30 Years of Milestones

To commemorate the 30th anniversary of the first reported cases of AIDS, the NICHD highlights some key moments in pediatric, adolescent, and maternal AIDS research

Thin-section transmission electron micrograph

Figure 1: Thin-section transmission electron micrograph depiction of structural details of a number of HIV virus particles. Image courtesy of the Public Health Image Library; credit to Dr. A. Harrison & Dr. P. Feorino.

As scientific understanding of the disease and its mechanisms continues to advance, we can find reasons to hope. Where once there were no treatment options, we now have multiple regimens that can help to manage the disease. Where once the disease spread seemingly without boundaries, we now have ways to prevent that spread. Researchers, health care providers, and communities around the world remain dedicated to preventing, treating, managing, and even curing AIDS.

During the last 30 years, the NICHD and its researchers have played important roles in improving the outlook for children, adolescents, women, and mothers who have or are at risk for AIDS. While keeping in mind the many challenges that remain, the NICHD highlights some of the key moments in the history of AIDS/HIV, specifically related to children, adolescents, women, and mothers. No single list of a 30-year span can be all inclusive, but these highlights provide a good overall picture of how far we've come, and how far we still have to go.

Select a period below to view the research highlights for that timeframe.

1981 to 1985


The Centers for Disease Control and Prevention (CDC) publishes the first reports of AIDS, although identified by another name, in the Morbidity and Mortality Weekly Report ( MMWR). The reports describe cases of Pneumocystis pneumonia and Kaposi's sarcoma in 41 otherwise healthy homosexual men. The reports appear in the June MMWR and July MMWR.


Three notable reports appear in the MMWR. The first describes cases of Pneumocystis pneumonia among patients with hemophilia A . The second details four infants with unexplained cellular immunodeficiency and opportunistic infections similar to those reported in adults. Of the four infants, three were born to mothers with then-identified risk factors for AIDS, while the other received a blood transfusion from a patient with AIDS. The authors note that "transmission of an 'AIDS agent' from mother to child, either in utero or shortly after birth, could account for the early onset of immunodeficiency in these infants." The third describes similar cases of immunodeficiency in patients with hemophilia A, including a 10-year-old boy.





1986 to 1990


The NICHDestablishes the Mother and Infants Cohort Study (MICS) at five study sites in the New York boroughs of Brooklyn and the Bronx, which had nearly one-half of all perinatally acquired AIDS cases at the time. The study is a collaboration between the NICHD and the National Cancer Institute (NCI). Researchers aim to evaluate factors associated with mother-to-child HIV transmission, how HIV affects pregnancy and pregnancy outcomes, how pregnancy alters the progression of HIV infection, and how it affects infant growth and neurodevelopment.


The U.S. Food and Drug Administration (FDA) approves AZT as the first antiretroviral drug for the treatment for AIDS in adults; use in children is not approved at this time.





1991 to 1995


  • In a collaboration between the NIAID, the NICHD, and the Agence Nationale de Recherche sur le Sida (ANRS) in France, researchers begin enrolling pregnant women in the United States and France in the first studies (called ACTG 076) to examine AZT for the prevention of mother-to-child HIV transmission in pregnancy, during labor, and after birth.
  • IVIG Study Group researchers report in the New England Journal of Medicine that the use of IVIG to prevent serious bacterial infections reduces the infection risk in children with HIV who are not receiving antiretroviral drugs.
  • The FDA approves IVIG for use in HIV-infected children (a new indication) to decrease the frequency of bacterial infections, increase the time free from serious bacterial infections, and decrease the frequency of hospitalizations.
  • The FDA approves didanosine, as the second antiretroviral drug approved for treatment of HIV infection, and was approved concurrently for adults and children.



  • The Data and Safety Monitoring Board of the NIAID-/NICHD-/ANRS-funded clinical trial examining whether AZT can prevent mother-to-child transmission of HIV (ACTG 076) halts the study early because results indicate that the AZT regimen is significantly more effective than placebo at preventing transmission. Findings indicate that mother-to-child transmission of HIV is reduced by two-thirds if women are treated with AZT during pregnancy and labor, and if newborns are given AZT for six weeks. Results, published in the New England Journal of Medicine, rapidly become the standard of care for HIV-infected pregnant women and infants in the United States.
  • The FDA approves new labeling for AZT, adding "prevention of HIV transmission from infected pregnant women to their children during pregnancy, in labor, and after birth."
  • The U.S. Public Health Service and the U.S. Department of Health and Human Services (DHHS) issue guidelines on the use of AZT to prevent mother-to-child HIV transmission in the United States.
  • The NICHD establishes the Adolescent Medicine HIV/AIDS Research Network (AMHARN). Studies conducted through the network focus on adolescents (ages 12 years to 19 years) who became infected with HIV from sex or drug-taking. The studies investigate medical, behavioral, and psychological aspects of HIV/AIDS in these adolescents. The ultimate goal of this project is to improve the care of HIV-infected adolescents based on a better understanding of the progression of HIV and of other diseases that often accompany HIV infection in adolescents.


  • The ACTG splits into two separate programs, the Adult ACTG and the Pediatric ACTG (PACTG), establishing a clinical trials group focused on HIV in children and pregnant women. The PACTG collaborates with the NICHD's Domestic and International Pediatric and Perinatal HIV Clinical Trials Network in the conduct of pediatric and perinatal trials.
  • The NCI launches the first studies in children of a new class of antiretroviral drugs, protease inhibitors. A study of the protease inhibitor ritonavir starts in June ( published in March 1998 in Pediatrics), followed by a study of indinavir in July ( published in July 1998 in Pediatrics).
  • The CDC issues guidelines for HIV testing in pregnancy. For the first time in the United States, routine HIV counseling and voluntary testing are recommended for all pregnant women. These recommendations are based on the results of the NIAID-/NICHD-/ANRS-funded clinical trial (ACTG 076), which demonstrated that AZT prevented mother-to-child HIV transmission.
  • Sites in the NIAID/NICHD-funded PACTG and the NICHD Domestic and International Pediatric and Perinatal HIV Clinical Trials Network launch studies of nevirapine, one of a new class of antiretroviral drugs called non-nucleoside reverse transcriptase inhibitors, in children. The drug is later approved for treating children based on the results of these studies, published in the Journal of Infectious Diseases in 1996 .
  • FDA approves lamivudine (3TC) for use in combination with AZT concurrently in adults and children.


1996 to 2000







2001 to 2005




The FDA approves the injectable HIV drug enfuvirtide, the first of a new class of antiretrovirals called fusion inhibitors. The drug is approved concurrently for HIV-infected adults and children older than age 6 years, based on studies performed by PACTG.



  • The FDA approves use of emtricitabine (FTC) for treatment of HIV infection in children two years after it is approved in adults.
  • The NICHD establishes the Pediatric HIV/AIDS Cohort Study (PHACS) to address two crucial issues in pediatric HIV research: the long-term safety of fetal and infant exposure to preventive antiretroviral chemotherapy, and the effects of perinatally acquired HIV infection and its treatment in U.S. adolescents. In addition to the NICHD, the initiative received support from NIAID; the National Heart, Lung, and Blood Institute; NIMH; NIDA; the National Institute on Deafness and Other Communication Disorders; the National Institute of Neurological Disorders and Stroke; and the National Institute on Alcohol Abuse and Alcoholism.
  • NIAID establishes the International Epidemiologic Databases to Evaluate AIDS (IeDEA), and the NICHD begins funding the pediatric component of the IeDEA. The initiative supports seven regional data centers, which bring together clinical and research data resources to answer questions about HIV/AIDS that single studies are too small to answer. By 2011, the database includes data on more than 50,000 HIV-infected children who live in resource-limited areas.


2006 to 2011








For more information on NICHD-supported research on HIV/AIDS, select a link below:

Originally posted: June 3, 2011

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