The poster-painters were members of the AIDS Policy Project, a group with roots in Philadelphia, and they struck during the International AIDS Conference, held last week in Washington. Again and again at the gathering, members of the group pressed their message: Push harder to find a cure for AIDS.
In the public consciousness, AIDS has morphed from being a certain death sentence to a chronic manageable disease for those getting antiretroviral treatment.
When that treatment became available, in the mid-1990s, many scientists thought the new drugs would lead to a cure. But the science proved more complicated and HIV sneakier and harder to kill than anticipated, and the idea of a cure faded from public discourse.
For millions in developing countries, though, treatment remains out of reach, and donors spend billions trying to catch up with growing demand. Some people living with HIV have built resistance to the antiretroviral drugs or suffer unbearable side effects.
In 2009, the world learned about Timothy Brown, the first person cured of HIV, known then as "the Berlin Patient." Brown had been living with HIV and had such severe leukemia that he needed a stem-cell transplant to reboot his immune system.
His doctor, Gero Hütter, opted to transplant stem cells from someone with a genetic resistance to HIV. Since the transplant, Brown has not needed to take HIV medication and has shown no signs of active HIV in his body.
Around that time, members of the AIDS Policy Project, longtime AIDS activists Katie Krauss and Jose de Marco of Philadelphia, and Stephen LeBlanc of Oakland, Calif., took a second look at the state of cure research.
In a paper for the 2010 AIDS conference, the group calculated that the National Institutes of Health, the largest funder of AIDS research in the world, was spending only 3 percent of its research budget on the cure.
This year saw their cause get more attention. There was a pre-conference symposium called "Towards an HIV Cure." But Jeff Sheehy, board member at the California Institute for Regenerative Medicine, which has funded $40 million in stem-cell models for the cure, wasn't impressed. "We're way out there on the frontiers looking at groovy new technology," he said, "but HIV researchers aren't even looking at them."
Part of what makes HIV so hard to cure is that the virus inserts itself into the cellular DNA of long-lasting immune cells. These cells can "sleep" for years without producing the virus, hidden in what are called latent reservoirs. But they can awaken at any time, so when people stop antiretroviral treatment (which stops HIV from replicating), the HIV that had been hiding and resting can come roaring back.
Much cure research focuses on these hidden HIV cells, and the new cure strategy calls for research into how latency works, where cells are hiding, how to awaken those cells and bolster the immune system to attack them, and strategies to improve patients' abilities to control viral replication.
The AIDS Policy Project activists think the lack of progress toward a cure is due to lack of funding and a blasé reliance on treatment.
At the AIDS conference, Krauss and LeBlanc accosted NIH director Francis Collins. They gave him a copy of their report, and pressed him on why cure research remains about 3 percent of the NIH's AIDS research budget.
Collins seemed taken aback. "Good heavens, of course we want a cure," he said, but the research is so young that the answers could come from anywhere. He gave LeBlanc his card and agreed to set up a phone call.
"We are stirring the drink," Krauss said. "We ask questions; we push the word cure down researchers' throats."
Allyn Gaestel can be reached