{{cite journal |vauthors=de Sousa JD, Müller V, Lemey P, Vandamme AM |title=High GUD incidence in the early 20th century created a particularly permissive time window for the origin and initial spread of epidemic HIV strains |journal=[[PLOS One]] |volume=5 |issue=4 |page=e9936 |date=April 2010 |pmid=20376191 |pmc=2848574 |doi=10.1371/journal.pone.0009936 |editor1-last=Martin |editor1-first=Darren P. |bibcode=2010PLoSO...5.9936S|doi-access=free }}</ref> While transmission rates of HIV during vaginal intercourse are low under regular circumstances, they are increased manyfold if one of the partners has a [[Sexually transmitted disease|sexually transmitted infection]] causing genital ulcers. Early 1900s colonial cities were notable for their high prevalence of prostitution and genital ulcers, to the degree that, as of 1928, as many as 45% of female residents of eastern [[Kinshasa]] were thought to have been prostitutes, and, as of 1933, around 15% of all residents of the same city had syphilis.<ref name=Sousa2010/> An alternative view holds that unsafe medical practices in Africa after World War II, such as unsterile reuse of single-use syringes during mass vaccination, antibiotic and anti-malaria treatment campaigns, were the initial vector that allowed the virus to adapt to humans and spread.<ref name=Marx2001/><ref name=Chitnis2000>{{cite journal |vauthors=Chitnis A, Rawls D, Moore J |title=Origin of HIV type 1 in colonial French Equatorial Africa? |journal=AIDS Research and Human Retroviruses |volume=16 |issue=1 |pages=5–8 |date=January 2000 |pmid=10628811 |doi=10.1089/088922200309548|s2cid=17783758 }}(subscription required)</ref><ref name=McNeil>{{cite news | last=McNeil |first=Donald G. Jr. |author-link=Donald G. McNeil Jr. |title=Precursor to H.I.V. Was in Monkeys for Millennia |url=https://www.nytimes.com/2010/09/17/health/17aids.html |quote=Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s. ... suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts. |work=[[The New York Times]] |date=September 16, 2010 |access-date=September 17, 2010 |url-status=live |archive-url=https://web.archive.org/web/20110511230019/http://www.nytimes.com/2010/09/17/health/17aids.html |archive-date=May 11, 2011 }}</ref> The earliest well-documented case of HIV in a human dates back to 1959 in the [[Belgian Congo|Congo]].<ref name=Zhu>{{cite journal |vauthors=Zhu T, Korber BT, Nahmias AJ, Hooper E, Sharp PM, Ho DD |title=An African HIV-1 sequence from 1959 and implications for the origin of the epidemic |journal=Nature |volume=391 |issue=6667 |pages=594–97 |date= February 1998 |pmid=9468138 |doi=10.1038/35400 |bibcode=1998Natur.391..594Z|s2cid=4416837 |doi-access=free }}</ref> The virus may have been present in the U.S. as early as the mid-to-late 1950s, as a sixteen-year-old male named [[Robert Rayford]] presented with symptoms in 1966 and died in 1969. In the 1970s, there were cases of getting parasites and becoming sick with what was called "gay bowel disease", but what is now suspected to have been AIDS.<ref>{{cite web|title=Forty years after first documented AIDS cases, survivors reckon with 'dichotomy of feelings'|url=https://www.nbcnews.com/feature/nbc-out/forty-years-after-first-documented-aids-cases-survivors-reckon-dichotomy-n1269697|access-date=June 6, 2021|website=NBC News|date=June 5, 2021|archive-date=June 6, 2021|archive-url=https://web.archive.org/web/20210606013840/https://www.nbcnews.com/feature/nbc-out/forty-years-after-first-documented-aids-cases-survivors-reckon-dichotomy-n1269697|url-status=live}}</ref> The earliest retrospectively described case of AIDS is believed to have been in Norway beginning in 1966, that of [[Arvid Noe]].<ref>{{cite book |veditors=Lederberg J |title=Encyclopedia of Microbiology |date=2000 |publisher=Elsevier |location=Burlington, MA |isbn=978-0-08-054848-7 |page=106 |edition=2nd |url=https://books.google.com/books?id=fhC_nz8eHh0C&pg=PA106 |access-date=December 12, 2016 |archive-url=https://web.archive.org/web/20170910145825/https://books.google.com/books?id=fhC_nz8eHh0C&pg=PA106 |archive-date=September 10, 2017 |url-status=live }}</ref> In July 1960, in the wake of [[Democratic Republic of the Congo#Independence and political crisis (1960–1965)|Congo's independence]], the [[United Nations]] recruited [[French language|Francophone]] experts and technicians from all over the world to assist in filling administrative gaps left by [[Belgium]], who did not leave behind an African elite to run the country. By 1962, Haitians made up the second-largest group of well-educated experts (out of the 48 national groups recruited), that totaled around 4500 in the country.<ref>{{cite book |url=https://books.google.com/books?id=OQ6tAgAAQBAJ |title=Geographies of the Haitian Diaspora |editor-last=Jackson |editor-first=Regine O. |page=12 |year=2011 |publisher=Routledge |isbn=978-0-415-88708-3 |access-date=March 13, 2016 |archive-url=https://web.archive.org/web/20160509142031/https://books.google.com/books?id=OQ6tAgAAQBAJ&printsec=frontcover |archive-date=May 9, 2016 |url-status=live }}</ref><ref name="Pépin">{{cite book |url=https://books.google.com/books?id=dTaMBrPBK6EC |title=The Origin of Aids |last=Pépin |first=Jacques |page=188 |year=2011 |publisher=Cambridge University Press |isbn=978-0-521-18637-7 |access-date=March 13, 2016 |archive-url=https://web.archive.org/web/20160509120414/https://books.google.com/books?id=dTaMBrPBK6EC&printsec=frontcover |archive-date=May 9, 2016 |url-status=live }}</ref> Dr. Jacques Pépin, a Canadian author of ''The Origins of AIDS'', stipulates that [[Haiti]] was one of HIV's entry points to the U.S. and that a Haitian may have carried HIV back across the Atlantic in the 1960s.<ref name="Pépin"/> Although there was known to have been at least one case of AIDS in the U.S. from 1966,<ref>{{cite news |last=Kolata |first=Gina |title=Boy's 1969 Death Suggests AIDS Invaded U.S. Several Times |work=[[The New York Times]] |date=October 28, 1987 |url=https://www.nytimes.com/1987/10/28/us/boy-s-1969-death-suggests-aids-invaded-us-several-times.html |access-date=February 11, 2009 |url-status=live |archive-url=https://web.archive.org/web/20090211024256/http://query.nytimes.com/gst/fullpage.html?res=9B0DEFD6173AF93BA15753C1A961948260 |archive-date=February 11, 2009 }}</ref> the vast majority of infections occurring outside sub-Saharan Africa (including the U.S.) can be traced back to a single unknown individual who became infected with HIV in Haiti and brought the infection to the U.S. at some time around 1969.<ref name="Thomas_Gilbert">{{cite journal |vauthors=Gilbert MT, Rambaut A, Wlasiuk G, Spira TJ, Pitchenik AE, Worobey M |title=The emergence of HIV/AIDS in the Americas and beyond |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=104 |issue=47 |pages=18566–70 |date=November 2007 |pmid=17978186 |pmc=2141817 |doi=10.1073/pnas.0705329104 |bibcode=2007PNAS..10418566G |doi-access=free }}</ref> The epidemic rapidly spread among high-risk groups (initially, sexually promiscuous men who have sex with men). By 1978, the prevalence of HIV-1 among gay male residents of [[New York City]] and [[San Francisco]] was estimated at 5%, suggesting that several thousand individuals in the country had been infected.<ref name="Thomas_Gilbert"/> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. If you do not want your writing to be edited mercilessly, then do not submit it here. You are also promising us that you wrote this yourself, or copied it from a public domain or similar free resource (see Christianpedia:Copyrights for details). Do not submit copyrighted work without permission! Cancel Editing help (opens in new window) Discuss this page