HIV prevention and treatments steadily advance, cure may still be far off

Today, on National Gay Men’s HIV Awareness Day, we recognize the substantial progress that HIV medications have made in the fight against HIV and AIDS, and how much work is still needed to continue the fight. 

For many of us who are a part of the LGBTQ community as well as those in the medical community, we are truly aware of the meaningful and impactful progress that has been made in HIV exposure and prevention. PrEP, or pre-exposure prophylaxis, almost completely eliminates the chances of contracting HIV, while PEP, or Post-exposure prophylaxis, can significantly reduce the chances of contracting the virus if it is taken soon enough after possible exposure to it. 

Also, increased testing helps identify positive cases more quickly, while individuals who are living with HIV and on effective treatment are able to live significantly lengthier and more healthy lives. It is also widely known that individuals who are on effective treatment and take it as prescribed become undetectable, and undetectable means untransmittable. 

However, with all of these amazing advances, an effective cure or vaccine still has not been discovered, despite how close scientists have come recently. But, new potential treatments are being introduced down the pipeline.

Nevertheless, There are still many ideas and attitudes that need to be adjusted, whether a vaccine is introduced or not. The longstanding stigma associated with the virus is one of the biggest problems being faced in the fight against HIV. 

In a special report, Financial Times spoke with Kimberly Smith, head of R&D at ViiV Healthcare, an HIV-focused pharmaceuticals company majority-owned by GlaxoSmithKline with Pfizer and Shionogi as shareholders. She recounted her experiences during the height of the HIV/AIDS epidemic of the 80s and 90s, which influenced her decision to pursue a career in infectious diseases, with focus on HIV. 

“The stigma from HIV was horrible then and continues to be horrible now, not to the same degree, but that really grabbed me,” she explains. “I wanted to do something, I wanted to make [patients] feel like someone cares about them, someone who’s not afraid to touch them.”

Smith also spoke about one of the newest and most hopeful advances in HIV prevention being developed. These new drugs would only require a shot once a month, or maybe even less frequently, according to Financial Times. 

The drug being developed by ViiV is called cabotegravir, which has been submitted to the US Food and Drug Administration for approval. The company hopes “it will be used widely for prevention, given it is easier to take, more effective than the current standard of care and needs to be administered less frequently.”

Though these new preventive medications are on the horizon, the fact also remains that an HIV vaccine still seems “very far away,” according to Smith. A Johnson & Johnson vaccine trial was recently stopped for not being efficacious enough, according to the Financial Times. 

“Eighteen months into the COVID pandemic and we have a vaccine”, Smith says, before acknowledging that developing an HIV vaccine or cure is more complicated because it has many more mutations which are harder to control, and because the virus is “different . . . sneaky, it comes in, it attacks immune cells and hides in immune cells”. 

Aside from the scientific complications, many worry about the effectiveness of HIV treatments because of the fact that many drugmakers have often been accused of gouging the prices. But Smith ensures this wouldn’t be the case with ViiV’s new treatment. 

“We have a clear, comprehensive access policy”, she states. “We want to make our medicines accessible to people in high-prevalence settings.” She adds that the drugmaker has agreements in place with generics manufacturers to do this.

The last big issue addressed by the Financial Times was that HIV, as with COVID, has highlighted the fact that the vulnerable and marginalized groups in society are most at risk of contracted diseases. Despite this fact, testing, tracing and follow-up care has been disrupted in these communities, and COVID is partially the blame

Smith argues that the COVID pandemic showed that authorities learned very little from the HIV epidemic. “Not getting on top of [this differential impact] was a big error” early on in the pandemic, she says. She adds that the world should “recognize the potential [of COVID] for a disproportionate impact on communities of color and poor communities, who are more likely to be frontline workers”.

When speaking of those who did not learn from the HIV epidemic and all the work she and those like her have already put in, she adds “I can’t do it my whole career and not let it be personal.”