It’s been 30 years since the Centers for Disease Control and Prevention reported the first U.S. cases of Acquired Immune Deficiency Syndrome (AIDS). The dark cloud of a death sentence that hung over those who tested positive in the epidemic’s early days has been lifted by hope brought by new medications. 


But there are still 1.2 million people nationwide living with HIV (the virus that causes AIDS), an estimated 20 percent of whom are still undiagnosed. Monterey County’s HIV-positive population is relatively small – 625 diagnosed, plus roughly 150 undiagnosed – but Central Coast HIV/AIDS Services Executive Director Tom Melville says those with the disease are typically some of society’s least visible and most at-risk citizens.


“They’re mostly lower-income, disenfranchised, and aren’t looking for attention,” Melville says. That’s why CCHAS’ seven staffers do much of their outreach at homeless shelters, jails and substance abuse recovery centers.


“We reach out to populations others won’t approach,” Melville says.


On a recent Monday afternoon, CCHAS staff and volunteers are running their twice-weekly syringe exchange, which serves nearly 700 people per month, at Dorothy’s Place in Salinas’ Chinatown. A steady stream of people comes through the door, exchanging used needles for clean ones, grabbing condoms and HIV prevention pamphlets, and chatting with Sharene Ashadi, who supervises CCHAS’ education, prevention and testing programs. 


During a lull, Arshadi talks about the challenges of connecting with people who’ve learned to trust no one.


“It can take years before clients will even let you test them [for HIV],” Arshadi says. “But it’s worth it in the end, when you finally get to them.”


CCHAS also provides counseling and therapy referrals for the diagnosed, emotional support groups for their loved ones, and permanent and supportive housing for over 250 individuals and families through a federal grant.


But Arshadi and Melville agree that prevention education and outreach is the central component of CCHAS, and increasingly necessary when AIDS no longer dominates the headlines.


“In some ways, we’ve become a victim of our own success,” Melville says of the the medical advances that have diminished the fear around AIDS. “People think, ‘What’s the big deal? I go to the clinic, I’ll be fine.’” 


Adds Arshadi: “But AIDS doesn’t discriminate. If you’ve got it and you don’t know it, you’re going to spread it.”


Stopping the spread got more difficult for CCHAS when the state Legislature slashed $52 million in AIDS education and prevention funding statewide earlier this year. Just like that, 95 percent of the funding for CCHAS’ education, prevention and testing program was gone, along with five staffers and outreach programs that targeted communities of color and other high-risk populations.


Local foundations have stepped in to help fill the gap, but Melville says the need’s still dire.


“We can do a lot with a little, but we can’t do anything with nothing,” he says.