By Octavio Vallejo, M.D., M.P.H.

California has one of the best HIV treatment access programs in the country, but far too many people lack the information to obtain assistance.

Hundreds of educators, medical experts, and people living with HIV/AIDS recently convened in Los Angeles for Staying Alive 2005, the annual conference of the National Association of People with AIDS. This meeting came at a particularly important time.

In the 25 years since its discovery, we have made great strides in combating HIV, especially since the development of the simplified combination therapies that have transformed HIV/AIDS into a serious but manageable condition for many. Advances in HIV/AIDS treatment and care services nationwide and in Los Angeles mean that more than one million Americans, including me, are living longer and better lives with this disease.

As a Latino, gay, HIV-positive physician, researcher, and educator, I participated in a panel at Staying Alive 2005 titled, appropriately enough, "Beyond Survival." Thanks to improvements in HIV testing and treatment, many HIV-positive Americans are doing more than merely surviving. We are living full, rich lives and contributing our skills, talents, creativity and experience to our communities. Unfortunately, these benefits are only available to those who know their HIV status, have access to care and the resources they need to facilitate effective treatment.

Make no mistake: HIV remains a very serious public health crisis for the gay community. While the number of HIV diagnoses for men who have sex with men decreased during the 1980s and 1990s, recent data show an increase in diagnoses for this group. This is particularly true among young minority races and ethnicities.

These statistics are alarming and reversible. Today's tools for fighting HIV/AIDS are more effective than ever. Confidential voluntary HIV testing -- essential to reducing the spread of HIV and getting HIV-positive patients into treatment -- is now easier than ever. New rapid testing technology means that results can often be provided on the spot in as few as 20 minutes with no blood draw required. These tests are often available free at a local health department or AIDS service organization.

Yet an estimated one in four people who are HIV-positive still do not know they have the virus and more than 40,000 new HIV infections still occur in the United States every year. Changing this reality requires more and better HIV prevention education and increased access to voluntary HIV testing and counseling services -- particularly in high-risk and under-served communities.

In my work as a physician who specializes in HIV treatment education, I have found that one of the biggest obstacles to HIV education and testing is the mistaken belief that a positive test offers no hope for the future. This is no longer true. HIV treatments are becoming simpler to take and easier to tolerate. California has one of the best HIV treatment access programs in the country, but far too many people lack the information to obtain assistance. We must improve education about treatment programs and remove barriers to accessing these services.

At the Staying Alive conference our community pressed for expanded, creative and frank HIV-prevention messages to at-risk groups -- particularly gay youth, ethnic minorities, women and the poor. If we are to reduce the number of new infections, we must reach these communities with the lifesaving information they desperately need. Prevention remains the only cure for HIV.

We must also recommit to eliminating the social stigma and other barriers that keep people from being tested for HIV and seeking treatment. Only through early knowledge can individuals act responsibly to protect themselves and their partners. Once tested, we must ensure that all HIV-positive individuals have access to the latest and most advanced HIV treatments, both in the United States and in the developing world.

HIV survivors in the LGBT community are at the vanguard of the movement to stop AIDS. Survivors from all walks of life embody courage and strength in the face of ignorance and discrimination. People living with AIDS will continue to play a pivotal role in promoting improved and expanded HIV treatment and access.

The annual Staying Alive conference gives HIV survivors the opportunity to share their stories, knowledge, and insight. There is a lot to learn from the people who gathered in Los Angeles this August. And there is no time more important to hear and respond to these messages than now.

Dr. Octavio Vallejo is the HIV/AIDS trainer at the UCLA Center for Health Promotion and Disease Prevention and serves on the faculty of the UCLA/Pacific AIDS Education and Training Centers.