When Michael Danyluk was finishing his grad studies in counselling psychology, his practicum involved working with people with HIV or AIDS. It was 1983. At the time, those diagnosed with the illness were mostly gay men who were generally given only months to live. The Vancouver counsellor may have seen many people through their toughest times, but he says he is the one who gained from the experience.

“It was a scary time for a lot of men,” Danyluk says in a telephone interview. “They came from the sexual revolution and gay liberation and were hit with this horrific epidemic.”¦But they had overcome the stigmatization of their sexuality. They showed that staying hidden is not helpful. They taught me a whole lot about compassion, about people’s capacity to love and take care of one another in ways they never thought possible, about how to be tender with respect to other people’s feelings and how to develop empathy.

“Clients teach you everything,” Danyluk adds. “They taught me that it is possible to live a good life and to have a good death.”

Much has changed since Danyluk started out 25 years ago, particularly the tremendous progress in treatments for HIV and AIDS. Although World AIDS Day—which takes place on December 1—is a time to remember people like Danyluk’s early clients, it’s also an opportunity to raise awareness of how much more work needs to be done.

At the top of the wish list for Thomas Kerr is more widespread use of highly active antiretroviral therapy (HAART). The research scientist at the B.C. Centre for Excellence in HIV/AIDS says that governments around the world are failing to live up to their promises to combat AIDS by not offering HAART to those who need it.

HAART became the standard of care for the treatment of HIV/AIDS in 1996. The treatment involves taking about three antiretroviral drugs every day for life and requires strict adherence to be effective. The drug cocktail decreases the level of the human immunodeficiency virus in the body, thereby reducing the risk of disease transmission while enabling the immune system to strengthen. The B.C. Centre for Excellence distributes the medication to all eligible British Columbians for free through the provincewide drug-treatment program.

According to a study published in the Journal of Infectious Diseases in July, an increase in HAART coverage from 50 percent of those in need to 90 percent could lead to a decrease in the number of people testing newly HIV-positive of more than 50 percent annually.

The B.C. Centre for Excellence has found that the number of new HIV cases in B.C. and Taiwan was cut in half because of the introduction of free access to HAART.

Despite HAART’s effectiveness, Kerr says it’s not used in places like Thailand and Russia because of political interference. Worldwide, about 2.7 million people became infected with HIV last year. Of those, 1.9 million live in sub-Saharan Africa and 370,000 are children.

“If this treatment decreases morbidity and mortality caused by AIDS and is effective in preventing HIV/AIDS, then why the hell doesn’t everybody have it? There’s only one answer: lack of political will,” Kerr tells the Georgia Straight. “We need a higher level of accountability. Governments are violating people’s human right to attain the highest level of health possible.”¦Governments develop policies based on ideologies, and people die as a result.”

According to the February 2008 issue of the Journal of Acquired Immune Deficiency Syndromes, 40 percent of people who died of HIV/AIDS–related causes in B.C. between 1997 and 2005 never accessed the therapy.

Among the reasons for not getting the drugs are poverty, mental illness, and language barriers.

David Swan, the executive director of AIDS Vancouver, says that it is crucial to fight the perception that because of medical advances people no longer need to practise safe sex.

“AIDS has kind of shifted off people’s horizons,” Swan says. “Some people think they don’t really need to worry because AIDS is treatable. But the medications can have toxic, difficult side effects, and we’re just starting to see the impact of long-term use of the drugs. We need ongoing vigilance about safe sex.”

Almost 4,200 people in B.C. have been diagnosed with AIDS, and another 13,000 have HIV. In 2007 alone, 395 British Columbians tested positive for HIV. Forty-three percent were gay or bisexual men, nearly 26 percent were known to be injection-drug users, and 21 percent were women. Twenty-two percent of new infections were attributed to heterosexual sex. First Nations individuals represented 12 percent of new infections.

“It’s an insidious disease that preys on the most vulnerable,” Swan says, noting that AIDS Vancouver is hosting its 25th-anniversary open house on World Aids Day. (The organization is at 1107 Seymour Street.)

Those who are newly diagnosed with HIV might feel scared, depressed, confused, or angry, according to AIDS Vancouver.

Among the coping strategies for people living with HIV or AIDS, Danyluk explains, are keeping their social network intact and asking “unabashedly” for help. He urges people to resolve issues of shame and to talk to those they trust.

“It’s important to both remember and look to the future on World AIDS Day,” Danyluk adds. “I look forward to the time when there isn’t a World AIDS Day.”