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"I thought I was going to die, and I wanted it to happen really fast because of how sick I was," said Viamontes, 36.
He was also coping with a knee that failed to heal after surgery, and the remnants of an addiction to methamphetamine that he picked up during a previous stint living in San Francisco during the 1990s.
"There was nothing going on in my life, and I didn't know how to change that," Viamontes said.
He credits programs such as the Marin AIDS Project, which provides him access to psychological counseling, and Whistlestop Wheels, which provides him with transportation, for helping to turn around his life.
"I'm so happy now," said Viamontes, who is taking classes at Heald College, pursuing a career as a paralegal.
Viamontes is just one of the 609 men and women in Marin County living with HIV infection or AIDS, as the world commemorates World AIDS Day, the 28th anniversary of the fight against AIDS. Since AIDS emerged in the 1980s, 1,086 Marin residents have contracted the disease. As of April, 734 Marin residents had died from the disease. The figures do not include inmates at San Quentin State Prison.
According to the World Health Organization, there were an estimated 2.7 million new HIV infections in 2008. WHO estimated that in 2008 there were 33.4 million people living with HIV
Five Marin residents died of AIDS during 2008, and 16 new Marin residents were diagnosed with AIDS that year.
Viamontes said the cocktail of drugs he takes - Kaletra, Truvada and Retrovir - has been effective in suppressing his disease with minimal side effects.
"There is hope," said Viamontes, who was 7 when he came to the United States from Cuba with his mother during the Mariel boatlift. "You can live a very normal life with this disease. I don't fear dying anymore. I look forward to waking up every day."
The introduction of protease inhibitors and drug cocktails in the late 1990s has stretched the life expectancy of people infected with the HIV virus from just a few years to decades. But a story published in New York Magazine last month raised new concerns about the effectiveness of these drugs.
According to the magazine story, researchers are finding that patients who have lived with AIDS for a number of years are displaying serious medical problems normally associated with aging, such as: osteoporosis, varieties of cancer, kidney disease, cardiovascular disease and dementia.
The article, written by David France, a contributing editor at New York Magazine, suggests the possibility that these conditions are being caused by side effects from the anti-AIDS drugs.
Dr. Milton Estes, who specializes in treating AIDS patients at the Tom Steel Clinic in Mill Valley, said some of his patients are developing the problems mentioned in the article. Estes, however, said the latest research indicates that antiviral drugs are not to blame.
"Most of these phenomena really appear to be due to HIV itself, not the drugs," Estes said.
Estes said he and other Bay Area doctors participated in a study that stopped administering the antiviral drugs to a test group of patients when their T-cell counts rose above 350.
"The study had to be stopped in the middle because the evidence came in quite to the contrary," Estes said. "There was quite a significant increase in deaths and morbidity from heart disease and liver disease and kidney disease in the group that was having intermittent HIV therapy as opposed to the group on continuous therapy.
"Since then, people have recognized that having active HIV itself seems to set up a kind of inflammatory process in small blood vessels that affect all the organs," Estes said.
Estes said it is particularly difficult for his HIV patients, half of whom are over age 60, to deal with these early aging problems.
"Not many of them have children or family support," Estes said.
He noted that increased needs for expanded services and medical attention due to these early aging problems are coming as the state is cutting spending, and the national health care system is in crisis.
Jennifer Malone, executive director of the Marin AIDS Project, said state cuts for AIDS education, testing and prevention, and reallocation of Marin Community Foundation funds, will cost her organization 30 percent of its total funding beginning in July. The nonprofit is attempting to replace the lost money by soliciting private donations.
"It's a difficult situation," Malone said.
Contact Richard Halstead via e-mail at rhalstead@marinij.com
