The reframing of acquired immune deficiency syndrome (AIDS) from an acute to a chronic disease brought about a different focus for public policy. Now viewed as the end stage of the human immunodeficiency virus (HIV), AIDS has emerged from the plague model. Many biological and social forces affected this change, including an increased understanding of HIV and its associated disease processes, radical shifts in the composition and needs of those affected by HIV, advances in biomedical technology, and the expansion of health and social services. This article offers an overview of institutional and social responses to the epidemic and discusses the changing social construction of HIV/AIDS as a chronic illness in a historical model. Psychosocial and health care issues within a continuum of care framework are reviewed and implications for future HIV/AIDS care are considered.
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