By: Marie Palumbo-Hayes, LICSW Chief of Community Services, Health Division FSRI
Forty years ago, when AIDS Project Rhode Island opened its doors, medicine had no answers and no treatments for those diagnosed with AIDS . It was a time defined by fear, funerals, and uncertainty—when we lost patients, friends, and loved ones far too soon, and far too often.
But once we discovered that HIV was the virus that caused AIDS, science started to re-write that story.
In 1983, scientists first identified HIV as the virus that leads to AIDS—a landmark moment in medical history. However, it wasn’t until 1986 that “HIV” became a standardized term used in public health and media conversations. This discovery was vital because it gave researchers a tangible target, allowing them to begin developing real treatments that could fight the virus and extend lives. The identification of HIV didn’t just change the course of medicine—it shifted the trajectory of the epidemic.
This scientific milestone unfolded alongside a cultural shift, in part thanks to the courage of individuals who put a human face on the crisis. One of the most prominent was Ryan White, a teenager from Indiana who contracted HIV through a blood transfusion. Diagnosed at age 13 and banned from attending school because of his condition, Ryan became a national symbol of compassion, advocacy, and the devastating impact of stigma. His battle—and the public’s reaction to it—helped transform HIV/AIDS from a taboo topic into a national conversation about rights, research, and respect.
Today, HIV is no longer a death sentence. With one pill a day, people living with HIV can lead full, healthy lives. In fact, many can reach an undetectable viral load—meaning they not only feel well, but they cannot transmit the virus to others through sexual contact. Undetectable equals untransmittable. That’s not just a slogan; it’s science. And it’s saving lives.
Today, a test that once took days now takes 20 minutes. One painless oral swab can give someone their HIV status—quickly, privately, and without stigma. If that result is positive, we can start treatment the same day. If negative, we can offer PrEP: a daily medication that reduces the risk of acquiring HIV by up to 99%.
These breakthroughs are nothing short of extraordinary. But they are also fragile.
All of this—the testing, the medication, the counseling and care—is made possible by decades of public health funding and policy. It is the result of sustained federal support and insurance protections like the Affordable Care Act’s preventive services mandate. Without them, the costs of prevention and treatment could return to pre-ACA levels. Medications like PrEP could once again become unaffordable—up to $22,000 a year for someone without insurance.
And we’ve seen what happens when care becomes inaccessible. HIV spreads. It spreads just as it did in the 1980s and 90s. The virus hasn’t changed. What’s changed is our knowledge—our power to fight it. That power depends on access.
As the Supreme Court now weighs whether no-cost coverage for preventive care is constitutional, we in the medical and public health communities are watching with deep concern. Because what’s at stake isn’t just policy. It’s progress. Lives. Futures.
AIDS Project Rhode Island is proud to mark 40 years of service this May. We remember those we’ve lost. We celebrate those who are thriving. And we remain steadfast in our mission: to ensure that anyone at risk for or living with HIV has the tools they need to live—and to live well.
Medical advances have carried us far. But medicine can’t do its job if people can’t afford it, access it, or trust it.
Let’s not allow the next 40 years to be a story of regression. Let’s keep writing a story of hope, resilience, and science that serves us all.
