Back in December 2018, I asked Rayceen Pendarvis what event in their life had changed them. Without hesitation, Rayceen told me that living through the AIDS crisis in Washington, DC was their most transformative experience. As somber memories of that period drifted back, Rayceen added that watching the disease “wreak havoc in our community made me realize the importance of … honoring friendships, honoring life and celebrating life because you don’t know how quickly it can be taken.” A decade ago, the District held the record for the most HIV infections. Since 2013, the number of new infections has dropped, but as recently as 2017, the rate of viral infections among Black men who have sex with men, and Black women who have heterosexual contact with Black men was on the rise. DC — Black DC especially — has been waging a war on HIV and AIDS since the 1980s. I’d interviewed Rayceen a few days before Christmas and I asked what was on their Christmas wishlist. “My first wish,” Rayceen said, “is to live to see a cure for HIV and AIDS.”
In early March, The New York Times reported that for the second time in 12 years, a patient appears to have been cured of HIV.
Scientists call him “The London Patient,” and in addition to HIV, the patient also suffered from Hodgkin’s Leukemia. Because the cancer was resistant to chemotherapy, doctors tried a more aggressive treatment plan that included a bone marrow transplant. Prior to working with the London Patient, researchers had two setbacks that taught them how the HIV virus attaches itself to proteins in the cells of our immune system. They found that a cellular mutation caused the absence of the protein CCR5, which prevented the virus from being able to attach to immune cells and multiply. Scientists gave the London Patient a bone marrow transplant with stem cells that included the CCR5 mutation to see if their theory worked. So far, it has. In response to radiation treatment for leukemia and stem cell treatment for HIV, scientists say the patient seems to be in complete remission.
The first successful HIV cure came under similar circumstances with Timothy Ray Brown (known as the Berlin Patient). In 2007, Brown underwent an almost fatal stem cell transplant to treat both his leukemia and HIV diagnoses. Although Brown would have to fight and defeat cancer once more after the transplant, to this day, the HIV virus has not returned. What the scientific and medical communities learned from these experiences will be invaluable to the next step in healing a disease that has devastated families and communities for more than three decades.
Researchers credit the Medicaid expansion option in the Affordable Care Act (ACA) with helping slow the spread of the disease by putting vulnerable patients in regular contact with healthcare providers. In February this year, the Journal of American Medical Association (JAMA) doubled down by publishing a plan, titled “Ending the HIV Epidemic,” that discussed how coordination between Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Indian Health Service (IHS) would aid in the prevention and treatment of HIV. It was a roadmap for how to achieve what was unthinkable a couple of generations ago.
Yet, despite the government’s investment in an HIV cure, Congressional Republicans’ efforts to cripple the ACA threatens to undermine any progress made, and thwart future progress in marginalized communities. The moral test of HIV prevention and cure will be whether poor and rural and nonwhite communities get access to these life-changing resources.