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AIDS Marks 20th Anniversary

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"They're making it so we take less, but the pills are two to three times bigger than they were," says Karchinski, who works for MTS, a nonprofit group in New York City that helps people with HIV and AIDS get back into the work force.

Still, he remains optimistic for the future.

"My first hope would be that they find a cure," he says. "In the interim, educating people is the next best thing, as well as finding drugs that have less toxicity and hopefully in the long term don't cause us to die of something else."

Frost says he believes the next big breakthrough in anti-AIDS drugs will come from drugs that take a different approach than what is now available.

"Right now we have drugs that target two places on the viral life cycle," he says. Protease inhibitors attack one spot, and drugs that attack reverse transcriptase constitute the other.

"There are potentially multiple spots in the viral life cycle that we could be attacking in this process that would, I believe, provide us with a far greater shot at really inhibiting the viral growth," he says.

Some experts worry that news of better medications may give the false impression that improvements in medication make HIV somehow less deadly and encourage those at highest risk to be less fearful of infection. Most of all, experts want HIV and AIDS to stay in the public consciousness, and they look toward better, more wide-reaching prevention programs.

"We still have 40,000 new infections every year," says Frost. "Much of my thinking around this 20th commemoration is ... why aren't we doing all that we could be and should be to stem the tide of this epidemic?"

The anniversary also brings to mind another major goal of AIDS research: to find an effective vaccine.

It's difficult, even for vaccine insiders like Mark Feinberg, MD, to predict how long it will be before a vaccine is available to prevent people from becoming infected and/or limit the amount of virus in an already infected person's body.

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