Since AIDS was first identified in 1981, an estimated 22 million people have died from AIDS-related complications worldwide. In the United States, deaths from AIDS have been in decline, thanks to improved medication. But many Americans with AIDS, or the virus that causes it still deal with a variety of struggles.
Bernard Jackson is a 36-year-old man who lives on the North Side of Chicago. He admits he did not know much about AIDS when he was diagnosed with HIV, the virus the causes AIDS, in 1995. "Six years ago, when I first found out, my first thought was that I was going to die from AIDS, as anyone else would probably think," he said.
But in the year 2001, Mr. Jackson says he is doing well. He was on medication to boost his immune system for several years, but doctors say his system is strong enough now that he no longer takes the four pills a day he used to swallow.
The director of the AIDS Foundation of Chicago, Mark Ishaug, says more people with HIV or AIDS living longer has meant a change in the work done by his group, which provides support and advocacy for affected individuals.
"Five or six years ago, we had planned services for people who were dying. Now we are planning, funding and trying to develop services for people who, thank goodness, are living for a long, long time," he said.
The medication required to manage HIV or AIDS can be expensive, up to $15,000 a year per person. In Chicago, people who cannot work because of their illness can qualify to have the State of Illinois pick up the cost of the drugs. But the state is facing a budget crisis in the current slumping economy. Lawmakers are considering cutting the state's AIDS drug program by about 25 percent. Mr. Ishaug says that would not only hurt patients, but could cost the state more than it saves by cutting the drug program budget.
"These drug programs, in the short and long term, save the state and the health care system money by keeping people healthy and working, if possible, and out of hospitals or long-term institutional settings," he said.
Another worry for people with HIV or AIDS is housing. Those who cannot work often find it difficult to afford a decent apartment, especially in Chicago where safe, affordable housing for any low-income person is scarce. Agencies that help people with HIV or AIDS find housing say Chicago alone has a shortage of about 5,000 housing units for people with AIDS.
These problems come at a time when many Americans - especially white, middle-income Americans - might think the AIDS crisis is over. AIDS is no longer among the top 15 causes of death in the United States, but it is still a leading killer among certain populations. Mr. Ishaug says, in Chicago, new HIV and AIDS cases are sharply rising in the city's Hispanic and African-American neighborhoods. "Infection rates among African-American men who have sex with men are at sub-Saharan African epidemic proportions. We are talking one-in-three, 35 percent, of African-American gay men who have sex with men are living with HIV," he said.
Chicago health officials hope to slow the spread of HIV and AIDS in minority neighborhoods the same way it found success in middle-class white neighborhoods during the 1980's and '90's - by educating people about how the disease is contracted, and encouraging people to get tested for HIV, so that those who have the virus can begin treatment.
Bernard Jackson says his own HIV diagnosis has forced him to make changes in his lifestyle that have kept him alive.
"I am more health-conscious than I was six years ago. I go to the doctor a lot more than I did six years ago," he said.
Health officials say education is as important now as it was in the 1980's and 90's, because young people at risk of contracting HIV are growing up in an era when such a diagnosis is not considered a death sentence. Mr. Ishaug says many people just aren't as afraid of HIV and AIDS today as they were 15 years ago.