HIV and AIDS have changed.

Patients are living longer and more normal lives, and the public’s concern has dwindled.

But it’s this new view of the virus and the disease that could contribute to a second wave of infection.

While the overall incidence of HIV transmission has decreased, it has increased in people under 30 among men who have sex with men (MSM) and among black women.

In 2006, New York City’s Department of Health and Mental Hygiene published data that illustrated this trend. Between 2001 and 2006, HIV diagnoses have decreased in the total population and remained relatively stable in the MSM category. However, the HIV infection in MSM between the ages of 13 and 29 has been steadily increasing.

Ann Kurth, an associate professor at the UW who studies sexually transmitted infections and HIV, attributes this trend partially to social factors such as individuals in these groups having fewer sexual partners to choose from. This creates densely interconnected sexual networks. Two couples can carry out exactly the same sexual behavior in different social networks and have different risks of infection, she said.

Improved treatments have lead to a commonly held belief that HIV is no longer the death sentence that it once was.

Symptoms of common STIs such as gonorrhea, chlamydia and syphilis can increase the risk of HIV infection; genital inflammation increases the viral concentration in semen and vaginal secretions.

Drug use is also a factor in impairing judgment and decreasing condom use. Kurth said popular drugs such as crystal methamphetamine, which can decrease sensitivity while under the influence, can prolong sexual activity and lead to rougher, more dangerous sex.

“If this trend continues, we may see the same prevalence as in San Francisco and New York in the 1980s,” Kurth said.

It’s less about individualist behaviors and more about structural and social issues. Racial-sexual segregation and the high incarceration rate of young black males decrease the number of potential sexual partners for young black women. This factor is less severe in Seattle where interracial relations are more likely, Kurst said.

Promising steps have been made. Studies show condom use during sexual debut has increased, but condom use sharply declines afterward. While Washington state includes sexual health curriculum, comprehensive sexual education needs to be standard on a national level, Kurth said.

“Every sexual generation needs to learn how to protect itself,” Kurth said.

For the past 10 years, the Centers for Disease Control and Prevention (CDC) has reported approximately 40,000 new infections per year. Later this month, the CDC is expected to release new data reporting nearly 60,000 new infections this past year. Kurth attributes this partially to changed regulation of state reporting practices and to changed testing methods.