The miracle of growing old was all but unimaginable for them 30 years ago, at the dawn of the age of AIDS. But today the number of people 50 and older diagnosed with HIV or living with AIDS is booming, both across the country and in Sacramento County, where they account for more than a quarter of the 3,300 known cases.

That percentage is expected to double within the next four years, making older adults America's fastest growing HIV demographic.

"The 45- to 64-year-old age group is growing so fast because they've survived," said Janet Parker, client services director for Sacramento's Center for AIDS Research Education and Services (CARES). "For the most part, they're not new infections. The population is aging."

Even so, according to the federal Centers for Disease Control, people who are 50 and older account for more than 15 percent of the nation's new HIV diagnoses.

These days, longtime survivors as well as the newly infected share not only a diagnosis but also a hopeful prognosis: With good medical care, they can live to a ripe old age.

"Some of our patients have been through it all," said Dr. Jody Gordon, a Sutter Medical Group HIV specialist whose practice includes a handful of patients in their 70s and 80s. "And some were infected after 50 and have been treated with good medications.

"If you are 50 and contract HIV, the overwhelming probability is that we can get you on a regimen and allow you to continue with your normal work. And you'll live close to a normal life span."

Not surprisingly, the lion's share of older people with HIV are gay men who have lived with the virus since the early days of the epidemic. Besides the normal issues of aging, they face medical challenges because of the long-term toll of the antiretroviral medications they take to keep the virus under control.

But they're alive.

"I watched the rise of Harvey Milk in the Castro" district of San Francisco, said Joseph Rosenblatt, 58, a former IT manager who moved to Sacramento in 2004. "I watched old Victorians get turned into condos, and I watched the brothers in the condos die of AIDS.

"It was a time of glory and celebration, and then we were attacked by this unknown disease. People were dying all over the place."

Rosenblatt was diagnosed with HIV in 1984, although he says a retroactive test of blood he had submitted for another medical study showed he was positive as early as 1980, a year before the CDC identified the AIDS virus.

The disease ravaged San Francisco in the 1980s and early 1990s, but Rosenblatt didn't get ill until 1997, two years after the first cocktail of anti-retroviral medications had been introduced. Although newer drugs have fewer side effects, some people suffered significant problems from the early AIDS drugs. Rosenblatt – who eventually developed bladder cancer and had his bladder and prostate removed – was one of them.

Medications saved his life, but their complications also led him to go on disability.

"It's an important point," he said. "Young people think if you get HIV, no problem, just take the meds. For me, the meds were the problem, not HIV."

Evidence also suggests that some HIV drugs may lead to an accelerated aging process, said Gordon, with patients more prone to the early onset of conditions such as high cholesterol, neuropathy, heart disease and osteoporosis.

For example, George Hansen III, a 45-year-old groundskeeper who lives in south Sacramento, has long had lipodystrophy, a side effect of early AIDS drugs in which body fat is redistributed, causing a buffalo hump and a paunch. Before he turned 40, he'd already had a hip replaced because of severe osteoporosis.

"We have to learn to talk about uncomfortable things," said Hansen, who was diagnosed with HIV in 1992. "In the past, I've had to wear an adult diaper. Currently, I'm having kidney issues."

At 56, Michael Jentes has seen it all – as a longtime survivor who lived in San Francisco at the height of the epidemic and now as a CARES case manager. By 2001, he was back in his hometown of Sacramento, slowly recovering from Stage IV colon cancer and coping with full-blown AIDS.

Many of his older clients have healthy attitudes and healthy lives, he says. They take their meds and go in regularly for blood tests, and they take care of themselves.

But for other people, he said, "When they're diagnosed, their whole life comes to an end. This is a serious, chronic illness, but it's also a life-changing event."

Just ask Deborah Jane Rafter, now 61. As the final hours ticked down on 2009, she learned she was infected with HIV. Her boyfriend of almost 13 years' time would die of AIDS within six months.

She said he hadn't previously told her that he carried the virus, and she doesn't know how he got it or how long he'd had it.

"He'd been tested, but he didn't adhere to a medical protocol," said Rafter, a Sacramento housing consultant. "He was in HIV denial. He didn't tell me until February 2010, when he was in the heat of dementia from this virus. He cried and told me he was sorry."

She's grieving for him still, even while she copes with the burden he left her. She wants to speak out, she says, so other people can learn from her story.

"This drove me into a state of panic and sorrow unlike anything I've ever experienced," she said. "That doesn't need to happen to other people. We need to be smart and educated.

"Trust? We all want trust. But this virus is on the rise. We can't give ourselves to trust any more. That's shattered. We need to give ourselves to the medical community and get tested."

© Copyright The Sacramento Bee. All rights reserved.

Call The Bee's Anita Creamer, (916) 321-1136.

• Read more articles by Anita Creamer