Intravenous drug users have always been a group at high risk for AIDS. Today, IV drug users make up 25 percent of annual new infections. But attempts to combat this with needle-exchange proposals have run head-on into the government's war on drugs.
McCague, founder of the New Jersey-based Chai Project, the state's first needle exchange program, has been arrested several times for providing clean syringes to drug users.
"We deal with preventing people from getting the disease in the first place," McCague said. "The U.S.'s war on drugs has failed and failed miserably, and the only way we're going to stop the spread of HIV among drug users is with needle exchange."
But others believe needle exchange programs will only encourage drug use and only exacerbate the spread of HIV.
"It's only adding on to the problem," said Alan Carlson. "When someone is putting something dangerous and destructive in their system, it doesn't help to provide them with clean needles. It's only encouraging the problem."
The Crisis Continues
What will the third decade of HIV/AIDS bring?
"The one thing we've learned about AIDS is that it moves with a velocity like no other disease," said Bartlett. "We've learned that whatever we say now about the disease is going to look pretty silly five years from now."
The debate over how much sex education to give teenagers will continue. Some stress abstinence programs are enough while others argue the "no sex" approach alone is not a realistic way to deal with more sophisticated teenagers.
"We have state-after-state adopting legislation mandating abstinence only education in secondary schools," said Reginald Fennel, University of Miami sex education professor who has given AIDS workshops around the world. "It is ironic that school systems would be teaching these programs when students in these systems are pregnant."
Cleve Jones hopes the public will remember the AIDS crisis is not over.
"We must move forward on all the fronts," Jones said. He knows that his life will be shortened by the HIV virus but is grateful he has lived through the first 20 years of the disease. And he still has hope that he'll continue to survive for 20 more years.
"I still have this perverse hope that I am going to live a long life," Jones said. "I'm 46 … I'm getting there."