James Purchase has lived with the HIV for nearly three decades. He was diagnosed not long after the disease was identified as spreading among gay men in North America.

At the time, he remembers, a diagnosis of HIV was a death sentence.

"How much time do I have? Three months, six months, a year at most? It was like doors shutting for my life," he says. "People were committing suicide. They were dropping like flies."

But James found refuge at Casey House, the first Canadian hospice for those with AIDS. At first, the hospice was focused on palliative care.

These days, the centre helps those with the virus to live longer lives with a raft of drugs that rebuild the immune system.

Many say the drugs have turned what was once a fatal disease into a chronic illness. Dr. Ann Stewart, the medical director of Casey House, says she amazed at how long patients can live now after a diagnosis.

"It s remarkable. We have had people who have been on medications for more than a decade," she says.

"The (medications) become popular in the late ‘90s so we are only a bit more than 12 or 13 years from that and we have patients who have been on medications all of that time."

Stewart says she's even seen patients who have become ill, whose blood have shown high levels of HIV, who then start on the medications and return to health.

She says the messaging that HIV-positive patients receive now is that they might still be able to live long lives.

"We do talk to people about planning to live your life as if you were not HIV-positive. Plan your career, plan for your retirement. Plan to be living. Because they could they live for 20 year."

James says, even 30 years after being infected, the virus is now almost undetectable in his body. But it's come at a cost. Many long-term survivors have what's called "accelerated aging," developing diseases of old age such as cancer, osteoporosis, diabetes and dementia in their 40s and 50s.

No one knows whether the premature aging is linked to the medication that patietns take, or to the virus itself, or some combination of both.

James uses a cane, like a man much older than his 57 years. But he says he doesn't mind. He is still alive, surviving a disease that could have killed him long ago.

"Every one of my friends from university, my university days, they are all dead now. Every last one of them …but I am still here."

With a report from CTV's medical specialist Avis Favaro and producer Elizabeth St. Philip