It has been 26 years since scientists first discovered AIDS in America. Till now, millions of dollars have poured into outreach efforts aimed at keeping especially young people off HIV -the virus that causes the disease.
Yet a disturbing fact looms on the eve of World AIDS Day - the number of newly infected teens and young adults is soaring.
The U.S. Centers for Disease Control and Prevention gives that for 2001 to 2005 the number of new cases of HIV infection diagnosed among 15-to-19-year-olds in the United States spiked from 1,010 in 2001, maintained a plateau for the next three years, then jumped 20 percent in 2005, to 1,213 cases.
For young people aged 20 to 24, cases of new infection have risen steadily, from 3,184 in 2001 to 3,876 in 2005.
Experts cite many reasons, including the fact that many HIV-infected patients are now being kept healthy with powerful drugs. This has made AIDS seem like less of a threat to young people than it did in the past.
"Certainly the 'scare factor' isn't there anymore," says Rowena Johnston, vice president of research at the Foundation for AIDS Research (amfAR) in New York City.
In the 1980s and early 1990s, the ravages of AIDS were visible to most Americans- high-profile celebrities succumbed to the disease and individuals lost friends or family members to HIV.
"To see people looking gaunt, skinny and skeletal, and to know that they were going to be dead soon," Johnston says, "it had a sobering effect."
Yet, the advent of antiretroviral drugs in the mid-1990s changed all that. "These days, for the most part, you can look at a person and not know that they even have AIDS," says Johnston .
This makes HIV seem like less of a threat to young people , opines Martha Chono-Helsley , executive director of REACH LA, a Los Angeles-based nonprofit that helps disadvantaged youth understand and defend against threats like poverty, drug abuse and HIV.
"They're in this age group that feels they are invincible -- that it's never going to happen to them," she says . "Yes, they're getting all these messages from public schools on HIV and AIDS, but they've never actually seen what HIV has done, up close and personal."
Chris Blades, one of REACH LA's young, black "peer educators," informs that he has seen a kind of nonchalance towards HIV among the gay or bisexual men of color that he counsels.
"On a daily basis, they don't see their friends suffering from it, so it's not a major threat to them," says Blades, 21. "They're in that whole mindset of 'Oh, it can't happen to me, it will never happen to me.'"
Yet the recent spike in new infections among gay men, young and old alike alarm health experts. According to the CDC, the rate of new cases of HIV infection linked to male-male sex which was constant held at around 16,000 cases between 2001-2004, has suddenly jumped to 18,296 in 2005.
Johnston and Chono-Helsley both feel advertisements for HIV-suppressing medicines could be one possible contributing factor.
"In gay magazines, you now see [ads with] buff, handsome men climbing mountains, with some kind of quote about how 'I'm not letting HIV get in my way,'" Johnston says . "It sends the message that you, too, can be hot, buff and handsome, even with HIV", he rues.
Chono-Helsley supports him. "It's always these bright, healthy vibrant young men in these ads. That could spur young gay men to relax their guard and take more risks, thinking that if they do contract HIV -I only have to take a pill," she says.
The reality of living with HIV is much different, however, even when medication is working, warns Johnston. The side effects of powerful HIV-suppressing drug cocktails include fat redistribution (including unsightly "humps"), insulin resistance, higher cholesterol, increased risks for heart disease, and dangerous liver toxicities.
There's also the fear that, someday, HIV will develop mutations that render these drugs useless, triggering the re-emergence of AIDS, Johnston warns.
Meanwhile HIV continues to cut a wide path through young men and women in the black community, too. According to the CDC, the number of new infections actually dipped slightly for black Americans between 2001 (20,868 cases) and 2005 (18,121 cases). However, black men remain six times more likely than white men to contract HIV, and black women are 20 times more likely to acquire the virus compared to white women.
"The young men that we work with are predominantly African-American, and HIV is not their No. 1 priority," says Chono-Helsley. "Often survival is their main priority -- where they are going to sleep tonight. They're kicked out of the house; they have substance abuse issues, they're in recovery."
Another trend, spiking rates of methamphetamine use over the past five years could also be fueling HIV infection rates for both blacks and young gay men, say the experts .
The right approach is of paramount importance says Blades . "If you deliver the message to them in a way that's not preachy or looking down on them, I think that's more effective.
"That's what we try to do - deliver HIV information in a way that will click in with them, so that they'll take home something that they didn't know the night before", he adds.
"One thing is for sure, we can't just shake our finger at young people and say, 'You're bad,'" Chono-Helsley gives. "We have to be supportive. They're young, we've all been there, remember. You can save some, but you can't save them all."