Stephen Kovacev's life is framed by two scores: One tells how much of the AIDS virus is circulating in his blood. The other records the strength of his immune system.
One day last week the report was mixed. The virus remained so low that it was beyond the detection of sophisticated tests. But the number of disease warriors in his immune system had fallen. ``And I really need them."
``It's like a game of Russian roulette every month," he says. ``And that game is no fun to be part of."
Kovacev is the face of AIDS, past and future. He has held two lovers in his arms as the virus took their lives. He has turned to spiritual advisers, holistic therapies, and vegetarian diets. And, since 1996, he has swallowed and injected powerful HIV medications, changing regimes upwards of a dozen times as the virus kept outwitting drug combinations.
But Kovacev is also running marathons: He finished the 26.2 miles in Boston this year in 6 hours, 41 minutes.
``Your life can be controlled by the disease, but you can't allow it," said Kovacev, 52, a man of sharp features and equally sharp wit. ``That's why I run marathons. It gives me that sense of control. I can still do what I want and what I dream of and not be shackled to the medication and the disease.
``Like anything, if your life is on the line, you'll do whatever you need to do."
Kovacev was living in Provincetown when the AIDS epidemic arrived in 1981. During the next nine years he witnessed the ravages of the virus in neighbors and in his partner, Kevin McLean, who developed the lethal pneumonia that killed so many.
``As soon as Kevin was diagnosed, I knew it was in my bedroom, I knew it was in my life."
Kevin died Dec. 1, 1990 -- World AIDS Day.
Another partner, Michael Kerwin, died five years later in much the same way.
``It was the sick taking care of the sick," Kovacev said. ``I was very sick, but not as sick as he was."
Kovacev survived, and even though he had been skeptical of the early-generation AIDS drugs, when the potent cocktails arrived in 1996, ``I didn't want to miss the bandwagon."
The next year he ran the Boston Marathon.
Now living in Truro, he takes medicine from each of the four classes of AIDS drugs -- 10 pills and two injections every day.
Taking the drugs -- and dealing with their consequences -- are Kovacev's full-time job. His intestines often churn, his extremities go numb, and his mind turns foggy.
Much is made of HIV being a chronic, easy-to-manage illness today. It is the image portrayed in glossy magazine advertisements with buff models astride bikes and at the beach.
One morning Kovacev held a magazine chockablock with such ads. His face crumpled into a sad smile. ``They're portraying it as, `It's no big deal to get HIV,' " he said later. ``If only they knew."
Stephen Smith can be reached at firstname.lastname@example.org.