"Visits didn't last that long," recalled Reilly, the first nurse to work in Nassau University Medical Center's AIDS clinic when it opened in 1986. "They got sick, they died. They didn't come back."

Last week, a mother carried a baby in a bassinet as she checked in at the hospital's HIV and AIDS Clinic. A man breezed in wearing a suit and tie, rolling up his sleeve to allow Reilly to draw blood. A little while later, Reilly chatted with a father about switching his kids to a new school.

Reilly has known some of the patients for more than a decade. "There's a degree of closeness," she said. "There are a couple, they could be like my sisters."

Twenty years after the clinic opened - and a quarter century since the discovery of AIDS - the view from the hospital's HIV and AIDS Clinic has changed dramatically. Reilly and the doctors could once offer little more than a hand to hold and some prescription drugs to ease the pain. Now, a collection of medicines keeps people living nearly normal lives. A once grim ward now feels like the outpatient clinic that it is.

Although the disease drew early attention in cities like New York and San Francisco, Long Island was one of the first suburbs to feel the impact of AIDS. Local doctors were treating patients soon after the researchers first defined the syndrome in 1981, and by 1992, the number of Long Islanders living with AIDS topped 2,000, making the region the first suburb in the nation to qualify for federal funding through the Ryan White CARE Act.

Although new treatments have improved the prognosis for people living with HIV and AIDS, the virus continues to spread on Long Island. Overall, 4,591 people were living on the Island with HIV or AIDS as of December 2004, the most recent information available.

When the Nassau University Medical Center opened its AIDS clinic, a diagnosis of AIDS meant almost certain death. North Shore University Hospital at Manhasset and the Stony Brook University Hospital had been treating patients at their clinics since 1983. The three hospitals still house the only state-designated AIDS centers on Long Island.

"They'd come to the hospital sick, then they'd leave. They'd come back in sicker, then they'd leave again. Finally, they'd come back to the hospital to die," said Dr. Janice Verley, medical director of the NUMC clinic. In the '80s and early '90s, she trained in a Baltimore AIDS clinic and joined the Nassau hospital in 1996.

With a new generation of drugs in the 1990s, HIV and AIDS became manageable conditions - so much so that today, the clinic has a laid-back feel.

Case managers, doctors and nurses like Reilly have long relationships with some patients, who return every three months for check-ups. "I know almost all their names. And I know all their faces," said Fran McDermott, the program coordinator, who has worked in the clinic for 12 years.

A few months ago, the staff held a party for long-term survivors. There was music, food, and flowers on the tables. And something else, said one patient - a big helping of dignity.

"It made us feel that we were worth something to them," said Belinda, a 49-year-old woman from Massapequa who was diagnosed with HIV in 1992. She used her middle name because she has not told some relatives about her status.

The clinic's staff works to maintain that welcoming atmosphere for good reason - HIV and AIDS, though treatable, requires a lifelong dedication to taking drugs and coming in for visits. "We try to give them the strength to come back," said Reilly. "They have to feel safe."

In many cases, management of AIDS and HIV takes a backseat to other life issues. "As people are living longer with HIV, a lot of other issues come up," said Verley. "They may not have expected to live this long. Spouses may leave, kids grow up and move away."

Some patients are addicted to illegal drugs. Others struggle with the psychological toll of living with a chronic disease. As a result, say Verley and others, case management has become more important. Case managers steer patients through a range of medical, financial, legal and other services. The clinic also employs a psychologist and a worker who screens for drug use.

The faces in the clinic have changed, too. Whereas doctors once saw mostly gay men and IV-drug users, patients at NUMC's clinic are increasingly diverse, ranging from white teenagers to black business-owners.

The clinic cares for about 650 patients, 60 percent of whom are male, Verley said. Sixty percent of its patients are black, 20 percent are white, and 15 percent are Hispanic. About half receive Medicaid, the government health insurance for the poor. Islandwide, 41 percent of people living with HIV or AIDS are black, 40 percent are white, and 17 percent are Hispanic, according to state health department statistics. Women make up 34 percent of Long Islanders living with either HIV or AIDS.

The way life has changed for patients surprises even those who live with the disease, including one 45-year-old man who was diagnosed with AIDS in December.

He lived through the AIDS epidemic in the 1980s, when he kept a special "funeral suit" for the services of friends. Since discovering he had the disease seven months ago, hehas made a nearly full recovery after slipping into an AIDS-related coma seven months ago.

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