"AIDS activists were very vocal and effective very early in the disease," said Dr. John Bartlett, chief of the division of infectious diseases at Johns Hopkins School of Medicine in Baltimore. "They inserted themselves into the decision-making [process], and that has extrapolated to other parts of medicine. People have learned from that."
Largely because of this work, AIDS today is not the quick death sentence it used to be. While there is no cure or vaccine, there are drugs to keep AIDS at bay. The death toll in the United States has dropped every year since 1996.
"We've gone from counseling patients and getting them ready to die to looking at the long-term, seeing how we can help patients live longer lives," said Dr. Margaret Fischl of the University of Miami School of Medicine. "Patients are healthier, going back to work and for the most part functioning and trying to live normal lives. We couldn't say that 20 years ago."
Stigmas and Complacency
Still, the face of AIDS and attitudes toward the disease have not changed so dramatically in some communities.
While the rates of reported infections have generally plateaued at 40,000 a year, there has been an increase in infections among people of color and young people between the ages 13 and 24. According to the CDC, African-Americans are making up 54 percent of new infections. And a CDC survey released Thursday said 4.4 percent of gay and bisexual men ages 23 to 29 are newly infected each year with HIV.
Dr. Robert Scott, who has been treating AIDS patients in a predominantly African-American community in Oakland, Calif., for 20 years, believes part of the reason for this trend is because drug addicts and prostitutes have been unwilling — or unable — to change their behavior. Another reason, Scott said, is the deep stigma people of color link to AIDS.
"Many families I still see lost their loved ones to AIDS, and they haven't gotten over it," Scott said. "In my community, I had a mother who told me her son had AIDS, and she said, 'Well, I hope he got it shooting up with some girl because certainly he's not gay.'"
"What we have to remember is many people of color are concentrated in poor areas and may not be able to afford the treatment to combat HIV," said AIDS activist Diana McCague. "In many ways, this is still a nation of haves and have nots."
For younger Americans, Scott and other doctors note the success of HIV therapy has contributed to the steady rate of infections. Unlike their surviving 40-something predecessors, the HIV patients of this new generation have not watched a slew of their friends die.
They did not see actor Rock Hudson in his final days or the deterioration of an AIDS patient. Instead, they see famous HIV-infected sports figures such as Magic Johnson and Greg Louganis leading productive lives and attractive vibrant models on billboards advertising HIV medications. They arguably are being lulled into complacency.
"Some [older] patients have told me that they've lost all their friends, people they've grown up with, to this disease, that they're the only ones left. That's dramatic," Scott continued. "If you're young and haven't had the losses — because sometimes death scares you into doing what you need to do — then it won't have an effect."
Reevaluating the Drug War