Tom\u00a0Perrault distinctly remembers the time he received an electric shock in the name of science.<\/p>\n
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\u201cI have a pretty high threshold for pain,\u201d he told SFGATE. But he had never experienced electroporation before, a procedure in which an electric current is used to disrupt cell membranes and make them more permeable to medical treatments. \u00a0<\/p>\n
The treatment was one of the first interventions in a recent medical trial based out of UC San Francisco. Researchers were trying to retrain Perrault\u2019s immune system to track down and hunt a hidden viral invader: HIV.<\/p>\n
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The disease may no longer be a death sentence, but it isn\u2019t yet a medical relic. There were nearly 39,000 HIV infections in the U.S. in 2023<\/a>, according to the Centers for Disease Control and Prevention. Globally, 1.3 million people contracted HIV<\/a> in 2024, according to data from the World Health Organization, and 630,000 people died due to HIV-related disease.\u00a0<\/p>\n And so, Perrault is part of a cohort of 10 study individuals who took part in a novel medical trial at UCSF that used three different therapies to treat people with HIV. Perrault recalled the warning from his medical team about the electroporation: \u201cIt\u2019s gonna be like somebody punched your arm.\u201d\u00a0<\/p>\n \u201cSo I go in, I\u2019m a little cavalier about it,\u201d he told SFGATE. The medical team held him down on the exam table, startling him, before giving him an electric jolt and a type of vaccine called a DNA vaccine simultaneously.\u00a0<\/p>\n Article continues below this ad<\/p>\n \u201cI screamed,\u201d Perrault recounted. \u201cI\u2019m like, \u2018That was not a punch, that was an electric shock, people!\u2019\u201d\u00a0<\/p>\n Unfortunately for Perrault, the procedure had to be immediately repeated in his other arm.\u00a0<\/p>\n \u201cI started trembling. I\u2019m like, \u2018That was bad, that was scary,\u2019\u201d he recalled. The researchers warned Perrault he would need another round of electroporation in a few weeks.<\/p>\n Tom Perrault is pictured at UCSF on Monday, March 9, 2026.\u00a0<\/p>\n Charles Russo\/SFGATE<\/p>\n Many people might give up before voluntarily subjecting themselves to pain like that again, especially with no promise of a cure. But Perrault, a former board chair for the San Francisco AIDS Foundation, had longed for this type of study for years. At the end of all these treatments, he would finally be able to pause his HIV medication for the first time in years and see firsthand how close the world is to a cure.<\/p>\n Article continues below this ad<\/p>\n \u201cGay men in the \u201980s and the early \u201990s would have crawled over glass on their hands and knees to get to a pill or a vaccine, \u201c he said. \u201c… Anything I can do to advance the idea that science is important.\u201d\u00a0<\/p>\n \u2018Dark days\u2019<\/p>\n In 1981, the\u00a0CDC published a report<\/a> of five sick young men who showed up in Los Angeles hospitals dying from a type of pneumonia commonly associated with older adults. Physicians realized their immune systems had essentially stopped working, but they didn\u2019t know why. It was the first ever time the condition known as (Acquired Immunodeficiency Syndrome<\/a>) AIDS was documented as a disease.\u00a0<\/p>\n For years, there was little the medical community could do for AIDS patients. In the beginning, those with the disease were only expected to live one to two years after diagnosis. Not only was the new disease extremely deadly, but research, funding and treatment access<\/a>\u00a0were stalled because of the stigma of a sexually transmitted infection most commonly associated with gay and bisexual men. President Ronald Reagan didn\u2019t even publicly\u00a0mention<\/a> the word AIDS until 1985, a full four years after it was discovered.<\/p>\n Article continues below this ad<\/p>\n In San Francisco, the disease took a devastating toll<\/a> on the queer community, although the city was also a model for care and opened the first outpatient AIDS clinic in the country in 1983.\u00a0<\/p>\n In the decades since, HIV treatment has come a long way. Early antiretroviral treatment discovered<\/a> in the late 1980s was toxic and much more fragile; a single missed dose could allow the virus to return. Today the modern form of ART, discovered in 1996, is much more effective and durable, effectively tamping down viral levels until they are undetectable in most people. If viral levels are undetectable, then people living with HIV cannot spread the infection to others.<\/p>\n The surviving members of the San Francisco Gay Men\u2019s Chorus shown in white, while those who died due to AIDS are represented in black, in this photo from May 1993.<\/p>\n S.F Chronicle\/Getty Images<\/p>\n Dr. Steven Deeks, a professor of medicine and an HIV expert at UCSF, designed and led the study Perrault took part in. He says while the current regimen of ART treatment is good, it still isn\u2019t good enough to solve a global problem like HIV.\u00a0<\/p>\n Article continues below this ad<\/p>\n \u201cThe big fundamental problem with treatment is that it has to be taken daily for life,\u201d he told SFGATE. \u201cThat means you have to find a regimen that you can tolerate, you can afford, that works and that\u2019s available. And that just doesn\u2019t happen for a large number of people globally, and even some people in San Francisco.\u201d\u00a0<\/p>\n Deeks completed his training in San Francisco in the late 1980s, a time he calls the \u201cdark days.\u201d He said the current success in treating HIV and stopping its spread remains tenuous and subject to political whims; in 2025, the Trump administration cut key funding<\/a> for HIV treatment abroad. This year, the Trump administration moved to cut\u00a0$600 million<\/a> in public health funding for multiple states \u2014 including California \u2014 that was earmarked for initiatives including HIV and sexually transmitted infection prevention and treatment.<\/p>\n \u2018Unprecedented\u2019 results\u00a0<\/p>\n Human immunodeficiency virus, aka HIV, is an insidious disease that attacks cells key to the immune system. Without a properly working immune system, a person with untreated HIV is vulnerable to even minor infection. The disease can grow for years before causing symptoms, hiding in cell DNA in tissue<\/a> so the immune system doesn\u2019t know it\u2019s there. If left untreated, HIV evolves into acquired\u00a0immunodeficiency syndrome, aka AIDS.<\/p>\n Article continues below this ad<\/p>\n By stopping the virus from replicating, antiretrovirals can keep HIV in check, but they require a patient to take the meds for life.<\/p>\n Deeks has been researching HIV for decades and is the principal investigator of the Institute for HIV Cure Research under the American Foundation for AIDS Research, or amfAR. The trial Perrault took part in got its start in 2016 when amfAR launched a $20 million, five-year partnership with UCSF to find a cure for HIV.\u00a0<\/p>\n Tom Perrault moved from Washington, D.C., to San Francisco in 1991.<\/p>\n Courtesy of Tom Perrault<\/p>\n Deeks and his team began enrolling patients in their study in 2020. They created a three-pronged approach to the immunotherapy treatment after being inspired by three different primate studies. Normally, when a person with HIV stops taking their ART medication, the virus rebounds in a matter of weeks. The researchers hoped to retrain the immune system of HIV patients to keep the virus at bay without medications for a longer period of time.\u00a0<\/p>\n Article continues below this ad<\/p>\n In 2020, the 10 patients in the trial received the DNA vaccine, along with the\u00a0electroporation, to train their T cells, a white blood cell that\u2019s a key component of the immune system, to find and destroy HIV cells. Then the individuals received two different types of antibodies, called broadly neutralizing antibodies. These proteins, which are a key part of the immune system, bind to foreign invaders like viruses or bacteria to destroy them. The\u00a0antibodies used in the study can prevent HIV from entering healthy cells as well as prime key immune cells to identify and destroy the virus.\u00a0<\/p>\n Researchers combined this first antibody treatment with another drug designed to force HIV out of hidden reservoirs in the body when it\u2019s in the latent stage. By forcing the HIV to be visible, the retrained immune system could, in theory, find and destroy the virus on its own.<\/p>\n After eight months, study participants were asked to stop taking their regular ART medication. Forty-eight hours before they stopped taking their medications, they received a dose of different broadly neutralizing antibodies in the hopes of drastically reducing any trace amounts of virus in their body and preventing the disease from returning as strongly as before.\u00a0<\/p>\n Article continues below this ad<\/p>\n The entire process took 34 weeks and included dozens of appointments and treatments. Perrault remembers the first day he woke up and didn\u2019t take his medication. It had been a decade straight of daily pills.<\/p>\n \u201cI remember it feeling very momentous,\u201d he said. \u201cIt was like, \u2018Wow, I\u2019m like, literally stopping my meds and I\u2019m going to see what my body can do.\u2019\u201d\u00a0<\/p>\n Tom Perrault has taken part in multiple AIDS marches and protests.\u00a0<\/p>\n Courtesy of Tom Perrault<\/p>\n For weeks, and then months, after,\u00a0Perrault and the other study participants had their viral levels checked periodically to see if the virus had rebounded. At no time did the UCSF team promise a cure; it was always expected the patients would have to go back on their medications.\u00a0<\/p>\n Article continues below this ad<\/p>\n But as Perrault went one, then two, then five months without the virus reappearing, his initially wary attitude became hopeful.\u00a0<\/p>\n \u201cEnd of October, the virus still hasn\u2019t come back and I\u2019m thinking, \u2018Wait a minute, what magic is going on here people?\u2019\u201d he said.<\/p>\n Then on a trip home to Washington, D.C., for Thanksgiving, he got a call from the team at UCSF. The virus had returned. It had been five months without meds.<\/p>\n \u201cI just go up into my room, and all of a sudden I start sobbing,\u201d he said. \u201cBecause I didn\u2019t realize, really, the enormity of it. Like f\u2014k, you know? We were so close.\u201d\u00a0<\/p>\n Article continues below this ad<\/p>\n<\/p>\n
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