This year marks three decades since a major breakthrough in medication for HIV/AIDS, where multiple drugs were combined in a new way that made people less sick within weeks. 

Discoveries like these – before many of the people reading this were born – are the foundation of the world we live in now, where AIDS is far less of a concern in the Western world. 

It could be easy to forget, or to not understand, the work that went into making a life without fear of AIDS possible today. 

In that spirit, I spoke with Greg Johnston this week. He’s an author and a former pharmacist who worked on Oxford Street, in the heart of Sydney’s gay village, during the height of the AIDS crisis in the 1990s. I wanted to know about his experiences, and what he wants young people to know about that era. 

Here’s what I learned.

Human immunodeficiency virus (HIV) is an incurable disease that attacks the immune system, transmitted through bodily fluids. Left untreated, the immune system deteriorates, which can lead to Acquired Immune Deficiency Syndrome (AIDS).

After decades of sporadic cases across Africa and Europe, the era we now know as the AIDS crisis began in 1981. In June of that year, different U.S. scientists reported similar symptoms appearing in otherwise healthy young gay men. 

The U.S. Centers for Disease Control (CDC) soon got on the case. While researchers couldn’t initially work out “if or how the clustering” of these symptoms “in homosexual men is related,” they would eventually start talking about “Acquired Immune Deficiency Syndrome”.  

Doctors diagnosed the first case in Australia in November 1982. The first death in Australia was recorded eight months later. By mid-1996, an estimated 5,100 Australians had died from AIDS-related illnesses, according to data from the Australian Bureau of Statistics. 

While anyone can contract HIV, its early spread among gay men linked the epidemic inextricably with the LGBT community. Around the world, the community mobilised to spread the word about safe sex and to advocate fiercely for government funding into research and care. In Australia, the safe sex campaign was so successful, new infections dropped from up to 3,000 in 1983 to 500 in 1987.

2026 is a far cry from Sydney, 1993, when Greg Johnston began working as pharmacist on Oxford Street. 

By that point, the World Health Organisation estimated the global death toll from AIDS-related illnesses had reached two million. 

Johnston saw young people who had become so ill they’d had to give up work, or grown old before their time. 

“They became as obsessed with their health as older people are obsessed with their health,” he said, leaving the pharmacy with “literally shopping bags of medication.” 

It was a time of grief, of burying friends gone before their time. Johnston said he knew people who “ suffered complete burnouts because they had just been to so many [funerals] and dealt with it so many times and been around that cycle of grief so quickly.” 

It was also a time of fear, stoked in part by a now infamous awareness campaign from the Australian Government. 

In 1987, the National Advisory Council on AIDS (part of the Department of Health) released a TV advertisement. 

It depicts the Grim Reaper bowling a ball at a group of Australians, as an ominous voice-over says: “At first, only gays and IV drug users were being killed by AIDS. But now we know every one of us could be devastated by it.” 

Johnston says the campaign sparked conversation. “Everyone was talking. Like, you just could not go out anywhere” without hearing about it. 

“I’m not convinced fear was the best mechanism to make people act responsibly,” Johnston said. Some were so fearful of their communities discovering they had HIV/AIDS that they would travel from country towns once a month to the pharmacy where Johnston worked to pick up their medication. 

“ It was the worst of times, but… there was also just this humor along with it,” Johnston said. 

“I don't think I'd ever met so many naughty young men and people with incredible sharp wits that in another form could have easily been on stage.”

In the mid 1980s, the CDC and a pharmaceutical company called Burroughs Wellcome worked together to revive a failed cancer drug called azidothymidine (AZT) as an AIDS treatment. Australian activists lobbied the Federal Government to broaden access to AZT trials, then to have it approved for prescription and subsidised on the Pharmaceutical Benefits Scheme (PBS). 

AZT was effective, but it wasn’t a miracle drug, Johnston said. 

“The side effects were horrendous,” including diarrhoea and nausea, “then you have to take a lot of other drugs to try and settle all of that down.” 

It also needed to be taken repeatedly throughout the day: “The dosing schedule was so rigid and so difficult for people to be on.” And, after a while, the body could become resistant to one medication. 

By 1993, the WHO projected eight million global deaths by 2000 without advancements in treatment.

In 1996, a decade of research from around the world culminated in triple therapy, also known as highly active antiretroviral therapy (HAART), a combination of drugs. It could bring down the level of HIV in a person’s system to undetectable levels, rapidly improving their quality of life and significantly lowering the death rate. 

“We had these skeletons kind of just coming back to life,” Johnston said. 

“These people who were so unwell, and they just came back and bloomed again”.

Today, people with HIV can take medication to reduce the disease’s presence in their body, to the point that it can’t be passed on – described medically as having an “undetectable viral load”. People without HIV can take a medication called PrEP to reduce their risk of contracting it.

Described by then-Federal Health Minister Greg Hunt as “one of the most significant advancements in HIV transmission Australia has ever seen,” PrEP was listed on the PBS in 2018, subsidising the cost of the drug to make it more accessible to the community.

In 2025, the UN’s AIDS agency said there were around 41 million people worldwide living with HIV, but the prevalence of what it called “lifesaving” treatments means HIV/AIDS is no longer the ‘death sentence’ it used to be. 

The agency estimates 78% of all people living with HIV were accessing treatment, while new HIV infections have dropped by 65% since the peak in 1994.

But just because we have come this far doesn’t mean we shouldn’t look back. 

Johnston says he thinks “ people have forgotten how dreadful it was…  there were horrendous deaths that people went through, and I don't think that should be kind of forgotten.” 

He also notes how much of the modern LGBTQIA+ community’s rights are built on the work done during the AIDS epidemic, including marriage equality. 

“Take some legacies from that, and take some lessons away from that as well.” 

Greg Johnston’s novel about that time, For a Moment More, is available now.

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