Billy Tingle says when he first began working at UAB in 1994, there was a sense of urgency among the general public about finding a vaccine to cure Human Immunodeficiency Virus (HIV) — the virus that causes AIDS.

He would know. Tingle was then on the front lines of the fight against HIV in Birmingham, recruiting people to be a part of UAB’s research into a vaccine to prevent the virus.

But these days, says the recruiter, there seems to be a totally different attitude toward HIV in the community.

“Nobody seems to be concerned about HIV,” Tingle says. “When I’m out recruiting people to be a part of our program and tell them what we’re doing and what we want them for, almost without exception the response I get is a blank stare.”

“People don’t seem to care.”

UAB is currently involved in an HIV vaccine trial called the Step Study, a Phase II study designed to yield information on that particular vaccine’s efficacy. Tingle and his colleagues, Tena Hilario-Hailey and James A. Mapson, are charged with recruiting men at risk of contracting HIV for this study. Other studies taking place at the Alabama Vaccine Research Clinic are recruiting men and women of low risk of contracting HIV to study preventative vaccines at the early stages of development.

The recruiters say that while they’re recruiting, they are also are fighting a culture with a changed opinion of the disease and the damage it can still cause. In 1995, Americans regarded HIV and AIDS as the nation’s most urgent health problem. Today, only 17 percent rank it as the top concern, according to a recent survey of Americans on HIV and AIDS by The Kaiser Family Foundation.

“People have accepted that it’s out there and if they get it, then they’ll just get the treatment they need,” Mapson says. “For whatever reason, some people think there’s already a cure out there, but there’s not. The reality is HIV is still out there, and we need people to help us find a vaccine.”

And such a vaccine would not be used in the United States alone.

It would be used to help prevent more than 5 million people worldwide from contracting the disease annually, especially in places like sub-Saharan Africa, where vulnerable young women are falling prey to the disease at an alarmingly high rate. Young women ages 15-24 in that region comprise 76 percent of all young people estimated to be living with HIV or AIDS.

“This research is about hope, real hope, and not just for the people of Birmingham and Alabama, but also for the millions and millions of people around the world,” Tingle says.

Hard to recruit
Tingle, who recruits high-risk men for the vaccine studies, says he sees more and more at-risk men who just accept as a reality that they will one day get HIV. He says they tell him they’ll “just get the treatment when the time comes.”

Those men do have some options: Dr. Paul Goepfert, principal investigator on the Step Study, says as of July 1, there are now 22 different medications to treat HIV. But while the medicines are effective, they come with a lot of baggage.

“First of all, the medications are extremely expensive, about $10,000 a year in developed countries for first-line agents,” Goepfert says. “Then there are the side affects to the medications, ranging from a nuisance to life-threatening.”

Plus, HIV can become resistant to the medication, making it less effective over the long run.

Goepfert says there is no doubt the treatment options available to those who have already contracted HIV have aided in the current thought processes.

“We’re really having a hard time recruiting volunteers for HIV vaccine study in the gay community because people think, ‘If I get it, there’s treatment for it,’” Goepfert says. “It’s still better not to have HIV.”

Study shows promise
Goepfert points out how experts boldly predicted there would be a vaccine for HIV “in a few years” after the disease was discovered.

“They were completely naïve,” he says of the forecasts. “The virus is extremely diverse.”

How diverse? There are at least 10,000 different strains of HIV in the Birmingham area alone, Goepfert says. So if a person has a strain of Virus A HIV and Vaccine A works on that strain, it doesn’t mean that it will work on Virus B.

The current efficacy study is showing some promise, however. Goepfert says a killer T-cell vaccine has been developed that, when administered, attacks only the HIV-infected cells.

“The hope is it will prevent infection, but if not infection, maybe it will prevent AIDS (the disease that is associated with HIV),” Goepfert says.

A five-year, $6 million grant from the pharmaceutical company Merck & Co., Inc., and the HIV Vaccine Trials Network is covering 20 different ongoing studies at UAB. Goepfert says it will be known within four years whether or not the current Step Study vaccine being tested to prevent HIV is working.

In the meantime, Tingle, Hilario-Hailey and Mapson will continue their tireless work in recruiting volunteers from the community and spreading the word about the hopeful work currently taking place on campus.

“The people who work here at UAB and live in our community should know about this study and what we’re doing,” Tingle says. “I’m sure there are people working here who know someone who might be interested in helping find a cure for HIV, or maybe somebody working here is interested in volunteering.

“We just want people to know about this and talk to their family and friends about it.”

If you or someone you know wants to volunteer or receive more information about the HIV vaccine studies, contact Tingle at 996-5589 or . Hilario-Hailey and Mapson can also be contacted at 934-6777 or or