The difficulty is that once you're a carrier, you're always a carrier. With modern ART these people can be expected to live long lives. ART decreases the odds o

The difficulty is that once you're a carrier, you're always a carrier. With modern ART these people can be expected to live long lives. ART decreases the odds of transmission, but not everyone is compliant with their medications. Reducing the spread is one piece of the puzzle. The only way we've managed to "cure" HIV is through a bone marrow transplantation from a donor that have a mutant CCR5 receptor (which the HIV virus needs infect T-cells). I think that reducing the spread alone still could get us to a point where we "manage this out over the long term" as you say. Say you're a person with many sexual partners that has say a 1 out of 100 chance of sleeping with someone infected with HIV on a given day. Say there's a 1 in 10 chance that encounter will lead to transmission of the virus. (These aren't like factual numbers, just examples). That's still a 1 in 1,000 chance per encounter, so it adds up over time. After 1000 encounters chances are you've contracted HIV. But say you're vaccinated against 99% of the serotypes. That reduces your chance per encounter to 1 in 100,000. Even after 1000 encounters your chance of contracting HIV is 1 in 100. Not terrible.