Decades ago, Dr. Diane Havlir thought she would never say "cure" and "HIV" in the same sentence.
Havlir was doing a residency at San Francisco General Hospital in 1985 amid a global crisis in which the number of new HIV/AIDS cases was rising, but there was no known origin or treatment regimen. Those infected were simply given a death sentence.
Now the chief of UC San Francisco's HIV/AIDS Division at San Francisco General, Havlir smiled as she said these words:
"1985 was a very, very dark time in the epidemic, but we have the tools right now in our hands to curb the HIV epidemic and to begin to end it."
On July 22, Havlir will be in Washington, D.C., to co-chair the XIX International AIDS Conference and talk with 25,000 colleagues about the steps necessary to develop a cure. There are as many as 34 million people worldwide living with HIV/AIDS and as many as 2.7 million new diagnoses each year.
Dr. Paul Volberding, director of the AIDS Research Institute at UCSF, said the conference presents an opportunity to showcase the strides in research and medication that have brought optimism to the fight against the disease.
Volberding chaired the last U.S.-based conference, which was held in 1990 in San Francisco. At that meeting, "there was no hope," Volberding said.
"Everyone who was diagnosed would die from the disease," he said. "We are obviously now in a completely different world."
Several key findings in recent research trials are expected to be discussed at the conference, including how important treatment is to preventing transmission; the role of drugs in preventing infection; and the possibility that a cure can be reached, since it's known that at least one person who transmitted HIV is no longer infected.
Discussions also will focus on new drugs and how to pay for it all.
Today, the International AIDS Society is making a declaration to end the disease with a new investment in the human rights of those at greatest risk, while also ending stigmas associated with HIV/AIDS and encouraging an increase in testing to prevent infection.
If the steps outlined by the society are taken, researchers say, they believe HIV/AIDS can be cured.
Havlir stressed that a cure will not be achieved unless populations who are disproportionately affected, such as men who have sex with men and drug users, are addressed and treated. She also said identifying where the money will come from to pay for treatment will be key.
"We're at a moment of unprecedented optimism," Havlir said. "Our point of departure is finances. We can't do it unless we get the global support and figure out how to reach the most affected populations."
Recent developments in the fight include an announcement by Kenyan officials that the country is attempting to get more than 1 million men circumcised by next year. Circumcisions can reduce males' chances of acquiring HIV/AIDS by 50 percent.
Also, earlier this month in the U.S., the Food and Drug Administration approved an at-home kit that uses a cheek swab to test for HIV. And in the Bay Area, a Foster City company is seeking FDA approval of a one-a-day pill for patients who haven't previously taken HIV therapies.
The International AIDS Conference has not been held in the U.S. since 1990 due to travel restrictions for infected foreigners. The International AIDS Society will not host a conference in any country with such a policy. However, the travel restriction was lifted in 2009.
A nine-point plan to end HIV/AIDS
-- Increase in new investments
-- Evidence-based HIV prevention, treatment and care for those at greatest risk and in greatest need
-- End to stigma, discrimination, legal sanctions and human rights abuses against those living with and at risk of the disease
-- Marked increases in testing, counseling and access to services
-- Treatment for all pregnant and nursing women living with disease, and an end to perinatal transmission of HIV
-- Expanded access to antiretroviral treatment for all in need
-- Identification, diagnosis and treatment of tuberculosis
-- Accelerated research on new tools for HIV prevention, treatment, vaccines and a cure
-- Mobilization and meaningful involvement of affected communities
Sources: International AIDS Society, UCSF