Faith, Hope and Destiny

[Note from This article originally appeared as an editor's note in the September/October 2010 issue of Positively Aware_. You can browse other articles in the issue by clicking the links in the "See Also" box on this page, or by visiting our index of articles from Test Positive Aware Network.]_

Jeff Berry At the 2010 International AIDS Conference in Vienna this July, there was genuine excitement in the air. The big news to come out of the conference was the CAPRISA 004 study, which for the first time established proof of concept for a vaginal microbicide.

Near the end of the Tuesday afternoon press conference, Hilary Beard of the Black AIDS Institute asked the study's lead investigator what the gel looked, smelled, and tasted like, and was offered an applicator like those used in the study to see for herself. Beard walked to the front of the room and dabbed some on the back of her hand, and after tasting it, looked around the room and nodded her approval. She then held the applicator up for others in the room. Nearly a dozen reporters, this one included, rushed to the stage to sample the gel (for the record it's tasteless, odorless, and looks and feels just like ordinary lubricant).

Later that evening during the Human Rights Rally and March, conference attendees paraded down the streets of Vienna holding banners and shouting slogans, and ended up at a gathering of over 10,000 people at Heldenplatz, the same site where Hitler once spoke after Germany invaded Austria. The rally included inspirational speakers and videos, and ended with a moving musical performance and powerful speech by Annie Lennox.

Also during the conference, the two Bills (Gates and Clinton), NIH's Tony Fauci, and other leading researchers and advocates spoke of advances in prevention and treatment, all the while advocating for wider access for everyone. The advancement of human rights was the overall theme of this year's conference, with a call for an end to discriminatory policies and practices which continue to contribute to the escalating pandemic worldwide.

But underneath it all ran an undercurrent which is the theme of this issue of Positively Aware, and which has slowly and steadily been gaining momentum once again -- the search for a cure.

Talk of a cure has been going on for decades, although it's been somewhat of a roller-coaster ride, much like the pendulum swing of antiretroviral treatment. At first there was no treatment, then not very effective ones, then, with the onset of HAART, we had "hit hard, hit early." Due to some of the toxicities it was then recommended for some to defer treatment, and now it's back to starting treatment earlier, with some even recommending treatment for everyone when they first test positive.

And so it goes with talk of a cure. Back in the 1980s, when I was first diagnosed, it seemed like a pipe dream. Friends were dying left and right, and we were hungry for something, anything, that might offer us hope. Then came the protease inhibitors, which produced "the Lazarus Effect," and were a lifeline for many. Death rates were dramatically reduced, people became healthier, and there was talk of a cure once again -- it suddenly seemed within reach. Dr. David Ho, a leading AIDS researcher, was Time magazine's Man of the Year in 1996. Ho and his group published data that demonstrated that combination therapy could possibly eradicate the virus from the body.

Unfortunately, the hopes for eradication never quite panned out at the time, and the main reason, it is thought, is because there are reservoirs hidden within the body which house latently-infected cells. There is now, however, renewed interest and research being focused on purging these latently-infected cells from their hiding places, and eradicating the virus once and for all. And there are some other promising strategies, compounds, and areas of research being looked at, some of which are discussed in this issue, and many of which are yet to be discovered.

Regrettably, all of this takes time and money. Inadequate funding and scant attention have been given thus far to cure research, but with today's economic realities, it makes even more sense than ever. Vaccine study results have been disappointing so far. Prevention outcomes, at least up until the recent microbicide news, have been less than stellar. And ramping up access is starting to look like a pipe dream itself. Not that we shouldn't continue to strive for developments and advancements in all of these areas, but just as no one drug suppresses the virus on its own, no one strategy is going to end this pandemic. It will take a combination of successful, affordable, and tolerable therapies; prevention strategies that work and are feasible; guarantees of human rights and dignity for everyone infected and at risk; and ramped up access to health care and treatment for all who need it.

There is an excellent article by Virginia Hughes in the July online supplement of Nature (see page 13) that ends with a quote by Mario Stevenson, professor of molecular medicine at the University of Massachusetts, that for me, sums it up perfectly, and gives me hope.

"Scientists are stubborn," says Stevenson. "That persistence on the part of the scientific community hopefully exceeds the persistent qualities of the virus."

Take care of yourself, and each other.

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