One of my main motivations in college and grad school was to work in drug discovery, specifically for HIV. At the time (~1995-2000) we were just starting to see positive results from protease inhibitors and reverse transcriptase inhibtors came somewhat later leading to the current "managment of HIV through HART" https://en.wikipedia.org/wiki/Management_of_HIV/AIDS
All of this came slowly - decades between significant new technologies/improvements in treatment. many sources of infection such as blood transfusions are now much less risky (people in the 70s and 80s were getting hep C and HIV from blood taken from HIV-positive donors). And the disease presents very differently in the US vs. other areas such as Sub-Saharan africa. But with extensive effort, prevention has gotten better and treatments have gotten much better. If there are truly usable preventatives for at-risk populations, and those medications are affordable, it will be a huge boon to the recipients.
Some interesting things to note:
- there was a lot of controversy about the source of infection and a lot of people used this to criticize gay people and injected drug users.
- one of the world's most famous virologists, https://en.wikipedia.org/wiki/Peter_Duesberg actively denied that HIV caused AIDS and instead thought it was transmitted by drug use. Note "Duesberg entered a long dispute with John Maddox, then-editor of the scientific journal Nature, demanding the right to rebut articles that HIV caused AIDS." which I think presages the current arguments about what scientists can say regarding the origins of COVID. The impact of his statements in South Africa was significant. From what I can tell he was completely off base and never made any truly convincing arguments for his position.
- Fauci, of COVID fame, played a big role in getting NIH and the various AIDS community organzations working together and making large improvements to HIV/AIDS treatment. Before that, Fauci was heavily criticized by various LBGTQ orgs (see https://www.nytimes.com/2022/12/31/opinion/anthony-fauci-hiv...) "Larry Kramer, one of the group’s founders, wrote an open letter to Dr. Fauci in The Village Voice calling him a murderer and comparing him to the Holocaust organizer Adolf Eichmann." Again, all this presages the later treatment of Fauci by various political groups during COVID. I often think back to Fauci during HIV/AIDS while reflecting on the current situation around COVID and I think we got lucky to find somebody like him, even if he said a few dumb things, and we'll be lucky if any public servants are willing to take up his role in the future.
- modern gene therapy often uses variants on HIV as the vector. That's right: it's so good at getting into cells and modifying the genome, that we use it as the preferred method. it took quite some time before the vectors were made safe enough (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152689/)