Tom Perrault distinctly remembers the time he received an electric shock in the name of science.

“I have a pretty high threshold for pain,” 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.  

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’s immune system to track down and hunt a hidden viral invader: HIV.

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The disease may no longer be a death sentence, but it isn’t yet a medical relic. There were nearly 39,000 HIV infections in the U.S. in 2023, according to the Centers for Disease Control and Prevention. Globally, 1.3 million people contracted HIV in 2024, according to data from the World Health Organization, and 630,000 people died due to HIV-related disease. 

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: “It’s gonna be like somebody punched your arm.” 

“So I go in, I’m a little cavalier about it,” 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. 

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“I screamed,” Perrault recounted. “I’m like, ‘That was not a punch, that was an electric shock, people!’” 

Unfortunately for Perrault, the procedure had to be immediately repeated in his other arm. 

“I started trembling. I’m like, ‘That was bad, that was scary,’” he recalled. The researchers warned Perrault he would need another round of electroporation in a few weeks.

Tom Perrault is pictured at UCSF on Monday, March 9, 2026. 

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.

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“Gay men in the ’80s and the early ’90s would have crawled over glass on their hands and knees to get to a pill or a vaccine, “ he said. “... Anything I can do to advance the idea that science is important.” 

In 1981, the CDC published a report 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’t know why. It was the first ever time the condition known as (Acquired Immunodeficiency Syndrome) AIDS was documented as a disease. 

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 were stalled because of the stigma of a sexually transmitted infection most commonly associated with gay and bisexual men. President Ronald Reagan didn’t even publicly mention the word AIDS until 1985, a full four years after it was discovered.

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In San Francisco, the disease took a devastating toll 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. 

In the decades since, HIV treatment has come a long way. Early antiretroviral treatment discovered 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.

The surviving members of the San Francisco Gay Men’s Chorus shown in white, while those who died due to AIDS are represented in black, in this photo from May 1993.

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’t good enough to solve a global problem like HIV. 

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“The big fundamental problem with treatment is that it has to be taken daily for life,” he told SFGATE. “That means you have to find a regimen that you can tolerate, you can afford, that works and that’s available. And that just doesn’t happen for a large number of people globally, and even some people in San Francisco.” 

Deeks completed his training in San Francisco in the late 1980s, a time he calls the “dark days.” 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 for HIV treatment abroad. This year, the Trump administration moved to cut $600 million in public health funding for multiple states — including California — that was earmarked for initiatives including HIV and sexually transmitted infection prevention and treatment.

‘Unprecedented’ results 

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 so the immune system doesn’t know it’s there. If left untreated, HIV evolves into acquired immunodeficiency syndrome, aka AIDS.

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By stopping the virus from replicating, antiretrovirals can keep HIV in check, but they require a patient to take the meds for life.

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. 

Tom Perrault moved from Washington, D.C., to San Francisco in 1991.

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. 

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In 2020, the 10 patients in the trial received the DNA vaccine, along with the electroporation, to train their T cells, a white blood cell that’s 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 antibodies used in the study can prevent HIV from entering healthy cells as well as prime key immune cells to identify and destroy the virus. 

Researchers combined this first antibody treatment with another drug designed to force HIV out of hidden reservoirs in the body when it’s 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.

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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. 

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The entire process took 34 weeks and included dozens of appointments and treatments. Perrault remembers the first day he woke up and didn’t take his medication. It had been a decade straight of daily pills.

“I remember it feeling very momentous,” he said. “It was like, ‘Wow, I’m like, literally stopping my meds and I’m going to see what my body can do.’” 

Tom Perrault has taken part in multiple AIDS marches and protests. 

For weeks, and then months, after, Perrault 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. 

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But as Perrault went one, then two, then five months without the virus reappearing, his initially wary attitude became hopeful. 

“End of October, the virus still hasn’t come back and I’m thinking, ‘Wait a minute, what magic is going on here people?’” he said.

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.

“I just go up into my room, and all of a sudden I start sobbing,” he said. “Because I didn’t realize, really, the enormity of it. Like f—k, you know? We were so close.” 

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Still, the study results, which published in December, were significant. Six of the 10 individuals in the study went months without medication before the virus returned to levels that required treatment. One individual never saw a return of measurable HIV levels during the 18-month study period. 

Most importantly, the viral burden remained lower in those seven individuals overall compared with before the trial began, a result that Deeks called “shocking.” A lower viral burden can mean less strain on the body from the infection. (The other three patients did not experience the same pause in viral levels and had to resume medication much sooner.)

“To keep seven out of 10 people to show some degree of control, that was unprecedented,” he said. 

Medical researchers as a rule do not like to overpromise. Whether a single-shot cure for HIV is possible remains to be seen. But Deeks says this research shows a viable path forward.

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“We haven’t quite made it to the promised land. We’re getting close, but we need to make it better,” he said of treatments. “And to make it better, we need to understand the mechanism.”

There are already signs the UCSF team’s approach is an effective one. In a new study presented in February in London, researchers from multiple institutions including Oxford University found similar results to UCSF’s trial in a study of 34 participants. 

Perrault said he’s happy he got to be part of the study, even if he’s now back on his HIV medications. At 60, he’s spent over half his life in San Francisco after arriving in the Castro in 1991 after he followed his partner at the time west from Washington, D.C. 

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“I came of age and came out at a time where the generations of men above me were all dying,” he told SFGATE. “A friend of mine, who also turned 60 this year, said, ‘Hey, you know, Tom, we’re the first generation of out gay men to come of age to make it to 60.’”

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Perrault says he took part in the study to make things even better for the next generation.

“I want them to avoid ever having to go through what the older generation of gay men went through,” he said. “We can do better as a country, we can do better as the world. And we should all be doing everything we can to absolutely get a cure.”

© SFGate