Kim Ball is on the frontline of fighting HIV/AIDS locally. She's one of three Public Health nurses who see patients with sexually transmitted diseases.

"I see patients with communicable infections of a sexual nature," she said. "But HIV/AIDS is my focus."

Ms Ball is the Government nurse assigned to handle all those with HIV or AIDS in Bermuda. She handles treatment, care and prevention. The latest statistics from the Ministry of Health show that there are 267 people living on the Island who have tested positive for HIV or AIDS. All of them are entitled to Ms Ball's help.

"I see most people — about 90 percent," she said. "There are some people seen privately by their primary care physician and some may not need my services. They are healthy with their disease."

While this may sound like an oxymoron, Ms Ball explained that many HIV positive patients can avoid the virus becoming AIDS. This is achieved largely by strict adherence to their medication.

"I teach them how the medication works in the body and the importance of taking it every day," she said.

She also educates them on the side effects and how to overcome them.

Anti-retroviral drugs, commonly called ARVs are the class of medication most HIV/AIDS patients have been prescribed. The drugs work by preventing the virus to replicate. However each drug is specific to the stage at which it interferes with this process. To beef up effectiveness, a combination of the drugs is often prescribed. This means that as the virus tries to replicate, it meets with interference at several stages instead of only one.

This combining of ARVs is called Highly Active Anti-retroviral Therapy or HAART. In layman's terms it is what is referred to when people speak of a cocktail of drugs being used to treat HIV/AIDS.

This medication is prescribed for all AIDS patients. However, in the case of HIV, Ms Ball explained that ARV medication is not always necessary. To determine whether ARV drugs are necessary, clinicians look at the number of a specific type of white blood cell in the blood.

White blood cells are like soldiers in the body. They detect foreign bodies and eliminate them as a means of keeping the body healthy. T-cells are a type of white blood cell and it is their numbers clinicians use to determine if ART (antiretroviral therapy) is needed. Patients with low numbers of T-cells are prescribed the medication.

Encouraging her patients to stick to taking their medication every day is the biggest challenge Ms Ball faces.

"New patients need encouragement to take their medication. I meet with them to see and find out what else is going on in their life," she said.

Familiarity with the personal lives of her patients often helps her to better help them. She said she puts patients having troubles with things like housing and finances, in touch with the relevant services to help them.

She said she tries to have them lead as normal a life as possible. Taking the medication each day is critical to this.

"Interruptions in taking the medication cause mutations to the viral resistance," Ms Ball said. This means that patients who stop taking their medication lose the protection they had garnered.

And many of her HIV patients do live normal lives.

"People at first think they are going to die, but we have some patients who have been living with HIV for 15 years," she said.

While a few suffer with depression she said most are alert and oriented.

"They hold jobs both full time and part time and lead pretty much normal lives," she said. In fact she's also seen HIV patients fall in love and marry someone who does not have the virus.

"If you are infected you can still live," she said. "You have to be considerate of your partner, your dentist and other healthcare providers." (Ms Ball also noted that it should be standard practice of all health care professionals to use universal precautions with all their patients.)

There is no mandate on how often Ms Ball must see her patients. "I see them as often as they will allow me" she said.

"I do not want to impose. I want to be there when someone needs me. I don't want to annoy anyone as that breaks down communication."

So she'll see her clients twice a week, once a month or even once every three months — whatever their individual circumstances dictate. And she's committed to being there for them. She meets them where they feel comfortable and makes sure she is abreast of what is going on with each of them.

"I've come to get a good feel for where someone will be at certain times and I will go there to check up on them," she said. "I really care about people."