When the AIDS epidemic first began in the early 1980s, the life expectancy for someone with the disease was 1 to 2 years, and many young gay men in particular were struck down in their prime. The idea of HIV/AIDS as a chronic disease was unthinkable.
But thanks to the dedication of researchers and subsequent advancements in medicine, HIV is a condition people can live with – not a death sentence. In fact, according to the Centers for Disease Control and Prevention, 53 percent of those living with HIV in the U.S. as of 2021 are age 50 or older. By 2030, that percentage will increase to about 70 percent. As a result, people with HIV are now experiencing all the things that go along with aging, as well as some different challenges due to their diagnosis.
In general, says Dr. Yijia Li, a provider at Allies for Health + Wellbeing, some of the things that people can face as they get older are high cholesterol, diabetes and high blood pressure.
“HIV is so controllable in these days with the new antiretroviral therapies we have,” Li said. “However, it still leaves those with HIV with a higher risk of suffering from consequences from those issues, including a higher chance of having cardiovascular diseases – heart attack, stroke – than people without HIV.”
Other conditions that may disproportionately affect people with HIV, even if their HIV is well-managed, include certain types of cancers like lung cancer, colon cancer and breast cancer, as well as human papillomavirus-related cancer.
At Allies, this means that staff work closely with patients to determine what course of action is best for each individual patient.
“We want to work closely with our clients to have shared decision making, be proactive and come up with a more individualized plan,” Li said. “We at Allies work closely with our clients to make sure up-to-date cancer screenings are discussed and performed, and we provide multiple resources for people who are in difficult financial and social situations, with a strong case management team.”
Dr. Li advises that for people living with HIV, it’s important to stay virally suppressed and to keep up with health screenings and vaccinations.
People also can experience long-term effects from some of the medications used to treat HIV and AIDS before antiretroviral therapies became available. Bart Rauluk, director of finance and operations for Veritas Communications Advisors LLC, attributes some of the health problems he’s faced to those early treatments.
“I am a long-term survivor of HIV,” said Bart Rauluk, “I was diagnosed in 1987 after living years in New York City in a state of denial.”
When he received his diagnosis at the county health department in Delaware, where he was living at the time, he was told, “Get ready to die.” But Rauluk remained asymptomatic for several years with good blood counts. He didn’t begin to experience effects of the illness until the early 1990s.
“Antiretrovirals came out, and I started taking antiretrovirals,” he said. “Before that, I tried a couple different kinds of drugs, and most of them were toxic and damaging.”
As Rauluk and many other people with AIDS learned, the side effects of some of the experimental treatments for HIV and AIDS could be as bad as the disease itself, and Rauluk was left with lingering consequences of those treatments.
“My liver doctor said, ‘You took AZT, and that’s why your liver is not right,’” Rauluk said, but he doesn’t regret doing so.
“I was glad that I took the antiretrovirals, because I do believe I wouldn’t be here now if I didn’t,” he said.
One thing Rauluk stresses is the importance of social support. When he started to become sick in the early 1990s, he began to tell certain people close to him about his illness so that he would have a support system in place.
“It was ‘93 or ’94 – I call it D-Day, where I told my mom that I was positive, I told some of my brothers and sisters, I told a few friends I was close to,” Rauluk said. “Of course, I had a number of gay male friends, and we were all in various stages of being positive.”
Thirty years later, at age 60, Rauluk said he’s come “full circle” as he’s once again looking toward his support system and putting plans in place for his healthcare.
“As I get older, I realize your health isn’t going to get any easier to manage,” he said. “Some things are going to happen because you don’t have a choice, and some things are going to be a biproduct of aging or whatever condition you might have. That’s why being prepared is really important. Have a sense of when you need help and who to ask when you need help. I am blessed because I’ve got a really good community of people around me. But that takes work.”
It’s work that can be done in partnership with a healthcare provider, like Dr. Li at Allies. Allies for Health + Wellbeing prides itself on offering holistic healthcare, looking at a patient’s entire lived experience and not just a single diagnosis.
“We desire to include each client as an active team leader of their own health and wellbeing,” Li said.
As for Rauluk, he says that his experience with HIV and AIDS has prepared him for whatever may come his way as he grows older.
“I’m ready for anything you throw on my plate,” he said.
Allies for Health + Wellbeing currently is accepting new patients across all areas of its clinical practice, from HIV specialty care, to primary care, gynecological care and gender-affirming care. To learn more about Allies and its services, or to make an appointment, visit AlliesPGH.org.