BRATTLEBORO — When Karen Peterson began work at the AIDS Project of Southern Vermont in 1993, the novice assistant toiled daily in the shadow of a disease that was a certain death sentence.
Peterson would go on to witness lifesaving advances in testing and treatment as she climbed the career ladder to become the Brattleboro-based nonprofit's executive director in 2013.
So why, as she prepares to step down after three decades of work, is her job harder than ever?
“I get comments like, 'Does AIDS still exist?'” Peterson said. “People aren't as conscious of it anymore. It's not front and center like it was for so many years.”
As most residents focus on COVID-19, the AIDS Project and Vermont's other two AIDS service organizations - the Burlington-based Vermont CARES (Committee for AIDS Resources, Education, and Services) and Upper Valley's HIV/HCV Resource Center - are facing continuing caseloads. Nearly 700 people statewide are living with the human immunodeficiency virus that causes the disease, according to the Vermont Department of Health.
Meanwhile, the federal government keeps shifting more of its financial aid from rural areas with fewer people and lower perceived risk to urban centers with larger populations.
“It's harder to find funding for a state like Vermont,” said Peterson, who commiserates with her counterparts.
Peterson, 58, was a high school student in 1981 when the U.S. Centers for Disease Control and Prevention first identified an incurable, fatal disease that would be named “acquired immunodeficiency syndrome.” Joining the AIDS Project five years after its 1988 founding, she was hired for what was supposed to be a four-week, part-time temp job.
“Growing up in Vermont, I hadn't heard much about AIDS and didn't know anybody with it,” Peterson said. “There weren't that many clients, and they were with us for a short time. We were helping people to die.”
That changed in the 1990s with the advent of antiretroviral drugs. Since the beginning of the epidemic, an estimated 40 million people have died from AIDS-related illnesses - and now an equal number are living with HIV.
That latter figure is both good and bad news.
At least a dozen or more Vermonters, 30,000 Americans, and 1.5 million people worldwide are newly diagnosed annually. But an infection that older generations once feared is now often dismissed by younger people as just another sexually transmitted disease - even though treatment is costly and required for the rest of one's life.
Over the past decade, the AIDS Project has served an ever-changing array of about 70 clients in Bennington and Windham counties. But in that same period, its annual budget has dropped 15%, from $529,000 in 2012 to $447,000 this year.
As a result, the organization was forced to cut a full-time clerical position - the one Peterson once held - as well as staffers for prevention efforts that focused on sexual health.
On the flip side, more money for drug-related projects is available due to concern over an increase in opioid overdoses. The AIDS Project's syringe services program, for example, offers harm-reduction education and equipment such as Narcan and sterile needles, as well as testing for HIV and hepatitis C (HCV).
Samba Diallo has experienced the shift firsthand. The 36-year-old started at the AIDS Project as a direct service associate in 2019, then became an HIV prevention specialist in 2021 and harm reduction coordinator this year because of changes in focus and funding. He's now set to succeed Peterson when she departs upon her 30th anniversary in January.
“I want to keep providing services,” Diallo said, “and add some new perspective.”
'Yes, it's still here'
Vermont's two other AIDS service organizations tell similar stories about trying to draw attention and money to their cause.
In Burlington, former Vermont CARES executive director Peter Jacobsen relinquished his responsibilities this past spring to colleague Theresa Vezina, who leads an organization that serves Addison, Caledonia, Chittenden, Essex, Franklin, Grand Isle, Lamoille, Orleans, Rutland, and Washington counties.
“A lot of the work that we're doing is around awareness,” Vezina said. “We aim to focus on helping to create increased access to health care and social services.”
In the Upper Valley, the HIV/HCV Resource Center serves Orange and Windsor counties under the leadership of Executive Director Laura Byrne.
“We do find the same challenges,” Byrne said. “There's a whole education component we're all trying to do.”
Back in Brattleboro, Peterson knows staff will continue to come and go.
But as for HIV and AIDS, “our message,” she says, “is, yes, it's still here.”