Eric Goosby, MD, Chief Executive Officer and Chief Medical Officer, Pangaea Global AIDS Foundation

HIV has been the focus of my professional career. This occurred largely by being in the San Francisco at the beginning of the outbreak in 1980. After my fellowship at UCSF in general medicine, I became a professor at San Francisco General Hospital and the medical director of Southeast Health Center in Bay View Hunter's Point. As more of my patients began to develop signs of AIDS, I became more focused on this burgeoning field and began working full time in the new HIV clinic at San Francisco General Hospital. In 1991, I moved to Washington, DC as the first director of the Ryan White CARE Act programs. I was later asked to create a new office in the Secretary of Health's office--the HIV/AIDS Policy Office--that provided direction on key policy issues. We have made progress domestically, but we continue to see 40,000 new infections each year, and many are unaware of their status and not receiving care. This continues to impact the most disenfranchised individuals in our society, especially African-Americans, young gay men, and injection drug users and their sexual partners. These communities will only be reached by developing unique strategies to prevent new infections and keep patients in care. This work remains undone. These same issues reverberate throughout the world. HIV/AIDS continues to dominate in sub-Saharan Africa and there are rapidly emerging epidemics in China, India and Eastern Europe. The work of the Pangaea Global AIDS Foundation allows for continued focus on populations most affected by HIV/AIDS. The urgency of AIDS remains and continues to grow. I continue to be driven to respond to the expanding epidemic and remain passionately committed to this work.

Maurice Graham, Member of SFAF's Black Brothers Esteem Program and living with HIV for nearly 25 years

HIV/AIDS has had a profound effect on my life. It has forced me to look at what really matters to me and to realize that the most valuable gifts in life are not material, but how I can best connect with God, who I believe is present in all of us. I know, without a doubt, that I would not be here if I had not come to realize that my purpose is to be of service to others in need. After ending 27 years of active addiction in 1996, I began allowing God to teach me how to let go of things that don't help me reach my goals. As a result, I founded a nonprofit organization called Aid for AIDS Africa that works in collaboration with many other organizations locally through a speaker's bureau and educational forums, and internationally with AIDS service organizations, including orphanages in Africa. Each of us needs a reason to live, especially those of us diagnosed with a terminal illness such as HIV. I believe this has forced us all to work for our mutual survival in ways we might not have dreamed in the past. This common effort has been the greatest blessing emerging from the epidemic.

Alexa Kasdan, former Pat Christen HIV/AIDS Future Leadership Intern at the San Francisco AIDS Foundation

I have known about HIV as long as I can remember, but throughout my youth, I did not fully understand the magnitude of the virus and its consequences around the world. This changed in 1999, when I was 19 and I went to Durban, South Africa to study abroad for a semester. One of my first days in the country, I went to a town called Hlabisa. I was told that one in three people were infected with HIV in the town. I remember looking around the town and seeing mostly young women, my age. It was then that I realized that if we don't do something now, if I don't make HIV my problem, if we as a society don't make HIV our problem, then in some parts of the world, my entire generation will be decimated. I think that events like the AIDS/LifeCycle, HIV/AIDS organizations like the San Francisco AIDS Foundation, ACT UP and activists like Zackie Achmat in South Africa have done tremendous work in making the world aware of HIV/AIDS. Still, I think there is a long way to go. World leaders must work to combat the issues that fuel the spread of HIV such as poverty, homelessness, racism, sexism and homophobia (to name a few). Government leaders must also support scientific, evidence-based policies to curb the spread of HIV rather than those that are driven by ideology

Jon Garrison, 25-year old living with HIV and second year rider in AIDS/LifeCycle

Since I tested positive for HIV in 2001, I've learned that time is valuable and it's not to be wasted or taken for granted. My body is holding up relatively well after five years of living with HIV, although it's taken a toll on my mental state. Coming to terms with this disease is a daily struggle that I don't think I'll ever fully understand or accept, though it has taught me to fight like hell. There is no doubt that we have made large advances in treating this disease. The amount of pills taken and their effectiveness have improved dramatically, allowing many of us to live longer, healthier lives. Sadly, there are still a huge number of people, young people especially, that are becoming infected. The AIDS epidemic is not over, though many think it is. Students in high schools and universities aren't being properly educated about ways to engage in safer sex. Today, abstinence is the widely accepted form of safe sex education; while this may work in theory, it is highly unlikely to be practiced, especially among youth. There needs to be more of a focus on practical ways to protect yourself when engaging in sexual activities. This lack of education, coupled with apathy, is another wave of the epidemic waiting to happen.

Susan W. Haikalis, LCSW, social worker, Client Services Director for the San Francisco AIDS Foundation from 1995 to 2002

Moving to the Bay Area in 1980 had a profound impact on my life and on my career as a social worker. Having already spent 15 years providing services and programs to complex client populations helped prepare me for what lay ahead. In the early years of the epidemic, being there for people, their lovers, partners, families and friends was challenging--and the most rewarding work I've ever done. Losing so many friends, colleagues, family members, however, has been heart wrenching. I spent the first 15 years of the AIDS epidemic helping people directly and designing programs that would meet the needs of individuals who often died within 18 months of receiving their diagnosis. Then in the mid-90s, new treatments arrived that turned many people's lives around. But for some people living with HIV/AIDS--particularly those who also have mental health and substance abuse issues--adhering to the multiple drug regimens is still a big challenge and needs attention from service providers. It's my fervent hope that within the next 10 years, we'll find even more effective treatments, vaccines that work and prevention strategies for people across the globe so that in my lifetime HIV/AIDS will become a chapter in our history books.

Paul Volberding, MD, Chief of Medical Services at the San Francisco Veteran's Affairs Medical Center

AIDS for me started on July 1, 1981, when I saw my first Kaposi's Sarcoma patient at San Francisco General Hospital; my life was changed dramatically and permanently by this epidemic. This work has been exciting and draining, filled with fear, loss, and hope, often simultaneously. The early days of the epidemic were marked by the searing images of a disfiguring and stigmatizing disease and the often rapid progression to death in essentially every patient I treated. This shifted at the Vancouver AIDS Conference in 1996 when I finally believed that the new drug combinations might actually allow infected persons to recover from AIDS. At all times in working with HIV/AIDS, I've been sustained by the firm belief that this was important work and that it was my honor--and obligation--to remain committed in this effort. The progress over these 25 years has been remarkable. HIV is without doubt the most potent example of the benefits of research to understand a disease and to then translate that knowledge into effective therapy. Now we have drug therapies available to us that are much more convenient, with fewer side effects, and with a greater chance of viral suppression. But we still have much to do to reduce the barriers to treatment for many infected persons living with HIV who are not receiving proper medical care. These drugs are still too costly and the side effects are still problems for many patients, but I believe we are making progress on both fronts. As a community we have a real responsibility to move therapy into all resource-limited settings where the epidemic still rages.