Today, December 1, is World AIDS Day. During my second year of medical school, I remember sitting in on a full day of presentations about AIDS. Gabriel Virella always organized an intricate set of lectures on World AIDS Day each year. That year, researchers had just failed (again) in a major trial of a vaccine. Along with immunology, we learned about social and cultural issues about HIV, the different medicines used to treat it, and the difficult journey to limit its impact. This day inspired me to spend a couple of weeks on a rotation with the HIV clinic at MUSC. I learned first-hand about patients and families suffering with HIV. Little did I then realize that a decade later, I’d still wrestle deeply with the impact of HIV/AIDS.
I now work in translational research at Vanderbilt and receive regular emails from various research trials seeking volunteers. One day, I noticed that one email was recruiting for an HIV vaccine. While I knew that HIV infections could be better controlled with inelegant methods, I believed – and still believe – that a vaccine is the best hope for long-term control of this disease. Still inspired by my former professor’s passion about this virus, I emailed this trial about volunteering for their study and explained my interest. Every trial has inclusion/exclusion criteria to focus results on one type of patient, and unfortunately, my bipolar disorder left me on the exclusion list. However, after reading of my personal interest in the disease, a study coordinator asked if I wanted to join the Community Advisory Board for the HIV Vaccine Trial Network (HVTN) at Vanderbilt.
This was early in the COVID era, and once a month, I joined Zoom meetings. Along with sharing community happenings and news of trials, most months, a presenter would speak about a related topic. Sometimes, the topic would be social; other times, it’d be more hard science. Either way, it was all quite interesting. It was one of the few times in my week where I could just listen and think. No one relied on me to perform, and I could simply focus on becoming a better person through caring.
I continue to meet with the Vanderbilt HVTN each month, and I have also read a dozen-or-so books about the world’s struggle with HIV disease. This spans America and the West, Haiti, Africa, and Asia. There are so many angles at play, including LGBTQ+ issues, IV drug users, healthcare inequities, and (at one time) even blood transfusions. As a devout Christian, I also felt that in a strict moralism avoiding compassionate treatment, the church has failed – and continues to fail – those affected by HIV. I hoped I could, in a small way, go against the cultural flow.
So today, I remember the many dead from AIDS: Those in the early days in San Francisco and New York City where young men died alone, eschewed by family, in hospitals; those in Africa who waited on expensive Western aid to come; those in Haiti who lacked the infrastructure for proper treatment; those whose innate sexuality caused them to be spit on by society; and vulnerable women who had to choose between leaving her family or living with HIV/AIDS. And I watch expectantly for a vaccine to limit its reach. It has slowed through many means – condoms, multi-drug therapy, and PrEP prophylactic treatment – but a vaccine is the only way to make it go the way of smallpox or polio. That is, only a vaccine can decisively defeat HIV, and final victory will come only through people like us doing our part. That’s why I remember World AIDS Day today.