HIV Epidemic

Abstract

The global pandemic of human immunodeficiency virus (HIV) infection is unprecedented in human history. While the bubonic plague in fourteenth-century Europe is estimated to have killed a quarter of the population, the epidemic of 1,347–1,350 was self-limited once a vast pool of susceptible humans and rodents were killed and persons who recovered were rendered immune [1, 2]. Plague reemerged periodically, but infrequently and with less intensity than the original devastating disease, and was not reported in Europe in epidemic form after the eighteenth century. In contrast, HIV emerged as a global pandemic in the 1980s and is now endemic throughout the world, declining only slightly in the first decade of the twenty-first century [3, 4]. HIV is a sexually transmitted infection (STI) and is propagated by human behavior. Without successful control by biological and behavioral means, HIV will not be so readily controlled as was Yersinia pestis, the plague bacterium that was controllable with improved sanitation and rodent control well before the era of antibiotics.