One instance of unprotected sex or sharing intravenous drugs, when safety and caution are replaced by heat-of-the-moment reprieve and gratification -- that's all it takes.
Nobody knows this better than four Pittsfield residents living with HIV/AIDS.
In light of Saturday's World AIDS Day, about a dozen people circled around Project Empowerment Case Manager Pat Wood in a snowy downtown Pittsfield Saturday afternoon. Project Empowerment is a local organization that helps Berkshire residents coping with HIV/AIDS.
Wood rang a small bell 71 times -- each ring representing a Berkshire County resident who has died of AIDS complications since 1990. One person has died this year.
Wood also read a proclamation by President Barack Obama, as well as the top 10 HIV or AIDS-related headlines, each one signifying a leveling playing field on the fight against AIDS.
"The same message is all around the world today," Wood said after Saturday's ceremony. "It's been a long road, but we'll gather together to keep working."
Protecting their identity by using either an alias or just their first name, the four Pittsfield residents shared their stories with New England Newspapers
Anita's life was filled with the promise of a musical career. She met singer Natalie Cole during their 1969 freshman year together at the University of Massachusetts. From 1976 to 1983, Anita was a background performer for Cole. She mixed her passion for music with a cocaine addiction.
It was drug use that would, at age 37, lead to Anita contracting HIV -- because of someone else's drug use.
She returned to her hometown of Springfield in 1991, where she had unprotected sex with a high school flame who had since turned into a heroin addict. Anita got the HIV-positive results during the eighth month of a 12-month drug recovery program.
"He never told me," Anita said. "He was doing his heroin. I was doing my crack."
The eight months of hard work toward recovery fizzled out of Anita's mind. She went back to using cocaine.
"I figured I was going to die anyway," Anita said.
It used to be music that was Anita's future and salvation, but "when you start using, everything else is out."
Anita fell back on drugs as an escape to hardships like when she got the HIV positive results, or when her mother died of pancreatic cancer in 1999.
But now, her only drug is the prescribed cocktail. She's been clean of any toxicity since 2008.
"I'll always be an addict, but I just choose not to be one today," she said.
Anita said she wants to appear on an upcoming TV show featuring Dr. Drew. She said she wants to stress the importance of protection to sexually active youngsters, as she did with New England Newspapers.
"People think it's not as serious today because not as many people are dying," she said. "You don't know who has the disease. I learned my lesson from experience."
When his test results came back almost 20 years ago, 47-year-old Conrad didn't have HIV -- he had AIDS.
The virus is now undetectable because of the medicine he takes daily.
Conrad said he got the disease by sharing hypodermic needles at parties when he was younger. His decision-making process was clouded by alcohol consumption.
For 10 years, Conrad kept it a secret, instead telling people he had terminal cancer.
"It was more accepted than HIV," Conrad said, sporting a paint-splattered outfit and burly beard. "It was a dirty, dark secret that I bore."
The virus caused a rift in his engagement, which he eventually ended because he "couldn't live with the guilt that [he] could have given it to her."
After suicide attempts were unsuccessful, Conrad found re fuge in Project Empowerment.
"It's been a rough struggle, but it's been a lot easier after getting hooked up with Pat and that bunch," Conrad said Saturday. "You know when you go in, that you're not going to be judged."
When Jennifer received her HIV-positive test results 11 years ago, she was eight months pregnant with the child of the man who infected her. He returned to Georgia, where he eventually died from AIDS complications.
Jennifer always knew that "he was running from something" when he moved to Pittsfield.
"Because he died, I was angry," Jennifer said. "I wanted to ask him so many questions.
"Back then, it was six months before you knew whether the baby would be negative or positive," Jennifer said. "You lived for that day to get the blood checked."
After the six-month window passes, and the results for the child are still negative, there is no chance the virus will be transmitted from the mother to the child.
"Back then, I put it all behind me," Jennifer said. "Now, I want to know everything, and I want to help. Because I have kids, I'm now living for my kids."
Delilah, a Pittsfield resident who chose the name as an alias to protect her identity, tested positive after getting very sick in 2006. She contracted it from her husband, who never told her he had the virus. He died in 2007.
But today, she's a fast-talking, bubbly 53-year-old woman.
"I'm such an outgoing kind of person," Delilah said. "Once you have it, there's nothing you can do about it."
But Delilah cautioned, "I wasn't always like this. It was really devastating at first."
She described the "funk" she was in after she received the positive results: She wouldn't take her medication. She refused to believe it was happening.
"But I had to go on and live, no matter what," Delilah added. "This can tear you down. I wouldn't wish it on my worst enemy."