Kathleen Pratt was 17, just out of high school and focused on the future when she was infected with HIV.

She didn’t know for a decade. When she tested positive for the virus that causes AIDS, Pratt thought it was a death sentence. She was told she’d have six years to live.

That was 18 years ago. Advances in anti-retroviral medications have extended the life span of those living with HIV and have increased the number of people living with the virus without advancing to AIDS.

But in some ways, little has changed.

“Teenagers don’t think it can happen to them,” said Pratt, an Amherst mother who now tells her story in the hopes of preventing others from being infected. “Neither do adults. They say one in five people who are positive don’t even know it.”

As people across the world and in Niagara County commemorate World AIDS Day on Tuesday, many are taking stock of how the epidemic has evolved. And they say the need for education and prevention measures — especially among the young and the elderly — is more pressing than ever.

“There was a time when it was considered a death sentence that people’s behavior changed radically,” said James Rowe, of the Niagara County AIDS Task Force. “Now, there’s a laissez faire sort of attitude toward it.”

Rowe and others say that advances in medical efforts to help those living with HIV have relaxed attitudes and erased a sense of urgency about the virus.

New infections are still occurring.

In Niagara County — which has the most cases of HIV and AIDS aside from Erie County in Western New York—there were five new HIV diagnoses in 2007, according to the latest statistics available from the state Department of Health. The year before, 13 new HIV diagnoses were reported. In total, 163 people in Niagara County were living with HIV and AIDS in 2007. Eight more cases were reported among state prisoners housed in the county that year.

Those numbers don’t include the people who are HIV-positive and do not know they have the virus.

“We like to sugar coat things, to say, ‘Yes, we’re cognizant of this,’ ” Rowe said. “The thing is, that they haven’t still come up, after 25 years, with a clear vaccination. It’s still a

long way away from the fact that we can eradicate this situation, and we continue to have individuals having risky behaviors.”

Jim Dreher, program coordinator for the AIDS Network of Western New York, said two groups in particular need to be brought back into the fold of AIDS education and prevention. One of those populations is older people who are entering the dating scene again with the help of Viagra and other drugs.

“There are increasing numbers of people who are becoming infected in their later years of life,” Dreher said. “But how do you go about bringing up safe sex discussions with someone you see as your father figure or your grandfather?”

The other, Dreher said, are young people who weren’t around in the 1980s and early 1990s when AIDS deaths were a national focus.

Pratt, the Amherst mother diagnosed with HIV 18 years ago, travels to schools throughout Erie and Niagara counties to tell teenagers about her own experience and to urge them to abstain from unprotected sex— one of the ways the virus is spread.

“I tell them, ‘A few seconds of pleasure, is this worth a lifetime of medications,’ ” Pratt said. “It’s not.”

She will speak during the Niagara County World AIDS Day commemoration from 5:30 to 7:30 p. m. Tuesday at the Niagara Arts and Cultural Center, 1201 Pine Ave., Niagara Falls.

Pratt believes she was 17 when she contracted the virus. She had just finished high school and had a young daughter she was focused on raising. She wasn’t interested in dating, but soon met a boy who was interested in her. They dated for three years before the relationship ended.

It wasn’t until 1990—about 10 years later—that a doctor suggested she have an AIDS test. Pratt had abnormal cells on her cervix and the doctor wanted to know why. Pratt couldn’t believe she was asked to be tested.

By then, she was married and was raising two children.

“I was blown away just by her suggesting it,” Pratt said. “Because, I thought, ‘You’ve got to be crazy. That can’t happen to me.’ ”

Pratt now tells everyone she meets—even at the grocery store—that she is HIV-positive. Many, she said, are shocked.

“I’m guessing in their minds, a person with HIV or AIDS is supposed to be sickly or black or a druggie or gay, and I’m none of the above,” Pratt said. “They just don’t expect to see an attractive white female who is a mother and a wife to have this disease.”

Barbara Jesz, who has been a member of the Niagara County AIDS Task Force since its formation, said people need to understand that HIV and AIDS are not far removed from their lives.

“There’s more information out,” said Jesz, a nurse who has taught HIV and AIDS education programs. “There’s more education, treatment available, but there’s still that idea that it’s not affecting me. It’s not affecting us.”

The Niagara County AIDS Task Force—the only remaining countywide task force in Western New York—is focused on spreading that message of education and prevention. The task force received a boost this year when the Health Association of Niagara County Inc. agreed to form a partnership with the organization to act as its fiscal agent. The association received a grant that will help the two merge.

While the task force provides a community-based organization to serve as a forum for those living with or affected by HIV and AIDS, those living with the virus in Niagara County face other difficulties.

Most have to travel to Erie County for treatment and other services, Dreher said.

“If you’re in Lewiston, that’s a 45-minute drive,” Dreher said. “And if you don’t have a car and you have two kids, how do you get there?”

Pratt tells the teenagers she speaks to about the difficulties of living with HIV. While the number of medications she has to take has been reduced, she still suffers from side-effects that cause her pain in her legs.

She has suffered through vomiting, diarrhea, stomach pain, kidney damage and other effects. She went three years without the ability to taste.

All, she said, because of a “stupid mistake as a teenager.”

Today, she still takes life one day at a time. Her children are healthy and grown. She had remarried her soul mate. Next month, she’ll celebrate another birthday she never thought she’d see.

“I’m 45. I’ll be 46 in December,” Pratt said last week. “I am very proud to say my age because I wasn’t supposed to be here.”