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In the spring of 1981, physicians in California and New York City became alarmed at the sudden appearance of multiple infections and oddly weakened immune systems among a small group of previously healthy gay men. The median survival rate of those men was 12 months. Over the next 14 years of the HIV/AIDS pandemic, that rate increased to 60 months, and today continuing advances in drug therapy and earlier diagnoses have radically extended the healthy years of millions of AIDS patients.

The United States has one of the heaviest loads of HIV/AIDS cases, with an estimated 468,578 people living with AIDS at the end of 2007. Intravenous drug users and men who have sex with men are most at risk. The odds a person will be diagnosed with AIDS in a year are 1 in 7,990, similar to the likelihood that a female will be diagnosed with ovarian cancer in a year (1 in 7,937).

Although the spread of HIV through the population continues unabated, 1996 brought great improvements in treatment with the advent of combination antiretroviral therapy (ART), which slows the virus’s progress within the human body. ART, a combination of several drugs, works by decreasing the amount of virus in one’s system. In areas where this treatment is widely available, survival averages range from 22.5 to 24.2 years, depending on the amount of HIV-fighting immune cells remaining in the blood at the time ART begins.

The odds a person diagnosed with AIDS in 2002 survived at least three years are 1 in 1.23 (81%).

High-risk behaviors, such as drug and alcohol abuse, late initiation of treatment, inconsistent use of therapy, and early discontinuance of therapy, significantly lower life expectancy for an AIDS patient. Lower survival rates for Hispanic men and women, for instance, are believed to have been caused by some of these irregularities in AIDS treatment. A recent study using data from the national HIV Research Network found that Hispanic individuals survived an average of 3.9 years less than other AIDS patients.

In San Francisco, male AIDS patients have the best survival rate. Of San Franciscans diagnosed with AIDS between 1996 and 2006, 81% of males were alive beyond five years, as were 72% of females, and 72% of transgender people. Researchers report that those gender differences coincide with greater intravenous drug use and lower use of ART among women and transgender people.

Living longer with AIDS brings consequences of its own. People living with chronic AIDS are at a higher risk for other illnesses that will require new maintenance methods. AIDS medications are also expensive. If antiretroviral therapy is started at the recommended stage of HIV illness, it is estimated that a patient will pay out $385,200 (including discounts from healthcare programs) over the next 22.4 years of life. Seventy-three percent of that cost is for the life-extending drug therapy.

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