On Monday, June 27, The Center and the National Association of People with AIDS will participate in the National HIV Testing Day, an annual campaign to encourage at-risk individuals to receive voluntary HIV counseling and testing. Following a year laden with statistics indicating an increase in HIV-infection rates across the board, we urge everyone to take advantage of this opportunity and get tested.

Here’s a powerful statistic: According to the Centers for Disease Control and Prevention, more than a quarter of the people living with HIV have not been diagnosed – that’s nearly 300,000 people who have the virus but are unaware of their status. Studies also show that the majority of new infections are transmitted by people with HIV who do not know they are infected.

Federal health officials recently released an annual report revealing that there are now 1 million people living with HIV in the U.S. In part, the increase is a testament to powerful new HIV/AIDS drugs and treatment options available for those living with HIV and AIDS. However, infection rates have continued to climb, topping out at 60,000 new infections per year, according to some experts. After more than two decades battling HIV, including millions spent targeting at-risk communities, why do we see more HIV than ever before?

Depending on which study you read or who you talk to, most will agree the spike in HIV is a result of multiple variables – some we are now just beginning to understand.

Advocacy groups believe the federal government’s campaign to curb the spread of HIV has been a complete failure, pointing to the lack of federal resources backing public awareness campaigns and other prevention programs, as well as politically motivated efforts that emphasize abstinence over condom use. But even the safe-sex message, at least in part, is falling on deaf ears.

The reality is people are living with HIV/AIDS. In the last 20 years, advances in medicines have drastically changed quality of live. From a prognosis of imminent death to now a manageable chronic illness, the messages we receive about HIV have changed and, therefore, so have behaviors. As the threat of HIV lessens, risky and unprotected sex will rise as people weigh the risks when determining sexual behavior – especially amongst the new generation disconnected from the early onset of AIDS.

And then there is the not-so-new phenomenon newly attributed to the increase in HIV: crystal meth. Making international headlines following the discovery of a super-HIV virus in a N.Y.C. man, who reportedly sero-converted after having unsafe sex with nearly 100 men while under the influence of the drug, crystal meth and its symbiotic relationship to HIV transmission is finally getting the play it deserves.

HIV is on the rise – that is for certain. How to effectively head off increasing infections and actually reverse these trends is unclear. Pushing safe sex and condom use is more effective than abstinence-based prevention programs, but this message does not resonate with our entire community.

Action for Gay Men’s Health has placed controversial full-page ads in the U.K. press that read: “Cum like a porn star, all over my back. … Fucking without condoms is the most common way that gay men pass on HIV. Pre-cum has HIV in it but cum has a lot more. If you fuck without a condom, don’t cum in his arse. Reduce the risk: CUM OUTSIDE!”

If we know that many men are not using condoms, shouldn’t we give this audience an alternative message in addition to pounding the safe-sex drum?

People living with HIV face many difficult challenges that are not discussed outside the HIV/AIDS community. If you’re negative, you need to know that medications do prolong life, but come with a laundry list of side effects. People with HIV encounter a multitude of physical, social and economic impacts that make living with HIV less than desirable. These sorts of messages may actually reach people. HIV has changed, have we?