Research studies suggest that the average time from infection with HIV to the development of AIDS is 8-11 years. HIV has long-term survivors, but persons recently diagnosed with AIDS survive longer than those diagnosed earlier in the epidemic. HIV is transmitted through sexual contact, exposure to infected blood or blood components, and perinatally from mother to child. Epidemiological evidence implicates only blood, semen, vaginal secretions, and breast milk in transmission. AIDS is now the sixth leading cause of premature death in the United States, after accidents, cancer, heart disease, murder, and suicide. Estimates indicate that 1 million Americans are currently infected with HIV and that at least 10-12 million are infected worldwide. AIDS affects both males and females, infants and children, and adolescents and young adults. Injecting drug users and their sex partners comprise nearly one-third of diagnosed AIDS cases in the United States and the fastest growing and second largest risk group for HIV infection. Blacks and Hispanics have suffered the highest death rates from HIV-related causes. AIDS awareness and prevention measures focus on media campaigns, better condom marketing, and word-of-mouth messages. Concerns of people living with the disease are the potential for being victims of violence, difficulties in obtaining and paying for health care, and discrimination. The lifetime cost of treating a person with AIDS is estimated at $102,000, up from $85,000 in 1991 and $57,000 in 1988, and an AIDS patient spends an average of $4,000 yearly on medications. State policy and program issues related to HIV/AIDS encompass blood donation and supply, confidentiality, the correctional system, criminal penalties for willfully transmitting HIV infection, discrimination, guardianship, health care workers, informed consent, notification, school education and condom distribution, sex offender testing, syringe and needle exchange, and testing and reporting. The key workplace issue associated with AIDS involves employer costs of retaining HIV-infected employees. With respect to tuberculosis, individuals most at risk include people with HIV, alcoholics, drug abusers, the homeless, inmates, and nursing home residents.