The range of new drugs and treatments that started to appear on the HIV/AIDS battlefront in 1995 have had a dual effect.
They have transformed the prospects for people living with HIV or AIDS, extending their lives but also creating a host of new health issues.
"As long-time survivors, the new face of the disease is aging faster than is normal, more heart problems, arteries clogging, chronic inflammation," said Robert Kavanagh, who was diagnosed with HIV in 1995.
"It's a whole new landscape of things we're facing nowadays that we never thought we'd be lucky enough to face," said Kavanagh, a case manager at Face to Face/Sonoma County AIDS, a nonprofit that provides services to people with HIV or AIDS.
"It has gotten difficult in a different way, but thank goodness we're not in those days where we were having patients die every day from this disease," said Mark Netherda, the county's deputy health officer and a former AIDS practitioner.
As well, the drugs have given new dimensions to efforts to fight the spread of HIV, the virus that causes AIDS and still infects about 50,000 people a year.
By lowering the amount of HIV virus in a person's body, doctors found that the drugs effectively reduced the ease with which the virus is passed on.
That creates a key opportunity in prevention efforts and is an added incentive to locate people who are HIV-positive but don't know it, experts say.
"If you can keep the viral load down by getting them into treatment, they're still contagious but the transmissibility of the virus goes way down," Netherda said.
Medical opinion also has changed, said Steve Bromer, medical director of the West County Health Centers' HIV program.
Until recently, he said, the powerful combinations of HIV drugs were typically not used until a patient's T-cell count dropped below 500, partly because they come with serious side effects.
T-cells manage the body's white blood cells, which fight infections. The typical healthy person has 600 to 1,200 T-cells.
In the past year, though, it has become more common to treat patients from the moment they are diagnosed, regardless of their T-cell counts.
"There's always a balance between the toxicity of the medications and the benefits of the medications," Bromer said. "That pendulum has swung to where we believe that everyone would benefit from being on medications.
"It gives us a tool to really achieve an AIDS-free generation, to stop the transmission of the virus."
(You can reach Staff Writer Jeremy Hay at 521-5212 or firstname.lastname@example.org.)