Sticking Point

An AIDS vaccine designed by renowned researcher Don Francis is in final testing. The Plague could be over - but the gay and scientific establishments are utterly unenthused.

Even so, the lack of response is puzzling.
"There's quite a bit of altruism among San Franciscans," he says, "but this is not as easy as we thought."

Perhaps the low turnout can be blamed on the unusual place vaccines occupy in the turn-of-the-millennium universe of AIDS. For many gay men, the AIDS crisis is over. Protease inhibitors and other drugs have considerably extended the lifetimes of HIV-infected people. Many Castro denizens haven't lost a close friend for years following a period during the '80s and early '90s when they seemed to lose one every couple of weeks. Anecdotal reports and some small studies indicate that S.F. gay men are returning to the old, unsafe-sex ways, as if the disease had ceased.

The criticism VaxGen's vaccine has received in the scientific press can be troubling to potential volunteers, too. VaxGen is only one of 30 companies engaged in research to produce an HIV vaccine. U.S. Rep. Nancy Pelosi is pushing to give such firms a 30 percent tax break, and the U.S. government is putting up $200 million to back Bill Clinton's 1997 pledge to have an AIDS vaccine by the year 2007. These facts present a unique quandary to potential vaccine-trial volunteers, who stand to be disqualified from future, perhaps-more-promising vaccine trials by signing up to be injected with gp120.

Given the nature of the way these trials measure a body's response to vaccines, one can be a vaccine virgin only once. If one is going to fill three years of one's life with repeated blood tests and AIDS talk, it may as well be for an inoculation that's likely to work, this line of thinking goes.

It's still too early to say whether the low volunteer turnout will hurt the trials. The AIDS clinics, hospitals, health agencies, and gay health groups around the country that are carrying out the trials have until the end of the year to finish recruiting the 5,000 necessary volunteers. A VaxGen spokesman insists plenty of volunteers will be signed up by then.

"Certain sites often have problems, but there are lots of sites," the spokesman says.

Recruitment efforts are sure to benefit from the proselytic verve of some study participants.

Marcus Loy, a 38-year-old gay man who works in the Financial District, says the reasons for volunteering were clear. Among them is the moment, while he's sitting around with friends, when he learns that AIDS has been eliminated from Earth.

"I'd like to have a magical day like that," he says. "It's been a long, dark, dreadful time. It's been going on since I lost my best friend from college in 1985, and things haven't gotten much better. Recently, guys are letting up on safe-sex practices, and people are still becoming infected, still people are dying, so a vaccine seems to be the logical solution.

"So I'm doing this for my friends who have died."

Given the irresistible drama of Don Francis' struggle so far, it's easy to believe volunteers will eventually sign up in droves to test his vaccine. It's easy to envision the gp120 vaccine swimming through 7,500 bloodstreams, startling thousands of immune systems to attention. It's not even much of a leap to conceive of a final step, in which millions, then billions of vials of colorless, watery liquid are shipped all over the globe and injected into the arms of African children, San Francisco gay men, Burlingame soccer moms, Mexico City taxicab drivers, Slovakian engineers. It's easy to imagine an afternoon happy hour in the Castro, during which guests overhear on the radio that the last of the AIDS virus has been eliminated; that scientists are putting one vial of the scourge into cold storage, for its historic and scientific value.

It's not a likely scenario, most AIDS researchers say, but it's possible. If it happens, it will have been in large part due to the efforts of a mild-featured man in a Brisbane office suite, the good-natured raconteur, the one with the venomous words for everything that stands in his way. The man with the effective bedside manner.

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