CHARLESTON, W.Va. -- Brandon was in his early 20s when he got the life-changing diagnosis -- he had HIV.
A part-time employee at a bar, Brandon (not his real name) said his first concerns were financial.
"The first thing I thought was that I can't pay for it," he said.
Then he worried about dying, although he knew, with modern medicine, HIV patients can live longer lives than before. He thought, "Why go back to college now?"
"Now I'm finishing my bachelor's degree like any other 24-year-old that doesn't have one," he said this week.
Brandon, who asked to remain anonymous because of the stigma attached to HIV, is one of about 70 West Virginians each year who are newly diagnosed with HIV, based on recent figures from the state Bureau for Public Health.
Between 2008 and 2010, 70 was the average number of new cases each year in West Virginia.
On Saturday, people around the world will mark World AIDS Day by remembering those who live with the disease and those who have lost their lives to it.
According to estimates from the U.S. Centers for Disease Control and Prevention, about 50,000 Americans are diagnosed with HIV each year. The majority of the new infections are among gay and bisexual men, according to the CDC.
Being from a small West Virginia town, Brandon said, one of the most difficult aspects of being diagnosed with HIV was telling his family members. They had known he was gay since he came out to them at 16.
"When I told her this, my mother immediately thought she was going to outlive me," Brandon said. "She was 48 and she's thinking, he's going to die in his 30s."
There's no cure for HIV/AIDS. Patients receiving medication to fight the virus still live an average of 11 years less than a person without HIV/AIDS.
Brandon's eligibility for the AIDS Drug Assistance Program, which helps those with HIV who are uninsured and underinsured, took care of his financial concerns.
However, the diagnosis has still made a major impact on his life.
Brandon worried that, if people knew, they would not want to buy drinks from him at the bar where he worked.
"I've heard of people who are waiters who don't tell people," he said. "They don't want it known, because there's such a stigma."
While treatment has progressed, those who work closely with the AIDS community say the stigma about the disease has not changed much over the years, especially in West Virginia.
Dave Bennett, health-action program manager for Covenant House, blames ignorance for the stigma.
"You say AIDS, and they haven't gotten out of that late-'80s fog," Bennett said. "They're still living in that. I just don't know where to begin, because people have to want to be educated.
"You can offer a clinic and people aren't going to go because they think, 'I know all about that.'"
Covenant House has offered housing assistance to HIV/AIDS patients since the late 1980s. Today, the organization also offers free HIV testing, an HIV/AIDS support group and a smoking-cessation class aimed at those in the lesbian, gay, bisexual and transgender community.
Michael Vincent, who heads up the AIDS Residential & Resource Program for the organization, said that because people sometimes shun those with AIDS, he's careful where he meets with clients.