A new wave of HIV infections is about to hit New York, and we had all better get ready for it–from AIDS service providers to all New Yorkers at risk. It is not just that many people have let their guard down when it comes to practicing safe sex or not sharing needles, but thousands of people are living with HIV without knowing it and are about to find out.

In June, our state legislature passed groundbreaking legislation requiring HIV testing to be offered routinely in medical settings. On September 1, the new law went into effect.

Previously, patients were required to sign a separate, written consent form in order to get tested for HIV. Now, if you agree to a quick swab test, you will only have to give oral consent. When undergoing routine medical procedures or check-ups, you will be offered a standard HIV blood test to sign off on, along with the battery of tests that most patients receive. Once you give your consent, it stays in effect for all your future blood tests.

The Centers for Disease Control and Prevention estimates that 100,000 people in New York City alone are currently living with HIV infection, but more than 25,000 of them do not know it. After all, HIV can take 10 years or more to progress to AIDS, the syndrome that destroys your immune system and leaves you vulnerable to all manner of opportunistic infections.

Most of these unknowing carriers of HIV feel and look healthy and are, in most respects. But they are missing out on treatments that could prevent them from progressing to AIDS. Plus, they are in danger of transmitting the virus to others, continuing to fuel the epidemic.

Yes, researchers have made enormous progress in treating HIV with anti-retroviral drugs that have extended the lifespan of people with HIV/AIDS by decades. HIV prevention was once driven in part by the fear of the horrible, disfiguring diseases that preceded the untimely deaths of our friends and loved ones. Now, the number of older people living with AIDS is skyrocketing as new infections rise among the young.

Today, fewer people even acknowledge having HIV/AIDS because they are experiencing relatively good health (if they have access to treatment) and do not want to complicate their employment or community lives. That has made HIV prevention much, much harder in 2010, especially among young people who are under the illusion that there is a cure for HIV that involves just taking a few pills. It, in fact, involves taking drugs almost daily that can have very debilitating side effects for the rest of your life.

Gay Men’s Health Crisis (GMHC) was founded 29 years ago by a brave band of gay men, led by Larry Kramer, who were screaming about the impending epidemic when almost no one in the community or media or government would pay attention to it. Today, there is a vast network of service organizations such as ours, along with government programs to help people with HIV/AIDS and prevent new infections. Yet, we are all going to have to step up our efforts to meet the new demand for AIDS services brought on by all the people who are going to find out about having HIV under the new testing protocol.

This new AIDS crisis is coming at a time when state and federal funding for AIDS is being cut in the current economic crisis. While New York has one of the best AIDS Drug Assistance Programs (ADAP) in the country to make sure that all people with HIV can afford their drugs, other states have long waiting lists to receive these lifesaving treatments. And with most HIV infections disproportionately hitting poorer people of color and others who are disenfranchised, the challenge of getting them the treatment, services and prevention they need is even more challenging.

The country took a big step forward in this fight on July 13 when President Barack Obama announced the nation’s first National HIV/AIDS Strategy, one that GMHC led the call for. It stresses the need for much more culturally relevant interventions targeting gay men and communities of color and the desperate need for greater cooperation among government, community- and faith-based organizations, and the private sector.

We are all going to have to pull together to meet this new challenge, and GMHC will continue to advocate vociferously for the public policies and funding needed to address it. As our city confronts a spike in bias-related violence, prejudice also fuels the spread of HIV. We have to see racism and anti-gay bigotry as the public health problems that they are if we are to get new HIV infections under control. We must also understand the central role that HIV stigma, intertwined with antigay stigma, continues to play in the epidemic.

In the midst of this, GMHC is going through a big transition of our own. Our 15-year lease on West 24th Street is up, and we had to move or face tens of millions more in costs. After a difficult search, we found a great new space on West 33rd Street that will save us millions that can be put right back into direct services and allow us to consolidate on two sprawling floors rather than the 12 smaller ones we currently occupy. We will continue to provide HIV testing and prevention services at a new Wellness Center in Chelsea.

GMHC and all HIV/AIDS service providers need your help and support to meet these new challenges. Concern about AIDS in the U.S. has receded as other crises have come to the forefront, and attention has justly shifted to the AIDS pandemic in the third world. But please remember that the crisis at home is far from over.

I am honored to be leading GMHC at this time. I have a job where I hear virtually each day from people who tell me, “Thank God for GMHC” or “GMHC saved my life.” While we look forward to the day when our services will no longer be needed, the time is now for us all to ramp up our commitment to serving those with HIV and vastly intensify our prevention efforts so that fewer and fewer will test positive.