(McClatchy-Tribune Regional News delivered by Newstex) -- Kristen Ries' walls are plastered with photographs of AIDS patients for whom progress came too late.

Four years after HIV, the virus that leads to AIDS, was identified in 1985, the University of Utah professor and HIV clinic director began treating her first infected patients. With a life expectancy of just 12 months, they perished at the rate of one a week. She spent her weekends helping them die.

Today, the story is different: Get a job, Ries tells her patients. You're going to live a long time.

But with successful treatments have come new problems.

Progress, Ries said, has bred complacency. The U.'s clinic is seeing a resurgence in infections among people in their late teens and early 20s. Some see the disease as no big deal, easily treatable. Others simply feel getting infected is inevitable.

"Older gay men are actually really upset about it because they lived through everyone dying and losing all of their friends," Ries said. "They don't understand the young people who think, 'Oh, you just take a pill -- no problem.'?"

John, who asked for anonymity, fearing discrimination, is a 26-year-old gay Salt Lake County man who tested positive for HIV in January 2003 after he used methamphetamine and had unprotected sex. Using condoms, he said, is "a killjoy in that culture."

He has a steady partner who is also HIV positive, but admits that if he were single again he would continue to have sex without a condom.

"I'm not the world's keeper," said John, whose viral load has remained undetectable since he tested positive. "It's not my responsibility to take care of other people's health."

Most gay men will eventually get HIV, he believes. "It's only a matter of time. I might be that time."

Other complications -- It's an attitude that people like Ries find hard to believe.

"It's a horrible disease," she said, "you don't want to get it still, even though we can treat it. It's preventable -- the whole thing is preventable. "

It's true, she said, that new HIV treatments have made the disease largely manageable. With some 25 drugs to choose from, doctors can prescribe triple combination therapies that thwart the virus and keep it from mutating. One triple combo is packed into a single, large brown pill -- Atripla -- that is popped just once a day. If taken regularly, patients' viral loads can drop to undetectable levels and most can expect to live a nearly normal lifespan.

But the medications are expensive, costing between $1,200 and $1,400 a month, and must be taken every day for the rest of a person's life to prevent difficult-to-treat mutations. The medications have side effects, too: bad dreams, nausea and diarrhea. They can lead to other health complications such as hypertension and liver failure.

John's 53-year-old partner, Rich, who did not want to use his last name, said the medication "makes your guts hurt." During a stint in jail this year, he said, he would take his pill and just "lie down and buzz."

Challenges to finding care -- Physicians who treat HIV patients are also becoming more scarce. "The young people aren't going into the field at all," Ries said. The money isn't good, she explained, and the patients are often difficult to manage. About 70 percent of the people seen at the U.'s HIV clinic suffer from mental illnesses, drug addictions and poverty. Half are uninsured.

At the same time, federal funding for the Ryan White Care Act, which covers HIV treatment for the poor and uninsured, has flat-lined, said Harry Rosado-Santos, an associate professor in the Department of Internal Medicine who sees patients at the clinic.

While all 1,300 or so patients are still able to be seen and treated for their HIV infection through this program, they no longer get help treating other health problems. "Now we can treat HIV," he said, "but somebody can die of a heart attack."

And many do. A third to half succumb to health complications unrelated to the virus, drug overdoses, suicide, homicide, car accidents and other kinds of trauma, Ries said. Another quarter get cancer. "A few die of HIV," she said.

'It's hard. It's different' -- Amanda Brown, who was infected with the virus in 2002 when she was raped by an HIV positive man, hopes her life is not cut short by HIV.

"As much as I like to think I'll probably live a normal life -- a normal statistical life span -- I don't know. I don't think I will," the 29-year-old said. "I think it will come down to money."

Brown, who spent a week in the intensive care unit earlier this year after having a seizure at home, has run up $8,000 in medical bills in the past six months. And that's with health insurance. "I feel like I got the death sentence, the judge and the jury," she said.

Then there's the misinformation and stigma -- still -- that surrounds the disease. "It's hard. It's different," she said.

One dentist donned what looked like a hazardous materials suit at an appointment, she said. Then there was the social services agency that rejected her application to volunteer for fear of putting children at risk. When workers in that office took a subsequent HIV education class, one person asked: Can we get it from sitting on the same toilet seat?

Brown, who lives with her partner Jess Cox in Herriman, decided when she was diagnosed that it was her mission to educate people about HIV. That education started in her home, with Cox's four children.

Using two giant stuffed microbes -- one white, the other black -- to illustrate, Brown recently sat at the dinner table with the children and explained to them how the "white kings," or the leukocytes, fight to the death to defend her from the "black army," or HIV.

"I get to be [the] face of the epidemic," Brown said. "And if that's all I can be, I'm OK with that."

lrosetta@sltrib.com

Dec. 1: World AIDS Day

The Weber-Morgan Health Department will conduct free HIV tests today for residents of the counties. Tests will be offered at the Weber-Morgan Health Clinic, 477 E. 23rd Street in Ogden from 9 a.m. to noon and 1 p.m. to 5:30 p.m. Appointments are required. Please call (801) 399-7252.

For information about other testing locations, visit http://www.aidsinfoutah.net/.

HIV and AIDS in Utah

Since 1983: 2,370 people have gotten AIDS; 1,158 have died from the disease.

Since 1989: 979 HIV cases have been reported.

The number of HIV cases has declined since 2005.

Most HIV and AIDS patients are white, male and gay. The next highest percentage is injecting drug users.

Source: Utah Department of Health

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