“When he got here he was very disappointed that there were no services at all and he had a dream to change that,” said Butch McKay, who now, 20 years later, directs an organization that fulfills that dream — the Okaloosa AIDS Support and Information Service (OASIS) center in Fort Walton Beach. The center received its nonprofit status Oct. 3, 1991, after a small band of volunteers, including Neal’s mother Carmelita, started meeting regularly. “The first office was Carmelita’s trunk, then it moved to the kitchen,” McKay said. St. Simon’s on the Sound Episcopal Church later let the group move into its first real office space.

A qualitative study conducted with people who have tested HIV-positive but never had HIV medical care in the United States has found that many of these individuals had poor experiences with testing, counselling and referral services. Health professionals were not always perceived to be compassionate, helpful or available, researchers from the Centers for Disease Prevention and Control (CDC) report in the June issue of AIDS Education and Prevention. Most of the participants were poor and often had no health insurance. Interviewees felt that the structural barriers to accessing healthcare were considerable.

HIV remains one of the most formidable challenges facing the human family and we ignore this challenge, literally, at our own peril. This is clear from the final declaration agreed by the U.N. General Assembly High Level Meeting on AIDS that met June 8-10 in New York. The cost in human suffering, lost opportunities and diversion of resources remains a challenge that no one can escape, but there is hope of better protection through increased access to anti-retroviral drugs, early testing, and recent medical breakthroughs.

While AIDS continues to infect and kill people -- the U.S. Centers for Disease Control report that more than 18,000 people with AIDS die annually in the United States and an estimated 56,300 Americans become infected with HIV each year -- perceptions, treatment and the demographics of the disease have changed since the 1980s. The church's awareness of and response to AIDS have changed along with them, with some Episcopal ministries growing and evolving, others dwindling. Yet the need remains, advocates say.

The "Lazarus effect" is a phrase coined by doctors and relief workers in Africa to describe what happens to AIDS patients after they start receiving antiretroviral medicines. On Sunday, churches around the world read from the Gospel of John and heard the story of Lazarus, in which Jesus raised his friend Lazarus from the dead, as part of Lazarus Sunday.

Retired Anglican Bishop Christopher Senyonjo, an outspoken activist for human rights and equality in Uganda, delivered a presentation at the United Nations in New York on April 8 calling for the global decriminalization of homosexuality as a way to make progress in the HIV/AIDS pandemic.

While most adoptions present challenges, there's a distinctive set of them facing parents who decide to adopt children living with HIV. A twice-daily medication regimen, lingering prejudice and fear, uncertainty about the child's longevity and marriage prospects.

Yet the number of U.S. parents undertaking HIV adoptions, or seriously considering them, is surging — from a trickle five years ago to at least several hundred. Most involve orphans from foreign countries where they faced stigma, neglect and the risk of early death.