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Why does a cure for HIV remain so elusive?
Last reviewed: 03.07.2025
Researchers at the Schulich School of Medicine and Dentistry are at the forefront of HIV research, working to develop treatments and better understand how the virus works.
Finding a cure for HIV is no easy task, but progress is being made.
The theme of World AIDS Day on December 1 this year is "Follow the right path: My health, my right!" In 2021, the Joint United Nations Programme on HIV/AIDS (UNAIDS) adopted the goal of ending HIV and AIDS as a public health threat by 2030.
To achieve this goal, UNAIDS has set three 95-95-95 targets: 95% of people living with the virus should know their HIV status, 95% of them should be receiving treatment, and 95% of people on treatment should have the virus suppressed to undetectable levels.
Schulich's Professor Jessica Prodger is researching ways to prevent HIV transmission in sub-Saharan Africa, as well as why some people are more susceptible to the virus.
Professor Jimmy Diakekos and postdoctoral fellow Mitchell Mumby study aspects of the HIV virus and how its proteins control the immune response in those infected. They spoke to Western News about progress towards UNAIDS targets and why finding a cure for HIV remains such a challenge.
What is HIV?
Jimmy Diakekos (JD): HIV is a relatively small and simple virus, but it is also incredibly complex. Once it enters cells, the virus tricks the immune system into noticing its presence. HIV belongs to the retrovirus family and hides in latent reservoirs, making it difficult to treat. Without treatment, HIV can lead to AIDS.
Jessica Prodger (JP): This virus infects the cells that provide immune memory, the same cells that provide lifelong protection after vaccination as a child.
Why is HIV so difficult to cure?
JP: HIV is difficult to cure because part of its life cycle involves inserting its DNA into the DNA of human cells. These cells can lie dormant for long periods of time, meaning the viral DNA inside them remains inactive. If the cells are activated, the virus begins replicating again, infecting new cells or infecting other people. While the cell is "sleeping," the immune system is unable to detect the virus.
Current drugs block new infections but do not target HIV DNA in latent reservoirs. The body also has no mechanism to remove foreign DNA from its own. This is the main challenge of HIV cure research.
What are the current treatments for HIV?
JD: Antiretroviral therapy (ART) involves drugs that block enzymes such as reverse transcriptase or integrase, which prevents the virus from replicating. This helps control the virus and significantly improves the quality of life for patients.
Mitchell Mumby (MM): ART drugs are also used as a preventative measure – pre-exposure prophylaxis (PrEP). When taken correctly, the drugs make it virtually impossible for HIV to be transmitted.
A recent study found that twice-yearly injections of lenacopavir completely prevented HIV transmission in young women in South Africa and Uganda. The finding could significantly improve adherence to treatment and reduce transmission rates.
How far has humanity progressed in the fight against HIV and AIDS?
JD: We have made huge strides in recent decades. There are now over 25 drugs to treat HIV. There are massive educational campaigns to motivate people to get tested for HIV.
However, in some countries, there remains strong stigma associated with HIV, leading many to avoid testing and treatment.
What needs to be done to achieve the 95-95-95 targets by 2030?
MM: The problem is more social and economic than medical. There is a need to increase investment in testing and access to ART for both treatment and prevention.
Particular attention should be paid to vulnerable groups: men who have sex with men, people who use drugs, sex workers, young women. Many of them fear discrimination or even punishment.
JD: These goals can only be achieved through education, testing, and integrating HIV services into the existing health infrastructure. We need to maintain hope and strive towards ending the epidemic.