20 Years of Fighting AIDS Is Too Long

David Merino stands Thursday morning in the midst of a storage garage full of groceries. You might call it his office, in that he runs the food pantry for the AIDS Services Foundation. Twice a month, the small bags of food go out to 450 people. It’s supposed to supplement their daily diet, but some say it’s the only food they get.

It’s quiet work, off the radar screen of most of us.

Just as, I suspect, AIDS is way off the radar screen. In the way that it once seemed as though AIDS conversations were everywhere in the public arena, now it seems as though they are nowhere.

Which is why the press release from the foundation jumped out at me. It noted that it would mark its 20th anniversary on April 1.

A 20th anniversary without a celebration. An anniversary that no doubt will involve reminiscing and tears, but also the happy acknowledgment that while death and the dying process once dominated the foundation’s work, it no longer does.

A lot has changed in combating HIV and AIDS since the mid-1990s, when a cocktail of drugs known as protease inhibitors greatly helped victims. “When I started as a volunteer in 1986,” says mental health director Maggie Decker, “we focused on end-of-life issues. We had an almost equal number of deaths as intakes, almost every month. Sometimes it was 30 in, 30 out. I remember we had a month [after the protease inhibitors breakthrough] when we didn’t have a death, and we acknowledged that at a staff meeting.”

Therein lies the irony, because AIDS hasn’t gone away. The foundation, in a commercial tract near John Wayne Airport, saw 1,550 clients last year. The Orange County Health Care Agency reported 211 AIDS cases in 2004, the most recent full-year figures available. The local foundation cites state figures that indicate 3,400 people have died of AIDS complications in Orange County.

Just as the county’s ethnic map has changed in 20 years, so has the HIV/AIDS demographic. Martin Salas, who runs the foundation’s health education programs, says 47% of its AIDS clients are Latino, about 10 percentage points higher than their representation in the local population. Various factors come into play, he says, but among them is a cultural tendency to deal with illness after the fact rather than focus on prevention.

With HIV or AIDS, that is a tragic mistake. Even as people live longer with the illness, Salas notes, the daily problems of taking the powerful medications and the long-term effects are becoming more evident.

And so the work goes on in the labyrinthian halls of the foundation, where social workers, nurses, financial advisors and transportation planners handle a piece of the AIDS problem.

And take note that the calendar keeps turning over.

Like Merino in the food pantry. “I came as a volunteer seven years ago and thought, well, there’ll be a cure in a few years. We all did. Of course, now we’re going on 20 years. In fact, we used to sit around and say, ‘As soon as the cure comes....’ ”

There is understandable concern that, with fewer high-profile cases acting as frightening beacons -- such as those provided by Rock Hudson and Magic Johnson -- people may become less diligent about prevention.

Decker says it would behoove people to think of the medical treatments as living with chemotherapy. Salas agrees, saying it would be a huge mistake for people to think that being HIV-positive is now a manageable illness, because they don’t realize how difficult that daily management really is.

All of which makes prevention and awareness as important as ever. Decker and Salas say that cure probably isn’t coming soon, which will make the anniversary a bittersweet occasion.

Decker says she’ll reflect on those who have died and those who donated to the foundation. And, she says, she’ll renew her commitment to what has become her life’s work.

Salas echoes that, and adds, wistfully: “I hope we don’t go for our 40th anniversary.”

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Dana Parsons’ column appears Wednesdays, Fridays and Sundays. He can be reached at (714) 966-7821 or at dana.parsons@latimes.com.