AIDS GROUPS SHIFT STRATEGY:

As More Patients Survive, Focus Now Is On Managing Long-Term Problems.

SAN FRANCISCO -- Predictability can offer a certain comfort, even if
this is what you know: You will die young, of AIDS.

Chip Supanich knows.

When he learned he was HIV-positive in 1985, the San Franciscan took
the diagnosis and his doctor's prognosis to heart. He started to
party, party, party. And he developed a methamphetamine habit.

But he lived beyond predictions, and by 1996 he was homeless, 45
pounds lighter and desperate for AIDS medications.

Now 38, Supanich says: "I have faith that my life is not near its
end." Yet, even as protease inhibitor drugs coax his weight back to
normal, he concedes: "I can be certain of nothing."

AIDS service organizations find themselves in this same dilemma,
simultaneously in transition and in limbo.

"We had a horrible certainty, and now we have a mixed-bag certainty,"
says

Craig E. Thompson, executive director of AIDS Project Los Angeles, who
is HIV- positive.

Once, these organizations focused on helping patients get their
affairs in order and on keeping them comfortable as they died.

Now, with more patients like Supanich living longer, just how
"exceptional" a disease is AIDS? And what happens to the funds and
supporters -- the network of help that became a phenomenon in itself?

They have to shift strategy, many say.

"Maybe in the long term we can't maintain that sense of crisis. Maybe
it's finding a way to manage AIDS as a decades-long health problem,"
says Tom Metzger, spokesman for the National AIDS Fund, a nonprofit in
Washington, D.C.

Though the AIDS death rate took a nosedive beginning in 1996 and
brought public donations down with it, the Centers for Disease Control
in Atlanta reports that the number of new HIV infections has remained
steady through the decade with some 40,000 new cases annually.

Nationwide, an estimated 15,000 groups serve patients with HIV. While
some focus narrowly on such issues as mental health counseling, others
are functioning more and more broadly, much as do welfare
organizations with clients who require housing, insurance and help
with drug abuse.

"HIV is a problem in their life, but it's not the biggest," says Pam
Coleman, a caseworker at AIDS Project Los Angeles for 10 years.

For example, the San Francisco AIDS Foundation not only helped
Supanich decipher state insurance coverage, it also got him into
subsidized housing, a more stable environment that proved crucial for
his daily regimen of 15 medications.

To adapt to this growing and needy population, nearly every
organization has been forced to shift money and priorities.

The San Francisco AIDS Foundation last year expanded its housing
program when the city gave it almost $3.3 million in housing grants,
up nearly $1.5 million from 1997. At the same time, its clientele grew
by 1,000 to 3,500, and it was forced to transfer one-third of its
Spanish-speaking clients -- 54 people -- and about 200 HIV- positive
women out of special case management programs when the city gave
$244,671 in grants to other agencies.

The National AIDS Fund, which has given more than $70 million to
community AIDS groups in the past decade, eliminated matching funds in
five cities last year as a handful of smaller organizations folded
into others or disbanded.

Some resent the suggestion that AIDS groups should consolidate, as is
happening in Los Angeles, or should rely on umbrella agencies for
social services. One is Daniel Zingale, executive director of AIDS
Action based in Washington, D.C.

If the services for HIV are so remarkable, he says, why treat AIDS
like other diseases? "Why not treat other diseases the way we treat
HIV disease?"