In his first five years as Baltimore city's health commissioner, Peter L. Beilenson attended a funeral a month for activists who died an AIDS-related death.

But in the past 10 years, including the last two-and-a-half as health officer for Howard County, "I don't know anybody personally or through work who's died of AIDS," said Beilenson, who was Baltimore city's health commissioner from 1992 to 2005.

The deadliness of the AIDS epidemic in the United States slowly is fading into history's rearview mirror.

It has been nearly 19 years since basketball superstar Earvin "Magic" Johnson announced he had tested positive for HIV, the virus that causes AIDS, and was retiring from the NBA. Johnson still is alive and well, and emblematic of the strides in AIDS research that have led to many people living with the disease for years, and sometimes decades.

"It's unusual to have someone dying of AIDS these days," Beilenson said. "It's more of a chronic, manageable disease."

But living with the disease is not easy. It is a life that involves a strict daily regimen of drugs and persistent stigmas about people who are HIV positive. It is a disease that still is spreading, especially in Maryland.

In 2007, the Centers for Disease Control and Prevention ranked Maryland's rate of reported new AIDS cases fourth out of 50 states, five dependent areas and the District of Columbia, which ranked first, with 148.1 new cases per 100,000 people.

Twenty years have passed since the death of Ryan White, the namesake of the federal program that provides services as the "payer of last resort" for people living with HIV.

At age 13, White contracted AIDS through a blood treatment for hemophilia. He was ostracized by his Indiana school and community and became an internationally known advocate for the fight against the disease.

HIV-positive advocates such as White are harder to come by today, said J. Channing Wickham, executive director for the Washington AIDS Partnership.

"There was a time when having HIV was a death sentence, and you really had nothing to lose," he said.

With new medications prolonging the lives of people living with HIV, "it's easier to be in the closet now and expect to have a relatively normal life," he said.

But old prejudices, fears and stigmas about HIV still exist — and having a "normal" life means having a life to lose, Wickham said. A woman he knows who formerly spoke out as an HIV-positive advocate has a family and a career — she no longer is so open about her experience.

The loss of visible first-person advocacy is a loss for the cause of AIDS awareness, Wickham said.

"People who are [HIV] positive are the best advocates because they speak about their experiences," he said.

HIV-positive advocates still are active in significant numbers, said Heather Hauck, director of the state Department of Health and Mental Hygiene's Infectious Disease and Environmental Health Administration. But their activism has taken on different forms.

"In the late '80s and early '90s, there were more protest types of advocacy because at the time, there was very little awareness about HIV," Hauck said.

Today, advocates work more within the system of government and health agencies, including HIV-positive members on statewide community planning groups for HIV and AIDS prevention and treatment.

Still, as the deadliness of the HIV and AIDS epidemic has declined, so has awareness, Wickham said.

In a world where various causes compete for attention — and money — people are "fatigued" when it comes to HIV and AIDS, he said.

Less affluent communities have less visibility and "HIV and poverty are linked now."

"The killing of a beautiful, white woman is a lead story," Wickham said. "If it's a low-income woman, it's not a story."